Localised cervical lymphadenopathy: a rare presenting sign of syphilis

2021 ◽  
Vol 14 (6) ◽  
pp. e243195
Author(s):  
Elisa Hendrika Adriaansens ◽  
Marieke E C van Winden ◽  
Peter van Wijngaarden
Keyword(s):  
Cervical Lymphadenopathy ◽  
Final Diagnosis ◽  
Treatment Delay ◽  
Lymphoproliferative Disease ◽  
Serological Tests ◽  
Cat Scan ◽  
Hiv Coinfection ◽  
Recovery Treatment ◽  
Night Sweats ◽  
The Individual

Recognising syphilis can be challenging due to enormous variability in disease presentation. We present a case of 56-year-old female patient, without any medical history, with unilateral cervical lymphadenopathy and night sweats since 3 weeks. Initial differential diagnosis consisted of infectious disease, lymphoproliferative disease and autoimmune disease. Despite considerable diagnostic efforts, including serological tests for common infectious diseases, a CAT scan and histologic examination, no diagnosis was found. After reconsideration, serologic testing for syphilis was performed and was positive. Hereby, the final diagnosis of syphilis was made. Neurosyphilis and HIV coinfection were ruled out before treatment with benzylpenicillin was initiated. After which our patient made a full recovery. Treatment delay could have been considerably diminished if the localised lymphadenopathy was recognised as possible syphilitic disease. In future cases this could not only prevent further dissemination and potential morbidity in the individual patient as well as further emergence within the population.

scholarly journals Serological Evaluation of Specific-Antibody Levels in Patients Treated for Chronic Chagas' Disease

2007 ◽  
Vol 15 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Olga Sánchez Negrette ◽  
Fernando J. Sánchez Valdéz ◽  
Carlos D. Lacunza ◽  
María Fernanda García Bustos ◽  
María Celia Mora ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Treatment Effectiveness ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Serological Tests ◽  
Recombinant Antigens ◽  
Antibody Titers ◽  
Laboratory Procedures ◽  
The Individual ◽  
Antibody Levels

ABSTRACT Serological tests are the main laboratory procedures used for diagnosis during the indeterminate and chronic stages of Chagas' disease. A serological regression to negativity is the main criterion used to define parasitological cure in treated patients. The aim of this work was to monitor the individual specificities of antibody levels for 3 years posttreatment in 18 adult patients. Conventional serological techniques (hemagglutination assays and enzyme-linked immunosorbent assay [ELISA]) were modified by using recombinant antigens to detect early markers of treatment effectiveness. For this purpose, serum samples were taken before and during treatment and every 6 months after treatment for at least 3 years. When hemagglutination assays were used, a decrease in antibody levels was observed in only one patient. When ELISA with serum dilutions was used, antibody clearance became much more apparent: in 77.7% (14/18) of the patients, antibody titers became negative with time. This was observed at serum dilutions of 1/320 and occurred between the 6th and the 30th months posttreatment. The immune response and the interval for a serological regression to negativity were different for each patient. For some of the recombinant antigens, only 50% (9/18) of the patients reached the serological regression to negativity. Recombinant antigen 13 might be a good marker of treatment effectiveness, since 66.6% (six of nine) of the patients presented with an early regression to negativity for specific antibodies to this antigen (P = 0.002).

scholarly journals Pre-diagnostic drop out of presumptive TB patients and its associated factors at Bugembe Health Centre IV in Jinja, Uganda

2020 ◽  
Vol 20 (2) ◽  
pp. 633-640
Author(s):  
Godfrey Ekuka ◽  
Ismael Kawooya ◽  
Edward Kayongo ◽  
Ronald Ssenyonga ◽  
Frank Mugabe ◽  
...  
Keyword(s):  
Associated Factors ◽  
Health Centre ◽  
Significant Proportion ◽  
Final Diagnosis ◽  
Drop Out ◽  
Population Characteristics ◽  
Dropping Out ◽  
Keywords Tuberculosis ◽  
Male Patients ◽  
The Individual

Background: Drop out of presumptive TB individuals before making a final diagnosis poses a danger to the individual and their community. We aimed to determine the proportion of these presumptive TB drop outs and their associated factors in Bugembe Health Centre, Jinja, Uganda. Methods: We used data from the DHIS2, presumptive and laboratory registers of Bugembe Health Centre IV for 2017. Descriptive statistics were used to summarize the population characteristics. A modified Poisson regression model via the generalized linear model (GLM) with log link and robust standard errors was used for bivariate and multivariate analysis. Results: Among the 216 registered presumptive TB patients who were less than 1% of patients visiting the outpatients’ department, 40.7% dropped out before final diagnosis was made. Age and HIV status were significantly associated with pre-diagnostic drop out while gender and distance from the health center were not. Conclusion: A high risk to individuals and the community is posed by the significant proportion of presumptive TB pa- tients dropping out before final diagnosis. Health systems managers need to consider interventions targeting young persons, male patients, HIV positive persons. Keywords: Tuberculosis (TB); Pre-diagnostic drop out; Presumptive TB; SORT IT.

scholarly journals The role of early prosthetic help in the system of rehabilitation of the military personnel with military trauma: organizational, legal and methodical aspects

2018 ◽  
Vol 20 (2) ◽  
pp. 40-47
Author(s):  
V G Suslyaev ◽  
O N Vladimirova ◽  
K K Shcherbina ◽  
A V Sokurov ◽  
Yu I Zhdanov ◽  
...  
Keyword(s):  
Artificial Limbs ◽  
Individual Choice ◽  
Disabled People ◽  
Express Method ◽  
Full Contact ◽  
Military Trauma ◽  
Recovery Treatment ◽  
Manufacturing Techniques ◽  
The Individual ◽  
And Training

The role and the place of early use of technical means of rehabilitation in the system of complex rehabilitation of patients and disabled people owing to a military trauma is considered. Need of early providing the needing persons with technical means of rehabilitation is proved during recovery treatment, including before establishment by him of disability and formation of the individual program of rehabilitation and an abilitation of disabled people. The efficiency of the developed non-plaster technology of prosthetics manufacturing techniques of artificial limbs of the lower extremities is proved by express method, options of her execution are offered. The first option of production of products on this technology consists in use of polymeric silicone covers and the water-hardening polymeric bandage directly on the patient’s stump. The second option of prosthetics is applied at some defects and diseases of a stump excluding application of silicone covers and full contact individual reception sleeves. For this purpose at production of medical and training artificial limbs of a shin and hip adjustable demountable reception sleeves from thermolayers for right-and left-side amputating defects are used. These options of prosthetics by express method are innovative, are aimed at early rendering the prosthetic and orthopedic help to patients with amputating defects. At production of artificial limbs on these technology domestic materials, modular and not modular accessories are used. The modular complete set of medical and training artificial limbs provides fast and individual setting up the scheme of construction, the individual choice of combinations of functional elements taking into account group of physical activity of the patient, a possibility of replacement of a reception sleeve and any of product elements without withdrawal of an artificial limb at the user. In need of service of a product, for example repair, replacement of the module (artificial foot, a knee) there is no requirement of urgent production of a similar design. Adjustable reception sleeves for primary artificial limbs of a shin and hip in the form of a standard series and moisture-curing bandage can add the list of products of medical appointment in laying for expansion of medical institutions during the special period.

Development of KABISA

2011 ◽  
pp. 518-526
Author(s):  
Jef Van den Ende ◽  
Stefano Laganà ◽  
Koenraad Blot ◽  
Zeno Bisoffi ◽  
Erwin Van den Enden ◽  
...  
Keyword(s):  
Operational Research ◽  
Final Diagnosis ◽  
Added Value ◽  
Sufficient Evidence ◽  
Individual Student ◽  
Tropical Regions ◽  
Computer Logic ◽  
Computer Based ◽  
Asking Questions ◽  
The Individual

KABISA is a computer-based program for training in diagnostic problems in (sub-) tropical regions. It challenges the individual student with a randomly generated case, for which he should try to find the diagnosis, asking questions, performing a physical examination, and ordering tests. The built-in tutor follows the student’s input with complex logical algorithms and mathematical computations, gives comments and support, and accepts the final diagnosis if sufficient evidence has been built up. Several problems arose with the development. In the first place, the evolution in the teaching of clinical logic is always ahead of the program, so regular updating of the computer logic is necessary. Secondly, the choice of MS Access as computer language has provoked problems of stability, especially the installation of an MSAccess runtime. Thirdly, and most importantly, scholars want proof of the added value of computer programs over classical teaching. Moreover, the concept of a pedagogical “game” is often regarded as childish. Finally, the planning and financing of an “open-ended” pedagogical project is questioned by deciders, as is the case with all operational research.

scholarly journals Kikuchi-Fujimoto Disease: A Report of 3 Cases

2007 ◽  
Vol 86 (7) ◽  
pp. 412-413 ◽  
Author(s):  
Eimear Phelan ◽  
Emer Lang ◽  
Peter Gormley ◽  
John Lang
Keyword(s):  
Weight Loss ◽  
Cervical Lymphadenopathy ◽  
Lymph Node Biopsy ◽  
Accurate Diagnosis ◽  
Histiocytic Necrotizing Lymphadenitis ◽  
Kikuchi’S Disease ◽  
Node Biopsy ◽  
Night Sweats ◽  
Necrotizing Lymphadenitis ◽  
Kikuchi's Disease

Cervical lymphadenopathy has many underlying etiologies. One of its rare causes is Kikuchi-Fujimoto disease (Kikuchi's disease, histiocytic necrotizing lymphadenitis). We discovered such a cause in a 37-year-old woman who had presented with malaise, night sweats, and weight loss in addition to cervical lymphadenopathy. We based our diagnosis on excisional lymph node biopsy. We also review 2 other cases of Kikuchi's disease that were diagnosed by others at our institution. Clinically and histologically, Kikuchi's disease is very similar to lymphoma, and distinguishing the two is difficult. However, despite the fact that Kikuchi's disease is benign, an accurate diagnosis is important because misdiagnosis might lead to unnecessary surgery and/or chemotherapy.

scholarly journals Persistent cervical lymphadenitis in a patient with prior thyroid cancer attributed to Kikuchi-Fujimoto disease

2018 ◽  
pp. bcr-2018-226457
Author(s):  
Roman Zuckerman ◽  
Louise Damiani ◽  
Hashem A Ayyad ◽  
Deborah R Alpert
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lupus Erythematosus ◽  
Cervical Lymphadenopathy ◽  
Needle Aspiration ◽  
Lymph Node Biopsy ◽  
Lymphoproliferative Disease ◽  
Low Grade ◽  
Cervical Lymphadenitis ◽  
Granulomatous Lymphadenitis

We describe a 50-year-old woman with a history of thyroid cancer who presented with bilateral cervical and submandibular lymphadenopathy, low-grade fevers, and increasing fatigue. The patient underwent lymph node fine-needle aspiration, which showed no evidence of metastatic or lymphoproliferative disease. This procedure was complicated by a parapharyngeal abscess and cellulitis. She was treated unsuccessfully with various courses of antibiotics, but briefly responded to short courses of steroids. As her cervical lymphadenopathy returned, she underwent an excisional lymph node biopsy, which demonstrated caseating granulomatous lymphadenitis. Extensive review of systems, physical examination, laboratory and imaging studies demonstrated no evidence of malignancy, infection or systemic lupus erythematosus . Our patient was clinically diagnosed with Kikuchi-Fujimoto disease and successfully treated with prednisone tapered over 3 months. She remains in clinical remission.

Chagas disease: comments on the 2018 PAHO Guidelines for diagnosis and management

2019 ◽  
Vol 26 (7) ◽  
Author(s):  
Francesca F Norman ◽  
Rogelio López-Vélez
Keyword(s):  
Chagas Disease ◽  
Chronic Infection ◽  
Treatment Strategies ◽  
Organ Damage ◽  
Response To Treatment ◽  
Serological Tests ◽  
Diagnosis And Management ◽  
Endemic Areas ◽  
Health Organization ◽  
The Individual

AbstractBackgroundChagas disease, or American trypanosomiasis, is a protozoan infectious disease endemic throughout most of the Americas, caused by the trypanosome, Trypanosoma cruzi, and mainly transmitted to humans by reduviid or kissing bugs. Some progress has been achieved in control of the disease mainly in endemic areas, but migration flows have acted as drivers for the emergence of the disease mainly in non-endemic areas of Europe and North America. Most imported cases of Chagas disease in Europe are reported in migrants from highly endemic areas of countries such as Bolivia and Paraguay, and reports of Chagas disease in travellers are extremely rare.MethodsPan American Health Organization (PAHO) recently updated their guidelines on the diagnosis and management of Chagas. These guidelines and their applicability to migrants and travellers are reviewed.ResultsPAHO recommends the use of two serological tests for diagnosis of chronic infection (allowing for the use of a single sensitive test followed by confirmation in special settings such as the screening of potential blood donors). The indication for specific trypanocidal treatment of acute infections, children and women of child-bearing age remains as before, with either benznidazole or nifurtimox being the treatment of choice. For chronic infection with/without organ damage, treatment recommendations are less well defined. Although treatment is generally not recommended in patients with visceral involvement, decisions regarding treatment need to be tailored to the individual. Either benznidazole or nifurtimox may be used for initial treatment.ConclusionsThe recent PAHO Guidelines provide a framework to aid the diagnosis and management of this infection, but several aspects such as the underdiagnosis of infections, the multidisciplinary approach to patient management, the investigation of novel biomarkers of disease progression/response to treatment and the development of new treatment strategies are areas which should be further strengthened.

scholarly journals Utility of Serology in DeterminingHelicobacter pyloriEradication after Therapy

1998 ◽  
Vol 12 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Carlo A Fallone ◽  
Vivian G Loo ◽  
Alan N Barkun
Keyword(s):  
Test Performance ◽  
Controlled Trial ◽  
Treatment Delay ◽  
Noninvasive Method ◽  
Serum Samples ◽  
Serological Tests ◽  
Duodenal Ulcers ◽  
Antibody Titres ◽  
H Pylori ◽  
To Receive

OBJECTIVE: To determine the usefulness of four serological tests in confirming cure ofH pyloriinfection before the previously reported six-month post-treatment delay.PATIENTS AND METHODS: As part of a prospective, blinded, controlled trial, in which patients with duodenal ulcers were randomized to receive different combinations of antibiotics, serum samples were obtained in 89 patients before treatment, as well as on several occasions after treatment. Antibody titres were determined by ELISA with Bio-Rad immunoglobulin (Ig) A, Bio-Rad IgG, Pyloriset EIA-A for IgA and Pyloriset EIA-G for IgG. Eradication was confirmed with antral biopsy three months after therapy.RESULTS: The percentage drop in titre following treatment was significantly larger for the group of patients who were treated successfully with all four kits. Optimal cut-offs for identifying successful therapy were determined, and accuracy improved as the interval between testing and therapy was prolonged. Six months after therapy, the IgG test from Bio-Rad achieved 100% sensitivity and 80% specificity, and that from Pyloriset achieved 88% sensitivity and 100% specificity. At three months, however, test performance was quite good, with 90% sensitivity and 80% specificity when using a Pyloriset IgA titre drop of 20% or greater to predict successful eradication.CONCLUSION: Serology is a simple, easily available, noninvasive method that exhibits good positive predictive value in the confirmation of successful cure ofH pyloriinfection three or six months after treatment.

scholarly journals Maxillary bone defects and their relationship to transverse maxillary discrepancies

2016 ◽  
Vol 6 ◽  
pp. 251-255
Author(s):  
Claludia A. Peña-Montero ◽  
Rafael Rivas-Gutierrez ◽  
Enrique Sierra-Rosales ◽  
Rogelio Diaz-Peña
Keyword(s):  
Orthodontic Treatment ◽  
Bone Defects ◽  
Chi Square ◽  
Axial Tomography ◽  
Old Patients ◽  
Maxillary Bone ◽  
Cat Scan ◽  
Computerized Axial Tomography ◽  
The Individual ◽  
The Relationship

Objectives The relationship between the presence of bone defects (fenestrations and dehiscences) observed in lateral slices in computerized axial tomography (CAT) images and maxillomandibular transverse discrepancies was determined. Methods The sample was composed of 160 CAT scan files, corresponding to 9–25-year-old patients, which had been taken prior to orthodontic treatment at a radiology center in Guadalajara, México, from 2009 to 2012. They were grouped by age, and we identified bone defects in maxillary teeth (first and second premolars and first molars). The maxillary (JL-JR) and mandibular (GA-AG) widths were measured, and the maxillomandibular discrepancy ([GA-AG]-[JL-JR]) was calculated. Chi-square and t-tests were performed. Results The values of maxillomandibular discrepancies increased with the age of the patient. There was no association between the magnitude of the maxillomandibular discrepancy and the presence of bone defects. The gender of the individual was not a decisive factor in whether bone defects were present. Conclusion Bone defects occur in the vast majority of patients pretreatment regardless of the magnitude of the maxillomandibular discrepancy.

scholarly journals Sero-prevalence of brucellosis, Q-fever and Rift Valley fever in humans and livestock in Somali Region, Ethiopia

2021 ◽  
Vol 15 (1) ◽  
pp. e0008100
Author(s):  
Mohammed Ibrahim ◽  
Esther Schelling ◽  
Jakob Zinsstag ◽  
Jan Hattendorf ◽  
Emawayish Andargie ◽  
...  
Keyword(s):  
Rift Valley ◽  
Rift Valley Fever ◽  
Q Fever ◽  
Animal Health ◽  
Zoonotic Diseases ◽  
Serological Tests ◽  
Cross Sectional ◽  
Valley Fever ◽  
Somali Region ◽  
The Individual

Information on zoonotic diseases in humans and livestock are limited in pastoral/agro-pastoral communities in Ethiopia. A multi-stage cross sectional cluster design study was implemented with the aim to establish the seroprevalence of zoonotic diseases including brucellosis, Q-fever and Rift Valley fever (RVF) in humans and livestock in Adadle Woreda of the Somali Region, Ethiopia. Blood samples were collected from humans and livestock and tested by relevant serological tests. For brucellosis, Rose Bengal test (RBT) and indirect ELISA was used for screening and confirmatory diagnosis respectively. Indirect and competitive ELISA were also used for Q-fever and RVF respectively. The individual seropositivity of Q-fever in livestock was 9.6% (95% CI 5.9–15.1) in cattle, 55.7% (95% CI 46.0–65.0) in camels, 48.8% (95% CI 42.5–55.0) in goats, and 28.9% (95% CI 25.0–33.2) in sheep. In humans, seropositivity of Q-fever was 27.0% (95% CI 20.4–34.0), with prevalence in males of 28.9% vs 24.2% in females (OR = 1.3; 95% CI 0.6–2.5). Camel seropositivity of Q-fever was significantly associated with age (OR = 8.1; 95% CI 2.8–23.7). The individual apparent seroprevalence of RVF was 13.2% (95% CI 8.7–18.8) in humans, 17.9% (95% CI 11.0–27.8) in cattle, 42.6% (95% CI 34.8–50.7) in camels, 6.3% (95% CI 3.3–11.6) in goats and 7.4% (95% CI 4.7–11.5) in sheep. Camels had the highest seropositivity of both Q-fever and RVF. Only a weak correlation was observed between human and livestock seropositivity for both Q-fever and RVF. Only cattle and camels were seropositive for brucellosis by iELISA. The individual seroprevalence of brucellosis was 2.8(0.9–6.4) in humans, 1.5% (95% CI 0.2–5.2) in cattle and 0.6% (95% CI 0.0–3.2) in camels. This study showed the importance of zoonoses in Somali Region and is the first published study to describe RVF exposure in humans and livestock in the country. Even though human exposure to RVF virus was reported, public health sector of Somali Region has not given attention to such zoonoses. Collaboration between public and animal health sectors for further investigation on these zoonoses using the One Health concept is indispensable.

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