Tongue ulcer in a patient with COVID-19: a case presentation

Abstract Background The emergence of COVID-19 has devastated many parts of the world. From asymptomatic to symptomatic, the virus causes a wide spectrum of presentations. COVID-19 patients may present with oral manifestations. In Afghanistan, where COVID-19 has severely strained the health care system, much of the population lacks proper oral hygiene. This makes the oral cavity a perfect site for SARS-CoV-2 to manifest clinical signs. Case presentation A 62-year-old male was evaluated in the Dentistry Teaching Clinic of Kabul University of Medical Sciences for a painful erosive lesion on dorsal surface of his tongue. He also complained of fever, cough, and taste alteration. He was referred to Afghan Japan Hospital for COVID-19 testing and tested positive. He was followed on for the treatment of SARS-CoV2. After 2 weeks, the patient tested negative and returned to the dentistry clinic for follow-up. Although there were no other signs of COVID-19, the painful erosive lesion on his tongue persisted. Oral evaluation were performed and the patient was advised to practice good hygiene. After 10 days, we observed an asymptomatic geographic tongue without fever and myalgias and the lesion of dorsal surface of tongue improved from severe condition to moderate. Conclusion In conclusion, patients with suspected or confirmed SARS-CoV-2 should be screened for symptoms and physical findings in the oral mucosa To prevent such an outcome, awareness programs need to be implemented for the diagnosis and management of clinical symptoms among patients.

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Some Clinical Manifestations and Laboratory Findings of Human Gigantica Fascioliasis in Pregnant Women and Children in Central-Coastal Provinces, Vietnam, 2003-2017

Journal of Pediatrics & Neonatal Biology ◽

10.33140/jpnb.04.03.02 ◽

2019 ◽

Vol 4 (3) ◽

Keyword(s):

Pregnant Women ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Clinical Signs ◽

Clinical Manifestations ◽

Fasciola Gigantica ◽

World Health ◽

Laboratory Findings ◽

Laboratory Parameters ◽

Women And Children

Introduction: Fascioliasis is a disease of the hepatobiliary system, caused by Fasciola spp that are increasing and threating of public health in the tropic areas, including of Central coastal of Vietnam. World Health Organisation estimates that at least 2.4 million people are infected in more than 70 countries worldwide, with several million at risk, and particularly, no continent is free from fascioliasis. This study carried out to evaluate several typical clinical and paracinical aspects in the pregnant women and children groups with fascioliasis. Methods: With the descriptive cross-sectional study design, and sample size in line with hospital based data. Results: the data post-analysis showed that total of 94 pregnant women and 212 child with gigantica fascioliasis were enrolled:- In the pregnant women group: the major clinical symptoms of epigastric and Chauffard Rivet triangle pain (95.74%), subshoulder muscle pain (97.87%), gastrointestinal disturbances as abdominal pain plus constipation (14.89%), loosed stool (22.34%), nausea and/or vomit (29.78%), mild fever (68%), allergic reaction with pruritis and urticaria (64.89%), mild anemia (4.26%), rare symptoms may be hepatomegaly (6.38%), chest pain, dyspnoea (43.62%), jaundice (2.13%); Laboratory parameters were positive ELISA test with Fasciola gigantica antigen (95.74%), hepatobiliary lesions by ultrasound (97.87%), majority in right liver (90.32%), eosinophilia is the predominant indicator (90.42%), In the children group: the clinical manifestations included of epigastric and Chauffard-Rivet area pain (94.34%), flatuence, nausea and intermittent vomiting (76.41%), digestive disoders (40.57%), allergy (30.66%), fatigue plus weight loss (12.74%); laboratory findings included of hepatobiliary lesions by US (100%), positive ELISA with Fasciola gigantica antigen (96.70%), eosinophil of 93.39% and 1.90% positive copro-examination with Fasciolae eggs. Conclusions: In pregnant women, symptoms are indistinguishable from hepatobiliary, digestive tract diseases or overlap with gestation terrains, and clinical signs of paediatric fascioliasis may mimic a wide spectrum of hepatobiliary disorders laboratory parameters and imaging diagnostics, especially in FasELISA, hypereosinophilia and liver lesions by ultrasound were very useful in positive diagnosis.

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Clinical and laboratory findings of patients with the possible diagnosis of influenza hospitalized in affiliated hospitals of Babol University of Medical Sciences, 2015-2016

Current Issues in Pharmacy and Medical Sciences ◽

10.1515/cipms-2018-0022 ◽

2018 ◽

Vol 31 (3) ◽

pp. 113-116 ◽

Cited By ~ 1

Author(s):

Mostafa Javanian ◽

Arefeh Babazadeh ◽

Soheil Ebrahimpour ◽

Mehran Shokri ◽

Masomeh Bayani

Keyword(s):

Clinical Laboratory ◽

Clinical Symptoms ◽

Clinical Signs ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Medical Sciences ◽

Laboratory Findings ◽

Cross Sectional ◽

Number Of Patients ◽

Epidemiological Characteristics

Abstract The clinical and para clinical manifestations of influenza in various patients have range from an autoimmune disease to a life-threatening respiratory infection. In addition, the severity of the disease is influenced by factors such as demographic factors, underlying diseases, and immune response. Therefore, in this study, we evaluated the clinical, laboratory and epidemiological characteristics of patients with this type of influenza in Babol (north of Iran). This study was conducted as a descriptive cross-sectional study from October 2015 to March 2016. Subsequently, in this study, records of 123 patients with clinical signs of the influenza-like disease who have undergone the clinical sign in hospitals affiliated to Babol University of Medical Sciences were reviewed. Of 123 patients admitted to a possible diagnosis of influenza, 58 patients (47.2%) were PCR positive for H1N1, while seventy nine (64.2%) participants were women and 21 (17.1%) had diabetes or underlying lung disease. Most of the involved age groups were of individuals above the age of 50. These were followed by the 21-35 years-old. Fever (78%), cough (65.9%), shivering (58.5%) and myalgia (56.1%) were the most common clinical symptoms. Increased levels of transaminases (43.1%), leukocytosis (35.8%) and thrombocytopenia (34.2%) were as well reported in patients as the most frequently reported para clinical findings. In the present study, the most usual clinical symptoms were fever, cough, chill, and myalgia, while gastrointestinal symptoms were also noticeably observed in patients. In an experimental study, a significant number of patients showed leukocytosis and thrombocytopenia and increased transaminases.

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Antiphospholipid syndrome: a case report with an unusual wide spectrum of clinical manifestations

Autoimmunity Highlights ◽

10.1186/s13317-019-0119-3 ◽

2019 ◽

Vol 10 (1) ◽

Cited By ~ 2

Author(s):

Carmela Mazzoccoli ◽

Domenico Comitangelo ◽

Alessia D’Introno ◽

Valeria Mastropierro ◽

Carlo Sabbà ◽

...

Keyword(s):

Antiphospholipid Syndrome ◽

Clinical Symptoms ◽

Wide Spectrum ◽

Clinical Manifestations ◽

Classification Criteria ◽

Inflammation Markers ◽

Case Presentation ◽

Pregnancy Morbidity ◽

Generalized Seizures ◽

Laboratory Examinations

Abstract Background Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis, and the detection of circulating antiphospholipid antibodies. The classification criteria for definite APS are actually met when at least one clinical criterion (thrombosis or pregnancy morbidity) is present in association of one laboratory criterion (LAC, aCL antibody or aβ2GPI antibody present on two or more occasions, at least 12 weeks a part), and thrombosis should be confirmed by objective validated criteria. The average age of primary APS patients has been reported to be about 35–40 years and the disease is more common in women than in men. Case presentation In this report, we described a rare case of an adult male who presented over a period of 9 years with a wide spectrum of clinical manifestations involving different organs that were not initially diagnosed as APS. Dizziness and syncope were his first clinical symptoms, and a non-bacterial thrombotic endocarditis (NBTE) involving the mitral valve was at first diagnosed. Subsequently, the patient also presented with generalized seizures and subsequent head injury. When the patient was admitted to our clinic with bilateral epistaxis and fever, thrombocytopenia was revealed. Moreover, laboratory examinations showed acute pancreatitis with an increase of levels of inflammation markers. Conclusion Based on the patient’s medical history and all the examination results, it was possible to make a diagnosis of primary APS and, starting from diagnosis of thrombocytopenia, we were allowed to conclude that all of manifestation were epi-phenomena of a unique clinical entity, rather than unrelated diseases. Though APS is one of the most common thrombocytophilias, unfortunately, it is not recognized often enough. The lack of prevention in undiagnosed patients may cause severe complications which can in turn result in the death of those patients.

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Instruction for authors

International Journal of Medical Sciences ◽

10.32441/ijms.v1i2.81 ◽

2018 ◽

Vol 1 (2) ◽

pp. 75-79

Author(s):

Abdulghani Alsamarai

Keyword(s):

Original Work ◽

Wide Spectrum ◽

Case Reports ◽

Editorial Policy ◽

High Standard ◽

Publication Ethics ◽

Current Interest ◽

Medical Sciences ◽

Medical News ◽

Review Articles

Introduction The International Journal of Medical Sciences [IJMS], ISSN 2522-7386, is a peer-reviewed, 3 issues published annually. Authors are invited to submit for publication articles with a wide spectrum of coverage reporting original work, in the fields of medicine, nursery, dentistry, and pharmacy sciences. Review articles are usually by invitation only. However, Review articles of current interest and high standard will be considered. Prospective work should not be back dated. There are also sections for Case Reports, Brief Communication, correspondence and medical news items. Authors should read the editorial policy and publication ethics before submitting their manuscripts. Authors should also use the appropriate reporting guidelines in preparing their manuscripts

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A 60-year-old woman with asymptomatic total thoracic–abdominal aortic aneurysm

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01600-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jianying Deng ◽

Wei Liu

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Effective Treatment ◽

Clinical Symptoms ◽

Aortic Aneurysms ◽

Case Presentation ◽

Second Stage ◽

Aortic Replacement ◽

Abdominal Aortic ◽

Thoracoabdominal Aortic Replacement

Abstract Introduction Total thoracic–abdominal aortic aneurysm is a rare disease in cardiovascular surgery, with high surgical risk and high mortality. Surgery is considered the most effective treatment for total aortic aneurysms. Case presentation Our group admitted a 60-year-old female patients with asymptomatic complex total thoracic–abdominal aortic aneurysm, and successfully performed two-staged surgery, namely Bentall + Sun’s operation in the first-stage and thoracoabdominal aortic replacement in the second-stage. The results of the surgery were satisfactory. Conclusions Patients with total thoracic–abdominal aortic aneurysm may not have typical clinical symptoms and require a careful and comprehensive physical examination and related auxiliary examinations by clinicians. Staged repair of total thoracic–abdominal aortic aneurysms is still a safe and effective treatment.

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Uptake of exogenous estrogen as a differential diagnosis of ovarian-remnant-syndrome in a bitch: a case report

BMC Veterinary Research ◽

10.1186/s12917-021-02923-9 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Sebastian Ganz ◽

Axel Wehrend

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Luteinizing Hormone ◽

Clinical Signs ◽

Menopausal Symptoms ◽

Case Presentation ◽

Estrogen Exposure ◽

Exogenous Estrogen ◽

Endocrine Parameters

Abstract Background Clinical signs of heat in bitches that have been previously spayed are often associated with the presence of ovarian remnant syndrome. The inclusion of exogenous estrogens as a differential diagnosis in this regard is often ignored and may lead to misinterpretation of the case. Case presentation Herein, we report a case of exogenous estrogen exposure over several months to a 6.5-year-old spayed crossbred bitch, weighing 8.4 kg. The bitch presented in the clinic because of suspected ovarian remnant syndrome. Castration was performed within the first 6 months after birth. Important endocrine parameters measured at the first appointment were Anti-Müllerian hormone (< 0.01 ng/mL), progesterone (0.36 ng/mL), estradiol-17ß (20.7 pg/mL), and luteinizing hormone (< 0.1 ng/mL). After an extensive conversation with the owner, it was revealed that she was using an estrogen spray because of severe menopausal symptoms. After the owner stopped using this spray, the symptoms of the bitch disappeared. Conclusion Therefore, the uptake of estrogens should be a differential diagnosis for symptoms of the ovarian remnant syndrome. A detailed anamnesis is crucial to identify the source of estrogen in the environment of the affected bitch.

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Concentrations of canine prostate specific esterase, CPSE, at baseline are associated with the relative size of the prostate at three-year follow-up

BMC Veterinary Research ◽

10.1186/s12917-021-02874-1 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Bodil S. Holst ◽

Sofia Carlin ◽

Virginie Fouriez-Lablée ◽

Sofia Hanås ◽

Sofie Ödling ◽

...

Keyword(s):

Clinical Symptoms ◽

Specific Antigen ◽

Relative Size ◽

Clinical Signs ◽

Serum Concentrations ◽

Prostatic Disease ◽

Follow Up Study ◽

Prostate Size ◽

Prostate Growth

Abstract Background Enlargement of the prostate is associated with prostatic diseases in dogs, and an estimation of prostatic size is a central part in the diagnostic workup. Ultrasonography is often the method of choice, but biomarkers constitute an alternative. Canine prostate specific esterase (CPSE) shares many characteristics with human prostate specific antigen (PSA) and is related to prostate size. In men with clinical symptoms of prostatic disease, PSA concentrations are related to prostate growth. The aims of the present follow-up study were to evaluate if the concentration of CPSE is associated with future growth of the prostate, and if analysis of a panel of 16 steroids gives further information on prostatic growth. Owners of dogs included in a previous study were 3 years later contacted for a follow-up study that included an interview and a clinical examination. The prostate was examined by ultrasonography. Serum concentrations of CPSE were measured, as was a panel of steroids. Results Of the 79 dogs included at baseline, owners of 77 dogs (97%) were reached for an interview, and 22 were available for a follow-up examination. Six of the 79 dogs had clinical signs of prostatic disease at baseline, and eight of the remaining 73 dogs (11%) developed clinical signs between baseline and follow-up, information was lacking for two dogs. Development of clinical signs was significantly more common in dogs with a relative prostate size of ≥2.5 at baseline (n = 20) than in dogs with smaller prostates (n = 51). Serum concentrations of CPSE at baseline were not associated with the change in prostatic size between baseline and follow-up. Serum concentrations of CPSE at baseline and at follow-up were positively associated with the relative prostatic size (Srel) at follow-up. Concentrations of corticosterone (P = 0.024), and the class corticosteroids (P = 0.0035) were positively associated with the difference in Srel between baseline and follow-up. Conclusions The results support the use of CPSE for estimating present and future prostatic size in dogs ≥4 years, and the clinical usefulness of prostatic size for predicting development of clinical signs of prostatic disease in the dog. The association between corticosteroids and prostate growth warrants further investigation.

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Simultaneous enterovirus EV-D68 and CVA6 infections causing acute respiratory distress syndrome and hand, foot and mouth disease

Virology Journal ◽

10.1186/s12985-021-01560-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Ivanildo Pedro de Sousa ◽

Heloísa Ihle Giamberardino ◽

Sonia Mara Raboni ◽

Maria Carmo Debur ◽

Maria de Lourdes Aguiar Oliveira ◽

...

Keyword(s):

Respiratory Distress ◽

Clinical Symptoms ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Rt Pcr ◽

Double Infection ◽

Chinese Strain ◽

Case Presentation ◽

Foot And Mouth ◽

Shed Light

Abstract Background Although most enterovirus (EV) infections can be asymptomatic, these viral agents can cause serious conditions associated with central nervous system, respiratory disease and uncommon manifestations of hand, foot and mouth disease (HFMD). EV-coinfections have been rarely reported with development of complications and severe clinical outcome. An atypical case of a child presenting HFMD and severe acute respiratory syndrome, co-infected with EV-D68 and CVA6, is reported herein. Case presentation A 3-year-old boy was admitted in the emergency department unit showing fever, abdominal pain and tachycardia. Twenty-four hours after hospitalization the child developed severe clinical symptoms associated with HFMD and was discharged after recovery. Two days later, the child was readmitted with fever, cough and respiratory distress. RT-PCR and Sanger sequencing confirmed positivity for EV-D68 and CVA6 in oro and nasopharynges swabs and vesicles fluid, respectively. Phylogenetic analysis based on VP1 gene sequences suggested that CVA6 was closely related with HFMD viruses circulating in Turkey, while EV-D68 was genetically related to a Chinese strain. Conclusions To the best of our knowledge, this case is the first report of a double infection caused by CVA6 and EV-D68, which shed light on the pathogenesis of enterovirus infections. Further studies must be conducted to ascertain the role and clinical significance of EV co-infections, as well as a potential synergistic pathway between these viruses.

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A case of statin-induced liver injury with positive rechallenge with a second statin. Is there a class effect?

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2021-0013 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Giovanna Onfiani ◽

Fabio Nascimbeni ◽

Francesca Carubbi

Keyword(s):

Liver Injury ◽

Clinical Symptoms ◽

High Risk Population ◽

Drug Induced ◽

Case Presentation ◽

Drug Induced Liver Injury ◽

Aged Woman ◽

Cardiovascular Morbidity And Mortality ◽

Middle Aged Woman

Abstract Objectives Statins have proved to reduce cardiovascular morbidity and mortality in high-risk population and are generally well tolerated, although adverse events can occur. Up to 3% of patients develop aminotransferases elevation, which usually normalizes with continued treatment and hardly is associated with clinical symptoms. Serious statin-related liver injury is exceedingly rare. Furthermore, literature regarding rechallenge with a second statin is extremely poor. Some authors caution that re-exposure to these drugs is associated with a more serious liver injury but safe switching to a second statin after drug-induced liver injury (DILI) is also reported. Case presentation We describe a case of a middle-aged woman who developed hepatocellular liver injury after simvastatin dose escalation; a rechallenge with low dose rosuvastatin caused rapid recurrence of DILI. Conclusions In our opinion, clinicians should be very cautious upon rechallenge and closely follow-up patients who experienced statin-induced liver injury when trying re-exposure to another statin.

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Improvement in mild anti-IgLON5 encephalopathy without immunotherapy: a case report

BMC Neurology ◽

10.1186/s12883-021-02145-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuting Wang ◽

Xiuling Wu ◽

Baoquan Lu

Keyword(s):

Sleep Disorder ◽

Clinical Symptoms ◽

Antiviral Treatment ◽

Primary Treatment ◽

Serum Analysis ◽

Autonomic Nervous System Dysfunction ◽

Case Presentation ◽

Mild Disease ◽

Prominent Symptom ◽

Vertical Gaze

Abstract Background Anti-IgLON5 antibody-related encephalopathy is a recently discovered and rare autoimmune disease, and its diagnosis and treatment are more challenging than for other autoimmune encephalopathic diseases. Sleep disorder is the most prominent symptom of the disease. It can also present with gait instability, dysarthria, dysphagia, dementia, ataxia, autonomic nervous system dysfunction, chorea, vertical gaze paralysis, and other symptoms. Immunotherapy remains the primary treatment for this disease; however, there is no definitive conclusion regarding the effect of immunotherapy. The clinical symptoms of the reported cases of anti-IgLON5 antibody-related encephalopathy were generally severe. However, the symptoms in our patient were mild and relieved without immunotherapy, unlike the previously reported cases. Case presentation A 62-year-old man presented with behavioural abnormalities and involuntary movements after nearly 2 months of fever and headache. He also had symptoms of mild sleep disorder. Due to the abnormal levels of infection-related indicators, antiviral treatment was started on the day of admission. The serum analysis confirmed the presence of IgLON5 antibody, and the patient was found to be genetically susceptible. The patient’s symptoms resolved rapidly without immunotherapy and did not recur. Conclusions This case demonstrated that IgLON5 antibody-related encephalopathy might have mild manifestations. Infection and a genetic predisposition may be important causes for the disease. Patients with a mild disease may have a better prognosis.

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