scholarly journals Case of Cutaneous Sarcoidosis with Direct Osseous Involvement

2021 ◽  
Vol 5 (4) ◽  
pp. 418-421
Author(s):  
Simran Arinder Chadha ◽  
Jennifer Shastry ◽  
Erin McComb ◽  
Christina Clarke
Keyword(s):  
Pulmonary Involvement ◽  
Initial Symptom ◽  
Cutaneous Sarcoidosis ◽  
First Line ◽  
Cutaneous Manifestations ◽  
First Line Therapy ◽  
Line Therapy ◽  
Osseous Involvement ◽  
Additional Imaging ◽  
Granulomatous Disorder

Sarcoidosis is a granulomatous disorder that presents with cutaneous manifestations in one-third of patients, often as an initial symptom prompting interaction with the healthcare system. Here, we report a case of cutaneous sarcoidosis on the forehead with directly underlying erosive osseous disease. The patient was imaged further, uncovering pulmonary involvement. The lesion was treated with topical and intralesional corticosteroids with significant resolution. Though there exist a range of classic eruptions associated with sarcoidosis, skin involvement can present variably and should prompt additional imaging, particularly to assess for osseous and pulmonary involvement. Topical and intralesional corticosteroids can be effective first-line therapy for cutaneous sarcoidosis.

scholarly journals Kocuria Species Peritonitis: Although Rare, we Have to Care

2015 ◽  
Vol 35 (1) ◽  
pp. 26-30 ◽  
Author(s):  
John Dotis ◽  
Nikoleta Printza ◽  
Stella Stabouli ◽  
Fotios Papachristou
Keyword(s):  
Abdominal Pain ◽  
First Generation ◽  
Initial Symptom ◽  
First Line ◽  
Duration Of Treatment ◽  
Predominant Species ◽  
First Line Therapy ◽  
Line Therapy ◽  
A Site ◽  
Micro Organisms

Kocuria species are found in the environment and on human skin. These micro-organisms are generally considered to be nonpathogenic saprophytes, rarely causing infection. However, the peritoneum has been reported to be a site of Kocuria infection. We reviewed all cases of peritonitis in peritoneal dialysis (PD) patients caused by Kocuria species that were reported in the worldwide literature. In total, 12 episodes of Kocuria species peritonitis have been reported in 9 PD patients. The median age of the patients was 62 years (range: 8 – 78 years). In the reported episodes, 4 different Kocuria species were isolated, with K. varians being the predominant species (41.7%). The most common initial symptom was abdominal pain (83.3%), followed by turbid effluent (75%) and fever (33.3%). Intraperitoneal first-generation cephalosporins and glycopeptides were the most-used antibiotics, with first-generation cephalosporins being more often preferred as first-line therapy. The median duration of treatment was 14 days, and in 2 episodes, the Tenckhoff catheter was removed. Although Kocuria peritonitis in PD patients is rare, it should be promptly treated because relapses can occur, especially with K. varians episodes.

scholarly journals Extrapulmonary sarcoidosis primarily presenting as cholestatic liver disease

2019 ◽  
Vol 12 (12) ◽  
pp. e232618
Author(s):  
Pieter De Mulder ◽  
Bert Maertens ◽  
Anne Hoorens ◽  
An Vonck
Keyword(s):  
Liver Function Tests ◽  
Pulmonary Involvement ◽  
Pulmonary Sarcoidosis ◽  
Cholestatic Liver Disease ◽  
Inflammatory Disorder ◽  
Granulomatous Hepatitis ◽  
First Line ◽  
Rare Presentation ◽  
First Line Therapy ◽  
Line Therapy

Sarcoidosis is a multisystem inflammatory disorder associated with non-caseating granulomas in affected organs, most commonly the lungs. Involvement of extrapulmonary organs is common, but lack of pulmonary involvement is rare and is called non-pulmonary sarcoidosis (NPS). Like pulmonary sarcoidosis, a definitive diagnostic test for NPS does not exist. Instead, the diagnosis of sarcoidosis requires the following elements: clinical and radiographic manifestations of sarcoidosis, histopathological detection of non-caseating granulomas and the exclusion of other diseases that may present similarly. Because of the experience with corticosteroids in pulmonary sarcoidosis, they are generally considered first-line therapy for NPS too. Ursodeoxycholic acid can be used to reduce cholestasis in NPS, but is inferior to corticosteroids in reducing inflammation. We hereby present a case that is particularly notable for its rare presentation of NPS as a granulomatous hepatitis with cholestatic liver function tests.

1904: Outcomes of Large Renal Calculi (>2-Cm) Treated with ESWL as First Line Therapy

2004 ◽  
Vol 171 (4S) ◽  
pp. 503-503
Author(s):  
Richard Vanlangendock ◽  
Ramakrishna Venkatesh ◽  
Jamil Rehman ◽  
Chandra P. Sundaram ◽  
Jaime Landman
Keyword(s):  
Renal Calculi ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Is digoxin still justifiable as single first-line therapy in fetal SVT associated with fetal hydrops?

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
DJ Kersten ◽  
J McDougall ◽  
C Schuller ◽  
JP Pfammatter ◽  
L Raio ◽  
...  
Keyword(s):  
First Line ◽  
Fetal Hydrops ◽  
First Line Therapy ◽  
Line Therapy

EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

2019 ◽  
pp. 28-32
Author(s):  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
High Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

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