scholarly journals Miller Fisher syndrome and polyneuritis cranialis in COVID-19

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. e601-e605 ◽  
Author(s):  
Consuelo Gutiérrez-Ortiz ◽  
Antonio Méndez-Guerrero ◽  
Sara Rodrigo-Rey ◽  
Eduardo San Pedro-Murillo ◽  
Laura Bermejo-Guerrero ◽  
...  
Keyword(s):  
Miller Fisher Syndrome ◽  
University Hospital ◽  
Low Grade ◽  
Fisher Syndrome ◽  
Neurologic Recovery ◽  
First Case ◽  
Oropharyngeal Swab ◽  
Bilateral Abducens Palsy ◽  
Bilateral Abducens ◽  
The University

ObjectiveTo report 2 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented acutely with Miller Fisher syndrome and polyneuritis cranialis, respectively.MethodsPatient data were obtained from medical records from the University Hospital “Príncipe de Asturias,” Alcalá de Henares, and the University Hospital “12 de Octubre,” Madrid, Spain.ResultsA 50-year-old man presented with anosmia, ageusia, right internuclear ophthalmoparesis, right fascicular oculomotor palsy, ataxia, areflexia, albuminocytologic dissociation, and positive testing for anti-GD1b–immunoglobulin G antibody. Five days previously, he had developed a cough, malaise, headache, low back pain, and fever. A 39-year-old man presented with ageusia, bilateral abducens palsy, areflexia, and albuminocytologic dissociation. Three days previously, he had developed diarrhea, a low-grade fever, and poor general condition. Oropharyngeal swab test for SARS-CoV-2 by qualitative real-time reverse transcriptase PCR assay was positive in both patients and negative in the CSF. The first patient was treated with IV immunoglobulin and the second with acetaminophen. Two weeks later, both patients made a complete neurologic recovery, except for residual anosmia and ageusia in the first case.ConclusionsOur 2 cases highlight the rare occurrence of Miller Fisher syndrome and polyneuritis cranialis during the coronavirus disease 2019 (COVID-19) pandemic. These neurologic manifestations may occur because of an aberrant immune response to COVID-19. The full clinical spectrum of neurologic symptoms in patients with COVID-19 remains to be characterized.

scholarly journals First Case of Liver Glycogen Documented in the Pediatric Ward of the University Hospital of Treichville (Cote D’Ivoire)

2017 ◽  
Vol 07 (02) ◽  
pp. 72-76
Author(s):  
Jean-Jacques Yao Atteby ◽  
Lassina Cissé ◽  
Jacob Enoh ◽  
Kouadio Richard Azagoh ◽  
Germaine Niamké ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Liver Glycogen ◽  
University Hospital ◽  
Cote D’Ivoire ◽  
Pediatric Ward ◽  
Côte D'ivoire ◽  
First Case ◽  
The University

Cryptococcosis at the University Hospital, Kuala Lumpur

1998 ◽  
Vol 28 (1) ◽  
pp. 34-39 ◽  
Author(s):  
S A R Doi ◽  
C T Tan ◽  
C K Liam ◽  
K Naganathan
Keyword(s):  
Amphotericin B ◽  
Surgical Resection ◽  
Cumulative Dose ◽  
Chest Radiographs ◽  
University Hospital ◽  
Low Grade ◽  
Kuala Lumpur ◽  
Early Presentation ◽  
Intracranial Pressures ◽  
The University

We review our experience with 27 cases of pulmonary and meningeal cryptococcosis at the University Hospital, (Kuala Lumpar, Malaysia) where this is the most common cause of adult meningitis in patients without debilitating illnesses. Of the 27 cases analysed, six presented primarily with pulmonary symptomatology which usually were mainly cough, chest pain and low grade fever. The rest presented with primarily central nervous system (CNS) symptomatology of which headaches and fever were the most consistent symptoms although a third of these patients also had pulmonary lesions noted on chest radiographs. Treatment in all cases was with amphotericin B and 5-fluorocytosine and usually till a total cumulative dose of 1.5 g of amphotericin had been reached (an average of 10 weeks). Primary pulmonary presentations, if symptomatic, were treated as per CNS cryptococcosis due to the high likelihood of CNS dissemination. Incidental pulmonary cryptococcoma found on routine chest radiographs were confirmed by biopsy under ultrasound or fluoroscopy guidance and booked for surgical resection. Death usually occurred early in patients who presented late. Once patients responded to therapy, mortality was usually avoided. The only cause of morbidity in survivors was visual impairment or blindness, and this was attributed mainly to intracranial hypertension with residual deficits determined by the measures taken to lower intracranial pressures. Our experience suggests that: (i) symptomatic patients should have combination therapy with 5-fluorocytosine and amphotericin B till at least a cumulative dose of 1.5 g amphotericin B is reached irrespective of whether they have primary CNS or pulmonary symptomatology; (ii) non-symptomatic pulmonary cryptococcoma could be treated primarily by surgical resection; (iii) visual failure or papilloedema should be treated aggressively; and (iv) prognosis is good with adequate therapy and early presentation.

scholarly journals SARS-CoV-2 outbreak in a tri-national urban area is dominated by a B.1 lineage variant linked to mass gathering events

2020 ◽  
Author(s):  
Madlen Stange ◽  
Alfredo Mari ◽  
Tim Roloff ◽  
Helena MB Seth-Smith ◽  
Michael Schweitzer ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
University Hospital ◽  
Contact Tracing ◽  
Phylogenetic Study ◽  
Mass Gathering ◽  
Travel History ◽  
First Case ◽  
The University ◽  
The City ◽  
Family Transmission

AbstractBackgroundThe first case of SARS-CoV-2 in Basel, Switzerland was detected on February 26th 2020. We present a phylogenetic study to explore viral introduction and evolution during the exponential early phase of the local COVID-19 outbreak from February 26th until March 23rd.MethodsWe sequenced SARS-CoV-2 naso-oropharyngeal swabs from positive 746 tests that were performed at the University Hospital Basel in the timeframe of our study. We successfully generated 468 high quality genomes from unique patients and called variants with our COVID-19 Pipeline (COVGAP). We analysed viral genetic diversity using PANGOLIN taxonomic lineages. To identify introduction and dissemination events we incorporated global SARS-CoV-2 genomes and inferred a time-calibrated phylogeny. We used epidemiological data to aid interpretation of phylogenetic patterns.FindingsThe early outbreak in Basel was dominated by lineage B.1 (83·6%), detected from March 2nd, although the first lineage identified was B.1.1. Within B.1, a clade defined by the SNP C15324T contains 68·2% of our samples (‘Basel cluster’), including 157 identical sequences at the root of the ‘Basel cluster’, suggesting local spreading events. We infer the origin of the ‘Basel cluster’ defining mutation to mid-February in our tri-national region. The remaining genomes map broadly over the global phylogenetic tree, evidencing several events of introduction from and/or dissemination to other regions of the world via travellers. We also observe family transmission events.InterpretationA single lineage variant dominated the outbreak in the City of Basel while other lineages such as the first (B1.1) did not propagate. We identify mass gathering events and less so travel returners and family transmission as causes for the local outbreak. We highlight the importance of adding specific questions to the epidemiological questionnaires that are collected, to obtain data on attendance of large gathering events and locations as well as travel history to effectively identify routes of transmissions in up-coming outbreaks. This phylogenetic analysis enriches epidemiological and contact tracing data, allowing, even retrospectively, connection of seemingly unconnected events, and can inform public health interventions.

Corynebacterium diphtheriae Infection in Mahajanga, Madagascar: First Case Report

2020 ◽  
Author(s):  
Rivo Solotiana Rakotomalala ◽  
Zo Zafitsara Andrianirina ◽  
Elisoa Ratsima ◽  
Patrick Randrianandraina ◽  
Frédérique Randrianirina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diphtheria Toxin ◽  
Throat Swab ◽  
Neurological Complications ◽  
Corynebacterium Diphtheriae ◽  
University Hospital ◽  
Rural Municipality ◽  
First Case ◽  
The University ◽  
Hospital Center

Abstract Diphtheria is an infection that has been unreported for more than two decades in Mahajanga. A child, aged 4, presented with a pseudomembranous pharyngitis was associated with a dysphagia. He was from a rural municipality of Ambato Boeny at Mahajanga province and was admitted to the Pediatric Unit of the University Hospital Center. The child was not immunized against diphtheria. A throat swab was performed and cultured, from which Corynebacterium diphtheriae was identified. The strain, of biovar Mitis, was confirmed as diphtheria toxin (DT)-gene positive and produced DT (Elek test). Unfortunately, the child developed cardiac and neurological complications and died of respiratory and heart failure.

scholarly journals The First Evidence of Lyme Neuroborreliosis in Southern Bosnia and Herzegovina

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Jurica Arapovic ◽  
Sinisa Skocibusic ◽  
Svjetlana Grgic ◽  
Jadranka Nikolic
Keyword(s):  
Bosnia And Herzegovina ◽  
Facial Palsy ◽  
Clinical Symptoms ◽  
Neurological Status ◽  
Antimicrobial Treatment ◽  
Lyme Neuroborreliosis ◽  
University Hospital ◽  
First Case ◽  
Dramatic Rise ◽  
The University

Lyme borreliosis (LB) is caused by the spirocheteBorrelia burgdorferi, which is transmitted to humans by ticks of theIxodes ricinuscomplex. It is manifested by a variety of clinical symptoms and affects skin, joints, heart, and nervous system. Neurological manifestations are predictable and usually include meningoencephalitis, facial palsy, or radiculopathy. Recently, a dramatic rise in the number of diagnosed cases of LB has been observed on the global level. Here we show the first case of Lyme neuroborreliosis in southern Bosnia and Herzegovina, which was first presented by erythema chronicum migrans. Unfortunately, it was not recognized or well treated at the primary care medicine. After eight weeks, the patient experienced headache, right facial palsy, and lumbar radiculopathy. After the clinical examination, the neurologist suspected meningoencephalitis and the patient was directed to the Clinic for Infectious Disease of the University Hospital Mostar, where he was admitted. The successful antimicrobial treatment with the 21-day course of ceftriaxone was followed by normalization of neurological status, and then he was discharged from the hospital. This case report represents an alert to all physicians to be aware that LB is present in all parts of Bosnia and Herzegovina, as well as in the neighboring regions.

scholarly journals Uterine cervical cancer: a study comprised of women in prison

2011 ◽  
Vol 5 (9) ◽  
pp. 2175
Author(s):  
Aurean D’Eça Junior ◽  
Sabrina Furtado Cunha ◽  
Marcia Ramos Costa ◽  
Vanessa Emille Carvalho de Sousa ◽  
Daniel Lemos Soares ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Elementary Education ◽  
Uterine Cervical Cancer ◽  
University Hospital ◽  
Low Grade ◽  
Factores De Riesgo ◽  
Women In Prison ◽  
Las Mujeres ◽  
Educación Primaria ◽  
The University

ABSTRACTObjective: to study uterine cervical cancer among women in prison. Method: an exploratory-descriptive and quantitative study conducted at a women's penitentiary in São Luís, Maranhão. The sample was composed of 38 women. A questionnaire was applied and, subsequently, a Papanicolau´s test was performed. The study was approved by the Committee of Ethics in Research by the University Hospital of the Federal University of Maranhão (protocol 010.07). Results: the predominant age was between 26 and 30 years of age (47.4%); 23 (60.6%) had incomplete elementary education; and 24 (63.2%) had no income. Regarding smoking, 20(52.6%) women were smokers, 10 (50.0) for more than fifteen years. Regarding sexuality, 24 (63.2%) do not use condoms at all during sexual relations; the majority of their first sexual intercourses occurred between 13 and 16 years of age (68.4%); the Papanicolau´s test has been previously performed by 30 (78.9%) and 08 (21.1%) never had one. The cytology showed that 97.4% of the tests were negative for intraepithelial lesion or malignancy, 2.6% were compatible with low-grade epithelial injury and 58% have compatibility with Gardnerella vaginallis. Conclusion: despite not showing a high prevalence of cancer precursor lesions, the women had risk factors for this type of cancer, demonstrating the importance of health strategies that target these factors. Descriptors: neoplasms; uterine cervical neoplasms; women´s health; health vulnerability.RESUMOObjetivo: estudar o câncer cérvico uterino entre mulheres em cárcere. Método: estudo exploratório-descritivo, quantitativo, realizado em uma penitenciária feminina da cidade de São Luís-MA. Participaram da pesquisa 38 mulheres na qual se aplicou um questionário e, posteriormente, realizou-se exame Papanicolau. Para a tabulação de dados foi construído um banco de dados no programa EPI INFO® os quais foram apresentados em tabelas. O estudo foi aprovado por Comitê de Ética em Pesquisa do Hospital Universitário, da Universidade Federal do Maranhão, com número de protocolo 010.07. Resultados: verificou-se que a faixa etária predominante foi de 26 a 30 anos (47,4%); 23 (60,6%) detentas possuíam ensino fundamental incompleto; e 24 (63,2%) não possuíam renda. Quanto ao hábito tabagista, 20 (52,6%) fumavam, 10 (50,0%) há mais de quinze anos. Quanto à sexualidade, 24 (63,2%) não utilizavam preservativo em todas as relações sexuais, a primeira relação sexual da maioria ocorreu entre 13 e 16 anos (68,4%), o Papanicolau já foi realizado anteriormente por 30 (78,9%) e 08 (21,1%) nunca o fizeram. A citologia oncótica evidenciou que 97,4% dos testes foram negativos para lesão intra-epitelial e malignidade, 2,6% foram compatíveis com lesão epitelial de baixo grau e 58.3% apresentaram compatibilidade com Gardnerella vaginallis. Conclusão: mesmo não evidenciando prevalência alta de lesões precursoras de câncer, as mulheres apenadas apresentaram fatores de risco para este câncer, mostrando a importância de estratégias de saúde direcionadas a estas. Descritores: neoplasias; neoplasias do colo do útero; saúde da mulher; vulnerabilidade em saúde.RESUMENObjetivo: estudiar el cáncer de cuello entre mujeres en la cárcel. Métodos: estudio exploratorio descriptivo, cuantitativo, desarrollado en una penitenciaría para mujeres en la cuida São Luis, en el estado de Maranhão, Brasil. Participaron 38 mujeres. Fue aplicado un cuestionario y  fue realizada la prueba de Papanicolaou. El estudio fue aprobado por el Comité de Ética del Hospital Universitario de la Universidad Federal de Maranhão (protocolo 010.07). Resultados: la edad predominante del grupo fue entre 26 y 30 años (47,4%); 23 reclusas (60,6%) tenían una educación primaria incompleta; y 24 (63,2%) no tenían renta. En cuanto al habito tabáquico,  20 (52,6%) fumaban,  10 (50,0%) durante más de quince años. Con respecto a la sexualidad, 24 (63,2%) no utilizan el preservativo en todas las relaciones sexuales, la primera relación sexual  de la mayoría ocurrió entre 13 y 16 años (68,4%), la prueba de Papanicolaou ha sido hecha por 30 (78,9%) y 08 (21,1%) nunca la hicieron. La citología oncótica mostró que 97,4% de pruebas fueron negativas para  lesión epitelial o malignidad, 2,6% eran compatibles con lesión epitelial baja y 58% tenían Gardnerella vaginallis. Conclusión: mismo no mostrando una alta prevalencia de lesiones precursoras del cáncer, las mujeres tuvieron factores de riesgo, mostrando la importancia de las estrategias de salud dirigidas a estos factores. Descriptores: neoplasias; neoplasias del cuello uterino; salud de la mujer; vulnerabilidad en salud.

scholarly journals SARS-CoV-2 outbreak in a tri-national urban area is dominated by a B.1 lineage variant linked to a mass gathering event

2021 ◽  
Vol 17 (3) ◽  
pp. e1009374 ◽  
Author(s):  
Madlen Stange ◽  
Alfredo Mari ◽  
Tim Roloff ◽  
Helena MB Seth-Smith ◽  
Michael Schweitzer ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
University Hospital ◽  
Contact Tracing ◽  
Phylogenetic Study ◽  
Mass Gathering ◽  
Travel History ◽  
First Case ◽  
Patient Questionnaires ◽  
Initial Source ◽  
The University

The first case of SARS-CoV-2 in Basel, Switzerland was detected on February 26th 2020. We present a phylogenetic study to explore viral introduction and evolution during the exponential early phase of the local COVID-19 outbreak from February 26th until March 23rd. We sequenced SARS-CoV-2 naso-oropharyngeal swabs from 746 positive tests that were performed at the University Hospital Basel during the study period. We successfully generated 468 high quality genomes from unique patients and called variants with our COVID-19 Pipeline (COVGAP), and analysed viral genetic diversity using PANGOLIN taxonomic lineages. To identify introduction and dissemination events we incorporated global SARS-CoV-2 genomes and inferred a time-calibrated phylogeny. Epidemiological data from patient questionnaires was used to facilitate the interpretation of phylogenetic observations. The early outbreak in Basel was dominated by lineage B.1 (83·6%), detected first on March 2nd, although the first sample identified belonged to B.1.1. Within B.1, 68·2% of our samples fall within a clade defined by the SNP C15324T (‘Basel cluster’), including 157 identical sequences at the root of the ‘Basel cluster’, some of which we can specifically trace to regional spreading events. We infer the origin of B.1-C15324T to mid-February in our tri-national region. The other genomes map broadly over the global phylogenetic tree, showing several introduction events from and/or dissemination to other regions of the world via travellers. Family transmissions can also be traced in our data. A single lineage variant dominated the outbreak in the Basel area while other lineages, such as the first (B.1.1), did not propagate. A mass gathering event was the predominant initial source of cases, with travel returners and family transmissions to a lesser extent. We highlight the importance of adding specific questions to epidemiological questionnaires, to obtain data on attendance of large gatherings and their locations, as well as travel history, to effectively identify routes of transmissions in up-coming outbreaks. This phylogenetic analysis in concert with epidemiological and contact tracing data, allows connection and interpretation of events, and can inform public health interventions. Trial Registration: ClinicalTrials.gov NCT04351503.

scholarly journals COVID-19 Induced Miller Fisher Syndrome Presenting With Autonomic Dysfunction: A Unique Case Report and Review of Literature

2021 ◽  
pp. 194187442110167
Author(s):  
Subhrajyoti Biswas ◽  
Ritwik Ghosh ◽  
Arpan Mandal ◽  
Alak Pandit ◽  
Dipayan Roy ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Autonomic Dysfunction ◽  
Clinical Picture ◽  
Miller Fisher Syndrome ◽  
Neurological Manifestations ◽  
Review Of Literature ◽  
Unique Case ◽  
Fisher Syndrome ◽  
First Case

A plethora of neurological manifestations are associated with the 2019 coronavirus infectious disease (COVID-19). We hereby report the first case of a patient infected with SARS-CoV-2 who acutely presented with autonomic dysfunction preceding the onset of complete clinical picture of Miller Fisher syndrome. She was finally diagnosed to be a case of anti-ganglioside antibody positive post-COVID-19 Miller Fisher syndrome with dysautonomia and treated with intravenous immunoglobulin with an excellent response. We also discuss the plausible pathogenic mechanisms of COVID-19 induced Miller Fisher syndrome and furnish a review of the post-COVID-19 Miller Fisher syndrome cases reported.

scholarly journals Efficacy of modified FOLFOX6 chemotherapy for patients with unresectable pseudomyxoma peritonei

2019 ◽  
Vol 25 (4) ◽  
pp. 774-781 ◽  
Author(s):  
Sakura Hiraide ◽  
Keigo Komine ◽  
Yuko Sato ◽  
Kota Ouchi ◽  
Hiroo Imai ◽  
...  
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Systemic Chemotherapy ◽  
Case Series ◽  
Progression Free Survival ◽  
University Hospital ◽  
Low Grade ◽  
Chemotherapeutic Regimen ◽  
First Case ◽  
Modified Folfox6 ◽  
Grade 3

Abstract Background Pseudomyxoma peritonei (PMP) is a rare malignancy, and there is insufficient evidence about systemic chemotherapy for this disease. Methods We retrospectively evaluated the efficacy and safety of a chemotherapeutic regimen with 5-fluorouracil and oxaliplatin (modified FOLFOX6, mFOLFOX6) for patients with unresectable pseudomyxoma peritonei. Patients who received the therapy between April 2000 and February 2019 at the Department of Medical Oncology, Tohoku University Hospital, were enrolled in this study. Results Eight patients were treated with mFOLFOX6. The sites of primary tumor were appendix in six patients, ovary in a patient, and urachus in a patient. Six patients received surgery. Seven patients had histologically high-grade PMP, and one patient had low-grade PMP. The median follow-up duration was 27.2 months. All the patients had non-measurable regions as the targets of tumor response. Non-complete response or non-progressive disease was observed in seven patients, with a disease control rate of 87.5%. The median progression-free survival and overall survival were 13.0 months and 27.9 months, respectively. An obvious reduction in the symptoms was observed in two patients. Five patients experienced decline in the serum tumor markers, CEA or CA19-9. The grade 3/4 toxicity that was observed was grade 4 neutropenia in one patient and grade 3 neutropenia in two patients. Conclusions mFOLFOX6 might be an effective and tolerable treatment option for patients with unresectable PMP. To our knowledge, this is the first case series of mFOLFOX6 in patients with unresectable PMP and the first case series of systemic chemotherapy for Asian patients with unresectable PMP.

scholarly journals Myelofibrosis-Associated Lymphoproliferative Disease: Retrospective Study of 16 Cases and Literature Review

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
A. Etienne ◽  
B. Gruson ◽  
D. Chatelain ◽  
R. Garidi ◽  
B. Royer ◽  
...  
Keyword(s):  
Overall Response Rate ◽  
Lymphoproliferative Disease ◽  
University Hospital ◽  
Cell Phenotype ◽  
Entire Group ◽  
Low Grade ◽  
Rare Manifestation ◽  
Line Of Therapy ◽  
The University

Background. To better describe the clinical, biological, and the outcome of non-Hodgkin's lymphoma (NHL) with, at the initial presentation, bone marrow fibrosis (MF).Patients and Methods. From January 2001 to January 2007, 16 eligible patients with NHL and MF were retrieved from the Pathology Department of the University hospital of Amiens. Median age of patients was 62 years (range 16–74) with a sex ratio male/female of 3.Results. MF is associated with all types of lymphoma predominantly with B-cell phenotype and it seems to be more associated with low-grade NHL. B-symptoms are more frequent at diagnosis and more patients presented with an elevated LDH level. JAK-2 was negative in the 10 patients analysed. Two patients presented with features of primary MF with no evidence of lymphoma. Overall response rate was 94% after the first line of therapy with regression or improvement of MF. Relapse occurred in 8 patients (47%) with recurrence of MF in all of them. After a median follow-up of 42 months, 12 patients were alive with an overall survival rate for the entire group of 75%.Conclusions. MF-associated NHL is a rare manifestation which may be associated with all types of NHL and its presence does not seem to confer a poor prognosis. A search for lymphoproliferation should be considered when the cause of MF is not apparent.

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