scholarly journals MON-693 Strongyloides Stercoralis Hyper Infestation Syndrome in Type 2 Diabetes: An ANCA Positive Case Report from India

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Kalpana Dash ◽  
Surekha Tippisetty ◽  
Vamsi Krishna Kolukula
Keyword(s):  
Molecular Mimicry ◽  
Past History ◽  
Parasite Load ◽  
Strongyloides Stercoralis ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Total Leukocyte Count ◽  
Stool Examination ◽  
Laboratory Findings ◽  
Precise Diagnosis ◽  
History Of

Abstract A 53-year old male patient with T2D and hypertension for 13 years, presented to Apollo Sugar Clinic, Raipur with recurrent abdomen pain, but no vomiting, constipation, diarrhea or fever. The patient has a past history of asthmatic bronchitis, recurrent eosinophilia, and one month prior to hospitalization, recovered from erythematous maculopapular serpentine rash measuring 6.0 x 1.5 cm over the abdomen post anti-allergic treatment. The patient was neither suffering from immunosuppressive condition nor was on immunosuppressant therapy, had normal vitals but the laboratory findings revealed high total leukocyte count and raised absolute eosinophil count (52%). The provisional diagnosis was made as hypereosinophilic enteritis in a long-standing T2D and hypertension. Immunological tests antinuclear antibody (ANA) and antineutrophil cytoplasmic antibodies (ANCA) resulted in positive ruling out vasculitis. Stool examination detected rhabditiform larvae of S Stercoralis and diagnosed as Strongyloides hyper infestation syndrome. The patient was managed with IV antibiotics, IV fluids, IV insulin and when abdomen pain reduced started with the oral diet. To remove larvae load, unlike routine treatment, the patient was put on albendazole and ivermectin for three consecutive days. After 15 days follow-up patient was completely asymptomatic; at 6 weeks TLC, stool test, ANCA and ANA titer were negative indicating no parasite load. These antibodies detected could be due to molecular mimicry triggered by parasite antigens which may help in diagnosing and monitoring the disease course. ANA and ANCA positive results have been rarely reported in the past for S stercoralis. This unique case of S stercoralis infestation in T2D may enlighten the health care physicians to investigate for this infestation in immunocompromised T2D patients with pain abdomen. Precise diagnosis with timely management can prevent steroid therapy due to eosinophilic enteritis which can be harmful to the patients.

Hand-foot lesion in old age asthmatic women

2015 ◽  
Vol 3 (1) ◽  
pp. 314-317
Keyword(s):  
Oral Cavity ◽  
Physical Examination ◽  
Old Age ◽  
Past History ◽  
Laboratory Findings ◽  
Normal Limits ◽  
History Of ◽  
Complete Blood Counts

papulovesicular eruption on the hands which had begun to appear on the palms of her hands 2 days previously and which progressed to the soles, and dorsum of the feet. He had past history of asthma for more than 30-years and was taking bronchodilator and steroid medications. Physical examination revealed multiple erythematous papules on the palms, soles. The oral cavity and other areas such as face and trunk were spared. Laboratory findings, including complete blood counts and blood chemistries, were within normal limits. After 3 1/2 weeks he was commenced on oral aciclovir 200 mg five times daily, with subsequent resolution of all lesions within 5 days.

scholarly journals Clinical Difference between Acute Appendicitis and Acute Right-Sided Colonic Diverticulitis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ji Ho Song ◽  
Yong Won Kim ◽  
Sanghun Lee ◽  
Han Ho Do ◽  
Jun Seok Seo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Acute Appendicitis ◽  
Logistic Regression Analysis ◽  
Past History ◽  
Colonic Diverticulitis ◽  
Laboratory Findings ◽  
Clinical Difference ◽  
Clinical Presentations ◽  
History Of

Background. Clinical presentations of acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are similar. However, the usual treatment for each disease differs between surgical and conservative management. The aim of this study was to identify clinical differences between AA and ARCD. Method. We performed a single-center retrospective study on adult patients, with uncomplicated AA and ARCD confirmed by computed tomography, who visited an emergency department between March 2018 and August 2019. Clinical variables including past medical history, presented symptoms and signs, and laboratory findings were compared between the two groups. A logistic regression analysis was subsequently performed to differentiate ARCD from AA based on results of univariate analyses. Results. A total of 212 (79.1%) and 56 (20.9%) patients were enrolled in AA and ARSD groups, respectively. Logistic regression analysis revealed that a past history of diverticulitis [OR: 102.679 (95% CI: 9.964–1058.055), p<0.001] was associated with ARCD, while ketonuria [OR: 2.907 (95% CI: 1.091–7.745), p=0.033], anorexia [OR: 21.544 (95% CI: 3.905–118.868), p<0.001], and neutrophilia [OR: 3.406 (95% CI: 1.243–9.336), p=0.017] were associated with AA. Conclusion. Anorexia, neutrophilia, and ketonuria were predictors of AA while a history of diverticulitis was a predictor of ARCD.

scholarly journals Central Nervous System Demyelination in a Charcot-Marie-Tooth Type 1A Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Christos Koros ◽  
Maria-Eleftheria Evangelopoulos ◽  
Costas Kilidireas ◽  
Elisabeth Andreadou
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Molecular Mimicry ◽  
Central Nervous System Involvement ◽  
Laboratory Findings ◽  
Charcot Marie Tooth ◽  
Demyelinating Disorder ◽  
History Of ◽  
Tooth Type ◽  
Simultaneous Existence

Introduction. Central nervous system involvement, either clinical or subclinical, has been reported mainly in X-linked Charcot-Marie-Tooth (CMT-X) patients.Case Presentation. We present the case of a 31-year-old man with a genetically confirmed history of CMT1A who developed CNS involvement mimicking multiple sclerosis (MS). Clinical, imaging, and laboratory findings suggested an autoimmune CNS demyelination.Discussion. Although the simultaneous existence of CMT1A and MS could be coincidental we postulate that overexpression of PMP22, the target protein in CMT1A, might influence the immunological self-tolerance to CNS proteins via molecular mimicry, leading to a CNS autoimmune demyelinating disorder.

scholarly journals Clinical difference between acute appendicitis and acute right-sided colonic diverticulitis

2020 ◽  
Author(s):  
Ji Ho Song ◽  
Sanghun Lee ◽  
Han Ho ◽  
Jun Seok Seo ◽  
Jeong Hun Lee ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Acute Appendicitis ◽  
Logistic Regression Analysis ◽  
Past History ◽  
Colonic Diverticulitis ◽  
Retrospective Case ◽  
Laboratory Findings ◽  
Clinical Difference ◽  
History Of

Abstract Background: The clinical presentations of acute appendicitis (AA) and acute right-sided colonic diverticulitis (ARCD) are similar, but the usual treatment for each disease differs between surgical and conservative management. This study aimed to identify the clinical differences between AA and ARCD.Method: We performed a single-center retrospective case-control study on adult patients with AA and ARCD confirmed by computed tomography who had visited an emergency department between March 2018 and February 2019. The clinical variables, including past medical history, presented symptoms and signs, and laboratory findings were compared between the two groups. We subsequently performed a logistic regression analysis for differentiating ARCD from AA based on the results of univariate analyses.Results: A total of 222 (79%) and 59 (21%) patients were enrolled in the AA and ARSD groups, respectively. Logistic regression analysis revealed that factors associated with ARCD were a past history of diverticulitis [OR 141.691 (95% CI: 12.222 – 1642.601), p < 0.001], ketonuria [OR 0.268 (95% CI: 0.099 – 0.726), p = 0.010], anorexia [OR 0.037 (95% CI: 0.007 – 0.207), p < 0.001], and neutrophilia [OR 0.179 (95% CI: 0.062 – 0.519), p = 0.002].Conclusion: Anorexia, neutrophilia, and ketonuria were predictors of AA and a history of diverticulitis was a predictor of ARCD.

Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study

2019 ◽  
Vol 27 (17) ◽  
pp. 1835-1845 ◽  
Author(s):  
Yoonkyung Chang ◽  
Ho Geol Woo ◽  
Jin Park ◽  
Ji Sung Lee ◽  
Tae-Jin Song
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Oral Hygiene ◽  
Past History ◽  
Population Based ◽  
Tooth Brushing ◽  
Missing Teeth ◽  
National Health Insurance System ◽  
Laboratory Findings ◽  
History Of

Aims Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure. This study aims to investigate association of oral hygiene indicators with atrial fibrillation and heart failure risk in Korea. Methods We included 161,286 subjects from the National Health Insurance System-Health Screening Cohort who had no missing data for demographics, past history, or laboratory findings. They had no history of atrial fibrillation, heart failure, or cardiac valvular diseases. For oral hygiene indicators, presence of periodontal disease, number of tooth brushings, any reasons of dental visit, professional dental cleaning, and number of missing teeth were investigated. Results During median follow-up of 10.5 years, 4911 (3.0%) cases of atrial fibrillation and 7971 (4.9%) cases of heart failure occurred. In multivariate analysis after adjusting age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, hypertension, diabetes, dyslipidemia, current smoking, renal disease, history of cancer, systolic blood pressure, blood and urine laboratory findings, frequent tooth brushing (≥3 times/day) was significantly associated with attenuated risk of atrial fibrillation (hazard ratio: 0.90, 95% confidence interval (0.83–0.98)) and heart failure (0.88, (0.82–0.94)). Professional dental cleaning was negatively (0.93, (0.88–0.99)), while number of missing teeth ≥22 was positively (1.32, (1.11–1.56)) associated with risk of heart failure. Conclusion Improved oral hygiene care was associated with decreased risk of atrial fibrillation and heart failure. Healthier oral hygiene by frequent tooth brushing and professional dental cleaning may reduce risk of atrial fibrillation and heart failure.

scholarly journals Strongyloides Infection in a Man with Abdominal Pain and a History of Rheumatoid Arthritis

2018 ◽  
Vol 10 (1) ◽  
pp. 23-28
Author(s):  
Fariborz Mansour-Ghanaei ◽  
Farahnaz Joukar ◽  
Alireza Samadi ◽  
Sara Mavaddati ◽  
Arash Daryakar
Keyword(s):  
Rheumatoid Arthritis ◽  
Severe Pain ◽  
Immunocompromised Patient ◽  
Gastrointestinal Symptoms ◽  
Strongyloides Stercoralis ◽  
Stool Examination ◽  
Immunocompromised Patients ◽  
Pathological Analysis ◽  
Immunosuppressive Medications ◽  
History Of

Background:Strongyloidiasis is self-limited by the complete immune system, it may be complicated and causes hyperinfection in immunocompromised patients. Objective: Here, we report a case of an immunocompromised patient with duodenal involvement ofStrongyloides stercoralis.Case Report:A 65-year-old man presented with severe pain in central abdomen and periumbilical regions. He had no history of alcohol consumption, smoking and surgery but the history of RA (Rheumatoid Arthritis) and hypothyroidism taking immunosuppressive medications. The patient underwent endoscopy and colonoscopy which pathological analysis of the biopsies revealed remarkable findings in favor of Strongyloidiasis. After two consecutive day’s consumption of ivermectin 200µg/kg, the symptoms were completely removed. Also, the stool examination was negative forS.stercoralislarvae two weeks after end of the treatment.Conclusions:It seems that in immunocompromised patients with gastrointestinal symptoms assumption of parasite-like infections such as Strongyloidiasis should be considered as one of the diagnosis options. Due to the physiological and gut microbial alternations, these patients are more susceptible to infectious diseases.

Levamisole-Induced Vasculitis: A Characteristic Cutaneous Vasculitis Associated With Levamisole-Adulterated Cocaine

2015 ◽  
Vol 139 (8) ◽  
pp. 1058-1061 ◽  
Author(s):  
Jordan A. Roberts ◽  
Patricia Chévez-Barrios
Keyword(s):  
Leukocytoclastic Vasculitis ◽  
Accurate Diagnosis ◽  
Cutaneous Vasculitis ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Laboratory Findings ◽  
Small Vessels ◽  
Erythrocyte Sedimentation ◽  
History Of ◽  
Rising Incidence ◽  
Purpuric Rash

Levamisole-induced vasculitis is a characteristic cutaneous vasculitis syndrome associated with the use of levamisole-adulterated cocaine. Patients will typically present with a painful, purpuric rash in a retiform or stellate pattern with or without central necrosis involving the extremities, trunk, nasal tip, digits, cheeks, and/or ears. A history of cocaine abuse can be elicited. Histologic features include microvascular thrombi and/or leukocytoclastic vasculitis involving small vessels of the superficial and deep dermis. Epidermal involvement is variably seen. Laboratory findings include leukopenia, neutropenia (including agranulocytosis), elevated erythrocyte sedimentation rate, normal coagulation studies, and positive autoantibodies including perinuclear and cytoplasmic antineutrophil cytoplasmic antibodies, antinuclear antibody, and lupus anticoagulant. Differential diagnosis includes other microscopic vasculitides, and clinical and laboratory correlation with histologic findings is essential. Lesions typically resolve with the cessation of cocaine use. Because of the treatment implications and rising incidence of this entity, rapid and accurate diagnosis is essential.

PREVALENCE AND RELATED FACTORS OF POSTNATAL DEPRESSION IN HIV INFECTED WOMEN

2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao
Keyword(s):  
Regression Analysis ◽  
Postpartum Depression ◽  
Hiv Infection ◽  
Postnatal Depression ◽  
Past History ◽  
Depression Scale ◽  
Multivariate Regression Analysis ◽  
Related Factors ◽  
History Of ◽  
History Of Depression

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

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