Clinical Features (Signs and Symptoms)

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

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Frequency and temporal sequence of clinical features in adults with anti-NMDA receptor encephalitis presenting with psychiatric symptoms

Psychological Medicine ◽

10.1017/s0033291718003665 ◽

2018 ◽

Vol 49 (16) ◽

pp. 2709-2716 ◽

Cited By ~ 3

Author(s):

Ronald J. Gurrera

Keyword(s):

Nmda Receptor ◽

Clinical Features ◽

Psychiatric Symptoms ◽

Autoimmune Encephalitis ◽

Signs And Symptoms ◽

Nmda Receptor Encephalitis ◽

Nmdar Encephalitis ◽

Unexplained Fever ◽

Study Inclusion

AbstractBackgroundAnti-NMDA receptor (NMDAr) encephalitis is the most common autoimmune encephalitis in adults. It mimics psychiatric disorders so often that most patients are initially referred to a psychiatrist, and many are misdiagnosed. Without prompt and effective treatment, patients are likely to suffer a protracted course with significant residual disability, or death. This study focuses on the frequency and chronology of salient clinical features in adults with anti-NMDAr encephalitis who are likely to be first evaluated by a psychiatrist because their presentation suggests a primary psychiatric disorder.MethodsA systematic search of PubMed and EMBASE databases identified published reports of anti-NMDAr encephalitis associated with prominent behavioral or psychiatric symptoms. After eliminating redundancies, the frequencies and relative timing of clinical features were tabulated. Signs and symptoms were assigned temporal ranks based on the timing of their first appearance relative to the first appearance of other signs and symptoms in each patient; median ranks were used to compare temporal sequencing of both individual features and major symptom domains.ResultsTwo hundred thirty unique cases (185 female) met study inclusion criteria. The most common features were seizures (60.4%), disorientation/confusion (42.6%), orofacial dyskinesias (39.1%), and mutism/staring (37.4%). Seizures, fever, and cognitive dysfunction were often the earliest features to emerge, but psychiatric features predominated and sequencing varied greatly between individuals.ConclusionsClinicians should consider anti-NMDAr encephalitis when new psychiatric symptoms are accompanied by a recent viral prodrome, seizures or unexplained fever, or when the quality of the psychiatric symptoms is unusual (e.g. non-verbal auditory hallucinations).

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Giant Intraluminal Polyps of the Esophagus

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948309200407 ◽

1983 ◽

Vol 92 (4) ◽

pp. 344-348 ◽

Cited By ~ 8

Author(s):

Donald P. Vrabec ◽

A. Thompson Colley

Keyword(s):

Clinical Features ◽

Surgical Complications ◽

Symptomatic Relief ◽

Signs And Symptoms ◽

Systemic Approach ◽

Case Histories ◽

Accurate Identification ◽

Endoscopic Picture

Giant intraluminal polyps of the esophagus are relatively rare. Their diagnosis often presents a confusing picture; radiographic studies are frequently misinterpreted as achalasia, and the endoscopic picture is often difficult to interpret. This report describes the case histories of three patients with giant intraluminal polyps of the esophagus. Each presents slightly different clinical features. The signs and symptoms are discussed in terms of the pathophysiology. Common pitfalls in diagnosis are reviewed. Suggestions to enable more accurate identification of these lesions are given. Finally, a systemic approach to treatment is outlined which offers the patient symptomatic relief while minimizing surgical complications and morbidity.

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Presentation and treatment of carotid cavernous aneurysms

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000200009 ◽

2008 ◽

Vol 66 (2a) ◽

pp. 189-193 ◽

Cited By ~ 18

Author(s):

Lucas Perez de Vasconcellos ◽

Juan Antônio Castro Flores ◽

José Carlos Esteves Veiga ◽

Mário Luiz Marques Conti ◽

Pedro Shiozawa

Keyword(s):

Clinical Features ◽

Internal Carotid ◽

Signs And Symptoms ◽

Initial Presentation ◽

Neurological Deficits ◽

Neurovascular Compression ◽

Neurological Signs ◽

Neurological Prognosis ◽

Pain Symptoms ◽

Carotid Aneurysms

We analyzed a group of patients with the diagnosis of internal carotid aneurysms in its intracavernous segment, with emphasis in prevalence, clinical features, treatments, evolution and neurological prognosis. Neurological signs and symptoms at initial presentation were registered and compared with final outcome. Patients were divided into two stratified groups, one with 19 patients which underwent interventionist treatment, and another with 21 patients who were conservatively treated. The present study demonstrated that intervention is significantly correlated with a better prognosis considering evolution of pain symptoms secondary to neurovascular compression (p=0,002). Regarding neurological deficits, an interventionist approach was also significantly correlated with better outcome in comparison with initial presentation (p=0,008). These results indicate that interventionist treatment determines improvement or resolution of pain symptoms in comparison with patients conservatively treated, as well as stabilization or partial improvement of neuro-ophthalmological deficits.

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Diagnosing melancholic depression: some personal observations

Australasian Psychiatry ◽

10.1177/1039856216657696 ◽

2016 ◽

Vol 25 (1) ◽

pp. 21-24 ◽

Cited By ~ 4

Author(s):

Gordon Parker

Keyword(s):

Family History ◽

Clinical Features ◽

Signs And Symptoms ◽

Diagnostic Process ◽

Melancholic Depression ◽

Classification Rate ◽

Course Variables

Objectives: The objective of this study was to offer some personal observations as to how melancholia can be diagnosed and differentiated from the non-melancholic depressive conditions. Methods: Personal clinical and research-based observations are presented following a critique of common current strategies. Results: The paper offers views on the most differentiating clinical features, argues for adding illness course variables to symptoms and provides details of the Sydney Melancholic Prototypic Index, a measure with a high overall classification rate in differentiating melancholic and non-melancholic depression. Conclusions: Greater precision in differentiating melancholic from non-melancholic depression is advanced by weighting signs and symptoms of psychomotor disturbance, as well as including illness correlates and family history in the diagnostic process.

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A CRITICAL REVIEW OF VYANGA W.S.R. TO MELASMA- CLASSICAL AND MODERN APPROACH.

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v8i03.616 ◽

2020 ◽

Vol 8 (03) ◽

Author(s):

Namrata S. Kote

Keyword(s):

Clinical Features ◽

Critical Review ◽

Dietary Habits ◽

Signs And Symptoms ◽

Modern Approach ◽

Classical View ◽

Self Confidence ◽

Facial Beauty ◽

The Face ◽

Current Article

ABSTRACT In todays globalized era facial impressions has become very important to survive. Good Facial complexion with depigmented skin helps to Improve personality and self-confidence. Various cosmetic disorders are occurring due to hectic lifestyle, dietary habits, increased pollution etc. Vyanga is one of those cosmetological issues which affect one’s facial beauty. Vyanga is classified as kshudraroga in classical texts which occurs due to vitiated vata and pitta dosha and characterized by the presence of Niruja and Shyavavarna mandalas on face. It is one of the most common problem as regards the face is concerned. On the basis of clinical features, it can be compared with facial melanosis, one of the hyperpigmented disorders. Before treating any disorder it is very important to understand it by all means like by signs and symptoms, etiology, pathogenesis, classification to achieve a success in treatment. Current article focuses to gather all of types, diagnosis, etiology, pathogenesis and treatment of vyanga according to both modern and classical view.

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Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

Iranian Journal of Parasitology ◽

10.18502/ijpa.v15i1.2530 ◽

2020 ◽

Author(s):

Abdolali MOSHFE ◽

Arash ARIA ◽

Najme ERFANI ◽

Ali JAMSHIDI ◽

Bahador SARKARI ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Epigastric Pain ◽

Serological Test ◽

Demographic Data ◽

Clinical Signs ◽

Signs And Symptoms ◽

Diagnosis And Management ◽

History Of ◽

Clinical Signs And Symptoms

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran. Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

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Tuberculosis Infection Could Mimic Malignant Lymphoma In F-18 FDG PET: A Case Report

Indonesian Journal of Cancer ◽

10.33371/ijoc.v14i4.711 ◽

2020 ◽

Vol 14 (4) ◽

pp. 135

Author(s):

Ryan Yudistiro ◽

Ivana Dewi Mulyanto ◽

Febby Hutomo ◽

Daniel Chung ◽

Andree Kurniawan ◽

...

Keyword(s):

Case Report ◽

Clinical Features ◽

Fdg Pet ◽

Recurrent Disease ◽

Neck Region ◽

B Cell Lymphoma ◽

Signs And Symptoms ◽

Tuberculosis Infection ◽

Chop Regimen ◽

History Of

Introduction: Lymphoma and tuberculosis in several cases share similar clinical features that are difficult to differentiate. Lymphadenopathy, fever, malaise, weight loss, and respiratory symptoms are clinical features that could be found in both lymphoma and tuberculosis. Positron Emission Tomography/Computed Tomography Fluorodeoxyglucose (F-18 FDG PET) is a pivotal modality for imaging patients with cancer. Several non-malignant diseases like tuberculosis infection show high FDG uptake and lead to low specificity of F-18 FDG PET.Case Presentation: This case report describes a 55-year-old male patient with a history of Diffuse Large B-cell Lymphoma (DLBCL) who was suspected of having a recurrent disease. The patient has had a 6-month remission period after 6 cycles of R-CHOP regimen chemotherapy. He denied any known history of tuberculosis infection and HIV. F-18 FDG PET was performed to assess the extent of suspected lymphoma recurrent disease. F-18 FDG PET demonstrated multiple hypermetabolic bilateral neck region, mediastinum, and bilateral axilla lymphadenopathies. There were also multiple high FDG uptakes in the liver, mesocolon, and bones. The patient was suspected of having a lymphoma recurrent disease based on these findings. He underwent an excisional biopsy in the neck and was found to have lymphadenitis granulomatous disease from tuberculosis. Based on the histopathology finding, the patient received anti-tuberculosis drugs for 12 months and showed relief of signs and symptoms. F-18 FDG PET for anti-tuberculosis treatment evaluation revealed a complete metabolic response.Conclusion: Tuberculosis should be one of the differential diagnoses when a lymphoma recurrent disease is suspected. Clinical features, laboratory results, and imaging findings sometimes show similarities between lymphoma and tuberculosis. Histopathology evaluation is mandatory to confirm the diagnosis.

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TOXOPLASMIC ENCEPHALOMYELITIS

PEDIATRICS ◽

10.1542/peds.1.4.478 ◽

1948 ◽

Vol 1 (4) ◽

pp. 478-494

Author(s):

GABRIEL A. SCHWARZ ◽

ELIZABETH KIRK ROSE ◽

WILFRED E. FRY

Keyword(s):

Mental Retardation ◽

Clinical Features ◽

Signs And Symptoms ◽

Infants And Children ◽

Communicating Hydrocephalus ◽

Infantile Form ◽

Cerebral Calcifications ◽

Pathologic Findings ◽

The Brain ◽

In Infants And Children

Six cases of toxoplasmic encephalomyelitis in infants and children are presented. In all of these cases, the diagnosis was made on clinical grounds alone. All of these patients are still living. A description of the pathologic findings in the retina of one case is given. In an analysis of these six cases it was noted that the ocular findings were the most constantly occurring of all the features. Mental retardation was also noted in all six cases. Cerebral calcifications were found in all but one of the cases. The cases already reported in the literature are enumerated and a review of the clinical features of toxoplasmic encephalomyelitis is given. The chief features noted in the infantile form are: (1) onset at birth or soon after, (2) convulsions, (3) bilateral communicating hydrocephalus, (4) bilateral focal chorioretinitis usually involving both macula and (5) multiple calcifications in the brain. It is our feeling that this constellation of signs and symptoms should suggest the diagnosis of toxoplasmosis without recourse to the isolation of the protozoan or the securing of positive neutralization reactions.

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Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: a comparison of patients with and without COVID-19

10.1101/2020.05.02.20082461 ◽

2020 ◽

Cited By ~ 1

Author(s):

Sachin J. Shah ◽

Peter N. Barish ◽

Priya A. Prasad ◽

Amy Kistler ◽

Norma Neff ◽

...

Keyword(s):

San Francisco ◽

Clinical Features ◽

Cardiac Injury ◽

Vital Signs ◽

Case Series ◽

Signs And Symptoms ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Respiratory Illnesses ◽

Laboratory Results

AbstractBackgroundEmerging data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have largely been presented as case series. Few studies have compared these clinical features and outcomes of COVID-19 to other acute respiratory illnesses.MethodsWe examined all patients presenting to an emergency department in San Francisco, California between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared demographics, comorbidities, symptoms, vital signs, and laboratory results including viral diagnostics using PCR and mNGS. Among those hospitalized, we determined differences in treatment (antibiotics, antivirals, respiratory support) and outcomes (ICU admission, ICU interventions, acute respiratory distress syndrome, cardiac injury).FindingsIn a cohort of 316 patients, 33 (10%) tested positive for SARS-CoV-2; 31 patients, all without COVID-19, tested positive for another respiratory virus (16%). Among patients with additional viral testing, no co-infections with SARS-CoV-2 were identified by PCR or mNGS. Patients with COVID-19 reported longer symptoms duration (median 7 vs. 3 days) and were more likely to report fever (82% vs. 44%) fatigue (85% vs. 50%) and myalgias (61% vs 27%); p<0.001 for all comparisons. Lymphopenia (55% vs 34%, p=0.018) and bilateral opacities on initial chest radiograph (55% vs. 24%, p=0.001) were more common in patients with COVID-19. Patients with COVID-19 were more often hospitalized (79% vs. 56%, p=0.014). Of 186 hospitalized patients, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p<0.001) and were more likely to develop ARDS (23% vs. 3%, p<0.001). Most comorbidities, home medications, signs and symptoms, vital signs, laboratory results, treatment, and outcomes did not differ by COVID-19 status.InterpretationWhile we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections. These findings enhance understanding of the clinical characteristics of COVID-19 in comparison to other acute respiratory illnesses.

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