Impact of HIV-1 infection on the clinical presentation of syphilis in men who have sex with men

Sexual Health ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 110 ◽  
Author(s):  
Craig Tipple
Keyword(s):  
At Risk ◽  
Clinical Features ◽  
Clinical Presentation ◽  
High Index ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
High Index Of Suspicion ◽  
Hiv 1

Men who have sex with men (MSM), especially those with HIV-1 infection, are disproportionately affected by syphilis in higher income countries. The course, and some of the clinical features of the disease, especially the development of neurosyphilis, can be affected by HIV-1 co-infection. This review documents potential differences in the clinical features of syphilis in HIV-1 infected and uninfected MSM and highlights the importance of a thorough examination and high index of suspicion when seeing and treating MSM at risk of sexually transmissible infections.

Neurobrucellosis associated with feral swine hunting in the southern United States

2020 ◽  
Vol 13 (12) ◽  
pp. e238216
Author(s):  
Harry Ross Powers ◽  
Jared R Nelson ◽  
Salvador Alvarez ◽  
Julio C Mendez
Keyword(s):  
United States ◽  
At Risk ◽  
High Index ◽  
Southern United States ◽  
Endemic Country ◽  
Feral Swine ◽  
Neurological Sequelae ◽  
Initial Symptoms ◽  
The Usa ◽  
High Index Of Suspicion

Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.

Recently Recognized Cases of Ophthalmofilariasis in Hungary

2009 ◽  
Vol 19 (4) ◽  
pp. 675-678 ◽  
Author(s):  
Eszter Fodor ◽  
Éva Fok ◽  
Erika Maka ◽  
Olga Lukáts ◽  
Jeanette Tóth*
Keyword(s):  
Clinical Presentation ◽  
High Index ◽  
Dirofilaria Repens ◽  
The Other ◽  
Slit Lamp ◽  
The Past ◽  
Red Eye ◽  
High Index Of Suspicion ◽  
Slit Lamp Biomicroscopy

Purpose To report four cases of zoonotic ophthalmodirofilariasis infection caused by Dirofilaria repens in Hungary. Methods Four cases of ophthalmofilariasis have been treated at our department during the last 14 months. A subconjunctival moving worm was observed by slit lamp biomicroscopy in two cases. In one of these a living filaria was surgically removed, but the other disappeared. Red eye and migrating edema were the presenting signs in two cases. A biopsy taken from the subcutaneous masses disclosed D repens. Results Histopathologic or parasitologic examination identified a female D repens in every case. Laboratory alterations were not found. Symptoms subsided after treatment. Conclusions The clinical presentation of filariasis is not always straightforward, and a high index of suspicion is necessary in cases presenting with orbital or periorbital inflammation. During the past 10 years the identification of locally acquired infections by D repens has increased in Hungary.

Pneumomediastinum due to tracheal foreign body granuloma

2005 ◽  
Vol 119 (12) ◽  
pp. 998-1000
Author(s):  
H Kishore Chandra Prasad ◽  
Suja S Sreedharan ◽  
Sydney D’Souza ◽  
Naveen Kumar ◽  
Sampath Chandra Prasad
Keyword(s):  
Foreign Body ◽  
Clinical Features ◽  
Rare Case ◽  
High Index ◽  
Foreign Body Granuloma ◽  
Differential Diagnoses ◽  
Granulomatous Reaction ◽  
Intubation Granuloma ◽  
Malignant Lesions ◽  
High Index Of Suspicion

Primary tracheal masses are rare. Secondary masses of the trachea are commonly foreign body granuloma, intubation granuloma or viral granuloma. The differential diagnoses given in such cases include both benign and malignant lesions. The otolaryngologist is often asked to perform a biopsy of the lesion to arrive at a diagnosis. However, even malignant processes can cause a granulomatous reaction. The timely diagnosis of tracheal masses depends upon maintaining a high index of suspicion. A rare case of tracheal granuloma leading to pneumomediastinum in a 53-year-old female is presented. The clinical features, investigations and treatment are detailed. The tracheal granuloma was managed by excision through bronchoscopy and the pneumomediastinum was managed conservatively.

Disseminated blastomycosis presenting as a neck mass

2000 ◽  
Vol 122 (2) ◽  
pp. 270-271 ◽  
Author(s):  
Kenneth R. Bergman ◽  
Peter Sorensen ◽  
Christopher Sinha
Keyword(s):  
United States ◽  
Clinical Presentation ◽  
Neck Mass ◽  
High Index ◽  
Blastomyces Dermatitidis ◽  
Dimorphic Fungus ◽  
Central United States ◽  
Uncommon Disease ◽  
High Index Of Suspicion

Blastomycosis is an uncommon disease caused by the dimorphic fungus Blastomyces dermatitidis. It is endemic to the central United States, especially the watersheds of the Mississippi, Missouri, and Ohio rivers. The clinical presentation of this disease often mimics that of malignancy, so a high index of suspicion must be present to avoid misdiagnosis. 1

scholarly journals Scrotal Ulcer is a Rare Presentationof TB Epididymis in Young Male

2021 ◽  
pp. 146-149
Author(s):  
Rekadi Srinivasa Rao ◽  
Senthil Kumar ◽  
R. Anantharamakrishnan ◽  
P. Varadaraju
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Clinical Presentation ◽  
Young Male ◽  
High Index ◽  
History Of ◽  
Scrotal Swelling ◽  
High Index Of Suspicion

Introduction: Scrotal tuberculosis (TB) is rare and may present as painful scrotal swelling with ulceration and discharging sinus. Case Report: A 28 years male with 2 months history of swelling and pain over left scrotum. Developed ulcer over the scrotal region with multiple sinus associated with pus discharge. Conclusion: The clinical presentation of TB scrotal ulcer can be atypical and a high index of suspicion is required for early diagnosis. Diagnosis is by using ultrasonography, microbiology, and biopsy. Treatment requires prolonged ATT for 6 months.

Unsuspected Nutritional Rickets

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Mary Rudolf ◽  
Karunyan Arulanantham ◽  
Robert M. Greenstein
Keyword(s):  
At Risk ◽  
Vitamin D ◽  
Clinical Features ◽  
Clinical Presentation ◽  
Black Children ◽  
Nutritional Deficiencies ◽  
Nutritional Rickets ◽  
Radiologic Examination ◽  
Long Time ◽  
Breast Fed

Based on the presentation and clinical features of four cases of nutritional rickets, it is suggested that particular groups of children, namely vegetarians, children breast-fed for an unusually long time, and black children, are at risk to develop the nutritional deficiencies of vitamin D and calcium that lead to clinical rickets. The diagnoses in these cases were made by fortuitous radiologic examination, even though the children had been receiving regular pediatric supervision, indicating a lack of awareness of the condition. This report is intended to emphasize the reemergence of nutritional rickets and to illustrate the different modes of its clinical presentation.

Ectopic Pregnancy - A 1 Year Clinical Study in King George Hospital, Visakhapatnam

2021 ◽  
Vol 8 (27) ◽  
pp. 2457-2461
Author(s):  
Vamsi Mudadla ◽  
Shyamala Kaitala ◽  
Satyavani Nandigama
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
High Index ◽  
Diagnostic Methods ◽  
Obstetric Emergency ◽  
King George Hospital ◽  
High Index Of Suspicion

BACKGROUND Ruptured ectopic is a life threatening obstetric emergency. Obstetrician must have a high index of suspicion for ectopic pregnancy and should be aware of importance of early diagnosis and early intervention. The present study was undertaken to evaluate the incidence, clinical presentation, risk factors, treatment and morbidity associated with ectopic pregnancy. METHODS Retrospective analysis of ectopic pregnancy was done in King George Hospital, Visakhapatnam from January 2020 to December 2020 in the department of OBG. The following parameters: Age, risk factors, clinical presentation, site of ectopic, diagnostic methods, mode of treatment were noted. RESULTS A total of 63 cases were reported during this time frame. It is a tertiary care centre getting referrals from nearby districts and other hospitals. Incidence of ectopic pregnancy in the present study is 0.89 %. 41.26 % of patients belonged to age group between 26 to 30 years. Out of 63 cases 49.20 % were multigravida. 28 % of the cases were associated with previous H/O abortions and 23 % of the cases were associated with PID and in 17.4 % of the cases there was no predisposing factors. 96.82 % the patients presented with pain abdomen. Shock in 34.92 % of the cases. Ampulla is the most common site of ectopic. In 76 % of the cases there was hemoperitoneum > 500 ml. Salpingectomy was done in 79.3 % cases. 84 % of cases required blood transfusion > 1 unit. There was no mortality. CONCLUSIONS Ectopic pregnancy is one of the obstetric emergency with significant morbidity and mortality. PID and post abortal sepsis are one of the important risk factors for ectopic pregnancy. As many patients may not have recognizable risk factors, a high index of suspicion is critical for early diagnosis. Early USG diagnosis of ectopic pregnancies reduces mortality and enables us to offer the patient conservative medical and surgical treatment. KEYWORDS Ectopic Pregnancy, TVS, Ampulla, Salpingectomy

scholarly journals A malignant wheeze!

2018 ◽  
Vol 88 (3) ◽  
Author(s):  
Kashyap Goyal ◽  
Subodh Kumar ◽  
Mayank Mishra ◽  
Ritisha Bhatt ◽  
Adabala Vijay Babu ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Features ◽  
Standard Therapy ◽  
Acute Asthma ◽  
High Index ◽  
Present Case Report ◽  
Tracheal Tumor ◽  
Common Disorder ◽  
High Index Of Suspicion ◽  
Tracheal Tumors

Asthma is a common disorder presenting with nonspecific features, which may mimic other conditions such as tracheal tumors. Tracheal tumors are often misdiagnosed as asthma. We report a case of a 38-year female who was being worked up for persistent wheeze that was initially attributed to acute asthma, only to be later discovered as tracheal tumor. A high index of suspicion for alternative diagnoses must be kept in mind while evaluating a patient who presents with clinical features suggestive of asthma, but fails to respond to standard therapy. The present case report emphasizes the fact that not all wheezes are asthma.

scholarly journals Chronic umbilical abscess secondary to a patent urachus in a 30 years male: a case report

2021 ◽  
Vol 8 (9) ◽  
pp. 2845
Author(s):  
Akula Nynasindhu ◽  
Swetana Palavalasa
Keyword(s):  
Case Report ◽  
Urinary Bladder ◽  
Ct Scan ◽  
Regional Anaesthesia ◽  
Clinical Presentation ◽  
Adult Population ◽  
High Index ◽  
Patent Urachus ◽  
Urachal Sinus ◽  
High Index Of Suspicion

Urachus is epithelialized, fibromuscular remnant part connecting urinary bladder with umbilicus. Urachal anomalies present and progress differently in paediatric and adult population. They remain largely asymptomatic until infected. Clinical presentation may vary from simple discharge from umbilicus to intrabdominal abscess and peritonitis. We present a case of urachal sinus presenting as recurrent umbilical abscess. 30 years male presented with complaints of umbilical mass with pus discharge. He was evaluated clinically and radiologically. Ultrasound revealed a localized collection near umbilicus whereas CT scan revealed connection of that collection to a fibrous strand like structure approximately 10 cm extending from umbilicus to urinary bladder. An open exploration was done under regional anaesthesia and 20 ml of abscess drained with excision of tract by ligating near the bladder end. Local debridement was done near the umbilical area. Wound closed in layers. Post-op period was uneventful without any recurrence. urachal anamolies need a high index of suspicion in adults to intervene early and get better outcomes with less morbidity.

scholarly journals COVID-19 and Gastrointestinal Symptoms—A Case Report

Geriatrics ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 31
Author(s):  
Alistair J. Mackett ◽  
Victoria L. Keevil
Keyword(s):  
Case Report ◽  
Older People ◽  
Clinical Features ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
High Index ◽  
Uncommon Presentation ◽  
Novel Coronavirus ◽  
High Index Of Suspicion

COVID-19, a new illness secondary to a novel Coronavirus emerged in December 2019 in China. Our early understanding of the clinical features of COVID-19 has been based on case series emerging from the first outbreak in Wuhan. These features included fever, a dry cough, myalgia and dyspnea. Gastrointestinal symptoms were rarely reported as a key feature. We present a case report of a 74-year-old male who presented with symptoms of gastroenteritis and subsequently tested positive for COVID-19. This article aims to highlight an uncommon presentation of COVID-19 and that a high index of suspicion is required for COVID-19 in older people given their greater likelihood of presenting atypically.

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