scholarly journals Eosinophilic Granulomatosis Polyangiitis (EGPA) Masquerading as a Mycotic Aneurysm of the Abdominal Aorta: Case Report and Review of Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Pooja Kumari ◽  
Debendra Pattanaik ◽  
Claire Williamson
Keyword(s):  
Abdominal Aorta ◽  
Mycotic Aneurysm ◽  
Review Of Literature ◽  
C Reactive Protein ◽  
Surgical Biopsy ◽  
Axillofemoral Bypass ◽  
Case Presentation ◽  
Reactive Protein ◽  
Eosinophilic Granulomatosis ◽  
Infrarenal Abdominal Aorta

Introduction. Aortic involvement leading to aortitis in eosinophilic granulomatosis polyangiitis (EGPA) is infrequent, and only 2 cases have been reported so far in the literature. Even more so, aortic aneurysm, secondary to EGPA, has never been reported and remains a diagnostic and therapeutic challenge. Case Presentation. We present a 63-year-old Caucasian male patient with a prior diagnosis of EGPA presenting with abdominal pain, nausea, and loose stools to the emergency department. Physical examination showed periumbilical tenderness. He had no peripheral eosinophilia but had high C-reactive protein and procalcitonin levels. CT abdomen revealed a mycotic aneurysm involving the infrarenal abdominal aorta. The patient declined surgical repair initially and was treated with IV antibiotics only. Unfortunately, 24 hours later, the aneurysm ruptured, leading to emergent axillofemoral bypass surgery. Surgical biopsy showed aortitis, periaortitis, and active necrotizing vasculitis. Conclusion. Abdominal aneurysms should be considered a complication of EGPA, and earlier immunosuppressive therapy should be considered to prevent further complications.

scholarly journals Disseminated Nocardia infection with a lesion occupying the intracranial space complicated with coma: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mei-Hong Yu ◽  
Xiao-Xin Wu ◽  
Chun-Lei Chen ◽  
Song-Jia Tang ◽  
Jian-Di Jin ◽  
...  
Keyword(s):  
Case Report ◽  
Immunosuppressive Treatment ◽  
Lung Infection ◽  
C Reactive Protein ◽  
Altered Consciousness ◽  
Blood Cell Count ◽  
Case Presentation ◽  
Reactive Protein ◽  
Nocardia Cyriacigeorgica ◽  
The Right

Abstract Background Disseminated Nocardia infection is a disease that is easily overlooked in patients with lesions occupying the intracranial space complicated with coma. Early diagnosis and treatment are crucial. Case presentation A 65-year-old man was admitted to the First Affiliated Hospital of Zhejiang University in October 2018 with weakness in the right limbs for 3 days and altered consciousness for 1 day. Five months earlier, he had been diagnosed with membranous kidney disease and had received cyclophosphamide and prednisone. At admission, the white blood cell count was 1.37 × 1010/L (with 86.4% neutrophils), and C-reactive protein was 115.60 mg/L. Imaging examinations revealed a lesion occupying the intracranial space, lung infection, and multiple abscesses in the rhomboid muscle. The abscesses were drained. Pus culture confirmed Nocardia cyriacigeorgica infection. With antibiotics and vacuum-sealed drainage of the back wound, the patient improved and was discharged from the hospital. Conclusions This case report shows that infection should be considered during the differential diagnosis of lesions in the intracranial space, especially in patients receiving immunosuppressive treatment. In patients with disseminated N. cyriacigeorgica infection, combination antibiotic therapy and surgical drainage of localised abscesses can be effective.

INFLAMMATION MARKERS AND BLOODSTREAM INFECTION (REVIEW OF LITERATURE)

2019 ◽  
Vol 64 (7) ◽  
pp. 435-442 ◽  
Author(s):  
N. M. Kargaltseva ◽  
V. I. Kotcherovets ◽  
A. Yu. Mironov ◽  
O. Yu. Borisova ◽  
A. T. Burbello
Keyword(s):  
Bloodstream Infection ◽  
Acute Phase ◽  
Bacterial Infections ◽  
Review Of Literature ◽  
C Reactive Protein ◽  
Coagulase Negative Staphylococci ◽  
Reactive Protein ◽  
Gram Negative Bacteremia ◽  
Γ Globulins ◽  
Factor Α

In response to inflammation there appear « reactants of acute phase» which are nonspecific but they can show the disease gravity and prognosis. The markers of the acute phase are: C-reactive protein (CRP), procalcitonin (PCT), neopterin (NP), presepsin (PSP), necrosis tumor factor α (NTF-α), erythrocyte sedimentation rate (ESR), the total amount of leucocytes, neutrophils, protein fractions (α, β2, γ-globulins), IgM. CRP concentrations rise in the presence of bacterial infections and they are significanly higher in the positive blood cultures than in the contamination or negative ones. PCT levels grow in case of gram-negative bacteremia, but the levels are normal in case of coagulase-negative staphylococci bacteremia. PCT levels are more helpful here than CRP levels with suspected bacteremia. NP levels rise in patients with bacteremia. In the presence of infection, PSP becomes more active than CRP and PCT, and PSP sensitivity is 91,4% in patients with sepsis. Patients with infectious endocarditis have high levels of NTF-α in case of staphylococci infection in blood but the levels of NTF-α are low with enterococci and corynebacterium bloodstream infection. In case of inflammation the acute phase protein level changes are infection markers including bloodstream infection but they are not specific for determining any bacteremia aetiology.

scholarly journals Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Espen Benjaminsen ◽  
Anne Reigstad ◽  
Vanja Cengija ◽  
Vibke Lilleby ◽  
Maria Carlsson
Keyword(s):  
Carotid Artery ◽  
Takayasu Arteritis ◽  
Common Carotid Artery ◽  
Right Hemisphere ◽  
Latent Tuberculosis ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Case Presentation ◽  
Reactive Protein ◽  
The Right

Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear.Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein.Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

scholarly journals 387. A Rare Manifestation of a Common Disease: Tenosynovitis Associated with Clostridium difficile: Case Report and Review of Literature

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S200-S200
Author(s):  
Greta M Josephson ◽  
Saira R Ajmal
Keyword(s):  
Clostridium Difficile ◽  
Reactive Arthritis ◽  
Streptococcal Pharyngitis ◽  
Common Disease ◽  
Review Of Literature ◽  
C Reactive Protein ◽  
Unique Case ◽  
Reactive Protein ◽  
Rare Manifestation ◽  
Severe Colitis

Abstract Background Reactive arthritis typically develops following enteric or genitourinary infection. The most common offending pathogens are Chlamydia, Salmonella, Shigella, Yersinia and Campylobacter. We report a unique case of a patient with tenosynovitis attributed to Clostridium difficile (C. difficile), and review of the literature. Methods We searched PubMed for “reactive arthritis” and “C. difficile” and found 53 cases. Two additional cases were excluded as they were published in French. Results An 18-year-old healthy male presented with nine days of abdominal pain and diarrhea, and two days of pain and swelling of bilateral fingers with an erythematous/ecchymotic rash over the second and third digits. Four weeks prior to symptom onset he received antibiotics for streptococcal pharyngitis. On presentation he had diffuse abdominal tenderness and edema of the PIP/DIP joints with tenderness throughout the phalangeal soft tissue, consistent with tenosynovitis. He had a leukocyte count of 33.0 thou/ μL and C-reactive protein of 12.0 mg/dL (normal < 1.0 mg/dL). C. difficile toxin PCR was positive, toxin EIA was negative. CT scan of the abdomen/pelvis demonstrated mural thickening consistent with extensive severe colitis. He received 14 days of oral vancomycin, with complete symptom resolution, including the tenosynovitis. Our literature review revealed 22.6% (12/53) of cases had involvement of hands, although all also had involvement of other joints. Our patient’s isolated tenosynovitis of bilateral hands is unique, and has only been reported once prior to our knowledge. Literature suggests treatment of the underlying C. difficile infection should result in rapid clinical improvement of tenosynovitis symptoms, as in our patient. Conclusion C. difficile continues to pose a significant threat to health and burden on the healthcare system. The association of reactive arthritis and C. difficile was first reported in 1976, with only 53 subsequent cases reported. Reactive arthritis classically presents as asymmetrical oligo- or polyarthritis involving lower extremities or large joints. Our case demonstrates isolated tenosynovitis of the hands may also be a possible presentation. Given the continued rise of C. difficile, it is imperative that this pathogen is considered in such cases. Disclosures All authors: No reported disclosures.

scholarly journals Factors Influencing Culture Positivity in Pyogenic Vertebral Osteomyelitis Patients with Prior Antibiotic Exposure

2015 ◽  
Vol 59 (4) ◽  
pp. 2470-2473 ◽  
Author(s):  
Chung-Jong Kim ◽  
Seung-Ji Kang ◽  
Doran Yoon ◽  
Myung Jin Lee ◽  
Moonsuk Kim ◽  
...  
Keyword(s):  
Tissue Culture ◽  
Confidence Interval ◽  
Vertebral Osteomyelitis ◽  
C Reactive Protein ◽  
Surgical Biopsy ◽  
Reactive Protein ◽  
Factors Influencing ◽  
Culture Positivity ◽  
Open Surgical Biopsy ◽  
Pyogenic Vertebral Osteomyelitis

ABSTRACTWe conducted a retrospective cohort study to evaluate factors influencing tissue culture positivity in patients with pyogenic vertebral osteomyelitis exposed to antibiotics before diagnosis. Tissue culture was positive in 48.3% (28/58) of the patients, and the median antibiotic-free period was 1.5 days (range, 0.7 to 5.7 days). In a multivariate analysis, a higher C-reactive protein (CRP) level (adjusted odds ratio [aOR], 1.18; 95% confidence interval, 1.07 to 1.29) and open surgical biopsy (aOR, 6.33; 95% confidence interval, 1.12 to 35.86) were associated with tissue culture positivity.

scholarly journals A case of thyrotoxicosis-induced anemia in a patient with painless thyroiditis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ichiro Komiya ◽  
Takeaki Tomoyose ◽  
Noriharu Yagi ◽  
Gen Ouchi ◽  
Tamio Wakugami
Keyword(s):  
Reference Range ◽  
Disease Onset ◽  
C Reactive Protein ◽  
Free Triiodothyronine ◽  
Case Presentation ◽  
Reactive Protein ◽  
First Case ◽  
Silent Thyroiditis ◽  
Painless Thyroiditis ◽  
Mild Hypothyroidism

Abstract Background There have been several reports of secondary anemia associated with Graves’ disease. There are no reports of secondary anemia resulting from thyrotoxicosis due to painless thyroiditis (silent thyroiditis). We report the case of a patient with pancreatic diabetes who developed anemia caused by thyrotoxicosis due to painless thyroiditis. Case presentation The patient was a 37-year-old man who visited the hospital complaining of fatigue, palpitations, and dyspnea. His hemoglobin was 110 g/l (reference range, 135–176), and mean corpuscular volume was 81.5 fl (81.7–101.6). His free thyroxine (FT4) was high, at 100.4 pmol/l (11.6–21.9); the free triiodothyronine (FT3) was high, at 27.49 pmol/l (3.53–6.14); TSH was low, at < 0.01 mIU/l (0.50–5.00); and TSH receptor antibody was negative. Soluble IL-2 receptor (sIL-2R) was high, at 1340 U/ml (122–496); C-reactive protein (CRP) was high, at 6900 μg/l (< 3000); and reticulocytes was high, at 108 109 /l (30–100). Serum iron (Fe) was 9.5 (9.1–35.5), ferritin was 389 μg/l (13–401), haptoglobin was 0.66 g/l (0.19–1.70. Propranolol was prescribed and followed up. Anemia completely disappeared by 12 weeks after disease onset. Thyroid hormones and sIL-2R had normalized by 16 weeks after onset. He developed mild hypothyroidism and was treated with L-thyroxine at 24 weeks. Conclusions This is the first case report of transient secondary anemia associated with thyrotoxicosis due to painless thyroiditis. The change in sIL-2R was also observed during the clinical course of thyrotoxicosis and anemia, suggesting the immune processes in thyroid gland and bone marrow.

scholarly journals Periodontal disease and atherosclerosis

2014 ◽  
Vol 13 (3) ◽  
pp. 208-216
Author(s):  
Jeferson Freitas Toregeani ◽  
Carlos Augusto Nassar ◽  
Krischina Aparecida Mendes Toregeani ◽  
Patrícia Oehlmeyer Nassar
Keyword(s):  
Periodontal Disease ◽  
Inflammatory Markers ◽  
Arterial Wall ◽  
Wall Thickening ◽  
Review Of Literature ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
High Prevalence ◽  
Using Data ◽  
Global Population

Atherosclerotic disease (AD) is one of the most important causes of morbidity and mortality in the world. It expresses inflammatory markers such as C-reactive protein (CRP) and can provoke arterial wall thickening, which can be evaluated using Doppler ultrasound. Risk factors associated with AD include diabetes mellitus, systemic arterial hypertension, dyslipidemia and smoking. More recently, periodontal disease (PD) has been identified as a factor related to AD. Periodontal disease has a high prevalence in the global population and the inflammatory process and bacterial activity at the periodontium appear to increase the risk of AD. Encouraging good oral hygiene can reduce expression of inflammatory markers of AD. A review of literature on PD, AD and inflammatory markers and the interrelationships between the two diseases was conducted using data published in articles indexed on the PUBMED, SCIELO and BIREME databases.

scholarly journals MYCOTIC ANEURYSM OF THE JUXTARENAL INFRARENAL ABDOMINAL AORTA : A CASE REPORT

2014 ◽  
Vol 3 (73) ◽  
pp. 15457-15460
Author(s):  
Meenakumari Ayekpam ◽  
Tseizo Keretsu ◽  
Farooq Shafi ◽  
Roshan N
Keyword(s):  
Case Report ◽  
Abdominal Aorta ◽  
Mycotic Aneurysm ◽  
Infrarenal Abdominal Aorta
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