scholarly journals Fever and Shock in a Child: How 'good' is a Good Blood Test?

2005 ◽  
Vol 16 (5) ◽  
pp. 301-303
Author(s):  
Nevin Kollannoor Chinnan ◽  
Pragnyadipta Mishra ◽  
GD Puri
Keyword(s):  
Pediatric Emergency ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Watery Diarrhea ◽  
Shortness Of Breath ◽  
Intermittent Fever ◽  
Case Presentation ◽  
Filling Time ◽  
History Of ◽  
Bilateral Lung

CASE PRESENTATION A 12-year-old girl presented with a history of intermittent fever (38.3°C to 40°C) for 10 days that was not associated with chills and rigours, and was relieved by antipyretics. She also had nonbilious and nonprojectile vomiting (seven days), shortness of breath (four days) and watery diarrhea (two days). At the beginning of her illness, she was treated with a complete course of oral chloroquine by a general practitioner. In the pediatric emergency room, she presented with a heart rate of 136 beats/min, a respiratory rate of 56 breaths/min, a temperature of 37.8°C, a blood pressure of 60/30 mmHg and a capillary filling time of 5 s to 6 s. Shock resuscitation measures were initiated with intravenous normal saline (20 mL/kg bolus) and dopamine 5 µg/kg/min. She developed ventricular fibrillation, which was cardioverted. After cardiac arrest, she was intubated and transferred to the intensive care unit. Two hours later, she started bleeding from the nasogastric tube and endotracheal tube. A chest radiograph revealed bilateral lung opacities suggestive of intraparenchymal bleeding. The other significant clinical findings included icterus, cervical and inguinal lymphadenopathy, soft tender hepatomegaly, moderate splenomegaly and an absence of focal neurological deficits and meningeal signs.

scholarly journals A Case Report of Malaria-associated Secondary Hemophagocytic Lymphohistiocytosis and a Review of the Literature

2020 ◽  
Author(s):  
Xiao Zhou ◽  
Meili Duan
Keyword(s):  
Intensive Care ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Multidisciplinary Approach ◽  
Review Of The Literature ◽  
Intermittent Fever ◽  
Case Presentation ◽  
Satisfactory Outcome ◽  
History Of ◽  
Secondary Hemophagocytic Lymphohistiocytosis

Abstract Background: Malaria-associated secondary hemophagocytic lymphohistiocytosis (HLH) is rare. Moreover, the literature on malaria-associated HLH is sparse, and there are no similar cases reported in China.Case presentation: We report a case of a 29-year-old young woman with unexplained intermittent fever who was admitted to our hospital due to an unclear diagnosis. The patient concealed her history of travel to Nigeria and Dubai before onset. We made a diagnosis of malaria-associated secondary HLH. The treatment strategy for the patient included treatment of the inciting factor (artemether for 9 days followed by artemisinin for 5 days), the use of immunosuppressants (steroids, intravenous immunoglobulin) and supportive care. The patient was discharged in normal physical condition after 25 days of intensive care. No relapses were documented on follow-up at six months and 1 year. Conclusion: Early diagnosis of the primary disease along with timely intervention and a multidisciplinary approach can help patients achieve a satisfactory outcome.

scholarly journals Fungki Ulcers

2020 ◽  
Vol 3 (1) ◽  
pp. 01-03
Author(s):  
Shaadi Abughazaleh
Keyword(s):  
Deep Vein Thrombosis ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Shortness Of Breath ◽  
Vein Thrombosis ◽  
Bilateral Lung Transplantation ◽  
Immunosuppressive Medications ◽  
History Of ◽  
Bilateral Lung ◽  
Deep Vein

A 61-year-old female with a history of bilateral lung transplantation for idiopathic pulmonary fibrosis presented with shortness of breath, cough and diarrhea. She was on chronic immunosuppressive medications, including Tacrolimus and mycophenolate, and on apixaban for deep vein thrombosis.

scholarly journals Microscopic polyangiitis presented with biopsy-confirmed pleuritis

2018 ◽  
Vol 88 (2) ◽  
Author(s):  
Naoto Ishimaru ◽  
Hisashi Ohnishi ◽  
Mao Fujii ◽  
Masako Yumura ◽  
Sho Yoshimura ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Microscopic Polyangiitis ◽  
Rapidly Progressive Glomerulonephritis ◽  
Shortness Of Breath ◽  
Pulse Steroid Therapy ◽  
Biopsy Specimens ◽  
History Of ◽  
Bilateral Lung ◽  
Thoracoscopic Biopsy ◽  
Pulse Steroid

We describe a case of microscopic polyangiitis manifested as pleuritis confirmed by thoracoscopic biopsy. An 80-year-old man presented with a three-day history of shortness of breath and cough. Chest radiography revealed patchy opacities in the lower fields of the bilateral lung and right-sided pleural effusion. Thoracentesis revealed lymphocytic pleural exudates. Thoracoscopic biopsy specimens were compatible with fibrotic pleuritis. He developed rapidly progressive glomerulonephritis with elevated myeloperoxidase anti-neutrophil cytoplasmic antibody titer in blood and pleural effusion. Although the patient was resistant to two weekly courses of pulse steroid therapy, he was successfully treated with a five-day course of intravenous immunoglobulin.

scholarly journals A rare case of severe gastroenteritis caused by Aeromonas hydrophila after colectomy in a patient with anti-Hu syndrome: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Greiner ◽  
Alexia Anagnostopoulos ◽  
Daniel Pohl ◽  
Reinhard Zbinden ◽  
Andrea Zbinden
Keyword(s):  
Aeromonas Hydrophila ◽  
Past History ◽  
Opportunistic Pathogen ◽  
Stool Culture ◽  
Watery Diarrhea ◽  
Culture Methods ◽  
Case Presentation ◽  
Severe Gastroenteritis ◽  
History Of ◽  
Stool Samples

Abstract Background Aeromonas hydrophila is a gram-negative facultative anaerobic coccobacillus, which is an environmental opportunistic pathogen. A. hydrophila are involved in several infectious diseases such as gastroenteritis, septicemia and wound infections. However, gastroenteritis caused by Aeromonas spp. are rare and the clinical relevance of Aeromonas species in stool specimens is still under debate. Case presentation Our case concerns a 32-year-old woman who presented at hospital with a worsening watery diarrhea and fever requiring intensive care. A cholera-like illness was diagnosed. The patient had a past history of an anti-Hu syndrome with a myenteric ganglionitis. A molecular multiplex RT-PCR (QIAstat-Dx Gastrointestinal Panel, QIAGEN) covering a broad spectrum of diverse gastrointestinal pathogens performed directly from the stool was negative but the stool culture revealed growth of A. hydrophila. Further investigations of the A. hydrophila strain in cell cultures revealed the presence of a cytotoxic enterotoxin. Conclusions Although A. hydrophila rarely causes gastroenteritis, Aeromonas spp. should be considered as a causative agent of severe gastroenteritis with a cholera-like presentation. This case highlights the need to perform culture methods from stool samples when PCR-based methods are negative and gastrointestinal infection is suspected.

scholarly journals Atypical pityriasis rosea in a young Colombian woman. Case report

Case reports ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 8-21
Author(s):  
Julián Felipe Porras-Villamil ◽  
Angela Catalina Hinestroza ◽  
Gabriela Andrea López-Moreno ◽  
Doris Juliana Parra-Sepúlveda
Keyword(s):  
Case Report ◽  
Primary Care Physicians ◽  
Clinical Findings ◽  
Conclusive Evidence ◽  
Case Presentation ◽  
Pityriasis Rosea ◽  
Bipolar Ii ◽  
Patient Reported ◽  
History Of ◽  
Human Herpesviruses

Introduction: Pityriasis rosea is an acute and self-limited exanthemfirst described by Gilbert in 1860. Its treatment is symptomatic, and although there is no conclusive evidence, it has been associated with the reactivation of the human herpesviruses 6 and 7 (HHV-6 and HHV-7). Case presentation: A 28-year-old woman, from Bogotá, Colombia, ahealth worker, attended the emergency room due to the onset ofsymptoms that began 20 days earlier with the appearance of punctiformlesions in the left arm that later spread to the thorax, abdomen, opposite arm, and thighs. The patient reported a history of bipolar II disorder and retinal detachment. After ruling out several infectious diseases, and due to the evolution of the symptoms, pityriasis rosea was suspected. Therefore, treatment was started with deflazacort 30mg for 21 days, obtaining a favorable outcome and improvement of symptoms after 2 months. At the time of writing this case report, the patient had not consulted for recurrence. Conclusion: Primary care physicians should have sufficient training indermatology to recognize and treat dermatological diseases since manyof them are diagnosed based on clinical findings. This is an atypicalcase, in which the patient did not present with some of the pathognomonic signs associated with pityriasis rosea.

scholarly journals Propranolol Alleviating the Challenging Clinical Course of Birth Onset Generalized Lymphangiomatosis. A Case Report

2019 ◽  
pp. 1-6
Author(s):  
Gregory Nicolas ◽  
Abbas Shebli ◽  
Afaf Michel Minari ◽  
Ahmad El Haj Sleimen ◽  
Fayez Abou Jaoude ◽  
...  
Keyword(s):  
System Development ◽  
Care Center ◽  
Cystic Hygroma ◽  
Whole Body ◽  
Treatment Modalities ◽  
Watery Diarrhea ◽  
Case Presentation ◽  
Surgical History ◽  
History Of ◽  
Head Neck

Background: Cystic hygromas, interchangeably named Lymphangiomas, are rare, congenital, benign lesions due to an abnormal lymphatic system development that tend to occur mostly in the head, neck, and oral cavity. Case Presentation: This is a case of 18 year old male patient Syrian, smoker, with a history of multiple cystic hygromas since birth along with a generous surgical history of multiple laparotomies for intrabadominal cystic excisions, splenectomy herniorrhaphies (bilateral inguinal hernias and 2 incisional hernias due to laparotomies) left orchieopexy then testiculectomy, scrotal skin graft , multiple abdominal radioguided cystic drainage and sclerotherapy; presented to our care center for fever, dry cough, pleuretic chest pain, and mild abdominal pain with watery diarrhea. Conclusion: Cystic Hygroma is still being considered as a rare entity and can virtually occur in the whole body sites mostly at head and neck regions as explained above. Challenges in this disease is by finding cases where the presence of such cystic lesions is in extremely rare and unusual sites as well as different treatment modalities and prognostics depending on the site and size of the detected cystic formations.

Facklamia Hominis Pyelonephritis in a Pediatric Patient: First Case Report and Review of the Literature

2021 ◽  
Author(s):  
Samantha Perez Cavazos ◽  
Daniela Cisneros Saldaña ◽  
Fernando Espinosa Villaseñor ◽  
José Iván Castillo Bejarano ◽  
Denisse Natalie Vaquera Aparicio ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Urine Culture ◽  
Current Treatment ◽  
Intermittent Fever ◽  
Case Presentation ◽  
Gram Positive Bacteria ◽  
First Case ◽  
History Of ◽  
Gram Negative Organisms ◽  
Tract Infections

Abstract Background Pyelonephritis is one of the most serious bacterial illnesses during childhood. Gram-negative organisms account for up to 90% of the cases. Gram-positive bacteria are uncommon causes of urinary tract infections, and only a few cases caused by Facklamia hominis have been reported in the literature. Case presentation: A five-year-old girl with tracheostomy and gastrostomy and past medical history of congenital lymphangioma presented with a two-week history of with intermittent fever, frequent urination, and vesical tenesmus. Diagnosis of pyelonephritis was made. Urine culture reported colonies with alpha-hemolysis in blood agar at 48-hours of incubation and Facklamia hominis was identified by MALDI-TOF. The patient was successfully treated with gentamicin. Conclusions This is the first reported case of pyelonephritis by Facklamia hominis in a child, and the second involving infection in a pediatric patient. Although this pathogen is uncommon, current treatment of F. hominis is a challenge for physicians. This case illustrates the requirement to standardize identification and treatment of care to avoid treatment failure and antimicrobial resistance.

scholarly journals Radiological and Clinical Findings of Multiple Cerebellar Liponeurocytoma: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Shan Wang ◽  
Xiaopei Xu ◽  
Chao Wang
Keyword(s):  
Surgical Resection ◽  
Clinical Course ◽  
Clinical Findings ◽  
Imaging Findings ◽  
Case Presentation ◽  
Rare Benign Tumor ◽  
History Of ◽  
Cerebellar Liponeurocytoma ◽  
Magnetic Resonance Imaging Mri

Background: Cerebellar liponeurocytoma is an extremely rare benign tumor which generally occurs in cerebellum and is almost always solitary. Multifocal cerebellar liponeurocytoma is exceedingly rare, only 8 cases has been reported so far. Herein we present the 9th case of multifocal cerebellar liponeurocytoma in a 70-year-old woman with the complete clinical course and comprehensive imaging findings.Case Presentation: A 70-year-old woman presented with a history of intermittent headache for 5 years. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain have been performed and suggested a diagnosis of teratoma based on the imaging findings. After the surgical resection of the lesion, histopathological and immunohistochemical analyses revealed neuronal, glial, and lipomatous components and confirmed the diagnosis of multifocal cerebellar liponeurocytoma after surgical resection. During the 2-year follow-up period, the patient showed no signs of recurrence or metastasis.Conclusion: We described the radiological characteristics and clinical course of an exceedingly rare case of multifocal cerebellar liponeurocytoma in the cerebellar vermis and temporal lobe. The clear multifocality makes this case unusual.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

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