Scrub typhus meningoencephalitis presenting as opsoclonus myoclonus syndrome: A video-based case

2021 ◽  
pp. 004947552110343
Author(s):  
Laxmikant Ramkumarsingh Tomar ◽  
Dhrumil Jatinbhai Shah ◽  
Utkarsh Agarwal ◽  
Atul Gogia ◽  
Anshu Rohatgi ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Scrub Typhus ◽  
Clinical Manifestations ◽  
Clinical Entity ◽  
Response To Treatment ◽  
Rare Clinical Entity ◽  
Initial Manifestation ◽  
Excellent Response ◽  
Opsoclonus Myoclonus Syndrome

Opsoclonus myoclonus syndrome secondary to scrub typhus infection is a rare clinical entity. Hence, it is important to know its clinical manifestations and complications, so that it can be properly managed. We report a 28-year-old female whose initial manifestation was only fever, which subsided in four days. Two days later, she developed opsoclonus myoclonus syndrome. This was managed with doxycycline and clonazepam, but as it persisted, intravenous immunoglobulin was added. She showed excellent response to treatment.

scholarly journals Role of Immunotherapy in Pulmonary Angiosarcoma: A Case Report

2021 ◽  
pp. 797-801
Author(s):  
Quang Tien Nguyen ◽  
Anh Tuan Pham ◽  
Thuy Thi Nguyen ◽  
Tam Thi Thanh Nguyen ◽  
Ky Van Le
Keyword(s):  
Case Report ◽  
Poor Prognosis ◽  
Checkpoint Inhibitor ◽  
Therapeutic Strategies ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Excellent Response ◽  
First Case

Pulmonary angiosarcoma is a rare clinical entity with a poor prognosis and no established therapeutic strategies. We present the first case to our knowledge of metastatic pulmonary angiosarcoma, treated with checkpoint inhibitor immunotherapy, and have an excellent response. Until now, patient has been treated with immunotherapy for 1 year, and his disease is stable and well-tolerated.

scholarly journals Primary Pancreatic lymphoma: a rare clinical entity

2020 ◽  
Vol 13 (1) ◽  
pp. e231292
Author(s):  
Louise Dunphy ◽  
Syed Hussain Abbas ◽  
Ihsan Al Shoek ◽  
Wassim Al-Salti
Keyword(s):  
Epigastric Pain ◽  
Clinical Manifestations ◽  
Biliary Tree ◽  
Epidemiological Studies ◽  
Clinical Entity ◽  
Primary Lymphoma ◽  
Rare Clinical Entity ◽  
T Cell Therapy ◽  
Pancreatic Lymphoma ◽  
Primary Pancreatic Lymphoma

Primary pancreatic lymphoma is a rare clinical entity representing <0.5% of pancreatic cancers and 1% of extranodal lymphomas. Due to the paucity of cases described in the literature, its clinicopathological features, differential diagnosis, optimal therapy and outcomes are not well defined. As the clinical manifestations are often non-specific, it can create a diagnostic pitfall for the unwary physician. Preoperative distinction of adenocarcinoma and primary pancreatic lymphoma is critical since the management and prognosis of these malignancies are mutually exclusive. Due to its rarity, epidemiological studies have been difficult to conduct. Chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin and vincristine) has proven to be effective. The authors present the case of a 52-year-old man with epigastric pain and obstructive jaundice. Further investigation with a CT of the abdomen and pelvis showed a low attenuation mass in the head of the pancreas measuring 35×25 mm, suspicious for malignancy. The mass involved the common bile duct distally causing moderate retrograde intrahepatic and extrahepatic biliary tree dilation of 14 mm. He underwent endoscopic retrograde cholangiopancreatography, sphincterotomy and insertion of a stent. Core biopsies confirmed the diagnosis of a high-grade B cell pancreas lymphoma. He started treatment with R-CHOP and prednisolone. Due to disease progression, he started treatment with DA-EPOCH-R (etoposide phosphate, prednisone, vincristine sulfate, cyclophosphamide, doxorubicin hydrochloride and rituximab). There was no clinical response, and treatment with RICE (rituximab, ifosfamide, carboplatin and etoposide) was initiated. He showed partial response and was under consideration for chimeric antigen receptor T cell therapy. He deteriorated clinically and succumbed to his disease 5 months following his initial presentation. This paper will provide an overview of the spectrum of haematological malignancies and describe useful features in distinguishing primary lymphoma of the pancreas from an adenocarcinoma, hence avoiding its surgical resection.

scholarly journals Kikuchi's Disease: A Rare Clinical Entity of Cervical Lymphadenopathy with Review of Literature

2016 ◽  
Vol 8 (3) ◽  
pp. 101-105
Author(s):  
Sudhir Naik ◽  
BL Yatish Kumar ◽  
S Ravishankara ◽  
T Shashikumar ◽  
R Navya ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Empirical Therapy ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Review Of Literature ◽  
Kikuchi’S Disease ◽  
Kikuchi's Disease

ABSTRACT Background and objectives Kikuchi disease is an uncommon, idiopathic, generally self-limited cause of lymphadenitis. The disease runs a self-limiting course usually resolving in 6 to 8 months of occurrence, with the usual clinical manifestations being cervical lymphadenopathy, with or without systemic manifestations. Materials and methods A retrospective study was done in three cases of Kikuchi disease reported over 2 years. All three females had cervical lymphadenopathy not responding to empirical treatment. All had excision of the lymph nodes with immunohistochemistry, which suggested the necrotizing lymphadenopathy. Other similar diagnoses, like systemic lupus erythematosus, non-Hodgkin's lymphoma, Kawasaki, tuberculous, metastatic lymphadenopathy, were excluded. Conclusion The rare possibility of cervical lymphadenopathy being Kikuchi's disease should be thought if empirical therapy fails. So, a meticulous effort by the pathologist and surgeon helps in diagnosing the self-limiting, little understood disease of Kikuchi in young patients with cervical lymphadenopathy and fever. How to cite this article Naik SM, Kumar BLY, Ravishankara S, Shashikumar T, Navya R, Sathya P. Kikuchi's Disease: A Rare Clinical Entity of Cervical Lymphadenopathy with Review of Literature. Int J Otorhinolaryngol Clin 2016;8(3):101-105.

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

scholarly journals Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199223
Author(s):  
Xiaolin Zhang ◽  
Hongmei Jiao ◽  
Xinmin Liu
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Respiratory Infections ◽  
Relevant Literature ◽  
Rare Condition ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Esophageal Diverticulum ◽  
Bronchoesophageal Fistula ◽  
Fatal Complications

Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses

2021 ◽  
pp. sextrans-2020-054887
Author(s):  
Silvia Achia Nieuwenburg ◽  
Ricardo Jamie Sprenger ◽  
Maarten Franciscus Schim van der Loeff ◽  
Henry John Christiaan de Vries
Keyword(s):  
Hiv Infection ◽  
Controlled Trial ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Disease Stage ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Serological Response ◽  
History Of ◽  
Hiv Negative

ObjectivesHIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored.MethodsThis retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3–6 months. We included data of participants with ≥1 syphilis diagnosis in 2014–2019. Pearson’s χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses.ResultsWe included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032).ConclusionsIn repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM.

scholarly journals Primary tubercular caecal perforation: a rare clinical entity

BMC Surgery ◽  
2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Devendra K Jain ◽  
Gaurav Aggarwal ◽  
Parvinder S Lubana ◽  
Sonia Moses ◽  
Nitin Joshi
Keyword(s):  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Caecal Perforation

scholarly journals Cartilaginous Choristoma of the Gingiva: A Rare Clinical Entity

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Ramalingam Suganya ◽  
Narasimhan Malathi ◽  
Subramani Vijaya Nirmala ◽  
Chinnaswami Ravindran ◽  
Harikrishnan Thamizhchelvan
Keyword(s):  
Connective Tissue ◽  
Histopathological Examination ◽  
Clinical Entity ◽  
Fibrous Connective Tissue ◽  
Rare Clinical Entity ◽  
Normal Cells ◽  
Connective Tissue Stroma

Choristomas are rare entities which are aggregates of microscopically normal cells or tissues in aberrant locations. They are a “heterotopic” rest of cells, as they appear as a tumor-like mass. Herein we report a case of cartilaginous choristoma in a 54-year-old male who presented with a swelling on right lower gingiva. The histopathological examination revealed features of a well circumscribed mass of mature cartilage in a dense fibrous connective tissue stroma.

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