scholarly journals Pertussis-like syndrome or pertussis: a delay diagnosis

2012 ◽  
Vol 52 (1) ◽  
pp. 28
Author(s):  
Heda Melinda Nataprawira ◽  
Finia Cahayasari ◽  
Arifin Kashmir
Keyword(s):  
Bacterial Pneumonia ◽  
Disease Burden ◽  
Whooping Cough ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Gender History ◽  
Laboratory Findings ◽  
Negative Results ◽  
History Of ◽  
Pertussis Epidemiology

Background Recent reports of pertussis epidemiology from Asia,Africa and South America have been limited, but the WorldHealth Organization estimates indicate that these regions havethe highest disease burden. Difficulty in estimating the prevalenceof pertussis is due to lack of access to diagnostic methods,misdiagnoses, under-reporting, and different countries' reportingcriteria. A syndrome characterized by severe episodes of coughingresembling whooping cough (pertussis) has also been defined aspertussis-like syndrome.Objective To report eleven cases of pertussis or pertussis-likesyndrome in the pediatric ward of Hasan Sadikin Hospital.Methods This retrospective study was conducted by reviewingmedical records from 2008-2010. Characteristics of 11 pertussislikesyndrome patients were documented including age, gender,history of pertussis immunization, clinical manifestations,laboratory findings, initial diagnosis, treatment and clinicalresponse. Isolation of Bordetella pertussis using Bordet-Gengouagar was also noted. Pertussis diagnoses were grouped based ontwo classifications: probable and confirmed.Results Eleven patients were diagnosed with pertussis-likesyndrome, including 5 boys and 6 girls. Most subjects were lessthan 6 months of age. Only one subject had received previouspertussis immunization. Dyspnea, paroxysmal cough, and feverwere the most common symptoms. All were initially diagnosedto have had severe bacterial pneumonia, and later changed toprobable pertussis. Three subjects exhibited post-tussive vomitingand cyanosis, while none had apneic symptoms. All B. pertussisisolations yielded negative results. Ampicillin or cephalosporinwas initially administered. Patients receiving subsequentclarithromycin showed good clinical responses.Conclusion All infants were likely considered to have pertussis,as most had no pertussis immunizations. However, B. pertussisisolation was unsuccessful in all cases. As such, diagnoses couldnot be confirmed. [Paediatr In don es. 2012;5 2: 28-31].

scholarly journals COVID-19 in Cancer and non-Cancer Patients

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Farzad Taghizadeh-Hesary ◽  
Pejman Porouhan ◽  
Davood Soroosh ◽  
Babak PeyroShabany ◽  
Soodabeh Shahidsales ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Patients With Cancer ◽  
History Of ◽  
Global Concern ◽  
Novel Coronavirus ◽  
Practice Methods ◽  
Control Study ◽  
Chest Ct Scan

Background: There is a global concern for the susceptibility of patients with cancer to the adverse effects of novel coronavirus disease (COVID-19). Objectives: Nevertheless, there is a signal of potentially increased vulnerability of patients with cancer to more COVID-19-induced mortality, this notion needs to be further evaluated in various societies with different cancer epidemiology and practice. Methods: In this case-control study, done in Iran, we evaluated the medical records of patients with cancer (Ca+ patients) who infected with COVID-19 and compare them with patients without a medical history of cancer (Ca- patients). Clinical data were collected from 19 February 2020 to 17 May 2020. The extracted data were classified into demographics, underlying medical conditions, clinical manifestations, imaging and laboratory findings, and clinical outcomes. Results: A total of 24 Ca+ patients were compared with 44 Ca- patients in terms of clinical manifestations and outcomes of COVID-19. The Ca- patients significantly developed more dry cough (75.0% vs 29.2%, P = 0.01) and fever (72.7% vs 45.8%, P = 0.02). Findings of the chest CT scan was comparable between groups, except for pleural effusion and lymphadenopathy that exclusively reported in Ca+ patients. (3% and 4%, respectively). At the end of observation, 13 (19.1%) patients died from COVID-19. This rate was significantly higher in Ca+ patients (41.7 vs 6.8%, P = 001). Likewise, Ca+ patients experienced more mechanical ventilation (25.0 vs 4.7%, P = 0.01). However, the rate of ICU admission was comparable between groups (P = 0.29). Conclusions: The patients with cancer had a higher rate of mechanical ventilation and COVID-19-induced mortality.

scholarly journals Subacute Sclerosing Panencephalltis: Clinical and Laboratory Manifestations

2019 ◽  
Vol 32 (5-6) ◽  
pp. 107-17
Author(s):  
Hardiono D. Pusponegoro ◽  
Jimmy Passat ◽  
M. Hardjono Abdoerachman
Keyword(s):  
Age Of Onset ◽  
Subacute Sclerosing Panencephalitis ◽  
Clinical Manifestations ◽  
Social Contact ◽  
Cortical Atrophy ◽  
Laboratory Findings ◽  
Immunization Programme ◽  
Positive Antibody ◽  
Burst Pattern ◽  
History Of

We reviewed clinical and laboratory findings of 12 cases of Subacute sclerosing panencephalitis (SSPE) hospitalized at our department from 1985 to 1991. All cases were diagnosed and hospitalized at the 2nd stage. The principal clinical manifestations were mental changes, myoclonus, and frequent falls. Other clinical manifestations were ocular changes, involuntary movements, loss of social contact, and spasticity. Diagnosis was based on suppression-burst pattern in EEG and positive antibody titer to measles in serum and cerebrospinal fluid. CT scan was not diagnotic, since it was either normal or showed only non-specific cortical atrophy. Eleven patients (91, 7%) recalled a history of measles in the past. Age of onset of SSPE varied among cases and was difficult to specify precisely due to its subtle nature. None of the cases had been vaccinated against measles. SSPE is a rare disease, but is almost always fatal with prolonged suffering of the patient. Based on our experience with SSPE patients, we recommend to broaden the immunization programme against measles.

scholarly journals Background History, Clinical Presentation and Laboratory Profile in Cases of Suspected Neurometabolic Disorders

2016 ◽  
Vol 39 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Mustafa Mahbub ◽  
AZM Mosiul Azam ◽  
Suraj C Mazumder ◽  
Bithi Debnath ◽  
Naila Zaman Khan
Keyword(s):  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Normal Activity ◽  
New Delhi ◽  
Laboratory Findings ◽  
Neurometabolic Disorders ◽  
Wide Range ◽  
History Of ◽  
Background History ◽  
Biotinidase Activity

Background : Neurometabolic disorders (NMD) in children may present at any age with a wide range of clinical manifestations. Unexplained or intractable seizure is one of the important associations. Consanguinity, regression of development and sibling death are the clues to suspect neurometabolic disorders when laboratory support is limited. Laboratory findings however, provide the confirmatory diagnosis which is unavailable in Bangladesh.Objectives : To determine the association of consanguinity, regression of development, seizures, EEG findings and other laboratory investigations in children suspected to have neurometabolic disorders and to aid clinicians working in resourcepoor countries.Methodology : A retrospective analysis was done from the records of the patients suspected to have neurometabolic disorders admitted in the department of Neurosciences, Dhaka Shishu Hospital, Dhaka during the period of July 2007 to February 2011. Tandem Mass Spectrometry (TMS), biotinidase activity and other enzyme assay were done through a private laboratory in New Delhi, India.Results : Total 128 children were studied and the parents of 39 (31%) had history of consanguineous marriage. Seizure was associated with 96 (75%) children and abnormal EEG findings were recorded in 83 (65%). Plasma ammonia was done in 98 cases and found to be increased in 53 (54%) cases. Plasma lactate was done in 94 cases and found high in 40 (43%). TMS were done in 111 (85%) children and abnormality were found in 70 (63%) cases. Serum biotinidase activity was advised for 41 children as per TMS result and measured in 25 children of which deficient activity was found in 17(68%); borderline in 4 (16%) and normal activity in 4 (16%) cases.Conclusion: Background history and clinical presentation followed by stepwise laboratory investigation is necessary to identify neurometabolic disorders. Early and appropriate intervention can reduce neurodisability in many situations.Bangladesh J Child Health 2015; VOL 39 (1) :24-29

scholarly journals Clinical and laboratory findings in COVID-19 adult hospitalized patients from Alborz province / Iran: comparison of rRT-PCR positive and negative

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Farnaz Karimi ◽  
Amir Abbas Vaezi ◽  
Mostafa Qorbani ◽  
Fatemeh Moghadasi ◽  
Saeed Hassani Gelsfid ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Vital Signs ◽  
Diagnostic Methods ◽  
The Novel ◽  
Global Public Health ◽  
Laboratory Findings ◽  
Computed Tomographic ◽  
High Prevalence ◽  
Wbc Count ◽  
Novel Coronavirus

Abstract Background The novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019. The disease rapidly expanded and led to an epidemic throughout China, followed by the rising number of cases worldwide. Given the high prevalence of COVID-19, rapid and accurate diagnostic methods are immediately needed to identify, isolate and treat the patients as soon as possible, decreasing mortality rates and the risk of public contamination by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). Methods This case-control study was conducted in two hospitals in Alborz Province in Iran. All recruited cases in this study were symptomatic adults hospitalized as COVID-19 patients with compatible Computed tomographic (CT) scan findings and available rRT-PCR results. The patients were recruited in this study. The patients were categorized into positive and negative rRT-PCR groups and evaluated for symptoms, initial vital signs, comorbidity, clinical and laboratory findings. Finally, the results were assessed by SPSS software. Results Between March 5 to April 5, 2020, 164 symptomatic COVID-19 patients were studied. In total, there were 111 rRT-PCR positive (67.6%) and 53 rRT-PCR negative patients (32.4%). In terms of statistics, the frequency of symptoms revealed no difference, except for cough (P.V:0.008), dizziness (PV: 0.048), and weakness (P.V:0.022). Among initial vital signs, PR (P.V:0.041) and O2 Saturation (PV: 0.014) were statistically different between the two groups. Evaluation of comorbidities revealed no difference except for hyperlipidemia (P.V:0.024). In the comparison of laboratory findings, only WBC count (PV: 0.001), lymphocyte count (PV: 0.001), and Hb (P.V:0.008) were statistically different between the two groups. Conclusion In case of the negative rRT-PCR result, it is necessary to take a logical approach, and we recommended that the physician decides according to clinical manifestations, laboratory findings, and positive CT results.

scholarly journals Brucellosis Spondylodiscitis: A case report

2020 ◽  
pp. 92-97
Keyword(s):  
Musculoskeletal Pain ◽  
Serological Test ◽  
Clinical Manifestations ◽  
Animal Husbandry ◽  
Clinical Suspicion ◽  
Diagnostic Methods ◽  
Positive Serology ◽  
Serological Tests ◽  
Regular Treatment ◽  
Negative Results

Brucellosis is an endemic disease in Iran that is transmitted from animal to human. The clinical manifestations of brucellosis are nonspecific and its complications involve bones and joints. Brucellosis osteomyelitis can mimic the manifestations of neoplasms; therefore, it cannot readily be diagnosed in some cases. Under such circumstances, high incidence can be a helpful factor. We reported a 49-year-old man patient who presented with chronic musculoskeletal pain in the lower back. Initially, he was treated for osteoarthritis due to several negative serological tests for brucellosis. He was referred to a specialized clinic with no recovery achievement after 5 months treatment. The musculoskeletal pain together with the patient’s occupation (animal husbandry), was resulted in a high clinical suspicion of brucellosis. Consequently, the patient underwent another serological test and Magnetic resonance imaging (MRI). He was diagnosed with brucellosis-induced spondylodiscitis by positive serology result and bone involvement on MRI. Regular treatment was then started, which led to clinical and radiological improvement at the end. With regard to chronic symptoms of the disease and despite the negative results of serological tests, it is recommended that radiological diagnostic methods such as MRI should be adopted in cases where there is a clinical suspicion of brucellosis.

scholarly journals Prophylaxis AgainstMycobacterium aviumComplex Infection in AIDS

1994 ◽  
Vol 5 (suppl b) ◽  
pp. 10B-13B
Author(s):  
DW Cameron
Keyword(s):  
Human Immunodeficiency Virus ◽  
Natural History ◽  
Mycobacterium Avium Complex ◽  
Virus Disease ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Wasting Syndrome ◽  
Immunodeficiency Virus ◽  
The Face ◽  
History Of

Disseminated Mycobacterium avium complex (MAC) infection in AIDS is increasing in frequency, although it remains under-recognized due to unlocalized clinical manifestations and subtle initial presentation, if not the need for specialized laboratory diagnostic methods. Ultimately, MAC accounts for much of the “wasting syndrome” in the natural history of human immunodeficiency virus disease. Multidrug treatment of MAC in AIDS is problematic. That MAC is preventable has been demonstrated, and how much clinical benefit can be had from successful prophylaxis remains to be evaluated in the face of improved efficacy of both treatment and prophylaxis regimens under investigation.

scholarly journals Congenital Pseudohypoparathyroidism – A Late Diagnosis

2019 ◽  
Vol 16 (2) ◽  
pp. 73-81
Author(s):  
Andreea Ruxandra Ilina ◽  
Andra Elena Gorun ◽  
Camelia Georgeta Badea ◽  
Cristian Răsvan Băicuș
Keyword(s):  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Medicine Department ◽  
Immunological Tests ◽  
Fourth Finger ◽  
Dilatative Cardiomyopathy ◽  
History Of ◽  
Patient’S History ◽  
Severe Hypocalcaemia

AbstractThe purpose of this paper is to present a case of congenital pseudohypoparathyroidism, late diagnosed in a 22-year-old patient.The patient’s history revealed hypocalcaemia, diagnosed at birth and persistent despite the treatment with calcium. At 8 years old, the patient is diagnosed with epilepsy and receives treatment with Levetiracetam and Oxcarbazepine; at 12 years old she is diagnosed with dilatative cardiomyopathy and receives treatment with Spironolactone and Glycosides. At 22 years old, she visits our Internal Medicine Department with the suspicion of polymyositis and psoriasis. Clinical examination shows armonic short stature, fourth finger hypoplasia, laboratory findings show severe hypocalcaemia, the hand X-ray - third and fourth metacarpal hypoplasia, immunological tests were negative. All data leads to the diagnosis of congenital disease, and given the history of the patient and the evolution of the clinical manifestations we presume hypoparathyroidism or pseudohypoparathyroidism, therefore PTH is dosed – with normal values, and the diagnosis of congenital pseudohypoparathyroidism is established. The patient was referred to endocrinology, where genetic tests were performed to confirm the diagnosis.In conclusion, in the absence of multiple pathology integration into a single disease, the diagnosis of the genetic disease is delayed. Therefore, it is important to have a comprehensive approach and collaboration between different specialties to establish the correct diagnosis.

scholarly journals Xanthogranulomatous pyelonephritis in a 7-year-old girl

2020 ◽  
Vol 8 (1) ◽  
pp. 99-109
Author(s):  
V. V. Sizonov ◽  
M. I. Kogan ◽  
I. I. Babich ◽  
A. KH-A. Shidaev ◽  
O. A. Shaldenko
Keyword(s):  
Clinical Manifestations ◽  
Xanthogranulomatous Pyelonephritis ◽  
Radiological Imaging ◽  
Imaging Data ◽  
Laboratory Findings ◽  
Clinical Observations ◽  
Disease Pattern ◽  
History Of ◽  
Isotope Studies ◽  
Acute Perforation

The paper presents a case history of xanthogranulomatous pyelonephritis that developed in a 7-year-old girl in combination with urolithiasis background. Our available sources for the last 50 years contain only 283 descriptions of pediatric xanthogranulomatous pyelonephritis (XGP) cases. We were able to find in domestic publications descriptions of two clinical observations of histologically proven XGP in children of 15 and 17 years. Clinical manifestations of the disease, radiological imaging data, and laboratory findings during the initial three months of the condition fit the disease pattern of a diffuse acute pyelonephritis. A remarkable peculiarity of the presented case was in the two-month interval during which the girl with a severe destructive renal process remained under medical supervision as an outpatient, suffered no pain, and had normal urinalysis results. Nephrectomy was performed from lumbotomy access considering clinical manifestations, data from laboratory and radiological isotope studies. The postoperative period was complicated by the development on the 2nd day of acute perforation of a duodenal ulcer. The intensity of perinephric process was unique and never encountered in our earlier practice. The described changes made kidney exposure extremely difficult. Therefore, nephrectomy should be carried out exclusively in the national highly specialized pediatric urological centers.

scholarly journals The Impact of Dysmetabolic Sarcopenia Among Insulin Sensitive Tissues: A Narrative Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Angelo Armandi ◽  
Chiara Rosso ◽  
Gian Paolo Caviglia ◽  
Davide Giuseppe Ribaldone ◽  
Elisabetta Bugianesi
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Clinical Studies ◽  
Disease Burden ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Current Evidence ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
The Impact

Sarcopenia is a common muscular affection among elderly individuals. More recently, it has been recognized as the skeletal muscle (SM) expression of the metabolic syndrome. The prevalence of sarcopenia is increasing along with visceral obesity, to which it is tightly associated. Nonetheless, it is a still underreported entity by clinicians, despite the worsening in disease burden and reduced patient quality of life. Recognition of sarcopenia is clinically challenging, and variability in study populations and diagnostic methods across the clinical studies makes it hard to reach a strong evidence. Impaired insulin activity in SM is responsible for the altered molecular pathways and clinical manifestations of sarcopenia, which is morphologically expressed by myosteatosis. Lipotoxicity, oxidative stress and adipose tissue-derived inflammation lead to both alterations in glucose disposal and protein synthesis in SM, with raising insulin resistance (IR) and SM atrophy. In particular, hyperleptinemia and leptin resistance interfere directly with SM activity, but also with the release of Growth Hormone from the hypohysis, leading to a lack in its anabolic effect on SM. Moreover, sarcopenia is independently associated to liver fibrosis in Non-Alcoholic Fatty Liver Disease (NAFLD), which in turn worsens SM functionality through the secretion of proinflammatory heptokines. The cross-talk between the liver and SM in the IR setting is of crucial relevance, given the high prevalence of NAFLD and the reciprocal impact of insulin-sensitive tissues on the overall disease burden. Along with the efforts of non-invasive diagnostic approaches, irisin and myostatin are two myokines currently evaluated as potential biomarkers for diagnosis and prognostication. Decreased irisin levels seem to be potentially associated to sarcopenia, whereas increased myostatin has shown to negatively impact on sarcopenia in pre-clinical studies. Gene variants in irisin have been explored with regard to the impact on the liver disease phenotype, with conflicting results. The gut-muscle axis has gain relevance with the evidence that insulin resistance-derived gut dysbiosis is responsible for increased endotoxemia and reduction in short-chain free fatty acids, directly affecting and predisposing to sarcopenia. Based on the current evidence, more efforts are needed to increase awareness and improve the management of sarcopenic patients.

scholarly journals Hypoglycemia after bariatric surgery: importance of exhaustive hormonal study

2021 ◽  
Vol 2021 ◽  
Author(s):  
Alejandra Perez-Montes de Oca ◽  
Silvia Pellitero ◽  
Manel Puig-Domingo
Keyword(s):  
Bariatric Surgery ◽  
Gh Deficiency ◽  
Clinical Manifestations ◽  
Clinical Problem ◽  
Medical Problem ◽  
Dumping Syndrome ◽  
Diabetic Patients ◽  
List Type ◽  
Laboratory Findings ◽  
History Of

Summary Hypoglycemia is an uncommon clinical problem in non-diabetic patients or patients not being treated for diabetes mellitus. It is a rare, but well-established complication of bariatric surgery and, in some cases, it can be the only symptom of another medical problem. A 50-year-old woman with a history of partially recovered hypopituitarism after transsphenoidal surgery for a non-functioning pituitary macroadenoma complained about symptomatic hypoglycemia after sleeve gastrectomy surgery. Our initial studies failed to determine the cause for these episodes and treatment with acarbose (suspecting a dumping syndrome) was not helpful. Finally, laboratory findings revealed growth hormone (GH) deficiency. The patient received treatment with GH, with the resolution of symptoms after 3 months of treatment. Our case suggests that all causes of hypoglycemia should be considered and studied after bariatric surgery. An improvement in insulin-resistance following bariatric surgery can trigger clinical manifestations of GH deficiency. Learning points Postprandial hypoglycemia after bariatric surgery is usually due to dumping syndrome. Even after bariatric surgery, all causes of hypoglycemia should be considered and studied. After significant weight loss, insulin sensitivity is usually restored and can trigger clinical manifestations of GH deficiency. Hypoglycemia is a rare symptom of GH deficiency.

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