Isolated Hip Infection by Paracoccidioides Brasiliensis: A Case Report

2003 ◽  
Vol 13 (3) ◽  
pp. 193-195 ◽  
Author(s):  
C.H.F. Picado ◽  
F.L. Garcia ◽  
C.H. Barbieri
Keyword(s):  
Case Report ◽  
Fungal Infection ◽  
Paracoccidioides Brasiliensis ◽  
Clinical Manifestations ◽  
Diagnostic Challenge ◽  
Hip Infection ◽  
Endemic Areas ◽  
Unusual Situation

Paracoccidioidomycosis is a fungal infection that presents a diagnostic challenge even in endemic areas, due mainly to the multiplicity of clinical manifestations and organs involved. We describe a case of the disease that only affected the hip, a very unusual situation.

scholarly journals Primary Histoplasmosis of Vocal Cord in an Immunocompetent Elderly Man- A case Report with Literature Review

1970 ◽  
Vol 13 (1) ◽  
pp. 77-81
Author(s):  
Shah Khaled Habib ◽  
Shamsul Arefin Patwary ◽  
Mohammad Ahik Imran Khan ◽  
Md Titu Miah ◽  
Ratan Das Gupta ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Fungal Infection ◽  
Vocal Cord ◽  
Unusual Case ◽  
Chronic Infections ◽  
Diagnostic Challenge ◽  
Endemic Areas

Histoplasmosis is a fungal infection primarily acquired through inhalation, and is rarely encountered outside endemic areas. In non-endemic areas, histoplasmosis poses a diagnostic challenge, especially since the presenting lesions can mimic carcinoma and other chronic infections including tuberculosis. We report an unusual case of isolated vocal cord histoplasmosis in a 60 year old immunocompetent man from Bangladesh presenting with hoarseness of voice. DOI: http://dx.doi.org/10.3329/jom.v13i1.10080 JOM 2012; 13(1): 77-81

scholarly journals Excellent Functionality Despite Clinico-Radiological Deformity in Osteomyelitis Variolosa - A Case Report

2015 ◽  
Vol 9 (1) ◽  
pp. 114-119
Author(s):  
Aakash Mugalur ◽  
Sunil M Shahane ◽  
Ashwin Samant ◽  
Aditya C Pathak ◽  
Rajeev Reddy
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Cortical Thickening ◽  
Diagnostic Challenge ◽  
Left Hand ◽  
Articular Surfaces ◽  
The World ◽  
Radiological Abnormality ◽  
Endemic Areas ◽  
The Right

Despite the eradication of smallpox from the world in 1980 the osteo-articular sequelae of smallpox are still occasionally noticed in previously endemic areas. The sequelae of osteomyelitis variolosa may raise a diagnostic challenge to the untrained eyes of the surgeon. We present a case of “osteomyelitis variolosa” in a 70 years old patient. The patient had bilateral dislocation of the elbow joint with multidirectional instability. There was distortion of the articular surfaces and ankylosis of the bilateral proximal radio-ulnar joint. Hypoplasia of the right ulna with short fourth and fifth metacarpals of the left hand and hypoplasia of right fourth metacarpal with cortical thickening was noted radiologically. The patient had minimal disability of his elbows despite the striking radiological abnormality and was functionally independent.

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 Prolonged Fever and Exaggerated Hypercoagulopathy in Malaria Vivax Relapse and COVID-19 Co-infection: A Case Report

2021 ◽  
Author(s):  
Tri Pudy Asmarawati ◽  
Okla Sekar Martani ◽  
Bramantono Bramantono ◽  
Muhammad Vitanata Arifianto
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Malaria Infection ◽  
Treatment Guidelines ◽  
Clinical Manifestations ◽  
Malaria Prevalence ◽  
Nasopharyngeal Swab ◽  
Delayed Treatment ◽  
History Of ◽  
Endemic Areas

Abstract BackgroundCoronavirus disease 2019 (COVID-19) often causes atypical clinical manifestations similar to other infectious diseases. In malaria-endemic areas, the pandemic situation will very likely result in co-infection of COVID-19 and Malaria, although reports to date are still few. Meanwhile, in areas with low malaria prevalence, this disease will be challenging to diagnose because the symptoms closely resemble COVID-19.Case presentationA 23-year-old male patient presented to hospital with fever, anosmia, headache, and nausea since one week before. He was diagnosed with COVID-19 and treated for approximately ten days then discharged to continue self-quarantine at home. Two weeks later, he came back to the hospital with fever that was raised intermittently every two days, and was marked by a chilling-fever-sweating cycle. We conducted a laboratory test for malaria and nasopharyngeal swab for SARS CoV-2 PCR which confirmed both of the diagnosis. The laboratory examination showed markedly elevated D-dimer. He was treated with Dihydroartemisinin-Piperaquine (DHP) 4 tablets per day for three days and Primaquine 2 tablets per day for 14 days according to Indonesian national anti-malarial treatment guidelines. After six days of treatment, the patient had no complaints, and the results of laboratory tests had improved. This report describes the key points in considering the differential diagnosis and prompt treatment of malaria infection during the pandemic of COVID-19 in an endemic country to prevent the worse clinical outcomes. COVID-19 and malaria may also cause hypercoagulable state, so a co-infection of those diseases may impact on the prognosis of the disease.ConclusionThis case report shows that considering the possibility of a co-infection in COVID-19 patient who presents with fever can prevent delayed treatment that can worsen the disease outcome. Paying more attention to a history of travel to malaria-endemic areas, a history of previous malaria infection, and exploring anamnesis regarding the fever patterns in patients are important points in making a differential diagnosis of malaria infection during the COVID-19 pandemic.

scholarly journals Tinea incognito: Report of two cases

1970 ◽  
Vol 6 (3) ◽  
pp. 46-49
Author(s):  
SK Kedia ◽  
M Mathur
Keyword(s):  
Case Report ◽  
Fungal Infection ◽  
Clinical Presentation ◽  
Topical Steroid ◽  
Medical Sciences ◽  
Diagnostic Challenge ◽  
Over The Counter ◽  
Inappropriate Use ◽  
General Physicians ◽  
Tinea Incognito

Tinea incognito remains diagnostic challenge even to expert specialist because of modified clinical presentation caused by of inappropriate use of topical steroid. Topical steroid are being prescribed frequently for vary many dermatosis including fungal infection of skin and being used by patient as "over the counter drug" leading to varied clinical presentation of common dermatosis. This case report is of iatrogenic dermatosis that was invariably misdiagnosed by general physicians. Key words: Tinea incognito; dermatosis; fungal infection. DOI: 10.3126/jcmsn.v6i3.4076Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.46-49

scholarly journals Scrub septicemia progressing to polyneuropathy: a case report

2021 ◽  
Vol 8 (1) ◽  
pp. 64-67
Author(s):  
Dr. Pradeep Kumar Jena ◽  
◽  
Dr. Swasthi Kabi Satapathy ◽  
Dr. Alok Satya Prakash Nayak ◽  
Dr. Sarthak NaIik ◽  
...  
Keyword(s):  
Public Health ◽  
Case Report ◽  
Health Problem ◽  
Scrub Typhus ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Endemic Areas ◽  
Gi Bleed

Scrub typhus is a major public health problem in India with a wide spectrum of clinicalmanifestations and a low index of suspicion is low endemic areas which in turn can increasemorbidity and mortality. The clinical manifestations of scrub typhus can range from mild non-specificfebrile illness or constitutional symptoms such as fever, rash, myalgia, headache to various organdysfunction such as AKI, myocarditis, pneumonia, meningitis, encephalitis, GI bleed, hepatitis. Herewe report a case of a 9-year-old girl who presented with scrub septicemia and progressed to developcritical illness myopathy, which is very unusual.

DIAGNOSTIC VALUE OF SPECIFIC ANTIBODY SYNTHESIS IN BRAIN OF PATIENTS WITH NEUROINFECTIONS

2019 ◽  
Vol 72 (8) ◽  
pp. 1437-1441
Author(s):  
Pavel Dyachenko ◽  
Igor Filchakov ◽  
Anatoly Dyachenko ◽  
Victoria Kurhanskaya
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Diagnostic Challenge ◽  
Specific Antibodies ◽  
Intrathecal Synthesis ◽  
Varicella Zoster ◽  
Mrz Reaction ◽  
Wide Range

Introduction: Viral encephalitis accounts for 40-70% of all cases worldwide, central nervous system infections pose a diagnostic challenge because clinical manifestations are not typically pathognomonic for specific pathogens, and a wide range of agents can be causative. The aim: To assess the diagnostic value of intrathecal synthesis of specific antibodies in patients with inflammatory lesions of the central nervous system. Materials and methods: Within the framework of the study, two groups of 90 people in each were formed from the patients with neuroinfections admitted to our Center. Intrathecal synthesis (ITS) of total (unspecific) IgG in members of one of group (group of compare) was determined. Brain synthesis of specific antibodies (Ab) to some neurotropic pathogens (herpes simplex virus 1/2, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, rubella virus, Borrelies) was studied in the second group of patients (group of interest). There were no statistically significant differences between groups by gender and age. Encephalitis and encephalomyelitis prevailed among patients of both groups Results: ITS of total IgG was established in 30 (33.3 ± 6.1 %) patients of the first group with IgG index more than 0.6 indicating on inflammatory process in CNS and no marked changes of CSF. ITS of specific Ab was determined in 23 of 90 (25.6 ± 4.6 %) patients included into group of interest. In more than half of cases Ab to several infectious agents were detected simultaneously. ITS of various specificity, in particular, to measles and rubella viruses, and VZV, known as MRZ-reaction, is characteristic of some autoimmune lesions of CNS, multiple sclerosis first of all. In fact, further research of 5 patients with MRZ-reaction confirmed their autoimmune failure of CNS. Detection of ITS in the CSF samples didn’t depend on concentration of specific Ab in serum and CSF and wasn’t followed by HEB dysfunctions which were observed with the same frequency in patients with or without ITS (13.0 % and 13.6 % respectively). Conclusion: Specific Ab synthesis to several neurotropic pathogens in the CSF of significant part of examined patients was established. Thus, diagnostic value of ITS of specific immunoglobulins seems to be limited to cases in which autoimmune damage of the CNS is suspected.

Alergia à Proteína do Leite de Vaca Persistente em Adulto: Relato de Caso / Persistent Cow’s Milk Allergy in Adult: Case Report

1970 ◽  
Vol 5 (4) ◽  
pp. 51-60
Author(s):  
José Henrique Pereira Pinto ◽  
Renan Lemos de Toledo ◽  
William do Prado Franquelo
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Inflammatory Disease ◽  
Clinical Manifestations ◽  
Milk Proteins ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Current Prevalence ◽  
Keywords Allergy ◽  
Ige Mediated

RESUMOIntrodução: Alergia à Proteína do Leite de Vaca (APLV) é uma doença inflamatória secundária à reação imunológica contra uma ou mais proteínas do leite de vaca (LV) que afeta principalmente a faixa pediátrica. A real prevalência é discutida em muitos estudos. As manifestações clínicas dependem do tipo da resposta imunológica, ser IgE mediada ou não. Os sintomas se iniciam por volta dos 06 meses de vida e na maioria dos casos, esse processo alérgico regride, com o paciente desenvolvendo tolerância até a adolescência. Casuística: Relata-se um caso de um paciente do sexo masculino, apresentando desde os 6 meses de idade de anafilaxia e broncoespasmo. Nesta época foi levado em hospitais e ambulatórios sendo diagnosticado e tratado como asma apenas, porém sem sucesso. Aos 18 anos, em consulta com especialista foi diagnosticado com APLV, apesar da dieta de exclusão, apresentou diversas reações anafiláticas, devido a ingestão acidental do alérgeno. Discussão: O paciente iniciou os primeiros sintomas quando houve contato com LV e apresentou teste laboratorial com valores compatíveis a patologia. Segundo a literatura a prevalência de APLV cai para menos de 1% aos 6 anos de vida e está persistência pode estar associada a múltiplos fatores, no caso relatado, o paciente não apresentou tolerância até o presente momento. Conclusão: APLV é uma doença usualmente de criança em que, se estas não adquirirem tolerância, complicações podem perdurar indefinidamente. O Diagnóstico precoce e o manejo adequado desta condição, revela grande importância na qualidade de vida e na prevenção de anafilaxia.Palavras chave: Alergia, Proteína do leite de vaca, Anafilaxia. ABSTRACT Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease secondary to immune response against one or more cow's milk proteins (LV) which primarily affects pediatric patients. The current prevalence is discussed in many studies. The clinical manifestations depend on the type of immune response, being IgE mediated or not. Symptoms start at about 06 months of life and in most cases, the allergic process subsides, and the patient develops tolerance through adolescence. Case Report: We report the case of a male patient, who was presenting, since his 06 months of age, anaphylaxis and bronchospasm. At that time he was taken into hospitals and clinics being diagnosed and treated as asthma, but without success. At 18, in consultation with expert was diagnosed with CMPA, and despite the exclusion diet, presented several anaphylactic reactions due to accidental ingestion of the allergen. Discussion: The patient began the first symptoms when there was contact with LV and presented laboratory test values compatible with the pathology. According to the literature the prevalence of CMPA drops to less than 1% to 6 years of life and this persistence can be associated with multiple factors, in our case, the patient did not develop tolerance to date. Conclusion: CMPA is usually a child disease but ,if they do not acquire tolerance, complications can last indefinitely. Early diagnosis and appropriate management of this condition, reveals a great deal on quality of life and prevention of anaphylaxis. Keywords: Allergy, Cow’s milk protein, Anaphylaxis. 

Apresentação e Evolução Atípicas da Granulomatose de Wegener: Relato de Caso/Atypical Presentation and Evolution of Wegener's Granulomatosis: Case Report

1970 ◽  
Vol 5 (3) ◽  
pp. 53-67
Author(s):  
Aline Dos Santos ◽  
Ana Caroline Balducci Scafi ◽  
Luciene Azevedo Morais ◽  
Pablo Girardelli Mendonça Mesquita
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Case Report ◽  
Chronic Renal Failure ◽  
Early Diagnosis ◽  
Wegener’S Granulomatosis ◽  
Immunosuppressive Treatment ◽  
Clinical Manifestations ◽  
Wegener's Granulomatosis ◽  
Creatinine Concentration

RESUMOIntrodução: A Granulomatose de Wegener (GW) é uma vasculite rara e idiopática associada à presença do anticorpo Anticitoplasma de Neutrófilo (ANCA) que acomete, preferencialmente, os pequenos vasos. As manifestações clínicas são diversas, ocorrendo em mais de 90% dos casos, sintomas do trato respiratório. O comprometimento renal é tardio e preditor de mau prognóstico.  Sua morbidade a médio e longo prazo inclui insuficiência renal crônica. A probabilidade de sucesso de manutenção da função renal depende da concentração sérica de creatinina ao início do tratamento, o que indica a importância do diagnóstico e terapêutica adequada precoces. Casuística: Relata-se o caso de uma paciente do sexo feminino, 61 anos, portadora de GW com comprometimento renal avançado à apresentação não precedido por sintomas pulmonares esperados. O tratamento imunossupressor associado a plasmaferese permitiu a melhora da função renal da paciente poupando-a de tornar-se dialítica- dependente. Discussão: A paciente iniciou a doença através de insuficiência renal assintomática, com valores de função renal compatíveis com o estágio mais avançado de doença renal crônica, ultrassonografia dos rins sem alterações compatíveis e sem os sintomas respiratórios esperados. Segundo a literatura, a combinação de imunossupressores e plasmaferese associa-se à recuperação renal em três meses com sobrevivência sem necessidade de diálise por 12 meses, no caso relatado, obteve-se tal resultado em 22 dias sem a necessidade de diálise após um ano. Conclusão: Devido ao diagnóstico precoce, o tratamento adequado foi instalado rapidamente proporcionando à paciente um aumento da expectativa e da qualidade de vida, evitando dependência de terapia renal substitutiva.Palavras-Chave: Granulomatose de Wegener, Plasmaferese, Doença renal crônica.  ABSTRACTIntroduction: The Wegener's Granulomatosis (WG) is a rare and idiopathic vasculitis associated with the presence of Antineutrophil Cytoplasmic Antibody (ANCA), that affects, preferentially, the small vessels. The clinical manifestations are diverse, occurring in over 90% of cases, symptoms in the respiratory tract. Kidney damage is a late and bad prognostic predictor. Morbidity in the medium and long term includes chronic renal failure. The probability of renal function maintenance success depends on serum creatinine concentration at the beginning of treatment that indicates the importance of early diagnosis and deployment of an appropriate therapy. Case Report: We present a case of a 61-year-old female patient, carrier of GW with advanced renal impairment presentation, not preceded by expected pulmonary symptoms. The immunosuppressive treatment associated with plasmapheresis allowed the improvement of the patient’s renal function, saving her from becoming dialysis-dependent Discussion: The patient developed the disease through asymptomatic renal failure, renal function with values that are compatible with the most advanced stage of chronic kidney disease, ultrasound of the kidneys without compatible changes and without the expected respiratory symptoms. According to the literature, the combination of immunosuppressive drugs and plasmapheresis is associated with renal recovery in three months with survival without dialysis for 12 months. In this case, a result was obtained in 22 days without the need for dialysis after one year. Conclusion: Due to the early diagnosis, appropriate treatment was quickly installed giving the patient increased life expectancy and quality, preventing dependence on renal replacement therapy.Keywords: Wegener’s granulomatosis, Plasmapheresis, Chronic renal failure.

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