scholarly journals POTT DISEASE IN IMMUNOSUPPRESSED PATIENT, A CASE REPORT.

2020 ◽  
Vol 7 (1) ◽  
pp. 52-54
Author(s):  
Heloyse Nascimento Lima ◽  
Romulo Braga Pires ◽  
Angelica Gomes de Carvalho ◽  
Isabella Vilane Braga Saboia Rythowem ◽  
Pedro Miranda Portugal Junior ◽  
...  
Keyword(s):  
Symptomatic Improvement ◽  
Lower Limbs ◽  
Immunosuppressed Patient ◽  
Rare Entity ◽  
Good Clinical Outcome ◽  
Pott’S Disease ◽  
Night Sweats ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Extrapulmonary Manifestation

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. The pulmonary form is more frequent, but other body structures may be affected. Pott's Disease is a rare entity and accounts for about 0.5% - 1% of extrapulmonary manifestation, especially in immunosuppressed patients. It occurs through reactivation of sites for the spine and sometimes lower limbs. The symptomatology presents itself through the triad: abscess, paraplegia and gibbosity, associated with the classic clinical picture of pulmonary TB: fever, night sweats and chills. The aim of this study is to demonstrate a case of Pott's disease in a 56-year-old female patient with a history of chemotherapy due to non-Hodgkin's lymphoma. After treatment, the patient evolved with symptomatic improvement and good clinical outcome.

scholarly journals Protracted severe systemic cytomegalovirus disease in an immunosuppressed patient with ulcerative colitis

2017 ◽  
Vol 9 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Matthew James Armstrong ◽  
Tom Thomas ◽  
Tariq Iqbal ◽  
Ralph Boulton ◽  
Jason Goh
Keyword(s):  
Ulcerative Colitis ◽  
Antiviral Therapy ◽  
Immunosuppressed Patient ◽  
Intravenous Ganciclovir ◽  
Once Daily ◽  
Reactive Protein ◽  
Night Sweats ◽  
History Of ◽  
Distal Sigmoid ◽  
Dna Pcr

A 33-year-old man with ulcerative colitis presented with 5-day history of fever, night sweats, abdominal pain and increased stool frequency. He was on mesalazine M/R 1 g once daily, 6-mercaptopurine (6-MP) 75 mg once daily and prednisolone 40 mg once daily. Examination revealed fever and tachycardia. Blood examinations identified a persistent leucopenia, C reactive protein of 23 mg/L and an initial alanine transaminase of 855 IU/L. Flexible sigmoidoscopy revealed well-demarcated, punched-out ulcers in the proximal rectum and distal sigmoid, with histology pathognomonic of cytomegalovirus (CMV). CMV DNA PCR was 51 140 copies/mL. Despite prompt withdrawal of 6-MP, steroids and initiation of intravenous ganciclovir on day 2 of admission, his systemic illness, diarrhoea and fever persisted until day 19 of antiviral therapy. Other copathogens and lymphoma were ruled out on serology and CT scan, respectively. After an unusually prolonged course of antiviral therapy, the patient made a full clinical recovery, bloods normalised and there were two consecutive undetectable CMV DNA PCRs.

scholarly journals Brachial artery pseudo-aneurysm in intravenous drug abuser: a rare case report

2019 ◽  
Vol 6 (6) ◽  
pp. 2207
Author(s):  
Naveed Nabi ◽  
Firdous Beigh ◽  
Showkat Mir
Keyword(s):  
Brachial Artery ◽  
Lower Limbs ◽  
Rare Entity ◽  
Sample Collection ◽  
Intravenous Drug Abuser ◽  
Rare Case Report ◽  
History Of ◽  
Pseudo Aneurysm ◽  
Cubital Fossa ◽  
Danlos Syndrome

Brachial artery pseudo-aneurysm (BAP) is a rare entity because pseudo-aneurysms are common in lower limbs.1 Usual causes of BAP are humeral fractures, iatrogenic causes (repeated punctures for sample collection, following construction of Brachio-cephalic fistula) or some genetic causes like Ehler Danlos syndrome (EDS). This case has been reported to highlight the importance of considering all the differential diagnosis while evaluation of an upper limb swelling especially in the cubital fossa and due consideration of history of any IV drug abuse.

scholarly journals Seizure in isolated brain cryptococcoma: Case report and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 153
Author(s):  
Laura Brunasso ◽  
Roberta Costanzo ◽  
Antonio Cascio ◽  
Ada Florena ◽  
Gianvincenzo Sparacia ◽  
...  
Keyword(s):  
Immunocompetent Patient ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Granulomatous Reaction ◽  
Pertinent Literature ◽  
Cranial Nerve Dysfunction ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Nerve Dysfunction ◽  
Immunocompetent Patients

Background: Central nervous system (CNS) cryptococcosis is an invasive fungal infection predominantly seen among immunosuppressed patients causing meningitis or meningoencephalitis. Rarely, cryptococcosis can affect immunologically competent hosts with the formation of localized CNS granulomatous reaction, known as cryptococcoma. Common symptoms of CNS cryptococcoma are headaches, consciousness or mental changes, focal deficits, and cranial nerve dysfunction. Rarely, seizures are the only presenting symptom. Case Description: We report the case of an immunocompetent patient with a solitary CNS cryptococcoma presenting with a long history of non-responsive generalized seizure who has been successfully operated. Conclusion: CNS cryptococcoma is a rare entity, and in immunocompetent patients, its diagnosis can be challenging. The pathophysiology of lesion-related seizure is discussed along with a review of the pertinent literature.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

Congenital Intercostal Hernia: A Rare Entity

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 48
Author(s):  
Syed Muzamil Andrabi ◽  
Mohd Yousuf Dar ◽  
Javid Ahmad Bhat
Keyword(s):  
Male Patient ◽  
General Surgery ◽  
Rare Entity ◽  
Intercostal Hernia ◽  
History Of ◽  
Lateral Chest ◽  
Patient Department

A 35-year-old male patient presented to the General Surgery Out Patient Department with a history of swelling on the left lateral chest since birth. The swelling appeared during inspiration and disappeared during expiration. JMS 2018;21(1):48 

scholarly journals Cancer immunotherapy in special challenging populations: recommendations of the Advisory Committee of Spanish Melanoma Group (GEM)

2021 ◽  
Vol 9 (3) ◽  
pp. e001664
Author(s):  
Maria Gonzalez-Cao ◽  
Teresa Puertolas ◽  
Mar Riveiro ◽  
Eva Muñoz-Couselo ◽  
Carolina Ortiz ◽  
...  
Keyword(s):  
Cancer Immunotherapy ◽  
Multidisciplinary Approach ◽  
Checkpoint Inhibitors ◽  
Solid Organ Transplantation ◽  
Latent Tuberculosis ◽  
Solid Organ ◽  
Chronic Infections ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Evidence Based Guidelines

Cancer immunotherapy based on the use of antibodies targeting the so-called checkpoint inhibitors, such as programmed cell death-1 receptor, its ligand, or CTLA-4, has shown durable clinical benefit and survival improvement in melanoma and other tumors. However, there are some special situations that could be a challenge for clinical management. Persons with chronic infections, such as HIV-1 or viral hepatitis, latent tuberculosis, or a history of solid organ transplantation, could be candidates for cancer immunotherapy, but their management requires a multidisciplinary approach. The Spanish Melanoma Group (GEM) panel in collaboration with experts in virology and immunology from different centers in Spain reviewed the literature and developed evidence-based guidelines for cancer immunotherapy management in patients with chronic infections and immunosuppression. These are the first clinical guidelines for cancer immunotherapy treatment in special challenging populations. Cancer immunotherapy in chronically infected or immunosuppressed patients is feasible but needs a multidisciplinary approach in order to decrease the risk of complications related to the coexistent comorbidities.

scholarly journals Effective use of monoclonal antibodies for treatment of persistent COVID-19 infection in a patient on rituximab

2021 ◽  
Vol 14 (8) ◽  
pp. e243469
Author(s):  
Carlos X Rabascall ◽  
Becky X Lou ◽  
Brianne Navetta-Modrov ◽  
Stella S Hahn
Keyword(s):  
Monoclonal Antibodies ◽  
Symptom Onset ◽  
Severe Disease ◽  
Therapeutic Window ◽  
Immunosuppressed Patient ◽  
Unique Case ◽  
Risk Of Progression ◽  
Immunosuppressed Patients ◽  
Effective Use ◽  
Potential Use

As we are over a year into the COVID-19 pandemic, we have made many forward strides in therapeutics. These treatments, such as monoclonal antibodies, have help mitigate the detrimental and often fatal consequences of COVID-19. The current indication for the use of monoclonal antibodies is mild to moderate COVID-19 infection within 10 days of symptom onset in those who are at high risk of progression to severe disease. However, their role in patients with prolonged symptoms is not clear. We present a unique case of monoclonal antibodies use after 54 days of symptom onset in an immunosuppressed patient with persistent COVID-19 infection despite standard treatment. This case illustrates the potential use of monoclonal antibodies outside of the current recommended therapeutic window in immunosuppressed patients, who may have difficulty with viral clearance.

scholarly journals Sirenomelia: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asiyeh Shojaee ◽  
Firooze Ronnasian ◽  
Mahdiyeh Behnam ◽  
Mansoor Salehi
Keyword(s):  
Case Reports ◽  
Three Dimensional ◽  
First Trimester ◽  
Mendelian Inheritance ◽  
Lower Limbs ◽  
Congenital Deformity ◽  
White Family ◽  
Her Family ◽  
Caudal Regression ◽  
History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

IJV thrombophlebitis: be wary of the occult

2021 ◽  
Vol 14 (3) ◽  
pp. e238813
Author(s):  
Pamela Oshinyemi ◽  
Charlotte Lee ◽  
Antony Gough-Palmer ◽  
Iain McKay-Davies
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Palliative Chemotherapy ◽  
Jugular Vein ◽  
Thrombus Formation ◽  
Locally Advanced ◽  
Patients With Cancer ◽  
Occult Malignancy ◽  
Night Sweats ◽  
History Of ◽  
Nose And Throat

A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre’s syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.

scholarly journals Atypical cutaneous and musculoskeletal manifestation of SARS-CoV-2: ‘COVID-19 toes’ and spasticity in a 48-year-old woman

2021 ◽  
Vol 14 (3) ◽  
pp. e241410
Author(s):  
Avery Kopacz ◽  
Cameron Ludwig ◽  
Michelle Tarbox
Keyword(s):  
Nervous System ◽  
Adult Patient ◽  
Early Identification ◽  
Lower Limbs ◽  
Rare Occurrence ◽  
Cutaneous Manifestations ◽  
Crucial Component ◽  
History Of ◽  
Screening Questions ◽  
Insight Into

Establishing accurate symptomatology associated with novel diseases such as COVID-19 is a crucial component of early identification and screening. This case report identifies an adult patient with a history of clotting dysfunction presenting with rare cutaneous manifestations of COVID-19, known as ‘COVID-19 toes’', previously described predominantly in children. Additionally, this patient presented with possible COVID-associated muscle spasticity of the lower limbs, as well as a prolonged and atypical timeline of COVID-19 infection. The rare occurrence of ‘COVID-19 toes’' in this adult patient suggests that her medical history could have predisposed her to this symptom. This supports the coagulopathic hypothesis of this manifestation of COVID-19 and provides possible screening questions for patients with a similar history who might be exposed to the virus. Additionally, nervous system complaints associated with this disease are rare and understudied, so this novel symptom may also provide insight into this aspect of SARS-CoV-2.

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