scholarly journals Case reports of invasive mucormycosis associated neutropenic enterocolitis in leukemic children: diagnostic and treatment challenges and review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Amanati ◽  
Omid Reza Zekavat ◽  
Hamidreza Foroutan ◽  
Omidreza Azh ◽  
Ali Tadayon ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Fungal Infections ◽  
Case Reports ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Salvage Chemotherapy ◽  
Antimicrobial Treatment ◽  
High Morbidity ◽  
Disease Relapse ◽  
Neutropenic Enterocolitis

Abstract Background Bacterial enterocolitis is one of the most common neutropenic fever complications during intensive chemotherapy. Despite aggressive antibacterial treatments, this complication usually imposes high morbidity and mortality in cancer patients. Management of bacterial neutropenic enterocolitis are well known; however, management of fungal neutropenic enterocolitis may be more challenging and needs to be investigated. Prompt diagnosis and treatment may be life-saving, especially in patients at risk of mucormycosis-associated neutropenic enterocolitis. Case presentation We report two mucormycosis-associated neutropenic enterocolitis cases in pediatric leukemic patients receiving salvage chemotherapy for disease relapse. Both patients' clinical signs and symptoms differ from classical bacterial neutropenic enterocolitis. They were empirically treated as bacterial neutropenic enterocolitis with anti-gram-negative combination therapy. Despite broad-spectrum antimicrobial treatment, no clinical improvement was achieved, and both of them were complicated with severe abdominal pain necessitating surgical intervention. Mucormycosis is diagnosed by immunohistopathologic examination in multiple intraoperative intestinal tissue biopsies. Both patients died despite antifungal treatment with liposomal amphotericin-B and surgical intervention. Conclusion Mucormycosis-associated neutropenic enterocolitis is one of the most unfavorable and untreatable side effects of salvage chemotherapy in leukemic children with disease relapse. This report could be of considerable insight to the clinicians and scientists who counter the enigma of fungal infections during febrile neutropenia and help to understand better diagnosis and management.

Short Oral Antibiotic Treatment of Osteomyelitis Questioned

1980 ◽  
Vol 2 (1) ◽  
pp. 18-18
Keyword(s):  
Antimicrobial Therapy ◽  
Oral Therapy ◽  
Initial Period ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Oral Route ◽  
Antimicrobial Treatment ◽  
Blood Levels ◽  
Oral Antibiotic ◽  
Cortical Destruction

Dr. Rothman of Haverhill, MA questioned the short duration of antimicrobial treatment and use of oral route for the patient with osteomyelitis presented by Bennett in PIR 1:153, November 1979. He noted that the traditional regimen for osteomyelitis calls for six weeks of intravenous antimicrobial therapy. Dr. Bennett quotes from Telzlaff et al (J Pediatr 92:485, 1978). In this report good results were found when antimicrobial regimens for patients with osteomyelitis and suppurative arthritis consisted of a brief initial period of parenteral therapy of only one to seven days followed by oral antimicrobial therapy begun when there was a definitive decrease in clinical signs of inflammation and continued for three weeks or longer. It is important to note that surgical drainage of pus was carried out, that antimicrobial blood levels were obtained after initiation of oral therapy to ensure adequate levels, that therapy was continued until all signs and symptoms had subsided, that there was no evidence of cortical destruction or sequestrum formation on roentgenogram, and the erythrocyte sedimentation rate was less than 20 mg/hr. When these conditions are met it is clear that oral therapy can be an adequate substitute for prolonged intravenous therapy for osteomyelitis in children.

scholarly journals Clinico-epidemiological features of Japanese encephalitis patients hospitalized in a tertiary care center

2018 ◽  
Vol 5 (10) ◽  
pp. 4548
Author(s):  
Abu Hasan Sarkar ◽  
Bishnu Ram Das
Keyword(s):  
Japanese Encephalitis ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
High Morbidity ◽  
Medical College ◽  
Clinical Signs And Symptoms ◽  
One Year

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE. 

Incidence, Pathogenesis, and Management of Sepsis

2006 ◽  
Vol 17 (4) ◽  
pp. 385-393 ◽  
Author(s):  
Ruth M. Kleinpell ◽  
Brian T. Graves ◽  
Michael H. Ackerman
Keyword(s):  
Severe Sepsis ◽  
Nursing Care ◽  
Early Recognition ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
High Morbidity ◽  
Assessment And Monitoring ◽  
Clinical Signs And Symptoms ◽  
Evidence Based Guidelines ◽  
Sepsis Care

Sepsis is a complex condition that occurs as a result of the systemic manifestation of infection. It is associated with high morbidity and mortality risks for critically ill patients. Assessment and monitoring aimed at early recognition and treatment, on the basis of evidence-based guidelines, are advocated for optimizing outcomes for patients with severe sepsis. Awareness of the risk factors, clinical signs and symptoms, pathophysiology, and updates in the management of sepsis can enhance the nursing care for patients with severe sepsis to promote best practices for sepsis care in the intensive care unit. This article reviews the incidence and pathophysiology of sepsis, highlighting updates in treatment and implications for nursing care.

scholarly journals Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Brett A. Braly ◽  
David Lunardini ◽  
Chris Cornett ◽  
William F. Donaldson
Keyword(s):  
Surgical Technique ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Technical Difficulty ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Clinical Signs And Symptoms

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.

scholarly journals A Wide Database for Future Studies Aimed at Improving Early Recognition of Candidemia

2021 ◽  
Author(s):  
Sara Mora ◽  
Daniele Roberto Giacobbe ◽  
Chiara Russo ◽  
Elia Diana ◽  
Alessio Signori ◽  
...  
Keyword(s):  
Machine Learning ◽  
Early Recognition ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Optimal Level ◽  
Risk Scores ◽  
High Morbidity ◽  
Rapid Tests ◽  
Diagnosis Accuracy ◽  
Specific Symptoms

Invasive candidiasis is associated with high morbidity and mortality in critically ill patients, i.e. patients admitted to Intensive Care Units (ICUs) or in surgical wards. There are no clinical signs or specific symptoms and even though early diagnosis risk scores and rapid tests are available, none of such strategies has an equally-optimal level of sensitivity and specificity. In the era of Electronic Health Records (EHRs), several clinical studies exploited Machine Learning (ML) models and large database of features to improve the diagnosis accuracy. The main aim of this work is to build a wide dataset which can be exploited to apply ML models to further improve the early recognition of candidemia at the bedside of patients with compatible signs and symptoms.

scholarly journals Challenges in Management of Bartholin gland Leiomyoma: A Case Report

2020 ◽  
Author(s):  
Angela Vinturache ◽  
Lamiese Ismail ◽  
Stephen Damato ◽  
Hooman Soleymani Maid
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Symptom Control ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Postoperative Recovery ◽  
Long Term Follow Up ◽  
Vulvar Mass

Abstract Background: Leiomyomas are uncommon vulvar neoplasms often misdiagnosed as other Bartholin gland pathology. Due to their rarity and the absence of guidelines, their diagnosis and management remain challenging, largely based on expert opinion and evidence from case reports. Case Presentation: This case report describes a 44-year-old woman presenting with accelerating growth of a vulvar mass. Based on clinical signs and symptoms, the initial diagnosis was Bartholin cyst. Surgical excision was provided for symptom control and aesthetic reasons. The histopathologic diagnosis was vulvar leiomyoma. The postoperative recovery was complicated by secondary haematoma and dehiscence of the surgical site. There was no recurrence at two years follow up. Therefore, we discuss the dilemma posed by physical examination of a vulvar mass, the challenges of the management, and report on secondary morbidity and long-term follow up, aspects of care for patients with vulvar pathology not commonly addressed in the literature. Conclusions: Bartholin gland neoplasms are rare tumors, commonly misdiagnosed as Bartholin’s cysts. Excision is the treatment of choice. Short time follow up allows prompt management of potential postoperative complications. Continuing long term follow up is recommended due to recurrence risk.

scholarly journals Primary hydatid cyst in the adductor magnus muscle

2020 ◽  
Vol 6 (3) ◽  
pp. 20200019
Author(s):  
Meltem Özdemir ◽  
Rasime Pelin Kavak ◽  
Nezih Kavak ◽  
Noyan Can Akdur
Keyword(s):  
Hydatid Cyst ◽  
Case Reports ◽  
Critical Role ◽  
False Negative ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
High Rate ◽  
Adductor Magnus ◽  
Primary Hydatid Cyst ◽  
Adductor Magnus Muscle

Human hydatid cyst is a zoonotic disease caused by the larvae of the Echinococcus species, most commonly the Echinococcus granulosus. Although hydatid cyst can cause disease almost anywhere in the human body, it most commonly affects the liver and lungs. Primary musculoskeletal hydatid involvement is a very rare occurrence even in endemic regions. Musculoskeletal hydatid disease shows no pathognomonic clinical signs and symptoms. And the contribution of serology to the diagnosis is negligible due to the high rate of false-negative results. Therefore, radiological imaging studies have a critical role in the diagnosis of the disease. To the best of our knowledge, there are only a few case reports of primary hydatid involvement of the adductor magnus muscle in the current literature. Here we present a 55-year-old female patient with primary hydatid cyst in the adductor magnus muscle and discuss the case in terms of imaging.

Posterior nutcracker syndrome – a systematic review

VASA ◽  
2018 ◽  
Vol 47 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Jae Hyon Park ◽  
Gi Hoon Lee ◽  
Seul Mi Lee ◽  
Michael Eisenhut ◽  
Andreas Kronbichler ◽  
...  
Keyword(s):  
Renal Vein ◽  
Left Renal Vein ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Final Analysis ◽  
Evidence Base ◽  
High Morbidity ◽  
Nutcracker Syndrome ◽  
Paediatric Age ◽  
Posterior Nutcracker Syndrome

Abstract. Posterior nutcracker syndrome (PNCS) is the entrapment of the left renal vein between the aorta and the vertebral column. Although uncommon, it is still an important diagnosis due to the high morbidity associated with the risk of secondary anaemia from haematuria, from long-term left renal vein hypertension, vascular thrombosis, and even blood clots in the urinary system. A literature search of PubMed and EMBASE databases was performed and 27 publications containing 27 cases were included for the final analysis. The following frequency of clinical signs and symptoms was noted: twenty-five patients had haematuria, 13 patients had flank pain, and two had hypertension. Overall, male-female distribution was balanced and there were more adult than paediatric (age < 18 years) patients. All symptoms of patients with conservative treatment were either well-controlled or under spontaneous resolution. Conservative management instead of surgical treatment should be preferred in most cases. Taken together, despite the low incidence of PNCS, its recognition and management are highly important. This systematic study explores the evidence base for conservative and medical options.

From Endodontic Therapy to Regenerative Endodontics: New Wine in Old Bottles

2020 ◽  
Vol 15 ◽  
Author(s):  
Ghee Seong Lim ◽  
Mang Chek Wey ◽  
Noor Hayati Azami ◽  
Nora Sakina Mohd Noor ◽  
May Nak Lau ◽  
...  
Keyword(s):  
Stem Cells ◽  
Root Canal ◽  
Case Reports ◽  
Clinical Signs ◽  
Mineral Trioxide Aggregate ◽  
Signs And Symptoms ◽  
Regenerative Endodontics ◽  
Immature Teeth ◽  
Clinical Signs And Symptoms ◽  
The 1960S

: The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal systems has been a cutting-edge technology. Though the notion started as early as the 1960s even before the discovery of stem cells and regenerative medicine, it was in the 2000s, this procedure gained momentum. Ever since then, researchers continue to discover its essential benefit to immature teeth and its ability to overcome the caveats of endodontic therapy which is commonly known as root canal treatment. Further, through this therapy, one can redevelop root even in immature teeth with necrotic pulps which overall helps in maintaining skeletal and dental development. Past literature indicates that regenerative endodontic procedures seem to be successful especially when compared with other conventional techniques such as Mineral Trioxide Aggregate apexification. Besides, many clinicians have begun to apply regenerative endodontic procedures to mature teeth in adult patients with several clinical case reports that have shown complete resolution of signs and symptoms of pulp necrosis. Generally, three most desirable outcomes anticipated by clinicians from this procedure namely resolution of clinical signs and symptoms, root maturation and redevelopment of neurogenesis process. Despite this, whether these objectives and true regeneration of the pulp/dentin complex are achieved is still a question mark. Following the discovery that regenerative endodontics indeed is a stem cell-based treatment, addressing the fundamental issue surrounding stem cells might assist in achieving all identified clinical outcomes, while favoring tissue formation that closely resembles pulp-dentin complex.

Role of Dentist in Diagnosis and Management of Mucormycosis in Association with COVID-19

2021 ◽  
Vol 11 (7) ◽  
pp. 159-163
Author(s):  
Piyush Dongre ◽  
Tanya Bansal
Keyword(s):  
Early Diagnosis ◽  
Fungal Infections ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Review Article ◽  
The Novel ◽  
Diagnosis And Management ◽  
Global Pandemic ◽  
Clinical Signs And Symptoms

In surge of the novel corona virus, there is increase in the frequency of fungal infections. Mucormycosis is one of the deep fungal infections which are increasing rapidly in this global pandemic period. Thus the early diagnosis and management is of utmost importance to decline the rate of this fatal infection. The clinical signs and symptoms and the culture reports are strictly considered in the management of oral fungal infection. This review article focuses on the importance of early diagnosis, prevention and management of mucormycosis and the role of the dentist in doing so. Key words: Mucormycosis, diagnosis, management, dentist.

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