scholarly journals Fever in the Returned Pediatric Traveler

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110261
Author(s):  
Nahed Abdel-Haq ◽  
Basim I. Asmar
Keyword(s):  
Respiratory Infections ◽  
Hemorrhagic Fever ◽  
International Travel ◽  
Initial Assessment ◽  
Febrile Child ◽  
Diagnostic Challenge ◽  
Laboratory Findings ◽  
Incubation Periods ◽  
Visiting Friends And Relatives ◽  
Life Threatening

Global mobility has been steadily increasing in recent years. The assessment of the febrile child returning from international travel is a diagnostic challenge. The COVID-19 pandemic has profoundly affected international travel and made evaluation and management of the sick returned traveler more challenging. Children visiting friends and relatives abroad remain at higher risk of infection compared to tourists. This review presents a guidance on the initial assessment of a traveling febrile child including interpretation of medical history, physical examination, and laboratory findings. Important clues to etiology include exposure to different infectious agents, incubation periods of pathogens, and prophylaxis regimens and vaccines received. Early identification of potentially life-threatening and highly contagious infections is essential. In this article, we discuss the epidemiology, evaluation, and management of specific travel related infections such as malaria, typhoid fever, dengue fever, viral hemorrhagic fever, rickettsiosis, leptospirosis, schistosomiasis, gastrointestinal, and respiratory infections.

Anaphylaxis: an Emergency Physician's Perspective

2002 ◽  
Vol 9 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Hfl Lee
Keyword(s):  
Anaphylactic Reaction ◽  
Clinical Manifestation ◽  
Emergency Physician ◽  
Early Recognition ◽  
Initial Assessment ◽  
Diagnostic Challenge ◽  
Severe Anaphylaxis ◽  
Management Algorithm ◽  
Life Threatening ◽  
Physician’S Perspective

Anaphylactic reaction is a common problem encounter by the emergency physician. Although the drug treatment and management of anaphylaxis had been well published in the literature, the emergency management of anaphylaxis is still unsatisfactory. Severe anaphylactic reaction and death is not uncommonly reported. This article reviews the pathophysiology, aetiology, clinical manifestation, diagnostic approach, management algorithm and prevention of anaphylaxis with particular emphasis on the emergency physician's perspective. The clinical manifestation of anaphylaxis is significantly variable in terms of severity, onset and progression, which imposed a diagnostic challenge to emergency physician. An awareness that severe anaphylaxis can be rapidly fatal is essential for those working in the emergency room. Life threatening clinical features such as laryngeal oedema, bronchospasm and circulatory collapse must be recognize early and treated aggressively as favourable prognosis is well documented. The key to success in managing anaphylaxis emergency depends on the early recognition of anaphylaxis reaction, initial assessment, anticipation of deterioration and finally prompt and aggressive support of airway, oxygenation, ventilation and circulation. Adrenaline is the cornerstone of the treatment modality in anaphylaxis. This is currently underused, although, it is safe and almost always effective. At last prevention of subsequent episode of anaphylaxis should be considered a priority for emergency physician before discharging patient.

scholarly journals Haemophagocytic lymphohistiocytosis in Adult- A Case Report and Literature Review

2016 ◽  
Vol 33 (3) ◽  
pp. 166-176
Author(s):  
Syeda Fahmida Hossain ◽  
Nazmul Kabir Qureshi ◽  
Zahid Mahmud ◽  
Md Iqbal Hossain
Keyword(s):  
T Lymphocytes ◽  
Age Groups ◽  
Vascular Diseases ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Diagnostic Challenge ◽  
Laboratory Findings ◽  
Collagen Vascular Diseases ◽  
Threatening Condition ◽  
Life Threatening ◽  
High Index Of Suspicion

Haemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disease of normal but overactive histiocytes and lymphocytes that commonly appears in infancy, although it has been seen in all age groups. The disease may be inherited or acquired due to infections, collagen vascular diseases and malignancies. The pathological hallmark of the syndrome is uncontrolled activation of T lymphocytes and macrophages, together with an impaired cytotoxic function of NK cells and CD8+ T lymphocytes, resulting into massive cytokine release (e.g., interferon ”, TNF á, interleukin[IL]-6, 8,10,12,18 etc) from these cells and overwhelming inflammation. Lymphocytes and macrophages, sometimes with haemophagocytic activity accumulate in bone marrow, spleen, liver, or lymph nodes. This immune dysregulatory disorder is characterized by fever, hepatosplenomegaly, lymphadenopathy, skin rash, cytopenias, hepatitis, coagulopathy, neurological symptoms. We report a case of 65 years old male presenting with fever and erythroderma who developed typical clinical and laboratory findings consistent with diagnosis of HLH according to HLH-2004 guidelines. Despite receiving etoposide based chemotherapy, the patient succumbed rapidly from progressive HLH. This case high lightened the diagnostic challenge and the need for keeping a high index of suspicion for promptly diagnosis and treatment of this potentially life threatening condition as clinical features and laboratory investigations are non specific.J Bangladesh Coll Phys Surg 2015; 33(3): 166-176

New Insight for the Prognosis of CCHF: Clinical, Laboratory and Sonography Findings

2020 ◽  
Vol 16 (9) ◽  
pp. 1125-1130
Author(s):  
Hamid Owaysee Osquee ◽  
Sepehr Taghizadeh ◽  
Mehdi Haghdoost ◽  
Hadi Pourjafar ◽  
Fereshteh Ansari
Keyword(s):  
Odds Ratio ◽  
Clinical Laboratory ◽  
Fatal Outcome ◽  
Hemorrhagic Fever ◽  
Demographic Characteristics ◽  
Pelvic Cavity ◽  
Fatal Disease ◽  
Laboratory Findings ◽  
Report Data ◽  
Sistan And Baluchestan

Introduction: In this article, we report data on confirmed CCHF cases from Iran and describe the association between studying factors and outcomes of the disease. Objective: Crimean Congo Hemorrhagic Fever (CCHF) is an acute and fatal disease with various clinical and paraclinical characteristics. Methods: In the Study design, we evaluated demographic characteristics, clinical, laboratory and sonographic findings of 160 CCHF confirmed cases during 2003 and 2012 in Zabol (A city in Sistan and Baluchestan province of Iran). The association between these factors and the fatal outcome was evaluated by regression analysis. Results: The disease had a fatal outcome in 7 (4.4%) of patients. Females had more severe symptoms and higher odds for death (odds ratio11.57, p=0.005). Leukocytosis (p<0.001), PT (p<0.001) and PTT (p=0.008) elongation, AST (p=0.010) and ALT (p<0.001) elevation were significantly associated with fatal outcome. CNS related symptoms (odds ratio 5.9, p=0.027) in clinical examination and ascites (odds ratio 38.4, p=0.012) and liquid in the pelvic cavity (odds ratio 24.2, p=0.004) were also identified as risk factors of death in this study. Conclusions: Our data suggest that in addition to clinical and laboratory findings practitioners consider sonography for CCHF prognosis.

scholarly journals Mesenchymal Stem Cells: The Secret Children’s Weapons against the SARS-CoV-2 Lethal Infection

2021 ◽  
Vol 11 (4) ◽  
pp. 1696
Author(s):  
Mario Giosuè Balzanelli ◽  
Pietro Distratis ◽  
Orazio Catucci ◽  
Angelo Cefalo ◽  
Rita Lazzaro ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Unusual Event ◽  
Inflammatory Processes ◽  
Life Threatening ◽  
Severe Acute Respiratory Infections ◽  
Novel Coronavirus

Due to the promising effects of mesenchymal stem cells (MSCs) in the treatment of various diseases, this commentary aimed to focus on the auxiliary role of MSCs to reduce inflammatory processes of acute respiratory infections caused by the 2019 novel coronavirus (COVID-19). Since early in 2020, COVID-19, a consequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly affected millions of people world-wide. The SARS-CoV-2 infection in children appears to be an unusual event. Despite the high number of affected adult and elderly, children and adolescents remained low in amounts, and marginally touched. Based on the promising role of cell therapy and regenerative medicine approaches in the treatment of several life-threatening diseases, it seems that applying MSCs cell-based approaches can also be a hopeful strategy for improving subjects with severe acute respiratory infections caused by COVID-19.

scholarly journals Bedside examination of the vestibular and ocular motor system in patients with acute vertigo or dizziness

2019 ◽  
Vol 3 (2) ◽  
pp. 2514183X1988615
Author(s):  
Alexander A Tarnutzer ◽  
Marianne Dieterich
Keyword(s):  
Diagnostic Testing ◽  
Initial Assessment ◽  
Head Impulse Test ◽  
Motor Deficits ◽  
Ocular Motor ◽  
Bedside Examination ◽  
Life Threatening ◽  
Ocular Motor System ◽  
Bedside Tests ◽  
The Brain

In the initial assessment of the patient with acute vertigo or dizziness, both structured history-taking and a targeted bedside neuro-otological examination are essential for distinguishing potentially life-threatening central vestibular causes from those of benign, self-limited peripheral labyrinthine origin and thus for deciding on further diagnostic testing. In this article, the key elements of the vestibular and ocular motor examination, which should be obtained at the bedside in these acutely dizzy patients, will be discussed. Specifically, this will include the following five domains: ocular stability for (I) nystagmus and for (II) eye position (skew deviation), (III) the head-impulse test (HIT), (IV) postural stability, and (V) ocular motor deficits of saccades, smooth pursuit eye movements, and optokinetic nystagmus. We will also discuss the diagnostic accuracy of specific combinations of these bedside tests (i.e. HIT, testing for nystagmus and vertical divergence, referred to as the H.I.N.T.S. three-step examination), emphasizing that the targeted neuro-otological bedside examination is more sensitive for identifying central causes in acute prolonged vertigo and dizziness than early MRI of the brain.

School Nurses on the Front Lines of Medicine: Take a BREATH: The Approach to a Student With Respiratory Distress

2017 ◽  
Vol 33 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Morgann Loaec ◽  
Robert P. Olympia
Keyword(s):  
Emergency Department ◽  
Respiratory Distress ◽  
Respiratory Symptoms ◽  
School Setting ◽  
School Nurses ◽  
Initial Assessment ◽  
Level Of Care ◽  
Primary Health ◽  
Life Threatening

Students presenting with varying degrees of respiratory symptoms and distress occur commonly in the school setting. It is important to develop a differential diagnosis for respiratory distress, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary health care provider’s office, or directly to the closest emergency department via Emergency Medical Services). This article describes the initial assessment and management of a student presenting with respiratory distress.

Traumatic Penile Pseudoaneurysm After Straddle Injury Presenting With Life Threatening Anemia: A Unique Case and a Diagnostic Challenge

Urology ◽  
2019 ◽  
Vol 125 ◽  
pp. 210-212 ◽  
Author(s):  
Muhannad Alsyouf ◽  
Phillip Stokes ◽  
Jason Smith ◽  
Akin Amasyali ◽  
David Chamberlin
Keyword(s):  
Diagnostic Challenge ◽  
Unique Case ◽  
Life Threatening

scholarly journals Influenza A and B viruses in the population of Vojvodina, Serbia

2014 ◽  
Vol 66 (1) ◽  
pp. 43-50 ◽  
Author(s):  
J. Radovanov ◽  
V. Milosevic ◽  
I. Hrnjakovic ◽  
V. Petrovic ◽  
M. Ristic ◽  
...  
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Influenza Viruses ◽  
Influenza B Virus ◽  
Nasopharyngeal Swab ◽  
Influenza B ◽  
Influenza A Viruses ◽  
B Virus ◽  
Life Threatening ◽  
Seasonal Epidemic

At present, two influenza A viruses, H1N1pdm09 and H3N2, along with influenza B virus co-circulate in the human population, causing endemic and seasonal epidemic acute febrile respiratory infections, sometimes with life-threatening complications. Detection of influenza viruses in nasopharyngeal swab samples was done by real-time RT-PCR. There were 60.2% (53/88) positive samples in 2010/11, 63.4% (52/82) in 2011/12, and 49.9% (184/369) in 2012/13. Among the positive patients, influenza A viruses were predominant during the first two seasons, while influenza B type was more active during 2012/13. Subtyping of influenza A positive samples revealed the presence of A (H1N1)pdm09 in 2010/11, A (H3N2) in 2011/12, while in 2012/13, both subtypes were detected. The highest seroprevalence against influenza A was in the age-group 30-64, and against influenza B in adults aged 30-64 and >65.

scholarly journals EMERGENCY USE AUTHORIZATION: AT ZERO HOUR

2018 ◽  
Vol 3 (4) ◽  
pp. 18-23
Author(s):  
V. Balamuralidhara ◽  
Vaishnav A.M. ◽  
Bachu V. ◽  
Pramod Kumar T.M.
Keyword(s):  
Homeland Security ◽  
Ebola Virus ◽  
Hemorrhagic Fever ◽  
The United States ◽  
Vital Role ◽  
Test Device ◽  
Department Of Homeland Security ◽  
The Public ◽  
Life Threatening ◽  
Us Fda

The Emergency Use Authorisation (EUA) authority plays a vital role in US FDA. They provide the authority/permission to use the unregistered products/registered product with unregistered route to treat the life threatening damages to the patients in world in some emergency conditions. The aim of this work is to give an overview on EUA in life threatening conditions and there challenges in getting the permissions under regulations with example of E-bola virus. The e-bola is a virus. It is a hemorrhagic fever deadly disease caused by one of the E-bola viral strain, which is wide spread in West Africa. The -Secretary of the Department of homeland security (DHS), determined, pursuant to section 319F-2 of the Public Health Service Act, that the Ebola virus presents a material threat against the United States population sufficient to affect national security. Issuance of EUA by the FDA Commissioner requires several steps under section 564 of the FD&C Act. The FDA Commissioner, can only issue the EUA, if criteria for issuance under the statute are met. This study’s highlights the importance of the EUA in emergency when there is no medicine for disease/virus in the world. For example the FDA has issued a EUA to use the ReEBOV which is the Rapid Antigen Test device designed by Lusys lab co. Pvt. Ltd. for detecting the Zaire Ebola virus.

scholarly journals Oropharyngeal dysphagia as dominant and life-threatening symptom in dermatomyositis

2009 ◽  
Vol 66 (8) ◽  
pp. 671-674 ◽  
Author(s):  
Zorana Djakovic ◽  
Sonja Vesic ◽  
Maja Tomovic ◽  
Jelena Vukovic
Keyword(s):  
Aspiration Pneumonia ◽  
Oropharyngeal Dysphagia ◽  
Magnetic Resonance Images ◽  
Inflammatory Myopathies ◽  
Laboratory Findings ◽  
Endoscopic Gastrostomy ◽  
Nutritional Deficit ◽  
Swallowing Pain ◽  
Life Threatening ◽  
Proximal Myopathy

Background. Dysphagia can be a serious problem in patients with inflammatory myopathies. It may be associated with nutritional deficit, aspiration pneumonia, and poor prognosis. Case report. We presented a 60-year-old male, suffering from difficulty in swallowing, pain and weaknes in the proximal parts of his extremities, and skin manifestation. Laboratory findings showed increased creatine kinase and aldolase. Antinuclear antibodies to HEP-2 subtrate revealed titer of 1:40. Electromyoneurography demonstrated evidence of a proximal myopathy. A muscle biopsy revealed myositis. The baruim swallow test was remarkable for regurgitation, and nasal emerging of barium. Nuclear magnetic resonance images of cranium was normal. Tumor markers CEA, and Ca 19-9 were increased. A dose of 1 mg daily prednisolone was administered and percutaneous enteral feeding was performed. Two months later, the patient developed febrile state, aspiration pneumonia, and died due to respiratory failure. Conclusion. In cases of dermatomyositis with the serious dysphagia, percutaneous endoscopic gastrostomy should be performed as soon as possible. Owerall survival rate is low, even with an adequate therapy administration. Inflammatory myopathies should be considered in any patient with oropharyngeal dysphagia.

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