Chronic strongyloidiasis: a case of B symptoms and recurrent asthma exacerbations

2020 ◽  
Vol 13 (12) ◽  
pp. e238163
Author(s):  
Zara Latif ◽  
Marc J Crupie
Keyword(s):  
High Risk ◽  
Time Course ◽  
Clinical Presentation ◽  
High Index ◽  
Asthma Treatment ◽  
Asthma Exacerbations ◽  
Frequent Use ◽  
Immigrant Patient ◽  
High Index Of Suspicion ◽  
Variable Presentation

Strongyloidiasis is one of the neglected helminths infection that is often underdiagnosed and undertreated. Due to its variable presentation, its diagnosis is often a challenge. We report a case of an immigrant patient with asthma who later developed eosinophilia. After 3 years of unexplained eosinophilia, he developed B symptoms and had frequent asthma exacerbations. He was later diagnosed with strongyloidiasis and treated with ivermectin. His B symptoms resolved, and his asthma exacerbations decreased significantly. Due to the frequent use of corticosteroids in asthma exacerbations, this case illustrates the importance of Strongyloides screening in asthmatics from high-risk regions. It also displays the importance of further investigating patients with asthma who develop eosinophilia and have frequent exacerbations while on optimal asthma treatment. Having a high index of suspicion is essential when making this diagnosis, as clinical presentation is often variable and does not follow a standard time course.

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.

scholarly journals Foreign body stone in oesophagus: a unique case

2015 ◽  
Vol 12 (2) ◽  
pp. 140-142 ◽  
Author(s):  
B P Sah ◽  
S T Chettri ◽  
J N. Prasad ◽  
P P Gupta ◽  
S P Shah ◽  
...  
Keyword(s):  
Foreign Body ◽  
High Risk ◽  
Rare Case ◽  
Mentally Retarded ◽  
Risk Groups ◽  
High Index ◽  
Common Occurrence ◽  
Unique Case ◽  
History Of ◽  
High Index Of Suspicion

Foreign body ingestion is a common occurrence in children and in specific high-risk  groups. It is usually diagnosed based on a history of ingestion given by the patient  or an observer. However, children and mentally retarded adults may be unable to  give an accurate history, and a high index of suspicion must be maintained in these  groups. We report a rare case of foreign body stone in an mentally retarded adult  which presented with drooling and impaired feeds, thence enabling for high index  for suspicion.  Health Renaissance 2014;12(2): pp: 140-142

scholarly journals Two cases of imported respiratory diphtheria in Edinburgh, Scotland, October 2019

2020 ◽  
Vol 148 ◽  
Author(s):  
Lucy Li ◽  
Daniella Ross ◽  
Katherine Hill ◽  
Sarah Clifford ◽  
Louise Wellington ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Corynebacterium Diphtheriae ◽  
High Index ◽  
Contact Tracing ◽  
Emerging Infections ◽  
Diphtheria Antitoxin ◽  
History Of ◽  
Risk Areas ◽  
High Index Of Suspicion

Abstract We report two cases of respiratory toxigenic Corynebacterium diphtheriae infection in fully vaccinated UK born adults following travel to Tunisia in October 2019. Both patients were successfully treated with antibiotics and neither received diphtheria antitoxin. Contact tracing was performed following a risk assessment but no additional cases were identified. This report highlights the importance of maintaining a high index of suspicion for re-emerging infections in patients with a history of travel to high-risk areas outside Europe.

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.

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 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.

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.

scholarly journals Ovarian torsion in a 20-year-old patient

CJEM ◽  
2006 ◽  
Vol 8 (02) ◽  
pp. 126-129 ◽  
Author(s):  
Chris Martin ◽  
Kirk Magee
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Ovarian Torsion ◽  
High Index ◽  
Reproductive Age ◽  
The Difference ◽  
High Index Of Suspicion

ABSTRACTOvarian torsion is an uncommon gynecological emergency that requires prompt recognition and treatment. It may present with nonspecific signs and symptoms, and should be considered in any female with acute abdominal pain. The diagnosis is based on an awareness of the relevant risk factors, the clinical presentation, and a high index of suspicion. Timely investigation and management can make the difference between ovarian loss and salvage — an outcome of great importance in the population of reproductive age females.

scholarly journals Palmoplantar Involvement in Leprosy: A Clinicopathological Study

2021 ◽  
Author(s):  
Garima Dabas ◽  
Tarun Narang ◽  
Sunil Dogra ◽  
Divya Aggarwal ◽  
Bishan Das Radotra
Keyword(s):  
Clinical Presentation ◽  
High Index ◽  
Clinicopathological Study ◽  
Leprosy Patients ◽  
High Index Of Suspicion

Palmoplantar involvement has been infrequently reported in leprosy and is an easily misdiagnosed entity. The institutional database of leprosy clinic from 2015 to 2018 was accessed. Details pertaining to demography, clinical presentation, comorbidities (if any), treatment received, and outcome were analyzed in leprosy patients with palmoplantar involvement. Among the 520 patients studied, the involvement of palms and/or soles was reported in 49 (9.4%) patients. Isolated palm involvement was the most frequent (26/49, 53.1%), followed by both palm and sole involvement (12/49, 24.5%) and sole involvement alone (11/49, 22.4%). A higher incidence of lepra reactions and disabilities was noted in patients with palmoplantar involvement than in those without (P < 0.0001). Palmoplantar involvement in leprosy, although uncommon, is associated with a higher risk of reactions and disabilities. A knowledge of this end of the spectrum can help in maintaining a high index of suspicion and reduce misdiagnosis.

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