scholarly journals A Rare Reason for Pelvic Pain in Pregnancy: Infectious Sacroiliitis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Yasemin Cekmez ◽  
Ahmet Göçmen ◽  
Oğuz Arslan ◽  
Fatih Şanlıkan ◽  
Simge Bağcı Türkmen

Introduction. Although the incidence of pregnancy-associated sacroiliitis is low, it is associated with significant morbidity and mortality. Timely diagnosis of the disease is confusing due to its nonspecific clinical features.Case. A 28-year-old woman at 34 weeks of gestation with severe pain in her right buttock radiating down the backside of the right thigh was admitted to our hospital. White blood cell (WBC) count and C-reactive protein (CRP) were elevated. The pelvic magnetic resonance imaging (MRI) scan revealed right sacroiliitis.Conclusion. Infectious sacroiliitis should be considered as a differential diagnosis even in low-risk women who present with debilitating pelvic pain in pregnancy and medical treatment should not be delayed.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fatemeh Sakhaee ◽  
Morteza Masoumi ◽  
Farzam Vaziri ◽  
Seyed Davar Siadat ◽  
Abolfazl Fateh

Abstract Background Mycobacterium jacuzzii (M. jacuzzii) was first isolated in 2003 by insertion of breast implants in Tel Aviv, Israel. In this case report, we describe our experience in detection of M. jacuzzii using phenotypic and genotypic test of wrist synovial sample. Case presentation A 73-year-old woman complained of pain and swelling in the right wrist for 4 months. Her body temperature was 37–38 °C, and symptoms, such as pain, swelling, and some movement limitation, were reported. Clinical laboratory parameters showed an elevated C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cells (WBC) count. The sequences of hsp65, rpoB, 16S rDNA, and sodA genes indicated very high homology to M. jacuzzii. Conclusion We report a case of synovial infection caused by M. jacuzzii in a patient with severe wrist pain in Iran, who was treated with amikacin, levofloxacin, and ethambutol. The outcomes of treatment after 8 months were positive, and no recurrence of infection was reported in the patient.


Author(s):  
Kotaro Matsumoto ◽  
Kentaro Kikuchi ◽  
Ayako Hara ◽  
Hiromichi Tsunashima ◽  
Koichi Tsuneyama ◽  
...  

AbstractA 25-year-old woman with fever and epigastric pain was referred to our hospital. Blood examination showed significant liver dysfunction, markedly high C-reactive protein (CRP 19.1 mg/dL) and procalcitonin (48.3 ng/mL) levels. Dynamic computed tomography showed a tumor approximately 120 mm in size in the right lobe of the liver, but with no abscess formation. The patient was hospitalized and started on antibiotics; her CRP level improved, but the procalcitonin level did not decrease. Histopathological examination of the liver tumor biopsy revealed fibrolamellar hepatocellular carcinoma (FLC). Positive staining of the FLC with an anti-procalcitonin antibody suggested the production of procalcitonin.


2020 ◽  
Vol 29 (1) ◽  
pp. 230949902096829
Author(s):  
Christina van Gerven ◽  
Kevin Eid ◽  
Tobias Krüger ◽  
Michael Fell ◽  
Daniel Kendoff ◽  
...  

Purpose: C-reactive protein (CRP) and white blood cell (WBC) count are routine blood chemistry parameters in monitoring infection. Little is known about the natural history of their serum levels in conservative and operative spondylodiscitis treatment. Methods: Pre- and postoperative serum levels of CRP and WBC count in 145 patients with spondylodiscitis were retrospectively assessed. One hundred and four patients were treated by debridement, spondylodesis, and an antibiotic regime, 41 only with a brace and antibiotics. The results of the surgical group were compared to 156 patients fused for degenerative disc disease (DDD). Results: Surgery had a significant effect on peak postoperative CRP levels. In surgically managed patients, CRP peaked at 2–3 days after surgery (spondylodiscitis: pre-OP: 90 mg/dl vs. post-OP days 2–3: 146 mg/dl; DDD: 9 mg/dl vs. 141 mg/dl; p < 0.001), followed by a sharp decline. Although values were higher for spondylodiscitis patients, dynamics of CRP values were similar in both groups. Nonoperative treatment showed a slower decline. Surgically managed spondylodiscitis showed a higher success rate in identifying bacteria. Specific antibiotic treatment led to a more predictable decline of CRP values. WBC did not show an interpretable profile. Conclusion: CRP is a predictable serum parameter in patients with spondylodiscitis. WBC count is unspecific. Initial CRP increase after surgery is of little value in monitoring infection. A preoperative CRP value, and control once during the first 3 days after surgery is sufficient. Closer monitoring should then be continued. Should a decline not be observed, therapy needs to be scrutinized, antibiotic treatment reassessed, and concomitant infection contemplated.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ademola Olusegun Talabi ◽  
Tewogbade Adeoye Adedeji ◽  
Oludayo Adedapo Sowande ◽  
Olusanya Adejuyigbe

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.


2017 ◽  
Vol 16 (2) ◽  
pp. 52-59
Author(s):  
Sotirios Kakavas ◽  
◽  
Aggeliki Papanikolaou ◽  
Evangelos Balis ◽  
Evgenios Metaxas ◽  
...  

Our aim was to prospectively assess the prognostic value of beta2- microglobulin (b2-M) in patients with acute pulmonary embolism (PE). We conducted a prospective study of 109 patients admitted in a pulmonary clinic due to acute PE. A panel of inflammatory markers including b2-M white blood cell (WBC) count and C-reactive protein (CRP) was determined for each patient. In this preliminary study, baseline b2-M levels significantly correlated with the impairment of oxygenation and with all the parameters that are used for the early risk stratification of patients. In multivariate analysis, patients’ age and baseline b2-M levels were significantly associated with an increased risk of death. These findings require further prospective validation.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Jae-Jung Kim ◽  
Sin Weon Yun ◽  
Jeong Jin Yu ◽  
Kyung Lim Yoon ◽  
Kyung-Yil Lee ◽  
...  

Kawasaki disease (KD) is an acute self-limiting form of vasculitis that afflicts infants and children and manifests as fever and signs of mucocutaneous inflammation. Children with KD show various laboratory inflammatory abnormalities, such as elevations in their white blood cell (WBC) count, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR). We here performed a genome-wide association study (GWAS) of 178 KD patients to identify the genetic loci that influence 10 important KD laboratory markers: WBC count, neutrophil count, platelet count, CRP, ESR, hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, and total protein. A total of 165 loci passed our arbitrary stage 1 threshold for replication ( p < 1 * 10 -5 ). Of these, only 2 SNPs (rs12068753 and rs4786091) demonstrated a significant association with the CRP level in replication study of 473 KD patients ( p < 0.05). The SNP located at the CRP locus (rs12068753) demonstrated the most significant association with CRP in KD patients (beta = 4.73 and p = 1.20 * 10 -6 according to the stage 1 GWAS; beta = 3.65 and p = 1.35 * 10 -8 according to the replication study; beta = 3.97 and p = 1.11 * 10 -13 according to combined analysis) and explained 8.1% of the phenotypic variation observed. However, this SNP did not demonstrate any significant association with CRP in the general population (beta = 0.37 and p = 0.1732) and only explained 0.1% of the phenotypic variation in this instance. Furthermore, rs12068753 did not affect the development of coronary artery lesions or intravenous immunoglobulin resistance in KD patients. These results indicate that common variants in the CRP promoter can play an important role in the CRP levels in KD.


2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Roslind Karolina Hackenberg ◽  
Arnd Von den Driesch ◽  
Dietmar Pierre König

We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.


PEDIATRICS ◽  
1969 ◽  
Vol 43 (4) ◽  
pp. 573-577
Author(s):  
Jer-Shoung Lin ◽  
Ramon Rodriguez-Torres

Clinical and laboratory data on five patients with appendectomy, later proved to have acute rheumatic fever, are presented in detail. The findings indicate that abdominal pain simulating acute appendicitis can be presented as the only initial symptom in acute rheumatic fever. Awareness and knowledge of the presence of clues-high fever, rapid sedimentation rate, prolonged P-R interval, and 4 plus C-reactive protein-usually help to make the differential diagnosis. However, if doubt remains, the right approach is to go ahead with surgery since these patients tolerate anesthesia and laparotomy very well.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.


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