scholarly journals Rhabdomyolysis and influenza a (H3N2) infection: A case report

2017 ◽  
Vol 70 (5-6) ◽  
pp. 173-175
Author(s):  
Anja Stojsin ◽  
Vedrana Petric ◽  
Grozdana Canak ◽  
Vesna Turkulov ◽  
Sinisa Sevic ◽  
...  
Keyword(s):  
Case Report ◽  
General Condition ◽  
Influenza A ◽  
Polymerase Chain Reaction Analysis ◽  
Reference Ranges ◽  
Laboratory Findings ◽  
Progressive Muscle Weakness ◽  
Good General Condition ◽  
Life Threatening ◽  
Acute Polyneuropathy

Introduction. Extrapulmonary complications of influenza infections are often unrecognized. The aim of this paper is to point to rhabdomyolysis as a potentially life threatening complication of influenza. Case Report. A month after the onset of influenza complicated by bronchopneumonia, the general condition of a nineteen year old female deteriorated with development of progressive muscle weakness and dark-colored urine. Despite intensive hydration and antibiotic therapy, her condition got worse, laboratory findings showed pancytopenia, hypoalbuminemia and creatine phosphokinase about 1000 times higher than normal. Influenza A H3N2 was confirmed by polymerase chain reaction analysis of the throat swab sample. Electromyoneurography showed severe acute polyneuropathy of muscles innervated by perineal nerve and signs of polymyositis; pathohistological examination of gastrocnemius muscle biopsy sample confirmed chronic myositis with necrotic neurogenic atrophy. In spite of intense hydration, the patient?s status continued deteriorating, so methylprednisolone was administered. Six weeks later, the patient was discharged in a good general condition, with blood test results within reference ranges, with weakness of foot dorsiflexors and tilting of the pelvis to the left during verticalization. Conclusion. Rhabdomyolysis caused by influenza-A is on the increase, and given the degree of morbidity and mortality, thorough assessment of patients is necessary.

scholarly journals Fatal Chemotherapy-induced Combined Infection in a Hodgkin’s Disease Patient: a Case Report

Folia Medica ◽  
2019 ◽  
Vol 61 (4) ◽  
pp. 620-623
Author(s):  
Yordan I. Kalchev ◽  
Gergana B. Lengerova ◽  
Uswah Asif ◽  
Hasan A. Burnusuzov ◽  
Marianna A. Murdjeva
Keyword(s):  
Case Report ◽  
Influenza A ◽  
Multiplex Polymerase Chain Reaction ◽  
Multimodal Therapy ◽  
Disease Patient ◽  
Infectious Complications ◽  
Chain Reaction ◽  
Life Threatening ◽  
Polymerase Chain ◽  
Combined Infection

Multimodal therapy, used for the treatment of patients with Hodgkin’s disease (HD), makes them prone to life-threatening infections, attributed mainly to febrile neutropenia. Herein, we present a case report of fatal combined bacterial and viral infection in a 49-year-old female patient, subject to polychemotherapy for HD. Rapid microbiological diagnosis performed by multiplex polymerase chain reaction elucidated the causes of the infection within hours. Listeria monocytogenes was detected in both the cerebrospinal fluid and blood samples. Nasopharyngeal swabs returned positive for two swine-derived strains of influenza A virus. We aimed to emphasize the importance of these pathogens and draw attention to their association in the aetiology of infections among patients receiving chemotherapy. In conclusion, better surveillance is needed to improve the early diagnosis of infectious complications in these patients.

scholarly journals When the Red Tide Rolls In: A Red Tide Associated Angioedema Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 222-225
Author(s):  
Sarah Rabinowitz ◽  
Joshua Solano
Keyword(s):  
Case Report ◽  
Cell Activation ◽  
Red Tide ◽  
Mast Cell Activation ◽  
Red Tides ◽  
Respiratory Compromise ◽  
Laboratory Findings ◽  
Voice Changes ◽  
Low Concentrations ◽  
Life Threatening

Introduction: Histamine-mediated angioedema is a potentially life-threatening reaction following exposures that incite mast cell activation. In Florida, red tides are a frequent phenomenon caused by overgrowth of the harmful algae species Karenia brevis, which contain environmentally detrimental brevetoxins. Even in low concentrations, brevetoxins can cause disease in humans through inducing histamine release. We report the first documented case of angioedema associated with red tide exposure. Case Report: A 52-year-old-male presented with severe angioedema encompassing both lips within a few hours after exposure to red tide algae. Other symptoms included voice changes and difficulty swallowing. Laboratory findings revealed complement factors that were within reference range, which ruled out a bradykinin-mediated pathology and supported the diagnosis of histaminergic angioedema. Symptoms resolved after 24 hours in the intensive care unit under management with epinephrine, diphenhydramine, methylprednisolone, and famotidine. Conclusion: In coastal regions, red tide algae should be recognized as a rare cause of acute angioedema. Emergency management of histamine-mediated angioedema should focus on preventing respiratory compromise with frequent airway monitoring and treatment with steroids, antihistamines, and epinephrine.

scholarly journals Influenza A triggered status asthmaticus requiring emergency ECMO

2016 ◽  
Vol 73 (4) ◽  
Author(s):  
F. Guarracino ◽  
M. Stefani ◽  
P. Maremmani ◽  
M. Corini ◽  
S. Pini ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Respiratory Failure ◽  
Influenza A Virus ◽  
Influenza A ◽  
Status Asthmaticus ◽  
Severe Pneumonia ◽  
Refractory Status ◽  
Threatening Condition ◽  
Life Threatening

We describe a case of acute respiratory failure due to severe pneumonia triggered by the influenza A virus, rapidly evolving into a refractory status asthmaticus requiring emergent ECMO assistance, in order to facilitate the clinical management of patients suffering from this rare but life-threatening condition. This case report demonstrates that infection with influenza A virus can present with severe pneumonia and status asthmaticus refractory to medical and ventilatory treatment. When medical treatment and mechanical ventilation fail, extracorporeal membrane oxygenation therapy should not be delayed as it will avoid injury resulting from inadequate mechanical ventilation and lung hyperinflation.

scholarly journals The Use of Liraglutide in Obese Patients With COVID-19: A Case Report

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A38-A39
Author(s):  
Taliê Zanchetta Buani Hanada ◽  
Rafael Silvestre Knack ◽  
Renata Silvestre Knack
Keyword(s):  
Case Report ◽  
General Condition ◽  
Interleukin 6 ◽  
Laboratory Tests ◽  
Low Grade ◽  
Obese Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Good General Condition ◽  
Anti Inflammatory

Abstract Introduction: In December 2019, a new type of coronavirus was discovered in Wuhan, China, characterized by a picture of atypical pneumonia composed of fever, dry cough and progressive dyspnea. Autopsy analyzes of patients with Covid-19 were performed, and hyperactivation of cytotoxic T cells was observed, suggesting an increase in humoral-type immunological signaling, where interleukin 6 (IL-6) is a mediator present that can fit as a potential critical agent for exacerbation of inflammatory conditions. In addition, not only interleukin-6, but also serum C-reactive protein (CRP) and ferritin have been recognized as strong predictors of COVID-19 severity. Recent studies have shown that the use of liraglutide has antioxidant and anti-inflammatory effects in vitro. Thus, the present case report discusses the possible anti-inflammatory properties of the antidiabetic drug liraglutide (Saxenda), in Covid-19. Clinical Case: JCMS, 45 years, male, married, obese grade 2 (BMI: 38.2), sought medical service on August 18, 2020, bringing a positive result of the RT-PCR test for Covid-19, performed in last day. The patient was in good general condition, reporting mild headache and adynamia. He was prescribed to start a treatment with Saxenda (6mg/ml - started 0.6mg/day at week 1, with a gradual increase up to 3mg/day at week 5); Jardiance (25mg / day); Fluimicil (600mg); Ivermectin (6mg) and Colchicine (0.5mg every 12 hours). In addition, collection of laboratory tests was requested. Examination results: IL6: <1.5 pg/mL; Ferritin: 819 ng/ml; C-reactive protein: 5.1mg/L. On August 24, the patient was tachycardic (HR 120–140 bpm) associated with headache and fever (38 °C). Azithromycin (500mg), dexamethasone (4mg) and dipyrone (1g) were prescribed. Collection of laboratory tests was requested. Examination results: IL6: 9.3 pg/mL; Ferritin: 1085 ng/ml; C-reactive protein:23.9mg/L. On September 3, the patient was in good general condition, eupneic, afebrile, with no complaints to declare. On September 6, the collection of laboratory tests was requested. Examination results: IL6: <1.5 pg/mL; Ferritin: 687 ng/ml; C-reactive protein: 1.7mg/L. Conclusion: Based on the described report, it is possible to observe a good clinical and laboratory evolution of the patient with Covid-19 who, among the drugs used, made use of liraglutida. Diabetes and obesity are considered significant risk factors for morbidity and mortality by COVID-19, since they are a condition of low-grade chronic inflammation and in these conditions, inflammatory markers such as CRP, IL-6 and ferritin have strong signs of alteration. Thus, the possible beneficial effect of the administration of liraglutide in obese patients is highlighted, as a potential anti-inflammatory effect, especially in the COVID-19 era.

scholarly journals Iatrogenic Iliac Arteriovenous Fistula Management after Lumbar Discectomy Surgeries: A Case Report and Review of the Literature

2020 ◽  
Vol 23 (6) ◽  
pp. E863-E866
Author(s):  
Mihaela Salagean ◽  
Carmen Ginghina ◽  
Roxana Carmen Geana ◽  
Razvan Dragulescu ◽  
Andra Balcangiu Stroescu ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Rare Complication ◽  
Lumbar Vertebrae ◽  
Lumbar Discectomy ◽  
Review Of The Literature ◽  
Endovascular Technique ◽  
The Third ◽  
Good General Condition ◽  
Life Threatening

Iatrogenic iliac arteriovenous fistula (IAVF) is an extremely rare complication after lumbar discectomy surgery (LDS), with potentially life-threatening consequences. An IAVF results from the close anatomic relation between the iliac vessels and the last lumbar vertebrae and the corresponding discs. We report the case of a 45-year-old woman who developed a large right IAVF 3 years after L4-L5-S1 laminectomy. The arteriovenous fistula (AVF) was successfully treated with an endovascular technique using a WALLSTENT self-expanding stent. The postoperative period was uneventful, and the patient was discharged from the hospital in good general condition on the third postoperative day.

scholarly journals Spontaneous pneumothorax in a newborn case report: original image, treatment process and follow-up

2020 ◽  
Vol 7 (1) ◽  
pp. 1-2
Author(s):  
Muhammet Mesut Nezir Engin ◽  
Gülden AK ◽  
Önder Kılıçaslan
Keyword(s):  
Respiratory Distress ◽  
General Condition ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Tube Placement ◽  
Laboratory Findings ◽  
Free Air ◽  
Good General Condition ◽  
Free Drainage ◽  
Gestational Week

Pneumothorax is a condition where there is free air between the parietal and visceral pleural leaves within the thoracic cavity. She was born with a cesarean section of 2780grams in 38th gestational week. As the patient had tachypnea and intercostal retractions, he was hospitalized in another hospital and started treatment. On the second day of hospitalization, pneumothorax was seen on the posterior anterior chest radiograph and he was referred to us. When the patient came to our clinic, his general condition was poor, tachypnea, intercostal withdrawal and groan breathing were present. When the patient had low saturation, he was intubated and connected to a mechanical ventilator. The chest tube was placement and free drainage was performed. She was discharged on the 9th day of his hospitalization because of his good general condition, improved laboratory findings and no additional difficulties. Spontaneous pneumothorax should be considered in the presence of sudden respiratory distress in the newborn period. Patients diagnosed with pneumothorax should be immediately chest tube placement, patients with respiratory distress should be evaluated and given supportive treatment.

scholarly journals Hemoglobin life-threatening value (1.9 g/dl) in good general condition: a pediatric case-report

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Emilia Parodi ◽  
Lorenzo Riboldi ◽  
Ugo Ramenghi
Keyword(s):  
General Condition ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Case Presentation ◽  
Chronic Anemia ◽  
Iron Supplements ◽  
Packed Red Blood Cells ◽  
Good General Condition ◽  
Life Threatening ◽  
Clinical Conditions

Abstract Background We report a pediatric patient presenting in good general condition despite a hemoglobin value of 1,9 g/dL, which is normally regarded as life-threatening. Case presentation An African 5 years-old girl presented to our Emergency Department (ED) for worsening asthenia, within a clinical picture of good general condition. The hemoglobin value at admission was 1,9 g/dL. The subsequent diagnostic-therapeutic pathway highlighted the presence of two different causes, both well known to be responsible for chronic anemia (with slow reduction of hemoglobin values): iron deficiency anemia (IDA) due to a very low dietary intake of iron-rich foods, and homozygous sickle cell disease (HbSS). She received transfusions of packed red blood cells (overall 15 ml/kg) and subsequently intravenous iron preparations (total amount 200 mg) followed by oral iron supplements. The Hb value at discharge, 10 days after the admission, was 9.8 g/dL. Conclusions When approaching a picture of severe anemia, we suggest pediatricians take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis.

scholarly journals Hemoglobin Life-threatening Value (1.9 g/dl) in Good General Condition: a Pediatric Case-report.

2021 ◽  
Author(s):  
Emilia Parodi ◽  
Lorenzo Riboldi ◽  
Ugo Ramenghi
Keyword(s):  
General Condition ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Case Presentation ◽  
Chronic Anemia ◽  
Iron Supplements ◽  
Packed Red Blood Cells ◽  
Good General Condition ◽  
Life Threatening ◽  
Clinical Conditions

Abstract Background: we report a pediatric patient presenting in good general condition despite an hemoglobin value of 1,9 g/dL, which is normally regarded as life-threatening. Case presentation: an African 5 years-old girl presented to our Emergency Department (ED) for worsening asthenia, within a clinical picture of good general condition. The hemoglobin value at admission was 1,9 g/dL. The subsequent diagnostic-therapeutic pathway highlighted the presence of two different causes, both well known to be responsible for chronic anemia (with slow reduction of hemoglobin values): iron deficiency anemia (IDA) due to a very low dietary intake of iron-rich foods, and homozygous sickle cell disease (HbSS). She received transfusions of packed red blood cells (overall 15 ml/kg) and subsequently intravenous iron preparations (total amount 200 mg) followed by oral iron supplements. The Hb value at discharge, 10 days after the admission, was 9.8 g/dL.Conclusions: when approaching a picture of severe anemia, we suggest pediatricians to take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis.

scholarly journals Ménétrier's disease associated with ulcerative collitis

2003 ◽  
Vol 60 (6) ◽  
pp. 747-751 ◽  
Author(s):  
Darko Mirkovic ◽  
Radoje Doder ◽  
Srbislav Ilic ◽  
Miroslav Mitrovic ◽  
Mile Ignjatovic
Keyword(s):  
Ulcerative Colitis ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
General Condition ◽  
Upper Endoscopy ◽  
Laboratory Findings ◽  
Menetrier’S Disease ◽  
Good General Condition ◽  
Ménétrier's Disease ◽  
Menetrier's Disease

In this paper a 21 year old patient was presented with M?n?trier's disease, associated with ulcerative colitis. The first symptoms of ulcerative colitis occured at the age of eleven, since when the patient has been conservatively treated several times because of the exacerbations of the desease. During control examinations presence of polipoid changes in stomach was discovered by upper endoscopy. Gastrectomy was suggested because the patient had excessive anemic syndrome which required weekly substitutional therapy with deplasmatic eritrocytes, as well as hypoproteinemia, while multiple polipoid changes suspect for malignancy were gastroscopically identifided. Patient accepted surgical treatment, and was transfered to the Clinic of Surgery. Total gastrectomy was performed, and patohystological finding confirmed M?n?trier's desease. After two weeks, the patient was released from the hospital in good general condition, with regular clinical and laboratory findings.

scholarly journals Plasmapheresis in the treatment of fatty liver of pregnancy: A case report

2019 ◽  
Author(s):  
Tahereh Ashrafganjoei ◽  
Soha Mirreza ◽  
Mitra Eftekhariyazdi ◽  
Forough Mortazavi
Keyword(s):  
Case Report ◽  
Fatty Liver ◽  
General Condition ◽  
Specific Treatment ◽  
Supportive Treatment ◽  
Third Trimester ◽  
Emergency Ward ◽  
The Third ◽  
Good General Condition ◽  
Acute Fatty Liver

Introduction: Acute fatty liver of pregnancy (AFLP) is a rare but lethal disease with liver involvement that appears in the third trimester of pregnancy. There is no specific treatment for AFLP. Because liver dysfunction is the most pathogenesis in AFLP the following hypothesis will be raised that plasma exchange can be useful. Case Report: A 26-year-old mother was referred to our emergency ward with AFLP. The ultrasonography reported a single alive anhydramnios fetus at 34 weeks and fatty liver G1-2. Emergent cesarean was performed and the patient was then admitted to the intensive care unit. The day after surgery, our patient developed periumbilical tenderness and displayed abnormal coagulative factors. Ultrasonography reported 500cc liquid in the abdominal space. Relaparotomy was performed and during the next several days, her general condition worsened and supportive treatment was not effective and the patient experienced a seizure. We started plasmapheresis and after 10 days platelet levels started to rise, lactate dehydrogenase began to reduce, the edema reduced significantly, and her orientation became better. We continued plasmapheresis for about 20 sessions. After one month, the patient was discharged from the hospital in good general condition. Conclusion: Plasmapheresis may be effective in the treatment of fatty liver of pregnancy.

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