Phenazopyridine is a commonly used urinary analgesic available throughout the United States. Ingestion of large quantities can lead to methemoglobinemia, hemolytic anemia, jaundice, and acute renal failure. We report a case of a 78-year-old male with previously normal renal function who developed acute renal failure and jaundice without methemoglobinemia or hyperbilirubinemia after taking nearly 8 g of phenazopyridine over the course of 4 days. Initially presenting with oliguria, the urine output began to increase by day 2 of his admission, and the creatinine peaked 11 days after he began taking phenazopyridine, and he was discharged safely soon after. To our knowledge, this is the first such case of renal failure and jaundice without methemoglobinemia or hemolytic anemia in an adult patient with normal renal function.
Epithelial ovarian cancer (OC) is a leading cause of death among females in the United States, due in part to challenges of diagnosis in the early stages of the disease. While efforts are underway to develop a high-quality screening test, it is equally important to consider whether high-risk populations are appropriate to screen. One such population may be females with hyperthyroidism, as epidemiologic studies have shown an association between this condition and OC. In this report, we present a case of a female with OC and Graves’ disease to highlight the potential significance of this association.
Infections of the adrenal glands remain an important cause of adrenal insufficiency, especially in the developing world. Indeed, when Thomas Addison first described the condition that now bears his name over 150 years ago, the vast majority of cases were attributable to tuberculosis. Here we describe a classic, but relatively uncommon, presentation in the United States of adrenal insufficiency followed by a review of the current literature pertaining to adrenal infections.
Cervical ectopic pregnancies are a rare occurrence in the United States. Here we present the interdisciplinary and conservative management approach to a cervical ectopic at an advanced gestational age. In addition, we review the surgical management of hemorrhage from cervical ectopic pregnancies, which is often catastrophic and life-threatening.
Abstract
Automated identification systems may misidentify Brucella, the causative agent of brucellosis, which may be re-emerging in the United States as the result of an expanding feral swine population. We present a case of Brucella suis likely associated with feral swine exposure that was misidentified as Ochrobactrum anthropi, a phylogenetic relative.
Unintentional drowning is the sixth most common cause of accidental death, accounting for 4,086 deaths (1.4 per 100,000) in the United States in 2007.1 In children, drowning is the second leading cause of injury-related death, and those aged 1–3 years have the highest rate of drowning.2 More than 1,400 pediatric drownings were reported in the United States in 2008.3 Many drowning deaths are due to lack of supervision in the bathtub, unprotected access to a pool, or lack of swimming skills.3 For every death by drowning, six children are hospitalized for drowning, and up to 10% of survivors experience severe brain damage.2
The author comments on the use of anthropological methodologies in economic development research and practice in a developed economy such as the United States. The focus is the article by Morales, Balkin, and Persky on the closing of Chicago's Maxwell Street Market in August 1994. The article focuses on monetary losses for both buyers (consumers of market goods) and sellers (vendors of those goods) resulting from the closing of the market. Also included are a brief history of the market and a review of the literature on the informal economy. The authors measure “the value of street vending” by combining ethnographic and economic analytical methods.
Acute Renal Failure and Jaundice without Methemoglobinemia in a Patient with Phenazopyridine Overdose: Case Report and Review of the Literature
