scholarly journals Severe Thrombocytopenic Purpura in a Child with Brucellosis: Case Presentation and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Alexandros Makis ◽  
Aikaterini Perogiannaki ◽  
Nikolaos Chaliasos
Keyword(s):  
Antimicrobial Agents ◽  
Brucella Melitensis ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Hematological Disorders ◽  
Presenting Symptoms ◽  
Mediterranean Countries ◽  
Significant Public Health

Brucellosis is still endemic and a significant public health problem in many Mediterranean countries, including Greece. It is a multisystemic disease with a broad spectrum of clinical manifestations including hematological disorders, such as anemia, pancytopenia, leucopenia, and thrombocytopenia. Thrombocytopenia is usually moderate and attributed to bone marrow suppression or hypersplenism. Rarely, autoimmune stimulation can cause severe thrombocytopenia with clinically significant hemorrhagic manifestations. We present the case of a girl with severe thrombocytopenic purpura as one of the presenting symptoms of Brucella melitensis infection. Treatment with intravenous immunoglobulin and the appropriate antimicrobial agents promptly resolved the thrombocyte counts. A review of similar published cases is also presented.

Possible role of Unani Pharmacology in COVID-19 – a narrative review

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Md Anzar Alam ◽  
Mohd Abdul Gani ◽  
G. Shama ◽  
Ghulamuddin Sofi ◽  
Mohd Aleemuddin Quamri
Keyword(s):  
Clinical Manifestations ◽  
Public Health Problem ◽  
World Health ◽  
Santalum Album ◽  
Boswellia Serrata ◽  
Unani Medicine ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Novel Coronavirus ◽  
Health Organization

AbstractAccording to the World Health Organization (WHO), viral diseases continue to rise, and pose a significant public health problem. Novel coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2. The pathogenesis and clinical manifestations of COVID-19 is close to Amraz-e-Wabai (epidemic diseases) which was described by Hippocrates, Galen, Aristotle, Razes, Haly Abbas, Avicenna, Jurjani etc. Presently, there is no specific or challenging treatment available for COVID-19. Renowned Unani Scholars recommended during epidemic situation to stay at home, and fumigate the shelters with aromatics herbs like Ood kham (Aquilaria agallocha Roxb.), Kundur (Boswellia serrata Roxb), Kafoor (Cinnamomum camphora L.), Sandal (Santalum album L), Hing (Ferula foetida L.) etc. Use of specific Unani formulations are claimed effective for the management of such epidemic or pandemic situation like antidotes (Tiryaqe Wabai, Tiryaqe Arba, Tiryaqe Azam, Gile Armani), Herbal Decoction (Joshandah), along with Sharbate Khaksi, Habbe Bukhar, Sharbate Zanjabeel, Khamira Marwareed, Jawarish Jalinus, and Sirka (vinegar). Such drugs are claimed for use as antioxidant, immunomodulatory, cardiotonic, and general tonic actions. The study enumerates the literature regarding management of epidemics in Unani medicine and attempts to look the same in the perspective of COVID-19 prevention and management.

scholarly journals Case Report: Case report: Systemic lupus erythematous associated with thrombotic thrombocytopenic purpura, a diagnostic challenge

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 552
Author(s):  
Horacio Suárez-Ale ◽  
Elizabeth Fabian-Aquino ◽  
Virgilio E Failoc-Rojas ◽  
Vicente A Benites-Zapata ◽  
Felipe Ignacio-Cconchoy
Keyword(s):  
Case Report ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Clinical Manifestations ◽  
Health Condition ◽  
Therapeutic Interventions ◽  
Severe Thrombocytopenia ◽  
Systemic Lupus Erythematous ◽  
Systemic Lupus ◽  
Diagnostic Challenge ◽  
Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura (TTP) is an uncommon microangiopathic disease and often occurs as a complication of systemic lupus erythematous (SLE). However, this probable causal relationship has not been completely proven. The diagnostic differentiation of both diseases is difficult in the first instance because they share similar characteristics that may overlap. We present a case of a 32-year-old woman with antecedents of epilepsy since she was 12 years old. The patient was admitted to the emergency room with a clinical picture of headaches, fever, paleness in the skin and mucosa, confused state, paresthesia, and transient spasticity of the extremities. The laboratory results revealed Coombs negative direct autoimmune hemolytic anaemia, severe thrombocytopenia, significant elevation of the enzyme lactate dehydrogenase, and presence of schistocytes ++ in the peripheral film.  In addition, positive antinuclear antibodies and positive anti-native DNA in titers of 1/320 and 1/160, respectively, were found. Renal function was conserved. We concluded that it was a case of TTP associated with SLE and indicated treatment with plasmapheresis and methylprednisolone pulses, obtaining a satisfactory response (normalization of biomarker levels, health condition) after the second session of plasmapheresis. Diagnosis of both SLE and TTP is often difficult to achieve; however, adequate correlation of clinical manifestations and laboratory tests, along with the help of partial therapeutic interventions, may lead to good clinical response.

scholarly journals Evaluation of in vitro Activities of Tigecycline and Various Antibiotics against Brucella spp.

2010 ◽  
Vol 59 (1) ◽  
pp. 55-60 ◽  
Author(s):  
BETIL OZHAK-BAYSAN ◽  
GOZDE ONGUT ◽  
DILARA OGUNC ◽  
FILIZ GUNSEREN ◽  
NEVGUN SEPIN-OZEN ◽  
...  
Keyword(s):  
Blood Culture ◽  
Brucella Melitensis ◽  
Synergistic Effects ◽  
Public Health Problem ◽  
Worldwide Distribution ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Culture Isolate ◽  
Synergy Test

Brucellosis is a zoonosis with a worldwide distribution and remains a significant public health problem mainly in the developing world. In this study we evaluated the in vitro activities and synergistic effects of antibiotic combinations against blood culture isolates of Brucella spp. In vitro susceptibilities of 76 blood culture isolates of Brucella melitensis and one blood culture isolate of Brucella abortus to doxycycline, streptomycin, gentamicin, trimethoprim-sulfamethoxazole, moxifloxacin, rifampin, ciprofloxacin, and tigecycline were examined by Etest method. For 37 patients with Brucella spp. isolates (36 B. melitensis, 1 B. abortus), antibiotic combinations used for treatment were identified with those tested in vitro for synergy using Etest method. Trimethoprim-sulfamethoxazole and tigecycline were the most active of the compounds tested with MIC90 value of 0.094 mg/l. Among antibiotic combinations only streptomycin-rifampin combination was synergistic for one Brucella spp. isolate. The other antibiotic combinations revealed antagonistic or indifferent activity. Complete clinical response was achieved in all patients. Further studies are required to determine the correlation between the antimicrobial susceptibility and synergy test results with the clinical course of patients. Brucellosis can be adequately treated with existing regimens in our region.

scholarly journals Incidental Laboratory Identification of Brucella melitensis in a case with Pancytopenia

2021 ◽  
Vol 10 (10) ◽  
pp. 193-198
Author(s):  
Mahalakshmi Kumaresan Lakshmi Shanmugam ◽  
Ketan Priyadarshi Mahathi Gopalakrishnan ◽  
Tamilarasu Kadhiravan Apurba Sankar Sastry
Keyword(s):  
Bone Marrow ◽  
Brucella Melitensis ◽  
Public Health Problem ◽  
Febrile Illness ◽  
Human Brucellosis ◽  
Automated Identification ◽  
Serological Tests ◽  
Test Culture ◽  
Significant Public Health Problem ◽  
Significant Public Health

Brucellosis is a bacterial zoonosis usually associated with exposure to infected animals or their products. Although a significant public health problem in India, exact prevalence and distribution are unknown owing to the imprecision of diagnosis and inadequacy of reporting and surveillance. Although the febrile illness is common, its manifestations are highly variable. Bone marrow suppression and consequent pancytopenia have been rarely reported. We present a case of 50 years old female diagnosed with human brucellosis associated with pancytopenia and non-specific clinical presentation, that was diagnosed incidentally on blood and bone-marrow culture. This was confirmed by serological tests like the standard agglutination test. Culture isolation using automated blood culture (e.g. BacT/ALERT), followed by identification using automated identification systems (e.g. MALDI-TOF and VITEK-2) help to reach accurate and timely diagnosis aiding in the management of the patient.

scholarly journals Prevalence of Hematological Disorders among Children with Brucellosis

2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Saber A. M. El-Sayed ◽  
Yasser F. Ali ◽  
Mostafa M. Ahmady ◽  
Salah F. Alsayed ◽  
Ahmed M. Baraka
Keyword(s):  
Blood Culture ◽  
Positive Family History ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
Positive Serology ◽  
Excessive Sweating ◽  
Hematological Disorders ◽  
Presenting Symptoms ◽  
History Of

Background: Brucellosis is a zoonotic systemic infection due to infection by Brucella organisms with a various clinical manifestations and complications. Hematological disorders is the most common and serious complications among children. Objectives: Our study aimed to evaluate frequency of hematological complications among brucellosis infected children. Patients and Methods: All 75 patients enrolled in the study with fever more than 5 days, arthralgia , myalgia, low back pain , hematological disorders and positive serology test ( positive results when the tires > 1:80 ) were referred to the infectious diseases unit in King Khalid hospital ,Al-kharj city ,K.S.A. during  April 2013 to August 2015, and  C.B.C., blood culture and bone marrow study were made for all patients .Results:  out of 75children with brucellosis with age 5-18 y, 63 (84%) gave a history of raw animal milk ingestion and 33 patients 44% had a positive family history of brucellosis. The commonly presenting symptoms and signs included; excessive sweating 43 patients (57.3%) bone aches 65 patients (62%) chills 40 patients (53.3%), arthritis 27 patients (36%). Hepatomegaly 10 patients (13.3%) and splenomegaly     11 patients (14.6%). The most commonly detected hematological manifestations included; anemia in 34 patients (45%). leukopenia in 30 patients (40%) and leukocytosis in 18 patients (24%). Meanwhile, pancytopenia was detected in 24 patients (32%). Positive blood culture for brucella was seen in 30 patients (40%). B. melitensis from 26 patients (34.6%) was cultured in vitro. Out of 15 BM aspiration cultures, 5 were positive for B. melitensis while 10 cultures were negative. Out of 24 patients (32%) with pancytopenia, 17 patients 71% presented with bone aches and weakness, 12  patients 50% presented with sweating and chills,12  patients 50%  had petechiae and purpura , 12 patients50% had splenomegaly and also 9 patients 37.5% had hepatomegaly.Conclusions: Our study showed that the clinical manifestations and hematological disorders in children with brucellosis are 45% of patients were anemic, 40% were leukopenia, pancytopenia were in 32% while leukocytosis were in 24% similar to that in the adults; specially in endemic areas like K.S.A. 

scholarly journals Oral Manifestations of Immune Thrombocytopenic Purpura

2021 ◽  
Vol 8 ◽  
Author(s):  
Marwa Bousserouit ◽  
Fouzia HAKKOU ◽  
Saliha CHBICHEB
Keyword(s):  
Case Report ◽  
Immune Thrombocytopenic Purpura ◽  
Oral Surgery ◽  
Clinical Manifestations ◽  
Treatment Center ◽  
Severe Thrombocytopenia ◽  
Oral Manifestations ◽  
Thrombocytopenic Purpura ◽  
Oral Corticosteroids ◽  
Surgery Department

Introduction: Hemorrhagic lesions of the oral mucosa are the most common clinical manifestations of Immune thrombocytopenic purpura (ITP). Case Report: A 41-year-old female patient consulted the oral surgery department of the dental consultation and treatment center in Rabat for spontaneous gingivorrhagia. Clinical examination and further examination showed severe thrombocytopenia associated with an anemic syndrome. The diagnosis of ITP was made. Treatment was based on oral corticosteroids and immunoglobulin in the hospital. Conclusion: These manifestations sometimes lead the patient to consult his dental surgeon in the first intention, hence the need to make the diagnosis based on a thorough global examination and to refer the patient to an adapted structure.

scholarly journals Musculoskeletal Brucellosis in Adults in the United Arab Emirates: A Retrospective Study

2021 ◽  
Author(s):  
Shamma Al Nokhatha ◽  
Fatima AlKindi ◽  
Shaima Al Yassi ◽  
Rayhan Hashmey
Keyword(s):  
United Arab Emirates ◽  
Early Recognition ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Raw Milk ◽  
Joint Involvement ◽  
Radiographic Findings ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
Brucella Infection

Introduction: Brucellosis is a zoonotic infection caused by the aerobic Gram-negative bacteria coccobacilli, and is considered a public health problem in the Mediterranean region and Arabian Peninsula. This paper studied the clinical characteristics of musculoskeletal brucellosis and the outcomes of treatment in Al Ain City, United Arab Emirates. Method: A retrospective chart review study was conducted at Tawam Hospital over seven years: January 2009–January 2016. Risk factors for brucellosis, musculoskeletal (MSK) manifestations, duration of Brucella infection (acute, subacute, chronic), and treatment were studied. Results: A total of 99 patients were diagnosed with brucellosis during the study period; the mean age was 44 years, the majority were males (71%), and the male to female ratio was 3:1. The most common risk factor for Brucella infection in the cohort was drinking raw milk (43.4%). Fever was the most common presenting symptoms (93%), followed by arthralgia, fatigue, and loss of appetite in 35, 21, and 14%, respectively. The clinical manifestations of brucellosis in the cohort were MSK involvement (30%), hepatitis (17%), epididymo-orchitis (2%), and endocarditis (1%). Thirty percent of patients (n=30) had MSK-specific symptoms and only one-third (n=10) had confirmatory positive radiographic findings. The majority of patients had lumbar and sacroiliac joint involvement. Most of the patients received antibiotics for a 4–8-week duration and the overall relapse rate of Brucella infection was 10%. Conclusion: This study demonstrates that MSK involvement is a common manifestation in brucellosis, occurring in one-third of the cases. The index of suspicion should be high in brucellosis-endemic countries for early recognition and treatment.

Biological Evaluation of Selected 1,2,3-triazole Derivatives as Antibacterial and Antibiofilm Agents

2020 ◽  
Vol 20 (24) ◽  
pp. 2186-2191
Author(s):  
Lialyz Soares Pereira André ◽  
Renata Freire Alves Pereira ◽  
Felipe Ramos Pinheiro ◽  
Aislan Cristina Rheder Fagundes Pascoal ◽  
Vitor Francisco Ferreira ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Staphylococcus Aureus ◽  
Biofilm Formation ◽  
Antimicrobial Agents ◽  
Public Health Problem ◽  
Biological Evaluation ◽  
Major Public Health Problem ◽  
Community Environments ◽  
Scanning Electron

Background: Resistance to antimicrobial agents is a major public health problem, being Staphylococcus aureus prevalent in infections in hospital and community environments and, admittedly, related to biofilm formation in biotic and abiotic surfaces. Biofilms form a complex and structured community of microorganisms surrounded by an extracellular matrix adhering to each other and to a surface that gives them even more protection from and resistance against the action of antimicrobial agents, as well as against host defenses. Methods: Aiming to control and solve these problems, our study sought to evaluate the action of 1,2,3- triazoles against a Staphylococcus aureus isolate in planktonic and in the biofilm form, evaluating the activity of this triazole through Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) tests. We have also performed cytotoxic evaluation and Scanning Electron Microscopy (SEM) of the biofilms under the treatment of the compound. The 1,2,3-triazole DAN 49 showed bacteriostatic and bactericidal activity (MIC and MBC 128 μg/mL). In addition, its presence interfered with the biofilm formation stage (1/2 MIC, p <0.000001) and demonstrated an effect on young preformed biofilm (2 MICs, p <0.05). Results: Scanning Electron Microscopy images showed a reduction in the cell population and the appearance of deformations on the surface of some bacteria in the biofilm under treatment with the compound. Conclusion: Therefore, it was possible to conclude the promising anti-biofilm potential of 1,2,3-triazole, demonstrating the importance of the synthesis of new compounds with biological activity.

Multiple Myeloma or Brucellosis: A Case Report

2020 ◽  
Vol 20 (1) ◽  
pp. 102-105 ◽  
Author(s):  
Hossein A. Rahdar ◽  
Mansoor Kodori ◽  
Mohamad R. Salehi ◽  
Mahsa Doomanlou ◽  
Morteza Karami-Zarandi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Brucella Melitensis ◽  
Severe Disease ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Bone Marrow Aspiration ◽  
Major Health Problem ◽  
Brucella Infection ◽  
Wide Range ◽  
Parental Treatment

Background: Brucellosis, a major health problem in developing countries, is a multisystem infection with a broad spectrum of clinical manifestations. Hematological complications, ranging from an intravascular coagulopathy to mild homeostasis disorders (such as gammopathy), have been reported in brucella infection. These signs and symptoms may lead to misdiagnosis of brucellosis with other hematological diseases. Case: A 65-year-old male whose occupation was shepherding was referred to our hospital as a known case of multiple myeloma with continuous fever, muscle weakness, and night sweating after taking 2 courses of chemotherapy. The laboratory diagnosis of multiple myeloma had been based on the observation of a high percent of plasma cells in the bone marrow aspiration. At follow- up, the result of patient's fever workup, with 2 sets of blood cultures, was positive for Brucella melitensis. Isolated brucella was confirmed as B. melitensis by 16S rRNA sequencing. Brucellosis serologic test was performed by agglutination test and positive results were obtained. The patient was discharged with the cessation of fever and general improvement after the end of the parental treatment phase of brucella bacteremia. Conclusions: Brucella infection may cause a severe disease, mimicking a primary hematological disease, which could complicate the correct diagnosis. In brucellosis cases, due to the wide range of symptoms, in addition to cultivation and serological methods, molecular methods should also be used to prevent inappropriate diagnosis and additional costs.

scholarly journals A Fatal and Rare Case of Hydatid Cyst in the Pouch of Douglas

2021 ◽  
Author(s):  
Ritu Asnani ◽  
Sunil Kumar Yeshvanth ◽  
Lancelot Lobo ◽  
Shipra Sonkusare
Keyword(s):  
Hydatid Cyst ◽  
Rare Case ◽  
Frozen Section ◽  
Public Health Problem ◽  
Zoonotic Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Pouch Of Douglas

Abstract Hydatid cyst is a zoonotic infection and a significant public health problem in low- and middle-income countries. A 79-year-old female patient was presented to the gynecology outpatient department with complaints of pain in the abdomen and difficulty in micturition, with a mass palpable per speculum. The ultrasound was suggestive of an ovarian cystadenocarcinoma, whereas computed tomography of the abdomen favored hydatid cyst with adnexal neoplasm as a differential diagnosis. Considering the contradictory findings, a frozen section was sent to confirm the diagnosis, which showed hooklets of Echinococcus granulosus/hydatid cyst under the microscope. This was a rare case of pelvic hydatid cyst mimicking ovarian malignancy and was associated with a less-preferred mode of investigation (frozen section). This article focuses on how a frozen section, despite its limitations and being expensive, can still be considered for accurate patient management.

Sign in / Sign up

Export Citation Format

Share Document