Fifteen-minute consultation: Paediatric night sweats—when to reassure and when to investigate

Background: India accounts for one-fourth of the global tuberculosis (TB) burden. Since the countrywide implementation of RNTCP, tuberculosis care has received renewed focus. Directly observed treatment short-term (DOTS) is a cornerstone of RNTCP program. Objective: To evaluate demographic profile, clinical presentation and outcome of TB in district Baramulla of North Kashmir. Methods: A prospective study over a period of seven years in patients diagnosed with TB in district Baramulla of North Kashmir. Results: This study was conducted prospectively over seven years from March 2011 to February 2017. A total of 802 patients were enrolled in the study. Among them, there were a total of 638 adult patients and 164 paediatric patients with a male: female ratio of 1:0.99. Majority of patients belonged to rural areas of north Kashmir and had received no or elementary education. Pulmonary tuberculosis was diagnosed in 530 (66 %) patients and 272 (34%) patients were diagnosed as extrapulmonary tuberculosis. Sputum for AFB was important mode of diagnosis in our series and was positive in 525 (65%) our patients. Majority of patients presented with fever, weight loss, and night sweats. None of the patients had Acquired Immunodeficiency syndrome (AIDS). There was a consistent improvement in AFB isolation among TB patients over the study period. Majority of our patients were cured completely of disease Conclusion: Sputum positive pulmonary tuberculosis remains the most common presentation of tuberculosis in North Kashmir. There is a steady increase in the proportion of bacteriologically confirmed TB cases over the study period. Furthermore, DOTS treatment is successful in all forms of tuberculosis. JMS 2018;21(1):11-16

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A case of chronic cough due to sarcoidosis

Proceedings of Singapore Healthcare ◽

10.1177/20101058211019053 ◽

2021 ◽

pp. 201010582110190

Author(s):

Qin Jian Low ◽

Mohd Nadzri Bin Misni ◽

Seng Wee Cheo ◽

Khai Lip Ng ◽

Noorul Afidza Muhammad

Keyword(s):

Computed Tomography ◽

Chronic Cough ◽

Pulmonary Sarcoidosis ◽

Granulomatous Disease ◽

Unknown Aetiology ◽

Caseous Necrosis ◽

Night Sweats ◽

Histopathological Lesion ◽

Treatment Of Sarcoidosis ◽

Steroid Sparing

Sarcoidosis is a multisystemic, chronic granulomatous disease of unknown aetiology that often affects the lungs. Diagnosis and treatment of sarcoidosis can be strenuous. Patients may be asymptomatic or experience cough, dyspnoea, fatigue, unintentional weight loss or night sweats. Computed tomography is valuable in the diagnosis of sarcoidosis. The typical histopathological lesion of sarcoidosis is granuloma without caseous necrosis in the involved organs. As tuberculosis is endemic in our region, clinicians should not forget this great mimicker. The cornerstone of treatment of sarcoidosis is corticosteroids but newer agents such as steroid-sparing agents and biological agents are available. We report a case of pulmonary sarcoidosis presenting with chronic cough.

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IJV thrombophlebitis: be wary of the occult

BMJ Case Reports ◽

10.1136/bcr-2020-238813 ◽

2021 ◽

Vol 14 (3) ◽

pp. e238813

Author(s):

Pamela Oshinyemi ◽

Charlotte Lee ◽

Antony Gough-Palmer ◽

Iain McKay-Davies

Keyword(s):

Colorectal Adenocarcinoma ◽

Palliative Chemotherapy ◽

Jugular Vein ◽

Thrombus Formation ◽

Locally Advanced ◽

Patients With Cancer ◽

Occult Malignancy ◽

Night Sweats ◽

History Of ◽

Nose And Throat

A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre’s syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.

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Night Sweats

The Family Nurse Practitioner ◽

10.1002/9781119603238.ch6.3 ◽

2020 ◽

pp. 139-143

Author(s):

Ivy M. Alexander ◽

Annette Jakubisin‐Konicki

Keyword(s):

Night Sweats

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Twenty-three year-old with pleuritic chest pain

Heart ◽

10.1136/heartjnl-2017-312718 ◽

2018 ◽

Vol 105 (6) ◽

pp. 464-469

Author(s):

Karina P Gopaul ◽

Helen M Parry ◽

Damien Cullington

Keyword(s):

Chest Pain ◽

Congenital Heart ◽

White Cell Count ◽

Coarctation Of The Aorta ◽

List Type ◽

Pleuritic Chest Pain ◽

Reactive Protein ◽

Pulmonary Angiogram ◽

Night Sweats ◽

Ct Pulmonary Angiogram

Clinical introductionA 23-year-old woman followed at another medical centre for congenital heart disease (CHD) presented to our emergency clinic with 3 weeks of bilateral pleuritic chest pain. She returned from holiday in Greece 6 weeks earlier where a tattoo and nasal piercing had been performed. There was no history of night sweats or fever.Her temperature was 37.5°C, heart rate 120 beats/min, oxygen saturations 94% on room air and blood pressure 110/74. Her chest was clear and there was systolic murmur on auscultation. The chest radiograph showed peripheral bilateral lower zone atelectasis. The ECG demonstrated sinus tachycardia. The haemoglobin was 11.2 g/dL, white cell count 10.18×109/L, C-reactive protein 67 mg/L (normal <5 mg/L) and D dimer=430 ng/mL (normal <230 ng/mL).A pulmonary embolus was suspected and a CT pulmonary angiogram was performed (figure 1).QuestionBased on the CT findings, what is the most likely underlying congenital heart lesion in this patient?Bicuspid aortic valveCoarctation of the aortaFontan circulationParachute mitral valveVentricular septal defectFigure 1CT pulmonary angiogram (coronal views).

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NIGHT SWEATS.

The Lancet ◽

10.1016/s0140-6736(01)17035-2 ◽

1922 ◽

Vol 200 (5177) ◽

pp. 1094

Author(s):

Marcus Paterson

Keyword(s):

Night Sweats

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Breathlessness, night sweats, and weight loss on natalizumab

The Lancet ◽

10.1016/s0140-6736(12)61401-9 ◽

2012 ◽

Vol 380 (9843) ◽

pp. 726-727 ◽

Cited By ~ 14

Author(s):

D Dahdaleh ◽

DM Altmann ◽

O Malik ◽

RS Nicholas

Keyword(s):

Weight Loss ◽

Night Sweats

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Poster 257 Tizanidine Reduces Night Sweats due to Dysautonomia in Syringomyelia: A Case Report

PM&R ◽

10.1016/j.pmrj.2016.07.430 ◽

2016 ◽

Vol 8 (9) ◽

pp. S243-S244

Author(s):

Ryan A. Menard ◽

Daniel Moon ◽

Paul Hurd

Keyword(s):

Case Report ◽

Night Sweats

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Metastatic pancreatic cancer with complete response to FOLFIRINOX treatment

BMJ Case Reports ◽

10.1136/bcr-2020-238395 ◽

2021 ◽

Vol 14 (5) ◽

pp. e238395

Author(s):

Paige T Shelemey ◽

Carla P Amaro ◽

Danny Ng ◽

Vincent Falck ◽

Vincent C Tam

Keyword(s):

Pancreatic Cancer ◽

Complete Response ◽

Large Mass ◽

Scar Tissue ◽

Pancreatic Mass ◽

Metastatic Pancreatic Cancer ◽

Liver Lesions ◽

Ultrasound Guided ◽

Cancer Antigen ◽

Night Sweats

A 59-year-old woman presented with abdominal pain associated with nausea and night sweats. A large mass was found in the pancreatic tail and innumerable liver lesions were identified. Ultrasound-guided biopsy of a liver nodule confirmed moderately differentiated adenocarcinoma consistent with a pancreatobiliary primary. On FOLFIRINOX chemotherapy, subsequent CT scans showed shrinkage of the pancreatic mass and liver metastases. Her cancer antigen 19-9 (CA 19-9) normalised after 11 months. Oxaliplatin was discontinued due to peripheral neuropathy but she completed 37 cycles of FOLFIRI during which her pancreatic mass disappeared, liver lesions decreased in size and were subsequently deemed to be scar tissue by the radiologist. After 4 years of treatment, the patient agreed to a break from chemotherapy. Eighteen months afterwards, an MRI abdomen continues to demonstrate no visible pancreatic mass and the two remaining liver lesions, believed to be scar tissue, remain stable. Her CA 19-9 level remains normal. This appears to be a complete response to FOLFIRINOX/FOLFIRI chemotherapy in a patient with metastatic pancreatic cancer.

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Abstract P724: Perimenopausal Women With Migraine Present With Stroke at a Younger Age and With Less Comorbid Diabetes

Stroke ◽

10.1161/str.52.suppl_1.p724 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Morgan Figurelle ◽

Dawn M Meyer ◽

Emily Perrinez ◽

Karen Rapp ◽

Rebecca Wells ◽

...

Keyword(s):

Native American ◽

Ischemic Stroke ◽

Menopausal Status ◽

Hot Flashes ◽

Future Research ◽

Significant Difference ◽

Perimenopausal Women ◽

Chi Squared ◽

Night Sweats ◽

Comprehensive Stroke Center

Introduction: Migraine is an independent risk factor for ischemic stroke. Frequency and severity increases in the perimenopausal period accompanied by marked vasomotor symptoms (VMS) such as hot flashes, flushing and night sweats. There is emerging evidence that VMS increases the risk of vascular disease including stroke. The purpose of this study was describe the demographics and co-morbidities of perimenopausal females with and without migraine that experience acute ischemic stroke (AIS). Methods: In this IRB approved study, electronic health record (EHR) data was obtained from a large, academic, comprehensive stroke center from 1/1/2015 to 1/1/2020. Inclusion criteria included female sex, age 42-65 years, and hospital diagnosis code of AIS. Hemorrhagic stroke, TIA, vasculopathy, and endocarditis associated strokes were excluded. Perimenopause was defined as age ≥42 and ≤65 years. Hormonal and menopausal status was not available in the EHR. We compared the baseline demographics and co-morbidities by ICD10 codes of subjects with and without migraine. Chi squared was used to compare categorical data and t test for continuous. Spearman rho was used to assess correlations. Results: We identified 660 subjects who met study criteria (n=83 with migraine; n=577 without migraine). Migraine positive subjects were significantly younger (mean age 58 vs 66 years, p=0.03) at time of AIS. Migraine positive subjects identified significantly more often as White (47%) compared to Black (10%), Asian (7%), Pacific Islander (1%), Native American/Alaskan (1%), Other/Mixed Race (31%), and unknown (3%), p=0.001. There was no significant difference in Hispanic ethnicity (p=0.87), hypertension (p=0.66), hyperlipidemia (p=0.12), or atrial fibrillation (p=0.84). Comorbid diabetes was significantly higher in the non-migraine group (94% vs 6%, p<0.001). Conclusion: Perimenopausal women with concomitant history of migraine present with AIS at younger ages and with lower rates of diabetes than those without a migraine history. Future research must be done to assess the correlation of menopausal symptom severity, hormone levels at time of AIS, and stroke characteristics to further understand the role of menopause in stroke risk.

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