scholarly journals Neonatal parechovirus infection mimicking a surgical abdomen

2019 ◽  
Vol 12 (6) ◽  
pp. e229053
Author(s):  
Megan J Kirkley ◽  
Christine Robinson ◽  
Samuel R Dominguez ◽  
Kevin Messacar
Keyword(s):  
Clinical Presentation ◽  
Febrile Illness ◽  
Abdominal Distension ◽  
Term Infant ◽  
Potential Utility ◽  
Rapid Testing ◽  
Human Parechovirus ◽  
Common Cause ◽  
Young Infants

Human parechovirus-3 (PeVA3) infection is a common cause of febrile illness in young infants and the spectrum of clinical presentation is broad. We describe a term infant who presented with marked abdominal distension and anorexia, concerning for an acute surgical abdomen. Evaluation revealed that the infant had PeVA3 infection. This case highlights the importance of recognising severe abdominal distension and discomfort as a clinical presentation associated with PeV and the potential utility of rapid testing for PeV.

CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 847-853
Author(s):  
I. Antonowicz ◽  
J. D. Lloyd-Still ◽  
K. T. Khaw ◽  
H. Shwachman
Keyword(s):  
Growth And Development ◽  
Clinical Presentation ◽  
Quantitative Estimation ◽  
Failure To Thrive ◽  
Normal Growth ◽  
Significant Rise ◽  
Small Intestinal Mucosa ◽  
Severe Diarrhea ◽  
Young Infants ◽  
Small Intestinal

Observations over a period of 6 years are reported on 10 children in whom the diagnosis of congenital sucrase isomaltase deficiency (SID) was confirmed by quantitative estimation of disaccharidase activity of the small intestinal mucosa. Repeat biopsies were performed on eight of the ten patients and showed no evidence that sucrase isomaltase activity is acquired. Sucrose tolerance tests (2 gm/kg) showed no significant rise in blood glucose in the seven patients in whom they were performed. This condition may appear in young infants with severe diarrhea resulting in a malabsorption syndrome and failure to thrive. It may also be manifest in a milder clinical presentation with bothersome diarrhea in spite of normal growth and development in the older infant or young child. The diagnosis in this latter group can be difficult, and is frequently missed.

scholarly journals Clinical Presentation and Treatment Outcome of Abdominal Tuberculosis

2014 ◽  
Vol 15 (2) ◽  
pp. 131-134
Author(s):  
Oliur Rahman ◽  
Anwarul Kabir ◽  
Prodip Kumar Biswas ◽  
AMM Shoriful Islam ◽  
AB Siddik ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Clinical Presentation ◽  
Abdominal Distension ◽  
Abdominal Tuberculosis ◽  
Final Diagnosis ◽  
Drop Out ◽  
Low Grade ◽  
College Hospital ◽  
Abdominal Lymph Node ◽  
Female Ratio

Background: Tuberculosis is common in our country. It commonly affects the lungs but in up to one third of the cases involve other organs. Abdominal tuberculosis is one of the important extrapulmonary tuberculosis.It has varied presentation, frequently mimicking other common and rare diseases. Materials and Methods:It is a prospective observational study done to see the clinical presentation and treatment outcome of abdominal tuberculosis in medicine, surgery and gastroenterology department Sylhet M A G Osmani Medical College Hospital during Jan 2008-Dec2008. Sample was collected purposively. All patients were undergone detailed history, clinical examination, relevant investigation and follow up till the end of six months anti tubercular chemotherapy.Data recorded in predesigned record form. Statistical analysis was done with SPSS software. All data presented as percentage or mean. Result: From the 50 cases of abdominal TB, 26 (52%) were male and 24 (48%) were female. Male and female ratio was 1.04:1. Here most of the patients were in the age of 21-30 years and mean age was 29.3 years,majority of them were from poor socioeconomic status(18%) had associated pulmonary tuberculosis.The common presentation exhibited by the patients were weight loss (100%), low grade fever (88%), abdominal pain (86%), bowel disturbance (84%), anorexia (80%), nausea and vomiting (70%), abdominal distension (46%), , ascites (42%).Most of the patients were anaemic with raised ESR.Ultrasonography revealed ascites,abdominal lymphadenopathy and thick walled bowel. Colonoscopy found nodularity and ulceration with narrowing. Ascitic fluid was exudative with predominant lymphocyte count. Laparoscopy and laparotomy revealed tubercle on the intestine and the mesentery with thickening and bowel stricture. All the biopsy reports were consistent with tuberculosis. Site of involvement in decreasing frequency were ileocaecal (44%), peritoneal (16%), abdominal lymph node (8%), ascending colon (8%), small bowel (6%),transverse colon (4%), sigmoid colon (2%), rectum (2%), gastric (2%) and duodenal (2%) but multiple site in 6%.The treatment was given as per the WHO guidelines with category I drugs and found- 86% cured with anti TB alone, 4% needed surgery for intestinal obstruction along with anti TB, and 10% drop out from follow up.Conclusion:The clinical presentations of abdominal TB appear not specific for the condition. Thus, careful approach and supportive results are required in order to issue the final diagnosis. If diagnosed early, it can be treated successfully with the conventional anti-TB drugs. DOI: http://dx.doi.org/10.3329/jom.v15i2.20686 J MEDICINE 2014; 15 : 131-134

scholarly journals Cerebrospinal Fluid Pseudocyst Complicating Ventriculoperitoneal Shunt: Report of Four Cases

2018 ◽  
Vol 07 (02) ◽  
pp. 135-138 ◽  
Author(s):  
Pradyumna Pan
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Presentation ◽  
Abdominal Distension ◽  
Surgical Removal ◽  
Ultrasound Guided ◽  
Vp Shunt ◽  
Multilocular Cyst ◽  
Computed Tomographic ◽  
Abdominal Pseudocyst ◽  
Uncommon Complication

Abstract Background Cerebrospinal fluid (CSF) abdominal pseudocyst (APC) is an uncommon complication following ventriculoperitoneal (VP) shunt. Aim To study the clinical features and management of this entity. The authors present their experience with cases of CSF pseudocyst in children. Materials and Methods Retrospective analysis of four cases diagnosed to have APC following VP shunt between 2005 and 2015. Results Clinical presentation was with progressive abdominal distension, highlights of intestinal obstruction, and signs of raised intracranial pressure (ICP). Diagnosis is readily made with ultrasonography and computed tomographic (CT) scan of the abdomen. The duration between insertion of the shunt and the presentation ranged from 4.11 to 12 years. In three patients, the cyst was unilocular and of varying size. The fourth one had a multilocular cyst. In three patients, the treatment involved was surgical removal of the catheter with excision of the pseudocyst wall and placement of a new catheter intraperitoneally in a different quadrant. Ultrasound-guided aspiration of the cyst and relocation of the distal end was done in one patient. Conclusion Initial suspicion with appropriate investigation and early treatment can avert morbidity and mortality.

scholarly journals Symptomatic Hypokalemia in a 19-Year-Old Student

2020 ◽  
Vol 63 (3) ◽  
pp. 137-140
Author(s):  
Sara Pereira ◽  
André Salgueiro ◽  
Paula Rosa ◽  
Carla Peixoto ◽  
Marta Ferreira ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Metabolic Alkalosis ◽  
Clinical Presentation ◽  
Adrenal Adenoma ◽  
Screening Tests ◽  
Common Cause ◽  
Confirmatory Tests ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Primary hyperaldosteronism (PA) is the most common cause of secondary arterial hypertension and is frequently undiagnosed. It affects all ages but is more frequent between 20 and 60 years old. The clinical presentation is variable, and the diagnosis is based on screening and, in equivocal cases, confirmatory tests. A 19-year-old student presented with complaints of extreme fatigue, arterial hypertension, hypokalemia and metabolic alkalosis, raising a high index of suspicion for PA. Screening tests were performed and its expressiveness excluded the need of confirmatory tests. CT-scan showed a unilateral adrenal adenoma and the patient was submitted to laparoscopic adenectomy without complications. Prompt diagnosis and treatment are essential to avoid long term complications of PA.

scholarly journals Antenatally Diagnosed Posterior Urethral Valve: A Case Report

2016 ◽  
Vol 5 (1) ◽  
pp. 42-45
Author(s):  
Mahzabeen Islam ◽  
Masudur Rahman ◽  
Sankar Narayan Dey ◽  
Netay Kumer Sharma ◽  
Mir Naz Farzana
Keyword(s):  
Clinical Presentation ◽  
Antenatal Diagnosis ◽  
Late Onset ◽  
Obstructive Uropathy ◽  
Lower Abdominal Pain ◽  
Posterior Urethral Valve ◽  
Caesarian Section ◽  
Common Cause ◽  
Obstructive Lesion ◽  
Urethral Valve

Posterior urethral valve (PUV) are the most common congenital obstructive lesion of the urethra and a common cause of obstructive uropathy in infancy. Clinical presentation depends on the severity of the obstruction. In case of severe obstruction, the diagnosis is usually made antenatally. Here, we present a case of antenatally diagnosed PUV of a fetus of a lady in her 9th month of pregnancy with mild lower abdominal pain for several hours. On ultrasound (US) examination, we found 36.5±2 weeks of pregnancy with mild to moderate oligohydramnios. Fetal urinary bladder was over distended; both the kidneys were grossly hydronephrotic and PUV like echo lucent area was seen at the prostatic region (Key hole sign). Emergency caesarian section (CS) was done and US of the baby showed typical US finding of PUV. The prognosis of antenatal diagnosis of PUV in early pregnancy is poor. But in this case due to the late onset of symptoms and as immediate necessary steps were taken, the baby was totally cured. This case was reported to aware about importance of antenatal anomaly scan and to share our experience. CBMJ 2016 January: Vol. 05 No. 01 P: 42-45

scholarly journals A Case of Congenital Tuberculosis in a Tertiary Care Hospital

2012 ◽  
Vol 1 (2) ◽  
pp. 85-87
Author(s):  
Ishrat Jahan ◽  
Mehedi Parvez ◽  
Laisha Yeasmin
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Male Infant ◽  
Abdominal Distension ◽  
Drug Regimen ◽  
Care Hospital ◽  
Gastric Aspirate ◽  
Congenital Tuberculosis ◽  
Low Weight

Congenital tuberculosis is an unusual and severe clinical presentation of Mycobacterium tuberculosis (MTB) infection. It is usually difficult to diagnose and treat. We report a tenweek-old male infant who had presented with fever, difficulty in breathing, abdominal distension, convulsion, low weight gain since one month of his age. The diagnosis was made by demonstration of MTB bacilli in the gastric aspirate of baby and chest radiography. Treatment with the four drug regimen including streptomycin was initiated, but the baby died   on the third day of ATT. This case gives an account of difficulties in diagnosis and therapeutic   management of congenital tuberculosis and alerts for development of protocols that foresee   these difficulties. DOI: http://dx.doi.org/10.3329/jemc.v1i2.11469   J Enam Med Col 2011; 1(2): 85-87  

scholarly journals Incidental Detection of Dent-2 Disease in an Infant with Febrile Proteinuria

2018 ◽  
Vol 27 (4) ◽  
pp. 392-395 ◽  
Author(s):  
Shpetim Salihu ◽  
Katerina Tosheska ◽  
Svetlana Cekovska ◽  
Velibor Tasic
Keyword(s):  
Molecular Weight ◽  
Sodium Dodecyl Sulfate ◽  
Clinical Presentation ◽  
Viral Infections ◽  
Sodium Dodecyl ◽  
Febrile Illness ◽  
Low Molecular Weight ◽  
Acute Febrile Illness ◽  
Low Molecular Weight Proteinuria ◽  
Sds Page

Objective: Febrile proteinuria is functional proteinuria and is seen as a transitory phenomenon during acute febrile illness, mainly viral infections. It is a benign phenomenon and clears promptly with resolution of the infection. Clinical Presentation and Intervention: In this report, we present a patient who was thought to have febrile proteinuria. Persistence of significant proteinuria after resolution of the infection prompted biochemical and genetic workup which led to the diagnosis of Dent-2 disease. Conclusion: We recommend the use of SDS-PAGE (sodium dodecyl sulfate electropheresis) for the detection of low molecular weight proteinuria.

scholarly journals Strategies to improve detection and management of human parechovirus infection in young infants

2019 ◽  
Vol 19 (2) ◽  
pp. e51-e58 ◽  
Author(s):  
Seilesh Kadambari ◽  
Heli Harvala ◽  
Peter Simmonds ◽  
Andrew J Pollard ◽  
Manish Sadarangani
Keyword(s):  
Human Parechovirus ◽  
Young Infants

scholarly journals Clinical profile of patients with pleural effusion admitted to KMCTH

1970 ◽  
Vol 7 (4) ◽  
pp. 438-444 ◽  
Author(s):  
KR Dhital ◽  
R Acharya ◽  
R Bhandari ◽  
P Kharel ◽  
KP Giri ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Clinical Presentation ◽  
Lateral View ◽  
Parapneumonic Effusion ◽  
Age Group ◽  
Common Cause ◽  
Fluid Analysis ◽  
Blood Haemoglobin ◽  
Chest X Ray

Background: pleural effusion is the common findings in patients presenting with cardiopulmonary symptoms but specific studies are lacking in Nepal. Objective: The main objective of this study is to find out the various causes of pleural effusion, their mode of clinical presentation and laboratory analysis of blood and pleural fluid to aid diagnosis of patients with pleural effusion. Materials and methods: Retrospective data from July 2009 to July 2007 from all the cases diagnosed with pleural effusion were taken. Altogether 100 cases diagnosed with pleural effusion by chest X-ray (Posterior- Anterior and Lateral view) and Ultrasonogram of the chest were studied. The following parameters were analysed: Patients demographic profile, causes, location (Unilateral, Bilateral), Blood haemoglobin and count, sputum profile, Monteux test, chest Xray and USG findings and pleural fluid analysis[Biochemical, Haematological, Microbiological(culture and stain) and cytological]. This study was analysed by using SPSS 16. Results: The mean age of the patient was 44.89 ± 21.59 and must patients with pleural effusion belong to age group 21- 30. Most common cause of pleural effusion was found to be tubercular effusion followed by parapneumonic effusion. Right sided effusion was seen in most cases of tubercular parapneumonic and malignant effusion whereas bilateral effusion was seen in 87.5% of the patient (7 out of 8) having congestive heart failure and all cases of renal disease (4 out of 4). Shortness of breath (83%), cough (67%) and fever (66%) are the most common mode of clinical presentation. Conclusion: Our study concluded that the most common cause of unilateral pleural effusion is tuberculosis followed by parapneumonic effusion and most cases of those belong to younger age group (21 -30yrs) and most common cause of bilateral pleural effusion is congestive cardiac failure. Key words: Pleural effusion; Tuberculosis; pneumonia; malignancy; protein; ADA DOI: 10.3126/kumj.v7i4.2772 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 438-444

Update on Amyloid-associated Intracerebral Haemorrhage

2012 ◽  
Vol 7 (1) ◽  
pp. 22 ◽  
Author(s):  
Rebbeca Grysiewicz ◽  
Philip B Gorelick ◽  
◽  
Keyword(s):  
Intracerebral Haemorrhage ◽  
Scientific Inquiry ◽  
Clinical Presentation ◽  
The Elderly ◽  
Superficial Siderosis ◽  
Amyloid Angiopathy ◽  
Common Cause ◽  
Prevention And Treatment ◽  
Primary Focus ◽  
Brain Haemorrhage

Cerebral congophilic or amyloid angiopathy (CAA) is a clinicopathological entity that is considered a common cause of primary non-traumatic brain haemorrhage in the elderly. CAA is frequently associated with Alzheimer’s disease (AD) and has become a primary focus of scientific inquiry. The spectrum of intracerebral haemorrhage (ICH) that may occur in CAA includes: cerebral lobar haemorrhages, deep haemorrhages, purely subarachnoid and subdural haemorrhages and cerebral microbleeds. CAA is also associated with microinfarcts, leukoencephalopathy and superficial siderosis. This brief article will provide an update on the advances in our understanding of CAA-associated ICH with a focus on the following topics: neuropathology and mechanism of CAA-related haemorrhage; epidemiology, including genetic and other possible risk factors; clinical presentation; diagnosis, including newer imaging modalities; and prospects for prevention and treatment.

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