scholarly journals Francisella tularensis human infections in a village of northwest Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saber Esmaeili ◽  
Mahdi Rohani ◽  
Ahmad Ghasemi ◽  
Mohammad Mehdi Gouya ◽  
Simin Khayatzadeh ◽  
...  
Keyword(s):  
Francisella Tularensis ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Geographic Area ◽  
Agglutination Test ◽  
Ocular Involvement ◽  
Local Fauna ◽  
Water Storage Tank ◽  
East Azerbaijan ◽  
The Village

Abstract Background Recent seroepidemiological studies have suggested that tularemia could be an endemic bacterial zoonosis in Iran. Methods From January 2016 to June 2018, disease cases characterized by fever, cervical lymphadenopathy and ocular involvement were reported in Youzband Village of Kaleybar County, in the East Azerbaijan Province, northwestern Iran. Diagnostic tests included Francisella tularensis serology (including tube agglutination test and ELISA), PCR, and culture. Results Among 11 examined case-patients, the tularemia tube agglutination test was positive in ten and borderline in one. PCR detected the F. tularensisISFtu2 elements and fopA gene in one rodent and a spring water sample from the same geographic area. Conclusions Based on the clinical manifestations of the disease suggesting an oropharyngeal form of tularemia, serology results in case patients, and F. tularensis detection in the local fauna and aquatic environment, the water supply of the village was the likely source of the tularemia outbreak. Intervention such as dredging and chlorination of the main water storage tank of the village and training of villagers and health care workers in preventive measures and treatment of the illness helped control the infection.

scholarly journals Current concepts in the diagnosis and management of antiphospholipid syndrome and ocular manifestations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gunay Uludag ◽  
Neil Onghanseng ◽  
Anh N. T. Tran ◽  
Muhammad Hassan ◽  
Muhammad Sohail Halim ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Clinical Manifestations ◽  
Autoimmune Disorder ◽  
Ocular Involvement ◽  
Ocular Manifestations ◽  
Different Types ◽  
Thrombotic Complications ◽  
Specific Factors ◽  
Arteries And Veins

AbstractAntiphospholipid syndrome (APS) is an autoimmune disorder associated with obstetrical complications, thrombotic complications involving both arteries and veins, and non-thrombotic manifestations affecting multiple other systems presenting in various clinical forms. Diagnosis requires the presence of antiphospholipid antibodies. The exact pathogenesis of APS is not fully known. However, it has recently been shown that activation of different types of cells by antiphospholipid antibodies plays an important role in thrombosis formation. Ocular involvement is one of the important clinical manifestations of APS and can vary in presentations. Therefore, as an ophthalmologist, it is crucial to be familiar with the ocular findings of APS to prevent further complications that can develop. Furthermore, the ongoing identification of new and specific factors contributing to the pathogenesis of APS may provide new therapeutic options in the management of the disease in the future.

scholarly journals Case report on the human infection with Tularemia in Mykolaiv Region, 2018

2020 ◽  
Vol 6 (1) ◽  
pp. 15-17
Author(s):  
O. B. Zlenko ◽  
O. S. Ignatenkov ◽  
K. V. Vinokurova ◽  
A. P. Gerilovych
Keyword(s):  
Case Report ◽  
Western Blot ◽  
Blood Serum ◽  
Francisella Tularensis ◽  
Water Samples ◽  
Human Infection ◽  
Agglutination Test ◽  
Surrounding Area ◽  
Type Settlement ◽  
Positive Results

The work aims to provide a study and report the case with a 47-year-old white man from urban-type settlement Oleksandrivka (Voznesensk District, Mykolaiv Region) diagnosed with pharyngitis, amygdalitis, polylymphoadenopathy, and buboadenitis caused by Francisella tularensis. The tularemia diagnosis in the patient was confirmed with agglutination test and western blot of patient’s blood serum in dilutions 1:100 and 1:200 respectively. The additional surveillance study (rodents, ticks, and water samples) in the surrounding area of the patient’s house showed positive results for F. tularensis in ticks in dilution 1:160++++

Sight-threatening progressive corneo-scleral involvement in porphyria cutanea tarda

2021 ◽  
Vol 14 (10) ◽  
pp. e245160
Author(s):  
Sonali Prasad ◽  
Vidhata Vidhata ◽  
Subhash Prasad
Keyword(s):  
Porphyria Cutanea Tarda ◽  
Clinical Manifestations ◽  
Ocular Involvement ◽  
Slit Lamp ◽  
Uroporphyrinogen Decarboxylase ◽  
Progressive Loss ◽  
The Right ◽  
Lost To Follow Up ◽  
Test Serum

Porphyria cutanea tarda is the most common type of porphyria. It is associated with a deficiency of uroporphyrinogen decarboxylase enzyme responsible for heme synthesis. Clinical manifestations are predominantly dermatological and very rarely present with ocular involvement. Although scleral thinning in the interpalpebral area is a well-documented entity, sight-threatening corneal involvement is rarely described. We, herein report a case of a 58-year-old man who presented with ocular surface dryness, photophobia and mild redness. Slit-lamp biomicroscopy revealed corneo-scleral thinning in both eyes. The diagnosis was confirmed with a urine porphyrin test, serum iron and serum ferritin levels. We started him on conservative management after which he was lost to follow-up. He presented again after 6 years with total corneal opacification and progressive loss of vision in the right eye.

scholarly journals Rare Presentation of Self-Limiting Kikuchi–Fujimoto Disease in Relapsing Nature

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karo Servatyari ◽  
Hero Yazdanpanah ◽  
Chamara Dalugama
Keyword(s):  
Lymph Nodes ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Presentation Of Self ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
One Year ◽  
Loss Of Appetite

Background. Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limiting disease that is commonly associated with cervical lymphadenopathy and fever. The disease has a wide spectrum of clinical manifestations, and definitive diagnosis is based on the histological appearance in the excision biopsy of the lymph nodes. Recurrence of KFD is reported rarely. Case Presentation. A 56-year-old Iranian woman with a background history of thrombocytopenia presented with fever, malaise, loss of appetite, and weight loss with cervical lymphadenopathy. The excision biopsy of the cervical lymph nodes confirmed the diagnosis of KFD, and she made a full recovery with improvement of symptoms, regression of cervical lymph nodes, and normalization inflammatory markers. One year after remission, she presented with similar clinico-biochemical profile, and repeat biopsy confirmed KFD. Conclusion. Although the rate of recurrence of the disease is very low, the treating physician should consider the possibility and confirm it histologically.

scholarly journals Relationship between ocular involvement and clinical manifestations, laboratory findings, and coronary artery dilatation in Kawasaki disease

Eye ◽  
2020 ◽  
Vol 34 (10) ◽  
pp. 1883-1887 ◽  
Author(s):  
Reza Shiari ◽  
Mohsen Jari ◽  
Saeed Karimi ◽  
Omid Salehpour ◽  
Khosro Rahmani ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Clinical Manifestations ◽  
Ocular Involvement ◽  
Laboratory Findings ◽  
Coronary Artery Dilatation

The unusual case of neck lymphadenopathy - oculoglandular form of tularemia

2018 ◽  
Vol 7 (2) ◽  
pp. 1-5
Author(s):  
Katarzyna Baranowska-Kempisty ◽  
Jolanta Kluz-Zawadzka ◽  
Sylwia Warzybok-Bajda ◽  
Krzysztof Szuber
Keyword(s):  
Adverse Effect ◽  
Case Report ◽  
Francisella Tularensis ◽  
Unusual Case ◽  
Drug Research ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Elisa Test ◽  
Gram Negative ◽  
The Right

Tularemia is anthropozoonosis caused by Bacteria Francisella tularensis a gram negative, non-motile aerobic bacillus.[5][8] The bacteria is transmitted mostly by rabbits, hares, rodents and arthropods. The pathogen penetrates into an organism via damaged skin, conjunctiva or mucosa- either through inhalation or ingestion. The clinical manifestations depend on the route of acquisition. Six forms of the disease can be distinguished: ulceroglandular or glandular, oculoglandular, oropharyngeal, respiratory, typhoidal, and intestinal. [11] We present a case report of the rarest oculoglandular form of tularemia. The patient was admitted to the hospital with right pre-auricular swelling, right sided neck lymphadenopathy, conjunctivitis and a nodule of the right eyelid. After excluding more common differential diagnoses, an ELISA test was performed and Francisella tularensis antibodies were identified. Patient administered proper antibiotic therapy. Tularemia is a rarely occurring disease in Poland and is nearly never taken into consideration by otolaryngologists when diagnosing patients with neck lymphadenopathy. In clinical practice, otorhinolaryngologists should always consider this infectious zoonosis, especially the oculoglandular and oropharyngeal forms, as delayed diagnosis and treatment may causes serious health consequences in patients. In the future new drug research should be conducted because of the adverse effect of widely used medications specially for children and pregnant woman.

Atypical Stevens-Johnson syndrome-like reaction in the setting of immune checkpoint inhibition.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 102-102
Author(s):  
Gabriel E. Molina ◽  
Zizi Yu ◽  
Ruth K. Foreman ◽  
Kerry Lynn Reynolds ◽  
Steven T. Chen
Keyword(s):  
Immune Checkpoint ◽  
Clinical Course ◽  
Checkpoint Inhibitors ◽  
Clinical Manifestations ◽  
Stevens Johnson Syndrome ◽  
Ocular Involvement ◽  
Drug Eruptions ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Epidermal Necrosis

102 Background: Stevens-Johnson syndrome (SJS) is a rare, life-threatening mucocutaneous toxicity that can occur in patients receiving immune checkpoint inhibitors (ICIs). ICI-induced SJS is scarcely reported in the literature and thus remains poorly understood, particularly regarding features that may distinguish it from classic SJS. Methods: To describe the timing, clinical manifestations, and treatment course of ICI-induced SJS, this multicenter, retrospective study identified seven patients with SJS in the setting of ICI use from January 2011 through May 2019. Results: All seven patients presented initially as benign, limited drug eruptions after a median of 4 ICI cycles (range, 1-7) and 63 days (range, 13-253 days) from ICI initiation. While none of the patients had prior drug allergies, all 7 were receiving new, recently initiated – i.e., within two months – medications at the time of rash onset. Cases demonstrated characteristic histologic findings of SJS, such as epidermal necrosis, and occasional unusual features, including interface dermatitis. All patients responded favorably and rapidly to systemic therapy, primarily intravenous corticosteroids, with near immediate symptomatic resolution and cessation of progressive skin blistering or detachment. Median length of stay was 11 days and no patients died from SJS. Conclusions: Our cohort defines an atypical SJS-like reaction secondary to ICI use, which is distinct from classic SJS in its delayed onset, mild initial presentation, and rare ocular involvement. The association with concomitant medication use suggests a potential mechanism whereby ICIs reduce patient immune tolerance to subsequent drug exposures. Reassuringly, this atypical SJS-like phenomenon exhibits a benign clinical course and favorable response to standard treatments.

scholarly journals Cervical lympahadenitis with risperidone induced cervical dystonia

2019 ◽  
Vol 5 (9) ◽  
pp. 257
Author(s):  
Ruchitha Reddy Akkati
Keyword(s):  
Cervical Dystonia ◽  
Antipsychotic Drugs ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Spasmodic Torticollis ◽  
Spinal Curvature ◽  
Adult Onset ◽  
Body Regions ◽  
Inflammatory Processes ◽  
Head Neck

<p class="abstract">Abiogenic cervical dystonia, the most ordinary form of adult-onset focal dystonia, is elucidated as reflex muscle contractions. Idiopathic cervical dystonia is also called as spasmodic torticollis. The most habitually obliging medications were tetrabenazine (68% of patients upgraded) and anticholinergics (39% upgraded). Clinical manifestations include spinal curvature, local pain, muscle spasm, head-neck tremor and tremor in additional body regions. Antipsychotic drugs induce persistent dystonia. Lymphadenitis particularly refers to lymphadenopathies that are kindled by inflammatory processes. Treatment for lymphadenitis is complete antibiotic course of 10-14 days. A female patient of 14 years old<strong> </strong>presented with altered sensorium and neck tightness. She was diagnosed with cervical lymphadenopathy with risperidone induced cervical dystonia. She was treated with antibiotics and the patient was relieved from her symptoms by stopping the intake of risperidone for about 2 days.</p>

scholarly journals Analysis of chikungunya outbreak of 2016 in Rajasthan: a clinico-epidemiological study

2018 ◽  
Vol 5 (1) ◽  
pp. 151
Author(s):  
Raman Sharma ◽  
Sunil Mahavar ◽  
Mayank Gupta ◽  
Sandeep Kumar ◽  
Jai Purohit ◽  
...  
Keyword(s):  
Epidemiological Study ◽  
Clinical Features ◽  
Joint Pain ◽  
Elevated Level ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Febrile Illness ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Diagnostic Certainty

Background: To describe the diversity of clinical manifestations, laboratory findings and outcome of chikungunya fever in patients attending SMS Hospital, Jaipur during the epidemic of 2016 (September to November).Methods: All cases of febrile illness with polyarthralgia/polyarthritis diagnosed as chikungunya were analyzed. Diagnosis was made by ELISA based IgM serology and RT PCR assay.Results: A total of 200 cases were studied. All of them presented with fever, severe crippling joint pain & tenderness, headache, anorexia and body rash. On examination, there was periarticular edema, erythema, and tenderness in joints with post auricular and cervical lymphadenopathy. Unusual manifestations were hyper pigmentation of face and forehead and scrotal ulcers. On investigations patient had leucopenia with elevated level of SGOT, SGPT with normal bilirubin levels. Other complications observed were encephalopathy, encephalitis, myocarditis and hepatitis. There was no mortality in this group.Conclusions: Chikungunya though prevalent is under-reported. The diagnostic certainty is mandated by presence of febrile transiently crippling polyarthragias / arthritis. On analyzing a large series, unusual clinical features may emerge.

scholarly journals Whipple's disease. Report of five cases with different clinical features

2001 ◽  
Vol 43 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Maria de Lourdes de Abreu FERRARI ◽  
Eduardo Garcia VILELA ◽  
Luciana Costa FARIA ◽  
Claudia Alves COUTO ◽  
Célio Jefferson SALGADO ◽  
...  
Keyword(s):  
Clinical Manifestation ◽  
Systemic Disease ◽  
Light And Electron Microscopy ◽  
Clinical Manifestations ◽  
Ocular Involvement ◽  
Jejunal Mucosa ◽  
Whipple’S Disease ◽  
Whipple's Disease ◽  
Full Remission

Whipple's disease (WD) is a rare systemic disease of infectious etiology which involves the small intestine but can virtually affect any organ. We present here five cases (four males and one female) ranging in age from 20 to 59 years. All patients had intestinal involvement associated or not with clinical manifestations linked to this organ. Vegetation in the tricuspid valve was observed in one patient, suggesting endocarditis caused by Tropheryma whippelii, with disappearance of the echocardiographic alterations after treatment. In one of the male patients the initial clinical manifestation was serologically negative spondylitis, with no diarrhea occurring at any time during follow-up. Ocular involvement associated with intestinal malabsorption and significant weight loss were observed in one case. In the other two cases, diarrhea was the major clinical manifestation. All patients were diagnosed by histological examination of the jejunal mucosa and, when indicated, of extraintestinal tissues by light and electron microscopy. After antibiotic treatment, full remission of symptoms occurred in all cases. A control examination of the intestinal mucosa performed after twelve months of treatment with sulfamethoxazole-trimethoprim revealed the disappearance of T. whippelii in four patients. The remaining patient was lost to follow-up.

Sign in / Sign up

Export Citation Format

Share Document