scholarly journals Endogenous Fusarium Endophthalmitis in Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
S. Balamurugan ◽  
Ashish Khodifad
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Endogenous Endophthalmitis ◽  
Uncontrolled Diabetes ◽  
Common Causes ◽  
Masquerade Syndrome ◽  
The Common ◽  
Immunocompromised State ◽  
Poor Outcomes ◽  
High Index Of Suspicion

Endogenous endophthalmitis accounts for 2% to 8% of cases of endophthalmitis. Immunocompromised state and intravenous drug use are the 2 most common causes of endogenous endophthalmitis due to molds fungi. Aspergillus, Fusarium, and Scedosporium are the common organisms in mold endophthalmitis. We report a case of Fusarium endophthalmitis in a patient with uncontrolled diabetes. While diabetes mellitus is a well-known risk factor for endogenous endophthalmitis, we did not find any reported case of Fusarium endophthalmitis in a case of diabetes mellitus. The patient presented with granulomatous uveitis masquerading as noninfectious uveitis with a very good response to steroids. The characteristic clinical features were established late in the clinical course associated with poor outcome. This case highlights the significance of uncontrolled diabetes as a risk factor for Fusarium endophthalmitis and also the presentation of endophthalmitis as a masquerade syndrome. The clinician should have high index of suspicion as these cases have poor outcomes.

scholarly journals THREE YEARS PROSPECTIVE STUDY OF NECROTIZING ENTEROCOLITIS

2003 ◽  
Vol 42 (149) ◽  
pp. 312-4
Author(s):  
Neeraj Jain ◽  
V Mangal
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Intestinal Wall ◽  
Common Risk Factor ◽  
Newborn Period ◽  
Mortality And Morbidity ◽  
The Common ◽  
High Index Of Suspicion

Necrotizing Enterocolitis (NEC) is a major cause of mortality and morbidity in the newborn period. Toknow the incidence of NEC at our Neonatal Intensive Care Unit (NICU). Over a 3 year period (Prospectivestudy) ,510 cases were studied for NEC. Incidence was 5.3%, mortality due to NEC was 22%, Asphyxia,Prematurity and enteral feeding were the common risk factor. Abdominal distention, blood in stool and airin intestinal wall were the main clinical features. Prevention and high index of suspicion are important tolimit the morbidity and mortality.Key Words: Necrotizing enterocolitis, Low birth weight.

scholarly journals Postvaginal Delivery Caecal Volvulus and Perforation

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
M. M. Abdullah Agha
Keyword(s):  
Intestinal Obstruction ◽  
Vaginal Delivery ◽  
Adverse Outcomes ◽  
High Index ◽  
Initial Presentation ◽  
Common Causes ◽  
The Common ◽  
High Index Of Suspicion ◽  
Caecal Perforation ◽  
Uncommon Complication

Intestinal obstruction is an uncommon complication of pregnancy and pueperium. It has different etiologies and voluvlus is one of the common causes. High index of suspicion is needed to diagnose it as initial presentation is nonspecific and that is critical to avoid adverse outcomes. We presented here one of these cases that followed vaginal delivery and ended with caecal perforation and hemicolectomy.

scholarly journals Haemoptysis in a toddler: An uncommon presentation of unusual foreign body ingestion

2020 ◽  
pp. 102490792094405
Author(s):  
Sadesvaran Muniandy ◽  
Mohd Faiz Mohd Shukri ◽  
Nur Izzah Ghazali ◽  
Mohd Saiful Adli Ishak ◽  
Irfan Mohamad ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Body Ingestion ◽  
Case Presentation ◽  
Unusual Foreign Body ◽  
Uncommon Presentation ◽  
Common Causes ◽  
History Of ◽  
The Common ◽  
Tract Infections ◽  
High Index Of Suspicion

Introduction: Haemoptysis is uncommon in toddler. Lower respiratory tract infections and foreign body are among the common causes. Case Presentation: We are reporting a case of a child presented to emergency department with complaint of mild haemoptysis, whom was later found to have a piece of broken satay skewer at the tonsillar region. The foreign body was removed during the procedure without any complication. Discussion: Foreign body ingestion, particularly a piece of broken satay skewer, is difficult to suspect without a proper history and eyewitness. Therefore, parent’s supervision is important. Emergency residents should have a high index of suspicion of foreign body ingestion in a child with vague symptoms. Conclusion: Foreign body is among the commonest cause of haemoptysis in an afebrile toddler. Acute haemoptysis in otherwise healthy toddler should alert the emergency residents about foreign body ingestion. History of food intake should be more thorough even if trivial.

scholarly journals A 21-Year-Old Woman with Hepatomegaly

2015 ◽  
Vol 10 (3) ◽  
Author(s):  
Caroline R. Barry MD ◽  
Amr M. Zaki MD ◽  
Vicki Munro MD ◽  
Glenn Patriquin MD MSc ◽  
Weei-Yuarn Huang MD ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Liver Enzymes ◽  
Diabetes Mellitus Type 1 ◽  
Insulin Regimen ◽  
Uncontrolled Diabetes ◽  
Elevated Liver Enzymes ◽  
Common Causes

We report the case of a 21-year old woman with uncontrolled diabetes mellitus type 1 presenting with tender hepatomegaly and mildy elevated liver enzymes, with negative investigations for common causes. She was diagnosed by liver biopsy with glycogenic hepatopathy, an uncommon and likely under-recognized complication of poor glycemic control. The disease is typically reversible after weeks to months of appropriate insulin therapy and is unlikely to lead to permanent liver disease. Our patient was treated with a new insulin regimen and analgesics and discharged home. Unfortunately, on follow-up imaging in our patient 10 months later, her hepatomegaly persists. Her glycemic control remains unchanged and she has since been admitted to hospital twice for episodes of diabetic ketoacidosis.

scholarly journals Pasteurella multocidaBacteremia in an Immunocompromised Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Shweta Kukrety ◽  
Jai Parekh ◽  
Theresa Townley
Keyword(s):  
Diabetes Mellitus ◽  
Pasteurella Multocida ◽  
Immunocompromised Patient ◽  
Altered Mental Status ◽  
Blood Cultures ◽  
Uneventful Recovery ◽  
Source Of Infection ◽  
Uncontrolled Diabetes ◽  
History Of ◽  
High Index Of Suspicion

We present the case of a 61-year-old Caucasian gentleman who presented with a one-day history of fever, chills, and altered mental status. His symptoms were initially thought to be secondary to cellulitis. Blood cultures grewPasteurella multocida, a rare pathogen to cause bacteremia. Our patient was treated with ciprofloxacin for two weeks and made a complete and uneventful recovery. Our patient’s uncontrolled diabetes mellitus and chronic kidney disease put him at a higher risk for developing seriousP. multocidainfection. The patient’s dog licking the wounds on his legs was considered as the possible source of infection. AsP. multicodabacteremia is rare, but severe with a high mortality rate, it is imperative to have a high index of suspicion for this infection especially in the vulnerable immunocompromised population.

scholarly journals Diabetic Myonecrosis: A Diagnostic and Treatment Challenge in Longstanding Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Lima Lawrence ◽  
Oscar Tovar-Camargo ◽  
M. Cecilia Lansang ◽  
Vinni Makin
Keyword(s):  
Diabetes Mellitus ◽  
Rare Complication ◽  
Acute Onset ◽  
Muscular Pain ◽  
Uncontrolled Diabetes ◽  
Long Term Prognosis ◽  
The Right ◽  
High Index Of Suspicion ◽  
Microvascular And Macrovascular Complications

Objective. Diabetes mellitus is associated with microvascular and macrovascular complications; the most commonly recognized ones include diabetic nephropathy, retinopathy, and neuropathy. Less well-known complications are equally important, as timely recognition and treatment are essential to decrease short- and long-term morbidity. Methods. Herein, we describe a case of a 41-year-old female with longstanding, uncontrolled type 2 diabetes, who presented with classical findings of diabetic myonecrosis. Results. Our patient underwent extensive laboratory and imaging studies prior to diagnosis due to its rarity and similarity in presentation with other commonly noted musculoskeletal conditions. We emphasize the clinical presentation, laboratory and imaging findings, treatment regimen, and prognosis associated with diabetic myonecrosis. Conclusion. Diabetic myonecrosis is a rare complication of longstanding, poorly controlled diabetes mellitus. The diagnosis requires a high index of suspicion in the right clinical setting: acute onset nontraumatic muscular pain with associated findings on clinical exam, laboratory studies, and imaging. While the short-term prognosis is good, the recurrence rate remains high and long-term prognosis is poor given underlying uncontrolled diabetes and associated sequelae.

Value of the anion gap in clinical diagnosis and laboratory evaluation.

1983 ◽  
Vol 29 (2) ◽  
pp. 279-283 ◽  
Author(s):  
P H Lolekha ◽  
S Lolekha
Keyword(s):  
Diabetes Mellitus ◽  
Malignant Neoplasm ◽  
Anion Gap ◽  
Laboratory Evaluation ◽  
Laboratory Error ◽  
Common Causes ◽  
High Incidence ◽  
Severe Hemorrhage ◽  
The Common ◽  
The Mean

Abstract We report the incidence of normal (50.4%), increased (46.7%), and decreased (2.9%) anion gap among hospitalized patients in a retrospective study. The mean and range of increased anion gaps were 25 and 19-28 mmol/L. Values exceeding 30 mmol/L were uncommon and may indicate either acidosis or laboratory error. The most common causes of the increased anion gap among patients were chronic renal failure, congestive heart failure, malignant neoplasm, and diabetes mellitus. Increased anion gap in this study may be due to excess acids along with decreases in sodium, chloride, and carbon dioxide. The mean and range of decreased anion gap were 6 and 3-8 mmol/L. Anion-gap values less than 3 mmol/L were uncommon (one of 500 cases), and a high incidence of such values may indicate laboratory error. Nephrotic syndrome, liver cirrhosis, intestinal obstruction, and severe hemorrhage were the common disorders associated with decreased anion gap, which resulted from hypoalbuminemia and hyponatremia. Although most patients with decreased anion gap had hypoalbuminemia, hypoalbuminemic patients did not necessarily have decreased anion gap.

scholarly journals Increased mortality associated with uncontrolled diabetes mellitus in patients with Pulmonary Cryptococcosis — a single U.S. cohort study

2021 ◽  
Author(s):  
Solana Archuleta ◽  
Amal A. Gharamti ◽  
Stefan Sillau ◽  
Paula Castellanos ◽  
Sindhu Chadalawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Case Control ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Pulmonary Cryptococcosis ◽  
Cox Proportional Hazard ◽  
Uncontrolled Diabetes ◽  
One Year

AbstractBackgroundDiabetes mellitus is an established risk factor for bacterial infections, but its role in Cryptococcosis is unclear. The study aimed to determine whether uncontrolled diabetes (HbA1c >7%) was an independent risk factor for mortality in cryptococcosis.MethodsA retrospective case-control study partially matched by age and gender was performed in patients tested for Cryptococcus infection at the University of Colorado Hospital from 2000-2019. A multivariable logistic regression model was used to identify mortality predictors. Cox proportional hazard model was used for survival analysis.ResultsWe identified 96 cases of Cryptococcosis and 125 controls. Among cases, cryptococcal meningitis (49.0%) and pneumonia (36.5%) constituted most infections. Cases with pulmonary cryptococcosis had a higher mortality at 10 weeks (50% vs 7%, p=0.006) and one year (66.7% vs 13.8%, p=0.005). Unadjusted Cox proportional hazard model found an increased rate of death for uncontrolled diabetes at 10-weeks (hazard ratio 8.4, CI: 1.4-50.8, p=0.02), and 1-year (hazard ratio 7.0, CI: 1.7-28.4, p=0.007) among pulmonary cryptococcosis cases. Multivariable analysis showed a significantly increased odds of 10-weeks (OR=4.3, CI: 1.1-16.5, p=0.035) and one-year (OR=5.9, CI: 2.2-15.8, p=0.014) mortality for uncontrolled diabetes among pulmonary cryptococcosis cases. After adjustment for gender, age, and case/control, for every 1% increase in HbA1c levels, the odds of pulmonary cryptococcosis mortality at one-year increased by 11% (OR = 1.6, CI 95%: 1.1-2.3, p= 0.006).ConclusionUncontrolled diabetes is associated with worse outcomes in pulmonary cryptococcosis, including a 4-fold and 6-fold increased odds of death at 10-weeks and 1-year, respectively. Glucose control interventions should be explored to improve clinical outcomes in patients with pulmonary cryptococcosis.

scholarly journals Clinico-radiological Profile of Stroke in Western Nepal

2016 ◽  
Vol 4 (2) ◽  
pp. 60
Author(s):  
Sumnima Acharya ◽  
Awadesh Tiwari ◽  
Raju Prasad Shakya
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Cerebrovascular Accident ◽  
Common Site ◽  
Radiological Findings ◽  
Public Health Burden ◽  
Factors Associated ◽  
Brain Ct Scan ◽  
Common Risk Factors ◽  
The Common

Introduction: Stroke is a major public health burden worldwide and is responsible for a large proportion of disability. It ranks third in the causation of morbidity and mortality. This study was carried out to establish the pattern of various types of cerebrovascular accident (CVA) in western Nepal, to correlate the clinical data and radiological findings in cases of stroke, and to identify the common risk factors associated with stroke.   Methods: A total of 200 patients presented at the department of Radiodiagnosis from emergency or ward within six months of study period from 18th of September 2015 to 17th of March 2016 with clinical diagnosis of stroke. Brain CT scan was done within 14 days of onset.   Results: There were 200 patients with stroke (124 males and 76 females), aged 19 to 92 years in which infarction was more common than hemorrhage (57% Vs 41.5%) clinically. Hypertension was the commonest risk factor noted in 59% cases followed by Diabetes Mellitus in 39%. Middle cerebral artery (MCA) territory infarction was the most common site of infarction. Clinical and CT localization of hemorrhage and infarct was correct in 153 cases (75%) which was statistically significant.   Conclusion: Infarction is more common than hemorrhage as the type of stroke. Hypertension is the commonest risk factor followed by diabetes mellitus.  

scholarly journals Severe Rhabdomyolysis without Systemic Involvement: A Rare Case of Idiopathic Eosinophilic Polymyositis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ayesha Farooq ◽  
Vivek Choksi ◽  
Andrew Chu ◽  
Dhruti Mankodi ◽  
Sameer Shaharyar ◽  
...  
Keyword(s):  
High Dose ◽  
Peripheral Eosinophilia ◽  
Laboratory Findings ◽  
Case Presentation ◽  
Systemic Involvement ◽  
Systemic Corticosteroids ◽  
Muscle Tenderness ◽  
Common Causes ◽  
The Common ◽  
High Index Of Suspicion

Introduction. Eosinophilic polymyositis (EPM) is a rare cause of rhabdomyolysis characterized by eosinophilic infiltrates in the muscle. We describe the case of a young patient with eosinophilic polymyositis causing isolated severe rhabdomyolysis without systemic involvement.Case Presentation. A 22-year-old Haitian female with no past medical history presented with progressive generalized muscle aches without precipitating factors. Examination of the extremities revealed diffuse muscle tenderness. Laboratory findings demonstrated peripheral eosinophilia and high creatinine phosphokinase (CPK) and transaminase levels. Workup for the common causes of rhabdomyolysis were negative. Her CPK continued to rise to greater than 100,000 units/L so a muscle biopsy was performed which showed widespread eosinophilic infiltrate consistent with eosinophilic polymyositis. She was started on high dose systemic corticosteroids with improvement of her symptoms, eosinophilia, and CPK level.Discussion. This case illustrates a systematic workup of rhabdomyolysis in the presence of peripheral eosinophilia. Many differential diagnoses must be considered before establishing a diagnosis of idiopathic eosinophilic polymyositis. To our knowledge, our case of eosinophilic polymyositis is unique as it presented with severe rhabdomyolysis without another organ involvement. Clinicians should maintain a high index of suspicion for this physically debilitating disease to aid in prompt diagnosis.

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