Fulminant hepatitis in a patient with secondary syphilis

2018 ◽  
Vol 29 (13) ◽  
pp. 1348-1350
Author(s):  
Ana Beatriz Affonso da Costa ◽  
Bruna Fornazari ◽  
Fernanda Perin Maia da Silva ◽  
Gibran A Frandoloso ◽  
Giovanni L Breda
Keyword(s):  
Acute Hepatitis ◽  
Fulminant Hepatitis ◽  
Unusual Case ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Clinical Suspicion ◽  
Diagnosis And Treatment ◽  
Atypical Presentation ◽  
High Clinical Suspicion

Despite the increasing incidence of syphilis and due to its wide variety of clinical manifestations, syphilis remains an under-diagnosed condition. We report an unusual case of secondary syphilis presenting with acute hepatitis and skin lesions, confirmed based on positive treponemal and non-treponemal assays. Despite adequate diagnosis and treatment, the patient developed fulminant hepatitis and brain death. This atypical presentation emphasizes the importance of high clinical suspicion in recognizing syphilis as an etiology for unexplained acute hepatitis, allowing early diagnosis and treatment and possibly avoiding severe complications such as fulminant hepatic failure.

Unusual Case of Sclerosing Angiomatoid Nodular Transformation of the Spleen in an Adolescent Patient: Case Report and Literature Review

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Abboud B ◽  
◽  
Honein K ◽  
Aidibi A ◽  
Yared F ◽  
...  
Keyword(s):  
Rare Case ◽  
Unusual Case ◽  
Benign Lesion ◽  
Relevant Literature ◽  
Clinical Suspicion ◽  
Radiographic Examination ◽  
Patient Case ◽  
Sclerosing Angiomatoid Nodular Transformation ◽  
High Clinical Suspicion ◽  
Red Pulp

Sclerosing Angiomatoid Nodular Transformation (SANT) is a rare and benign lesion arising from the red pulp of the spleen, with an unknown etiopathogenesis. These tumors are usually asymptomatic and are found incidentally on radiographic examination. Therefore, high clinical suspicion is of great importance for the diagnosis. Splenectomy provides complete cure, and no recurrence and/or malignant transformation was reported to date. In this study, a rare case of SANT was reported in aadolescent male, and was discussed with the relevant literature.

scholarly journals Staphylococcal scalded skin syndrome: A pediatric dermatology case report

2018 ◽  
Vol 6 ◽  
pp. 2050313X1775089 ◽  
Author(s):  
Girish Gulab Meshram ◽  
Neeraj Kaur ◽  
Kanwaljeet Singh Hura
Keyword(s):  
Complete Resolution ◽  
Skin Lesions ◽  
Clinical Suspicion ◽  
The Body ◽  
Intravenous Fluids ◽  
Effective Management ◽  
Pediatric Dermatology ◽  
Staphylococcal Scalded Skin Syndrome ◽  
High Clinical Suspicion ◽  
Hygiene Measures

Staphylococcal scalded skin syndrome is a condition which predominantly affects children and causes a spectrum of skin lesions. We present a case of a 2-month-old infant with complaints of fever and fragile blisters over the body. The mucosal areas were spared. The diagnosis of staphylococcal scalded skin syndrome was reached on clinical grounds and culture report. The patient responded well to the treatment, which included an antibiotic (cloxacillin), an analgesic (paracetamol), and hydration with intravenous fluids. He was discharged after 8 days, with almost complete resolution of his skin lesions. Having a high clinical suspicion for staphylococcal scalded skin syndrome, early diagnosis/treatment, and following robust hygiene measures are imperative for the effective management of staphylococcal scalded skin syndrome. More efforts are needed to develop novel therapies for staphylococcal scalded skin syndrome.

scholarly journals Essential syphilitic alopecia: Non-scarring alopecia in 21-year-old man

2021 ◽  
Vol 12 (e) ◽  
pp. 1-3
Author(s):  
Hafssa Chehab ◽  
Bertrand Richert
Keyword(s):  
Hair Loss ◽  
Previous History ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Laboratory Evaluation ◽  
History Of ◽  
High Level

ABSTRACT Alopecia syphilitica is a less common clinical manifestations of secondary syphilis. It is uncommon for hair loss to be the sole or predominant manifestation, as hair loss is the chief clinical and histologic differential diagnosis of. The main difference between alopecia areata and Alopecia syphilitica is the detection of Treponema pallidum in syphilis. We present the case of a 21- year-old belgium man with different patches of non-cicatricial alopecia of his scalp. The patient denied previous history of genital or other skin lesions. Laboratory evaluation was positive for syphilis. The diagnosis of alopecia syphilitica was made and he was treated with single intramuscular injections of benzathine penicillin. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.

scholarly journals Thoracic Endometriosis: a Clinical Review and Update of Current and Evolving Diagnostic and Therapeutic Techniques

2021 ◽  
Author(s):  
Ravi Kanth Velagapudi ◽  
John P. Egan
Keyword(s):  
Multidisciplinary Approach ◽  
Thoracoscopic Surgery ◽  
Clinical Manifestations ◽  
Clinical Suspicion ◽  
Diagnostic Workup ◽  
Medical Thoracoscopy ◽  
High Clinical Suspicion ◽  
Wide Range ◽  
Thoracic Endometriosis ◽  
Video Assisted Thoracoscopic Surgery

Abstract Purpose of Review The goal of this review is to provide a comprehensive understanding of the pathophysiology, clinical presentation, diagnostic workup, and clinical management of thoracic endometriosis (TE), as well as highlight our personal experience with TE workup and management. Recent Findings TE can present in a wide range of clinical manifestations. Without high clinical suspicion, diagnosis can be delayed. Since no specific laboratory testing is available, diagnosis is often based on careful history taking, imaging, and direct visualization of endometrial lesions through video-assisted thoracoscopic surgery (VATS). Medical thoracoscopy (MT) may also be a useful tool in the diagnostic workup of TE. Summary The diagnosis and management of TE require a multidisciplinary approach and a high index of clinical suspicion. While VATS remains the gold standard for diagnosis, we share our experience using MT to diagnose and manage a case of TE-related hemothorax.

Accuracy of MRI in Diagnosing Appendicitis during Pregnancy

2018 ◽  
Vol 84 (8) ◽  
pp. 1326-1328 ◽  
Author(s):  
Fabiola Aguilera ◽  
Brian F. Gilchrist ◽  
Daniel T. Farkas
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Delayed Diagnosis ◽  
Clinical Suspicion ◽  
Diagnosis And Treatment ◽  
Pathology Report ◽  
Mri Findings ◽  
Suspected Appendicitis ◽  
High Clinical Suspicion ◽  
Group 3

Appendectomy for presumed appendicitis is the most common surgical emergency during pregnancy. Delayed diagnosis and treatment of appendicitis carries risk for the fetus and mother. We sought to evaluate the accuracy of MRI in pregnant patients with suspected appendicitis. All pregnant patients with suspected appendicitis between January 2014 and April 2016 were included. MRI reports were categorized into positive, negative, and inconclusive groups. Diagnosis of appendicitis was based on pathology report. Fifty-two patients were included in the study. The MRI was positive in two, negative in 29, and inconclusive in 21 patients. Twelve patients had surgery, 11 of which had positive appendicitis on pathology. Both positive MRI patients had appendicitis. In the negative MRI group, 3 of 29 (10%) had appendicitis. In the inconclusive MRI group, 6 of 21 (29%) had appendicitis. A positive MRI result was very specific with a 100 per cent positive predictive value; however, the sensitivity was as low as 18 per cent (diagnosed only 2 of 11 cases). Although a positive MRI finding was reliable in making a decision to operate, a negative or inconclusive MRI was not. In patients with a high clinical suspicion of appendicitis, surgery should still be considered even without definitive positive MRI findings.

The Muddied Waters of Ibrutinib Therapy

2019 ◽  
Vol 141 (4) ◽  
pp. 209-213 ◽  
Author(s):  
Miri Schamroth Pravda ◽  
Nili Schamroth Pravda ◽  
Michael Lishner
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Small Molecule ◽  
Kinase Inhibitors ◽  
Opportunistic Infections ◽  
Cell Lymphoma ◽  
Clinical Suspicion ◽  
Atypical Presentation ◽  
High Clinical Suspicion ◽  
Mantle Cell

A 37-year-old male was admitted with an atypical presentation of central nervous system (CNS) aspergillosis while on ibrutinib therapy for a CNS relapse of mantle cell lymphoma. This case highlights the importance of a high clinical suspicion of opportunistic infections in patients receiving small-molecule kinase inhibitors. This report includes a review of reported cases of Aspergillus infections in patients receiving ibrutinib and the shared features of these cases.

scholarly journals Eosinophil rich infiltrate in secondary syphilis a rare histopathological variant

2021 ◽  
Vol 7 (4) ◽  
pp. 605
Author(s):  
Vidya D. Kharkar ◽  
Harish B. Rajendran
Keyword(s):  
Plasma Cells ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Transmitted Infection ◽  
Moderate Amount ◽  
Sexually Transmitted ◽  
Inflammatory Dermatoses ◽  
Perivascular Infiltrate

<p class="abstract">Secondary syphilis is a sexually transmitted infection, which is referred to as “the great imitator” and has a wide spectrum of clinical manifestations. Syphilis is classically associated with plasma cells and the presence of eosinophils usually argues against a diagnosis of syphilis. The differential diagnosis for eosinophil-rich skin lesions often includes a drug reaction, arthropod-bite reaction, allergic contact dermatitis, and a response to a helminth infestation. However, many unrelated entities, such as infections, neoplasms, and inflammatory dermatoses can have prominent eosinophilic infiltrate. We report a case of secondary syphilis which on histopathology showing psoriasiform hyperplasia with superficial perivascular infiltrate and on higher magnification these infiltrate were predominantly lymphohistiocytic along with the moderate amount of eosinophils with a paucity of plasma cells. This case report is presented to highlight the need for including secondary syphilis as one of the differential diagnoses in the presence of eosinophil-rich infiltrate when it is suspected clinically.</p>

scholarly journals A Rare Case of Septic Shock Secondary to Emphysematous Hepatitis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Khaled M. Nada ◽  
Ibrahim El Husseini ◽  
Mohammad E. Abu Hishmeh ◽  
Neerav S. Shah ◽  
Nadezhda Ibragimova ◽  
...  
Keyword(s):  
Rare Case ◽  
Relevant Literature ◽  
Clinical Manifestations ◽  
Mortality Rates ◽  
Clinical Suspicion ◽  
Rare Clinical Entity ◽  
Limited Data ◽  
Precipitating Factors ◽  
Emphysematous Pyelonephritis ◽  
High Clinical Suspicion

Objective. To describe a case of emphysematous hepatitis which is a rare clinical entity, characterized by a fatal, rapidly progressive infection of the liver with a radiological appearance simulating emphysematous pyelonephritis and to help provide more data about the causative organisms and precipitating factors of this pathology.Data Sources and Synthesis. Relevant literature was reviewed and, to the best of our knowledge, there is limited data regarding the pathogenesis, causative organisms, and management of this condition.Conclusion. Emphysematous hepatitis is a rapidly progressive infection that can be fatal in the absence of appropriate therapeutic intervention. Initial clinical manifestations are usually subtle and thus high clinical suspicion is required for early diagnosis and management of this condition to help decrease the mortality rates.

scholarly journals Neuroinfections: Presentation, Diagnosis, and Treatment of Meningitis and Encephalitis

EMJ Neurology ◽  
2020 ◽  
pp. 93-102
Author(s):  
Kaitlin M. Bowers ◽  
Vishnu V. Mudrakola
Keyword(s):  
Clinical Presentation ◽  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Clinical Suspicion ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
High Clinical Suspicion ◽  
Immunocompromised State ◽  
Neurological Infection

Neuroinfections cause significant morbidity, mortality, and long-term disability. These infections rarely present with the classic signs and symptoms taught in textbooks. Due to the similarities in presentation between neuroinfections and many other disease processes, delayed diagnosis is common. Thus, it is important that care providers have a high clinical suspicion for potential cases because early diagnosis and treatment can significantly improve outcomes. This article serves as a review of the approach to a patient with suspected neurological infection with an emphasis on clinical presentation, diagnosis, and treatment of the major causes of meningitis and encephalitis. Additionally, patients in an immunocompromised state are vulnerable to a whole host of additional neuroinfections that present atypically and will also be addressed.

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