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

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.

2016 ◽  
Vol 45 (2) ◽  
pp. 49
Author(s):  
Pramita G Dwipoerwantoro ◽  
Sri P Pulungsih ◽  
Nuraini I Susanti ◽  
Hartaniah Sadikin ◽  
Agus Firmansyah

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Monia Ghammam ◽  
Lobna Chouchane ◽  
Jihene Houas ◽  
Mouna Bellakhdher ◽  
Heyfa Bel Hadj Miled ◽  
...  

Abstract Background Pediatric neck masses are a common complaint in children. The most common etiologies include congenital lesions, lymphadenopathy, vascular malformations, inflammatory, and malignant lesions. Spontaneous sternocleidomastoid hematoma is exceptional in infant. Case presentation We describe a case of spontaneous cervical hematoma diagnosed in a 4-month-old child. Past history did not reveal a neck trauma, a history of difficult labor, a bleeding disorder or a pertinent family history. The diagnosis was suspected based on the imaging features and confirmed after surgical removal. Conclusions Sternocleidomastoid swelling is commonly encountered in infancy. Ultrasound still remains the initial modality of choice. The management modalities are controversial.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.


Author(s):  
Anushri Kale ◽  
Aditi Badwaik ◽  
Pallavi Dhulse ◽  
Archana Maurya ◽  
Bibin Kurian

Introduction: Hirschsprung's disease is the most common cause of large intestinal obstructing in neonates. Hirschsprung's disease is a congenital anomaly caused by migratory failure of neural crest cells leading to abnormal innervations of the bowel .The defect begins in the internal and sphincter and extends proximally for a variable length of gut. Hirschprung's disease is a disorder of the gut caused due to congenital absence of ganglion cells in the sub-mucosal and myenteric plexus of intestine. This disease is also known as megacolon or congenital Aganglionic megacolon. Case presentation: A 2 years old male child, known case of Hirschprung’s disease, was brought to AVBRH for further management. As narrated by the mother, the child was not passing stool since birth. There was no history of abdominal distention, vomiting or fever. The child pass the stool with the help of enema which was given to the child in the morning and evening. Mast. Devansh has past history of NICU stay. In View of not passing stools, USG of abdomen and pelvis done. Endorectal pull through surgery was done on 4/02/2021 under general anesthesia. No any past surgical history. There is a past history of rectal biopsy done in 1 1/2 month of age. Conclusion:The patient was admitted in AVBRH for further management. Then the report mainly focused on surgical management and quality nursing care due to which patient was discharged without any further complication and satisfaction.


2019 ◽  
Vol 13 (3) ◽  
pp. 526-531
Author(s):  
Shivantha Amarnath ◽  
Cheikh Talal El Imad ◽  
Kingsley Ebare ◽  
Hueizhi Wu ◽  
Stephen Mulrooney

Cryptosporidial enteritis has a rising incidence in the USA, mostly affecting immunocompromised individuals and children. It has a self-limiting course in healthy hosts. Herein, we present a unique case of a healthy middle-aged female who presented with a 1-month history of voluminous watery diarrhea and acute blood loss anemia. Cryptosporidial enteritis was diagnosed based on endoscopy with biopsy-proven evidence of 2 jejunal peptic ulcers infected with Cryptosporidiumspp. that was originally missed on routine stool culture, ova and parasite tests. The patient was successfully treated with nitazoxanide,and eradication of the protozoan was also confirmed on repeat endoscopic biopsies of the ulcer that were carried out 6 months later. To our knowledge, this is the first case to be reported in the literature with infective colonization of peptic ulcers with Cryptosporidiumspp.with consequent systemic symptoms.


2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Michael Owusu ◽  
Godfred Acheampong ◽  
Augustina Annan ◽  
Kwadwo Sarfo Marfo ◽  
Isaac Osei ◽  
...  

Abstract Background Ralstonia mannitolilytica is an emerging opportunistic pathogen that is associated with severe disease, including septic shock, meningitis, and renal transplant infections. Reports on this pathogen are limited, however, especially on the African continent. Case presentation A 2-year-old Akan child was presented to a hospital in the northeastern part of Ghana with a 1-week history of fever and chills. We identified Ralstonia mannitolilytica in her blood culture using both conventional and 16S ribosomal deoxyribonucleic acid (rDNA) techniques. The patient’s condition improved clinically upon treatment with cefuroxime. Conclusion Our report highlights the potential of Ralstonia mannitolilytica to cause sepsis and thus emphasizes the need for improved laboratory diagnosis and evidence for use of appropriate antibiotics in rural settings of Africa, where presumptive treatment using antimicrobial agents is rife.


2005 ◽  
Vol 16 (5) ◽  
pp. 301-303
Author(s):  
Nevin Kollannoor Chinnan ◽  
Pragnyadipta Mishra ◽  
GD Puri

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.


2020 ◽  
Vol 20 (2) ◽  
pp. 753-757
Author(s):  
Osita U Ezenwosu ◽  
Barth F Chukwu ◽  
Ndubuisi A Uwaezuoke ◽  
Ifeyinwa L Ezenwosu ◽  
Anthony N Ikefuna ◽  
...  

Introduction: Glanzmann’s Thrombasthenia (GT) is a rare autosomal recessive bleeding disorder due to defective platelet membrane glycoprotein GP IIb/IIIa (integrin αIIbβ3). The prevalence is estimated at 1:1,000,000 and it is commonly seen in areas where consanguinity is high. Case Presentation: The authors report a 12 year old Nigerian girl of Igbo ethnic group, born of non-consanguineous parents, who presented with prolonged heavy menstrual bleeding which started at menarche 3 months earlier, weakness and dizziness. She had a past history of recurrent episodes of prolonged epistaxis, gastrointestinal bleeding and gum bleeding during early childhood. On examination, she was severely pale with a haemic murmur and vaginal bleeding. The initial diag- nosis was menorrhagia secondary to bleeding diathesis possibly von Willebrand’s Disease. She was on supportive treatment with fresh whole blood, fresh frozen plasma and platelets until diagnosis of GT was made in the USA. Currently, she is on 3 monthly intramuscular Depo-provera with remarkable improvement. Conclusion: To the best of our knowledge, this is the first documented report of GT in our environment where consan- guinity is rarely practised. Our health facilities require adequate diagnostic and treatment facilities for rare diseases like GT. Keywords: Glanzmann’s thrombasthenia; Menorrhagia; Nigerian girl.


1987 ◽  
Vol 32 (9) ◽  
pp. 785-787 ◽  
Author(s):  
M.L. Thurling

This is a case presentation of a 52 year old woman with a past history of schizophrenia who develops an acute psychosis. The point is emphasized that a deterioration in mental state in a patient with schizophrenia should not too readily be attributed to the functional’ psychosis. Psychiatric patients may present with organic mental disorders requiring medical or surgical intervention. Thus the psychiatrist must always be alert to the possibility of new pathology and examine carefully for signs of organic disturbances. This case turned out to be one of acute hyperparathyroidism cured by surgical removal of an adenoma of the parathyroid gland.


1970 ◽  
Vol 31 (3) ◽  
pp. 209-215 ◽  
Author(s):  
JB Sherchand ◽  
NA Cuncliffe ◽  
S Tandukar ◽  
M Yookoo ◽  
BD Pandey ◽  
...  

Introduction: Rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide. The aim of the study was to determine rotavirus disease burden and distribution of rotavirus genotypes in children less than five years of age. Methodology: Stool samples were collected from 1768 hospital admitted children under 5 years of age with acute watery diarrhea during November 2005 to October 2008. Rotavirus in stool samples was detected by Enzyme Immuno Assay (EIA) and positive specimens for rotavirus positive was genotyped by reverse transcription-polymerase chain reaction (RTPCR) and sequencing methods. Results: The prevalence of rotavirus was 36.59% (647/1768). Detection was higher in male (33.3%) than female (26.9%). The prevalence was higher during the month of January (2005-06) and February in other periods. During 2005-06, high prevalence of rotavirus was noted in children of age between 6-11 months while in 2006-07 and 2007-08 high prevalence was seen in age group 12-23 months. The most common genotyping of rotavirus identified 5 G types and 3 P types. Genotypes G12 and P [8] were most common during both periods studied (G12; 50%, 29% 33.7% in 2005-06, 2006-07 and 2007-08 respectively and P[8]; 47%, 35% and 43.5% in 2005-06, 2006-07 and 2007-08 respectively). Among six combined genotypes, G12P [6] was most prevalent (34%, 24% and 47.5% in 2005-06, 2006-07 and 2007-08 respectively) where as G1P [6] (4%) was seen in year 2007- 08 only. Conclusions: The study demonstrates the burden of rotavirus diarrhea in Nepal. The data on rotavirus genotypes will help inform decisions as to whether rotavirus vaccine should be considered for inclusion in to Nepal’s National Immunization Program. Key words: Rotavirus; Diarrhea; Genotyping; Children   DOI: http://dx.doi.org/10.3126/jnps.v31i3.5360 J Nep Paedtr Soc 2011;31(3): 209-215


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