Clinical and epidemiological aspects of the incidence of nonpolio enteroviral infections in Primorsky Krai

There are considered problems of epidemiology and clinical presentation of enteroviral infections in the territory of Primorsky Krai. Among the hospitalized adult patients during the period from 2006 to 2012 persons aged from 18 to 39 years (49,3%) prevailed. The main clinicalforms of enteroviral infection (EVI) are a "minor" illness (55.6 %) and serous meningitis (21.7 %). In the study of a series of cytokines the differences in patients with the "minor" illness and serous viral meningitis have been identified. From 2009 to 2012 the incidence of EVI has a sporadic seasonal character (previously there was epidemic seasonal incidence). Adults are mainly affected. The epidemic process is formed owing to corporate and school-university types, with a dominated contact-community-acquired pathway of transmission. The dramatic shift in the nature of EVI rate in recent years, likely due to the exchange of the leading modes of transmission pathway, nutritional, which determined the carrying non-typical for the Primorsky Krai pathogen variants (ECHO - 30), by the contact-community-acquired pathway of transmission.

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Clinical features and management strategies of Meningitis in adult patients: A hospital based study from Kuwait

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v11i3-s.4893 ◽

2021 ◽

Vol 11 (3-S) ◽

pp. 53-60

Author(s):

Suhail Al Shammri ◽

Arpita Chattopadhyay ◽

Geeti Chadha ◽

Ahmed Zayada ◽

Faisal Al Shaifan ◽

...

Keyword(s):

Clinical Features ◽

Clinical Presentation ◽

Management Strategies ◽

Positive Culture ◽

Viral Meningitis ◽

Antimicrobial Treatment ◽

Clinical Suspicion ◽

Adult Patients ◽

Diagnostic Challenge ◽

Neisseria Meningitides

Introduction: High mortality rate of meningitis has been reported in Kuwait, however, limited data is available describing this disease in adult patients. With this background, we conducted a prospective study on patients admitted with meningitis, with an objective to describe the risk factors, clinical presentation, disease course and outcome; focus given on diagnostic problems and consequent management difficulties. Methods: Our team diagnosed, managed and documented hospital records of patients (n=44) admitted with suspected meningitis at a referral hospital during 2010-12. Detailed information was collected regarding clinical presentation, CSF analysis, treatment, hospital course and outcome as per Glasgow Outcome Scale (GOS). Results: Bacterial, viral, and tuberculosis (TB) meningitis were seen in 22.8%, 52.3%, and 15.9% of patients. Clinical features of our cohort were consistent with available literature. Positive identification of organism by culture, gram stain, or antigen test was possible in only 6 patients i.e. Streptococcus pneumonae-(n=3), Streptococcus agalactiae-(n=2), Neisseria meningitides-(n=1). CSF polymerase chain reaction was detected positive for Enterovirus RNA, and Herpes simplex virus DNA for one patient each. Empirical antimicrobial treatment directed against common causative organisms was the mainstay of management of bacterial meningitis. Viral meningitis was managed symptomatically. TB meningitis patients were administered anti-tubercular treatment. As per GOS, 38(85.4%) patients recovered with no neurological deficit. Six patients recovered with mild to moderate deficit. Conclusion: Low positive culture rates and inability to identify pathogens have been a diagnostic challenge faced by our team. Strong clinical suspicion, early empiric antibiotic and dexamethasone therapy perhaps contributed to very good recovery in our study. Keywords: Meningitis, Kuwait, Clinical Suspicion, Antibiotic, Dexamethasone

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Clinical and laboratory profiles of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, Bahir Dar, Ethiopia

SAGE Open Medicine ◽

10.1177/20503121211036787 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110367

Author(s):

Berhanu Tarekegn ◽

Ayanaw Tamene

Keyword(s):

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Clinical Presentation ◽

Winter Season ◽

Adult Patients ◽

Sand Fly ◽

Timely Initiation ◽

Vector Borne Disease ◽

Vector Borne ◽

Endemic Areas

Background: Visceral leishmaniasis is a vector-borne disease caused by Leishmania donovani transmitted by sand fly species. It is the third most common vector-borne disease globally. Visceral leishmaniasis is endemic in Ethiopia with an estimated annual incidence ranging from 3700 to 7400 cases. This research aimed to assess the clinical presentations and laboratory profiles of visceral leishmaniasis for early diagnosis and timely initiation of management. Objective: To describe the clinical and laboratory manifestation and diagnostic modalities of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, from 1 September 2016 to 30 August 2019. Method: Institution-based retrospective cross-sectional study was conducted among 141 patients admitted to Felege Hiwot Hospital from 1 September 2016 to 30 August 2019. Descriptive statistics were used to describe the clinical presentation and laboratory profiles of patients with visceral leishmaniasis. Results: Among a total of 141 enrolled patients in the study, males were affected 13-fold. Most of them were travelers to endemic areas during the winter season for labor work. The mean duration of illness was 48 days. Common symptoms were fever (96.5%), weightless (82.5%), jaundice (18.4%), vomiting/diarrhea (13.5%), and bleeding episodes (11.3%). Splenomegaly was seen in 98.6%, ascites in 35.5%, and lymphadenopathy in 9.9%. Lymphadenopathy was seen significantly in HIV patients (40%). Anemia was seen in 95%, thrombocytopenia in 90.2%, leukopenia in 86.4%, and pancytopenia in 79.4%. Half of the patients had coinfection. Neutropenic sepsis was seen in 21.3%. The diagnosis was made by tissue aspiration in 65% of patients. Conclusion: The majority of patients who were diagnosed to have visceral leishmaniasis were young male adults who traveled to the endemic areas seasonally. Fever and splenomegaly were seen as the commonest clinical presentation. Lymphadenopathy occurred in high frequency among HIV co-infected patients. Anemia was the commonest hematologic finding.

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Clinical presentation of geriatric polytrauma patients with severe pelvic fractures: comparison with younger adult patients

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-016-1822-7 ◽

2016 ◽

Vol 26 (8) ◽

pp. 885-890 ◽

Cited By ~ 4

Author(s):

Shozo Kanezaki ◽

Masashi Miyazaki ◽

Naoki Notani ◽

Hiroshi Tsumura

Keyword(s):

Clinical Presentation ◽

Pelvic Fractures ◽

Adult Patients ◽

Polytrauma Patients

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A case of subacute sclerosing panencephalitis presenting as depression

Acta Neuropsychiatrica ◽

10.1111/j.0924-2708.2006.00117.x ◽

2006 ◽

Vol 18 (1) ◽

pp. 55-57 ◽

Cited By ~ 2

Author(s):

Soumitra Shankar Datta ◽

Rajesh Jacob ◽

Sudhir Kumar ◽

Susan Jeyabalan

Keyword(s):

Clinical Presentation ◽

Subacute Sclerosing Panencephalitis ◽

Diagnostic Delay ◽

Depressive Syndrome ◽

Adult Patients ◽

Rare Presentation ◽

Affective Symptoms

Summary:Subacute sclerosing panencephalitis (SSPE) is rare in adult patients. Clinical presentation in intial phases of SSPE may be non-specific leading to diagnostic delay. We present a 24-year-old patient with depressive syndrome of five months' duration prior to the onset of typical features of SSPE, which is a rare presentation. This patient had responded partially to Sertraline, for a brief period, before he was diagnosed to have SSPE. This case illustrates affective symptoms can be the presenting features of SSPE in adults.

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Establishing a minor illness nurse in a busy general practice

BMJ ◽

10.1136/bmj.310.6991.1404b ◽

1995 ◽

Vol 310 (6991) ◽

pp. 1404-1405 ◽

Cited By ~ 2

Author(s):

A. Campbell ◽

M. Herdman ◽

N. Kearsley ◽

S. Maric

Keyword(s):

General Practice ◽

Minor Illness ◽

A Minor

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Establishing a minor illness nurse in a busy general practice

BMJ ◽

10.1136/bmj.310.6982.778 ◽

1995 ◽

Vol 310 (6982) ◽

pp. 778-780 ◽

Cited By ~ 46

Author(s):

G N Marsh ◽

M L Dawes

Keyword(s):

General Practice ◽

Minor Illness ◽

A Minor

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Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis

Italian Journal of Medicine ◽

10.4081/itjm.2011.274 ◽

2012 ◽

pp. 274-277

Author(s):

Andrea Celestini ◽

Federica Paglia ◽

Orlando Dell’ Unto ◽

Riccardo Guarisco ◽

Claudio Puoti

Keyword(s):

Bone Marrow ◽

Visceral Leishmaniasis ◽

Bone Marrow Biopsy ◽

Clinical Presentation ◽

Splenic Rupture ◽

Splenic Infarction ◽

Diagnostic Tools ◽

Minor Trauma ◽

Vector Borne ◽

A Minor

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis.

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Acalculous acute cholecystitis during the course of an enteroviral infection

BMJ Case Reports ◽

10.1136/bcr-2018-228306 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228306 ◽

Cited By ~ 1

Author(s):

Ana Sofia Simões ◽

Andreia Marinhas ◽

Paulo Coelho ◽

Sandra Ferreira

Keyword(s):

Acute Cholecystitis ◽

Clinical Presentation ◽

Clinical Course ◽

Clinical Report ◽

Healthy Children ◽

First Line ◽

Abdominal Ultrasonography ◽

Laboratory Findings ◽

Enteroviral Infection ◽

Underlying Diseases

Gallbladder diseases are uncommon in children. Acalculous acute cholecystitis, although rare, is the most frequent form of acute cholecystitis in childhood. In acalculous acute cholecystitis, clinical presentation and laboratory findings are unspecific, making the diagnosis challenging. Abdominal ultrasonography is the first-line exam. Most cases of paediatric acalculous acute cholecystitis have been described in critically ill patients, but can occur in previously healthy children, without underlying diseases or severe conditions. The authors present a clinical report of a child with acalculous acute cholecystitis and enteroviral infection. Diagnosis, treatment, clinical course and prognosis are described. Pathophysiology, aetiology, diagnosis and treatment of acalculous acute cholecystitis are also discussed.

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A well-appearing infant with a sudden anisocoria

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2020-319993 ◽

2020 ◽

pp. edpract-2020-319993

Author(s):

Alessia Giuseppina Servidio ◽

Francesca Peri ◽

Andrew Tenore ◽

Laura Cesca ◽

Laura Diplotti ◽

...

Keyword(s):

Clinical Presentation ◽

Brain Mri ◽

Vital Signs ◽

Sudden Onset ◽

List Type ◽

Case Presentation ◽

Third Nerve Palsy ◽

Age Limits ◽

Unilateral Mydriasis ◽

A Minor

Case presentationA 10-month-old boy was admitted to the emergency department due to a sudden onset of left unilateral mydriasis (figure 1). His medical history was unremarkable. A minor head trauma 2 days before was reported, without alarming signs or symptoms. His mother was putting him to sleep, after coming back from work, when she noticed a different pupil size and promptly went to the ED with her husband. The parents denied any use of medications, including nebulised therapy or direct contact with plants. The child was well appearing and his vital signs were within the standard age limits. His extraocular motility was normal as well as the rest of his neurological and physical examination. Parents’ behaviour was somehow remarkable. Even though the child was not suffering, the mother seemed very worried while the father was nervous and aggressive, repeatedly asking for a discharge.Figure 1Left unilateral mydriasis.QuestionsWhat is the most likely diagnosis based on this clinical presentation?Local contact with a mydriatic substanceIntracerebral haemorrhageBrain tumourThird nerve palsyWhat would be the next step in the investigation to confirm this diagnosis?Brain CTBrain MRIFundus oculi examinationToxicological screening of urineHow is this condition managed, and what is the prognosis?Answers can be found on page XX

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