scholarly journals Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features

2003 ◽  
Vol 45 (6) ◽  
pp. 307-313 ◽  
Author(s):  
Elizabeth De Francesco Daher ◽  
Denise Menezes Brunetta ◽  
Geraldo Bezerra da Silva Júnior ◽  
Rainardo Antonio Puster ◽  
Régia Maria do Socorro Vidal Patrocínio
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Histological Study ◽  
Pulmonary Hemorrhage ◽  
Signs And Symptoms ◽  
Fat Necrosis ◽  
Histopathological Features ◽  
Human Leptospirosis ◽  
Pancreatic Involvement

Hyperamylasemia has been reported in more than 65% of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases). All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement.

Ceftriaxone-Induced Acute Pancreatitis

1993 ◽  
Vol 27 (1) ◽  
pp. 36-37 ◽  
Author(s):  
Anthony E. Zimmermann ◽  
Brian G. Katona ◽  
Joginder S. Jodhka ◽  
Richard B. Williams
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Antibiotic Regimen ◽  
Intravenous Injections ◽  
Case Summary ◽  
Catheter Sepsis ◽  
History Of

OBJECTIVE: To report a case of probable ceftriaxone-induced acute pancreatitis. CASE SUMMARY: A patient with a history of short-bowel syndrome on home total parenteral nutrition developed fever, chills, and right flank pain. She was diagnosed with gram-negative catheter sepsis and prescribed antibiotic therapy to be administered for four weeks. After completion of the first week of therapy, the antibiotic regimen was changed to intravenous injections of ceftriaxone to be given daily at home. Prior to discharge the patient developed acute abdominal pain, leukocytosis, jaundice, and markedly elevated lipase and amylase concentrations consistent with acute pancreatitis. The patient's condition improved upon discontinuation of the ceftriaxone and the remainder of her stay was uneventful. DISCUSSION: There is only one other case report in the literature of probable ceftriaxone-induced pancreatitis. Multiple other medications have been implicated in causing acute pancreatitis. The exact mechanism of this uncommon adverse effect of ceftriaxone is unknown. CONCLUSIONS: There was a temporal relationship between the development of this patient's signs and symptoms and the administration of ceftriaxone. We could not identify any other factors that may have been responsible for the development of her acute pancreatitis. Ceftriaxone should be considered as a possible etiologic agent in patients who present with acute abdominal pain and elevated lipase and amylase concentrations.

scholarly journals Acute pancreatitis in a COVID-19 patient in Brazil: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Caroline Petersen da Costa Ferreira ◽  
Kalynne Rodrigues Marques ◽  
Gustavo Henrique Ferreira de Mattos ◽  
Tércio de Campos
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Epigastric Pain ◽  
White Male ◽  
Empiric Antibiotic Therapy ◽  
Pancreatic Involvement ◽  
Number Of Patients ◽  
Empiric Antibiotic

Abstract Background The consequences of the coronavirus disease 2019 pandemic have already exceeded 10 million infected and more than 560,000 deaths worldwide since its inception. Currently, it is known that the disease affects mainly the respiratory system; however, recent studies have shown an increase in the number of patients with manifestations in other systems, including gastrointestinal manifestations. There is a lack of literature regarding the development of acute pancreatitis as a complication of coronavirus disease 2019. Case report We report a case of acute pancreatitis in a white male patient with coronavirus disease 2019. A 35-year-old man (body mass index 31.5) had acute epigastric pain radiating to his back, dyspnea, nausea, and vomiting for 2 days. The patient was diagnosed with severe acute pancreatitis (AP)-APACHE II: 5, SOFA: 3, Marshall: 0; then he was transferred from ED to the semi-intensive care unit. He tested positive for severe acute respiratory syndrome coronavirus 2 on reverse transcription-polymerase chain reaction, and his chest computed tomography findings were compatible with coronavirus disease 2019. Treatment was based on bowel rest, fluid resuscitation, analgesia, and empiric antibiotic therapy. At day 12, with resolution of abdominal pain and improvement of the respiratory condition, the patient was discharged. Conclusion Since there is still limited evidence of pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection, no definite conclusion can be made. Given the lack of other etiology, we consider the possibility that the patient’s acute pancreatitis could be secondary to coronavirus disease 2019 infection, and we suggest investigation of pancreas-specific plasma amylase in patients with coronavirus disease 2019 and abdominal pain.

scholarly journals Acute Pancreatitis in acute viral hepatitis

2011 ◽  
Vol 51 (181) ◽  
Author(s):  
S K.C. ◽  
S Khadka ◽  
D Sharma ◽  
SP Chataut
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Viral Hepatitis ◽  
Hepatitis A ◽  
Acute Viral Hepatitis ◽  
Ultrasound Examination ◽  
Hepatitis E ◽  
Severe Abdominal Pain ◽  
Gastric Ulcers ◽  
Pancreatic Involvement

Introduction: The association of acute viral hepatitis and acute pancreatitis is well described. This study was conducted to find out the frequency of pancreatic involvement in acute viral hepatitis in the Nepalese population. Methods: Consecutive patients of acute viral hepatitis presenting with severe abdominal pain between January 2005 and April 2010 were studied. Patients with history of significant alcohol consumption and gall stones were excluded. Acute viral hepatitis was diagnosed by clinical examination, liver function test, ultrasound examination and confirmed by viral serology. Pancreatitis was diagnosed by clinical presentation, biochemistry, ultrasound examination and CT scan. Results: Severe abdominal pain was present in 38 of 382 serologically-confirmed acute viral hepatitis patients. Twenty five patients were diagnosed to have acute pancreatitis. The pancreatitis was mild in 14 and severe in 11 patients. The etiology of pancreatitis was hepatitis E virus in 18 and hepatitis A virus in 7 patients. Two patients died of complications secondary to shock. The remaining patients recovered from both pancreatitis and hepatitis on conservative treatment. Conclusions: Acute pancreatitis occurred in 6.5 % of patients with acute viral hepatitis. Cholelithiasis and gastric ulcers are the other causes of severe abdominal pain. The majority of the patients recover with conservative management. Keywords: acute viral hepatitis, acute pancreatitis, pain abdomen, hepatitis E, hepatitis A, endemic zone  

Ischaemic Optic Neuropathy and Retinopathy Associated with Acute Pancreatitis

1985 ◽  
Vol 30 (1) ◽  
pp. 46-47 ◽  
Author(s):  
W. G. J. Smith ◽  
J. D. Briggs ◽  
B. J. R. Junor ◽  
J. L. Jay
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Chronic Renal Failure ◽  
Purtscher’S Retinopathy ◽  
Ischaemic Optic Neuropathy ◽  
Ocular Changes ◽  
Simultaneous Loss ◽  
Optic Discs ◽  
Retinal Haemorrhages

A man with previously undiagnosed chronic renal failure developed acute pancreatitis. He had severe abdominal pain and simultaneous loss of vision. Ophthalmoscopy showed pale, swollen optic discs, soft exudates and superficial retinal haemorrhages similar to that of Purtscher's retinopathy. We suggest that the ocular changes may be due to fat microemboli secondary to acute pancreatitis.

Computed Tomography (CT) Appearances of Acute Pancreatitis Presenting as Polyarthropathy with Subcutaneous Fat Necrosis

1993 ◽  
Vol 38 (6) ◽  
pp. 183-184 ◽  
Author(s):  
J.C. Patel ◽  
E.M. Robertson
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Soft Tissue ◽  
Subcutaneous Fat ◽  
Pancreatic Disease ◽  
Fat Necrosis ◽  
Abdominal Ct ◽  
Subcutaneous Fat Necrosis ◽  
Subcutaneous Nodules

A case of severe acute pancreatitis presenting with polyarthropathy and subcutaneous nodules but no abdominal pain is described. Abdominal CT showed multiple subcutaneous soft tissue densities which on histological examination were identified as areas of fat necrosis consistent with pancreatic disease. Such CT appearances have not been described previously.

scholarly journals Pancreatitis Is a Silent Killer in Peritoneal Dialysis With Difficult Diagnostic Approach

2018 ◽  
Vol 11 ◽  
pp. 117954761876576 ◽  
Author(s):  
Roberta Aliotta ◽  
Luca Zanoli ◽  
Itria Lauretta ◽  
Rosa Giunta ◽  
Silvia Ferrario ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Peritoneal Dialysis ◽  
Pancreatic Pseudocyst ◽  
Rate Condition ◽  
Severe Pancreatitis ◽  
Left Shift ◽  
Fungal Sepsis ◽  
Candida Peritonitis

Until 2018, 236 cases of acute pancreatitis have been reported in patients who underwent peritoneal dialysis. Here, we presented a patient with double renal transplantation with chronic renal failure, under renal replacement therapy by peritoneal dialysis, who developed acute pancreatitis with abdominal pain, nausea, vomiting, leukocytosis with neutrophil left shift which is complicated by pancreatic pseudocyst, candida peritonitis, fungal sepsis, overlapping of Acinetobacter baumannii sepsis, and pneumonitis. After the percutaneous cystogastrostomy drainage of pancreatic pseudocyst, changes from peritoneal dialysis to hemodialysis, various thoracentesis, and polyantibiotics therapy, the resolution of the sepsis state was seen. The particular aspect of our case is the various comorbidity risks, severe pancreatitis associated with candida and A baumannii sepsis, and treatment strategy that lead to heal this kind of the high mortality rate condition.

scholarly journals Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Boushab Mohamed Boushab ◽  
Mohamed Salem Ould Ahmedou Salem ◽  
Ali Ould Mohamed Salem Boukhary ◽  
Philippe Parola ◽  
Leonardo Basco
Keyword(s):  
Renal Failure ◽  
Respiratory Distress ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Clinical Features ◽  
Signs And Symptoms ◽  
Plasmodium Falciparum Malaria ◽  
Severe Anaemia ◽  
World Health ◽  
Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

scholarly journals A Clinical and Histological Study about the Socket Preservation in a Patient under Oral Bisphosphonates Treatment: A Case Report

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 262
Author(s):  
Antonello Falco ◽  
Francesco Bataccia ◽  
Lorenzo Vittorini Orgeas ◽  
Federico Perfetti ◽  
Mariangela Basile ◽  
...  
Keyword(s):  
Case Report ◽  
Histological Study ◽  
Healing Process ◽  
Signs And Symptoms ◽  
Bisphosphonate Therapy ◽  
Graft Material ◽  
Oral Bisphosphonates ◽  
Socket Preservation ◽  
Oral Bisphosphonate ◽  
Histological Data

The aim of the present study is to assess the clinical and histological healing of a post-extractive alveolus following the procedure for socket preservation, in a patient receiving oral bisphosphonates for more than 6 years. After the extraction, enzymatically-deantigenated horse bone granules and an equine pericardium membrane were used to preserve the tooth socket. The patient was placed on a monthly follow-up in order to monitor the healing process. A 3 mm trephine bur was used to drill the bone for implant site preparation and to collect the bone sample. No signs and symptoms related to osteonecrosis of the jaws were reported. Histological data showed that, after 5 months, the mean percentages of trabecular bone, bone marrow and residual bone graft were respectively 45.74 ± 0.09%, 48.09 ± 0.08%, and 6.16 ± 0.01%. The residual graft material appeared to be osteointegrated and none of the particles appeared to be encapsulated. The present case report supports the guidelines that assume that patients undergoing oral bisphosphonate therapy can be eligible for surgical therapy. More clinical studies with larger sample sizes are needed to support this clinical evidence.

scholarly journals 17. Comparative Safety of Antibiotic Therapy for Outpatient Treatment of Uncomplicated Urinary Tract Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S9-S10
Author(s):  
Anne M Butler ◽  
Michael Durkin ◽  
Matthew R Keller ◽  
Yinjiao Ma ◽  
William Powderly ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Skin Rash ◽  
Adverse Drug Events ◽  
Vulvovaginal Candidiasis ◽  
First Line ◽  
Research Support ◽  
Comparative Safety

Abstract Background Urinary tract infection (UTI) is one of the most common indications for outpatient antibiotic prescriptions in otherwise healthy women, yet the comparative safety of antibiotics for empirical therapy is not well established. We compared the risk of adverse drug events by antibiotic treatment regimen among premenopausal women with uncomplicated UTI. Methods Using the IBM MarketScan Commercial Database (2006–2015), we identified healthy, non-pregnant women aged 18–44 who were diagnosed with UTI and prescribed a same-day antibiotic with activity against common uropathogens. Patients were followed for outcomes with varying follow-up periods: 3 days (anaphylaxis), 14 days (acute renal failure, skin rash, urticaria/hives, nausea/vomiting, abdominal pain), 30 days (vaginitis/vulvovaginal candidiasis, non-C. difficile diarrhea) and 90 days (C. difficile diarrhea, pneumonia, tendinopathy, retinal detachment). We estimated propensity score-weighted hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards models. Results Of 1,140,602 eligible women, the distribution of antibiotic receipt was fluoroquinolones (44%), trimethoprim-sulfamethoxazole (TMP/SMX) (28%), nitrofurantoin (24%), narrow-spectrum β-Lactam / β-Lactamase inhibitor combinations (“β-Lactams”) (3%), broad-spectrum β-Lactams (1%) and amoxicillin/ampicillin (1%). Of two first-line agents, we observed higher risk of outcomes among TMP/SMX vs. nitrofurantoin initiators: acute renal failure (HR 2.46, 95% CI 1.46–4.14), skin rash (HR 2.43, 95% CI 2.13–2.77), urticaria (HR 1.35, 95% CI 1.18–1.56), nausea/vomiting (HR 1.19, 95% CI 1.10–1.29) and abdominal pain (HR 1.14, 95% CI 1.09–1.19). Compared to nitrofurantoin, non-first-line agents (fluoroquinolones, broad-, and/or narrow-spectrum β-Lactams) were associated with higher risk of acute renal failure, skin rash, nausea/vomiting, abdominal pain, vaginitis/vulvovaginal candidiasis, diarrhea (C. difficile & non-C. difficile), pneumonia and tendinopathy. Conclusion The risk of adverse drug events differs widely by antibiotic agent, with substantial differences in first-line agents. Understanding antibiotic safety is critical to prevent suboptimal antibiotic prescribing and reduce adverse events. Disclosures Margaret A. Olsen, PhD, MPH, Merck (Grant/Research Support)Pfizer (Consultant, Grant/Research Support)

scholarly journals An unusual case of chronic abdominal pain: an association between Celiac disease and Crohn’s disease

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Leen Jamel Doya ◽  
Maria Naamah ◽  
Noura Karkamaz ◽  
Narmin Hajo ◽  
Fareeda Wasfy Bijow ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Celiac Disease ◽  
Crohn's Disease ◽  
Histological Study ◽  
Gastrointestinal Diseases ◽  
Bowel Diseases ◽  
Oral Corticosteroids ◽  
History Of ◽  
High Caloric Diet

ABSTRACT Inflammatory bowel diseases (IBD) and Celiac disease (CeD) are immune-mediated gastrointestinal diseases with incompletely understood etiology. Both diseases show a multifactorial origin with a complex interplay between genetic, environmental factors, and some components of the commensal microbiota. The coexistence of celiac disease with Crohn’s disease is rarely reported in the literature. Here, we report a case of a 13-year-old Syrian male who presented with a history of abdominal pain, anorexia and pallor. CeD and Crohn’s disease was documented on gastrointestinal endoscopy and histological study. The patient was treated with a gluten-free, low fiber, high caloric diet, and a course of oral corticosteroids with an improvement in growth rate and abdominal pain.

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