scholarly journals Atypical Kawasaki Disease in a Two-Year-Old Girl with Initial Presentation of Acute Diarrhea

2021 ◽  
Vol 3 (1) ◽  
pp. 46-60
Author(s):  
Desman Situmorang ◽  
Permata P Karina
Keyword(s):  
Kawasaki Disease ◽  
Acute Diarrhea ◽  
C Reactive Protein ◽  
Diagnostic Laboratory ◽  
X Ray ◽  
Reactive Protein ◽  
Prolonged Fever ◽  
Disease Case ◽  
Chest X Ray ◽  
Atypical Kawasaki Disease

Kawasaki Disease is a spectrum of idiopathic, self-limited fever disease affecting childrenunder 5 years old. This disorder can be challenging to be diagnosed by a pediatrician since thereis no specific diagnostic laboratory test. One atypical Kawasaki Disease case presented withgastrointestinal symptoms, a two-year-old girl was hospitalized with fever, accompanied by non-hemorrhagic diarrhea three days before admission. Physical examination revealed unilateralcervical lymph enlargement and mild-moderate dehydration. Initial laboratory examinationresult showed thrombocytosis, leukocytosis (shift to the left), and normal routine fecal analysis.The patient was initially diagnosed with acute diarrhea with mild-moderate dehydration. She wastreated with a rehydration regimen and antibiotic, but her fever persisted. On the third day ofhospitalization, she fulfilled 3 of the classic Kawasaki Disease criteria (conjunctivitis, crackedlips with strawberry tongue, and lymphadenopathy). Further blood work resulted in increased C-reactive protein 43.35 mg/L and ESR 72 mm/hour, while chest X-ray and electrocardiographwere within normal limit. This patient was proceed to Hasan Sadikin General Hospital for furtherexamination and therapy. Atypical Kawasaki Disease can be a puzzling diagnosis due to itsuncommon presentations. Clinicians should importantly keep it in mind as a differential diagnosisin patients with prolonged fever. Keywords: atypical Kawasaki disease; diarrhea; prolonged fever

scholarly journals Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz
Keyword(s):  
Vital Signs ◽  
C Reactive Protein ◽  
Nocardia Species ◽  
X Ray ◽  
Reactive Protein ◽  
Pulmonary Nocardiosis ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

scholarly journals Risk Factors and a Scoring System to Predict ARDS in Patients with COVID-19 Pneumonia in Korea: A Multicenter Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jun-Won Seo ◽  
Seong Eun Kim ◽  
Eun Young Choi ◽  
Kyung Soo Hong ◽  
Tae Hoon Oh ◽  
...  
Keyword(s):  
Prediction Score ◽  
World Health ◽  
Case Report Form ◽  
C Reactive Protein ◽  
Multicenter Cohort Study ◽  
X Ray ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Chest X Ray ◽  
Epidemiological Characteristics

Predictive studies of acute respiratory distress syndrome (ARDS) in patients with coronavirus disease 2019 (COVID-19) are limited. In this study, the predictors of ARDS were investigated and a score that can predict progression to ARDS in patients with COVID-19 pneumonia was developed. All patients who were diagnosed with COVID-19 pneumonia between February 1, 2020, and May 15, 2020, at five university hospitals in Korea were enrolled. Their demographic, clinical, and epidemiological characteristics and the outcomes were collected using the World Health Organization COVID-19 Case Report Form. A logistic regression analysis was performed to determine the predictors for ARDS. The receiver operating characteristic (ROC) curves were constructed for the scoring model. Of the 166 patients with COVID-19 pneumonia, 37 (22.3%) patients developed ARDS. The areas under the curves for the infiltration on a chest X-ray, C-reactive protein, neutrophil/lymphocyte ratio, and age, for prediction of ARDS were 0.91, 0.90, 0.87, and 0.80, respectively (all P < 0.001 ). The COVID-19 ARDS Prediction Score (CAPS) was constructed using age (≥60 years old), C-reactive protein (≥5 mg/dL), and the infiltration on a chest X-ray (≥22%), with each predictor allocated 1 point. The area under the curve of COVID-19 ARDS prediction score (CAPS) for prediction of ARDS was 0.90 (95% CI 0.86–0.95; P < 0.001 ). It provided 100% sensitivity and 75% specificity when the CAPS score cutoff value was 2 points. CAPS, which consists of age, C-reactive protein, and the area of infiltration on a chest X-ray, was predictive of the development of ARDS in patients with COVID-19 pneumonia.

scholarly journals SEPSIS NEONATORUM DAN PNEUMONIA PADA BAYI ATERM

2013 ◽  
Vol 4 (3) ◽  
Author(s):  
Praevilia M Salendu
Keyword(s):  
Staphylococcus Aureus ◽  
Fetal Distress ◽  
Developed Countries ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
Unpleasant Odor ◽  
Chest X Ray ◽  
Amnion Membrane ◽  
Developing And Developed Countries

Abstract: Sepsis neonatorum is the most frequent cause of admission to a hospital and of death in developing and developed countries. Microorganisms such as Gram positive and negative bacteria, viruses, parasites, and fungi can be the etiological factors. We reported a case of a female neonatus, aterm, and born with caesarean section due to fetal distress. After birth, the neonatus did not spontaneously cry and suffered from asphyxia. The risk factor of this sepsis neonatorum were the early rupture of the amnion membrane associated with an unpleasant odor. Besides that, the mother suffered from a urinary tract infection and fluor albus during pregnancy. Blood examinations showed moderate leucocytosis, slight thrombocytopenia, and a positive C-reactive protein. Chest X-ray showed infiltration in both lungs, indicating pneumonia. The blood culture confirmed Staphylococcus aureus (sensitive to meropenem). Conclusion: Based on all the tests performed, the diagnosis was an aterm neonatus with sepsis neonatorum and pneumonia. Keywords: sepsis, neonatus, pneumonia.     Abstrak: Sepsis neonatorum merupakan penyebab tersering dari perawatan di rumah sakit dan kematian neonatus baik di negara berkembang maupun negara maju. Mikroba seperti bakteri Gram positif dan negatif, virus, parasit, serta jamur dapat menjadi faktor etiologi. Kami melaporkan kasus seorang bayi perempuan, aterm, yang lahir dengan seksio sesaria oleh karena gawat janin. Setelah lahir, bayi tidak langsung menangis, dan memperlihatkan gejala asfiksia. Faktor risiko sepsis neonatorum ialah ketuban pecah dini dan air ketuban berbau. Selain itu, ibu pasien menderita infeksi saluran kemih dan fluor albus pada saat hamil. Pemeriksaan darah menunjukkan leukositosis sedang, trombositopenia ringan, dan C-reaktif protein positif. Foto toraks memperlihatkan adanya infiltrat pada kedua lapangan paru yang mengindikasikan suatu pneumonia. Kultur darah mengonfirmasikan stafilokokus aureus yang sensitif terhadap meropenem. Simpulan: Berdasarkan hasil pemeriksaan ditegakkan diagnosis bayi aterm dengan sepsis neonatorum dan pneumonia. Kata kunci: sepsis, neonatus, pneumonia.

scholarly journals Clinical factors, C-reactive protein point of care test and chest X-ray in patients with pneumonia: A survey in primary care

2019 ◽  
Vol 25 (4) ◽  
pp. 229-235 ◽  
Author(s):  
Geert H. Groeneveld ◽  
Robert J. van de Peppel ◽  
Margot W. M. de Waal ◽  
Theo J. M. Verheij ◽  
Jaap T. van Dissel
Keyword(s):  
Primary Care ◽  
Point Of Care ◽  
Clinical Factors ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
Point Of Care Test ◽  
Chest X Ray

scholarly journals Clinical features and outcomes of 2019 novel coronavirus–infected patients with cardiac injury

2020 ◽  
Author(s):  
Youbin Liu ◽  
Jinglong Li ◽  
Dehui Liu ◽  
Huafeng Song ◽  
Chunlin Chen ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Cardiac Injury ◽  
C Reactive Protein ◽  
Cardiac Biomarker ◽  
X Ray ◽  
Illness Onset ◽  
Reactive Protein ◽  
Chest X Ray ◽  
Novel Coronavirus

AbstractAimsTo explore the epidemiological and clinical features of 2019 novel coronavirus(2019-nCoV)-infected patients with cardiac injury.Methods and resultsData were collected from patients’ medical records, and we defined cardiac injury according to cardiac biomarker troponin I level > 0.03 μg/L. Among the 291 patients, 15 (5.2%) showed evidence of cardiac injury. Of 15 hospitalized patients with cardiac injury, the median age was 65 years, and 11/15 (73.3%) were men. Underlying cardiovascular diseases in some patients were hypertension (n=7, 46.7%), coronary heart disease (n=3, 20%) and diabetes (n=3, 20%). The most common symptoms at illness onset in patients with cardiac injury were fever (n=11, 73.3%), cough (n=7, 46.7%), headache or fatigue (n=5, 33.3%) and dyspnea (n=4, 26.7%). These patients had higher systolic pressures, white blood cell count, neutrophil count, troponin I, brain natriuretic peptide, D-dimer and lower lymphocyte count, and platelet count, compared with patients without cardiac injury, respectively. Bilateral infiltrates on chest X-ray and elevated C-reactive protein occurred in all patients with cardiac injury. Compared with patients without cardiac injury, patients with cardiac injury were more likely to develop acute respiratory distress syndrome, and receive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation and vasopressor therapy and be admitted to the intensive care unit.ConclusionCardiac injury is a common condition among patients infected with 2019-nCoV. Compared with patients without cardiac injury, the clinical outcomes of patients with cardiac injury are relatively worse.

scholarly journals Atypical Kawasaki disease in an early infant, a diagnostic challenge: Case report

2021 ◽  
Vol 8 (11) ◽  
pp. 394-396
Author(s):  
Kaifi Siddiqui ◽  
Ayub Ansari ◽  
Ishaq Farooq ◽  
Sheeba Farooqui
Keyword(s):  
Kawasaki Disease ◽  
Leukocyte Count ◽  
Intravenous Immunoglobulins ◽  
Total Leukocyte Count ◽  
C Reactive Protein ◽  
Diagnostic Challenge ◽  
Reactive Protein ◽  
Atypical Kawasaki Disease ◽  
Short Courses ◽  
Echocardiographic Findings

A 4.5-month-old girl presented to us with continuous fever for 10 days and loose stools for 2 days. She received short courses of multiple oral antibiotics during this period however, was not relieved. Initial investigations were suggestive of urinary tract infection for which broad spectrum antibiotics were started. However, fever persisted even after 72 h of antibiotics. Blood counts showed persistently high total leukocyte count and increasing platelet count, along with high C-reactive protein. Consequently, a diagnosis of Kawasaki disease (KD) was suspected, which was supported by echocardiographic findings. After she received intravenous immunoglobulins, her fever subsided and lab parameters showed significant improvement. This case highlights an unusual presentation of KD in an uncommonly young age group without much clinical pointers except for persistent fever.

scholarly journals The various prognostic scoring system used for predicting COVID-19 mortality

2021 ◽  
Vol 8 (9) ◽  
pp. 4611
Author(s):  
Khaled Mohamed Elsharkawy ◽  
Mohammed Abdulaziz Aljawi ◽  
Hani Helal Alhassani ◽  
Sadeen Essam Ezzat ◽  
Ziad Abdulmoti Alruwaithi ◽  
...  
Keyword(s):  
Scoring System ◽  
Severe Disease ◽  
Scoring Systems ◽  
Medical Attention ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
X Ray Imaging ◽  
Chest X Ray ◽  
Prognostic Scoring Systems

The widespread pandemic of Coronavirus disease 2019 (COVID-19) has been reported to affect most countries all over the world, and burden all of the affected healthcare systems. COVID-19 has first emerged in December 2019 within the district of Wuhan which is located in China. Many prognostic scoring systems have been developed to predict severe disease and death for patients with COVID-19. In this literature review, the aim to discuss the various prognostic scoring system used for predicting COVID-19 mortality. It has mainly approached the prognostic scoring systems in two main ways: The clinical and biochemical ways. In addition, the research also investigates the chest X-ray imaging findings based on scoring systems for predicting mortality for patients with COVID-19. Many scoring systems have been reported based on the biochemical and clinical parameters as age, D-dimer, presence of comorbidities, procalcitonin, C-reactive protein (CRP) and other features. Some of the reported scoring systems were recently developed in the COVID-19 pandemic while others were just modified based on the fact that patients with COVID-19 are critically ill, and usually require the same medical attention as other conditions. These scoring systems should be considered by clinicians to early predict and intervene against severe COVID-19 that might cause death. As for the imaging modalities, we have also reported many of the reported systems in the literature, including the ones that are based on chest computed tomography and X-ray findings, and are discussed in detail within this study.

The effect of C‐reactive protein on chest X‐ray interpretation: A decision‐making experiment among pediatricians

2021 ◽  
Author(s):  
Yuval Barak‐Corren ◽  
Netta Barak‐Corren ◽  
Alex Gileles‐Hillel ◽  
Eyal Heiman
Keyword(s):  
Decision Making ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
Chest X Ray

scholarly journals C-reactive Protein (CRP) as Diagnostic Marker of Pneumonia in Children

2021 ◽  
Vol 14 ◽  
pp. 1-9
Author(s):  
Iffat Naz
Keyword(s):  
Research Study ◽  
Diagnostic Marker ◽  
Severe Infection ◽  
Lung Parenchyma ◽  
Diagnostic Techniques ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
Chest X Ray ◽  
Inexpensive Technique

Pneumonia is an inflammation of the lung parenchyma tissue that mainly affects the respiratory bronchioles and alveoli. The present research study is focused on assessment of the C-reactive protein (CRP) test as a tool marker for the diagnosis of pneumonia among children. In the current study, a total of 450 patients admitted to the children ward at Lady Reading Hospital (LRH) Peshawar, Khyber Pakhtunkhwa, Pakistan were selected, out of which 55% were male and 45% were female. In addition, two groups were designed according to age i.e. 1-8 years and 9-16 years of age with a frequency of 55 and 45%, respectively. In case of chest X-ray assessment, it was observed that all patients were highly susceptible to pneumonia infection, while from blood culture analysis, it was perceived that 419 patients (93%) were highly susceptible to pneumonia infection. Two bacterial isolates (Klebsiella pneumoniae and Streptococcus pneumoniae) were characterised from all positive samples. In contrast with CRP assessment, 385 patients (85%) had positive CRP reports displaying more than 5 mg/L CRP values and 65 patients (15%) had negative CRP reports. Thus, it was concluded that patients with high CRP values presented clear evidence of a severe infection. Moreover, it is suggested that CRP is a sensitive, less time consuming and inexpensive technique; therefore, it has been recommended to be used as a tool marker along with other diagnostic techniques for the diagnosis of life-threaten infections to get a more clear picture about infections.

scholarly journals Splenic abscess in an immune competent individual: case report and review of the literature

2016 ◽  
Vol 4 (1) ◽  
pp. 414
Author(s):  
Kamal Elzaki Elsiddig ◽  
Walid Elhaj Abd Elrahim ◽  
Eltahir Awad Gasim Khalil
Keyword(s):  
Pasteurella Multocida ◽  
Splenic Abscess ◽  
Individual Case ◽  
C Reactive Protein ◽  
X Ray ◽  
Individual Case Report ◽  
Reactive Protein ◽  
Abdominal Symptoms ◽  
Chest X Ray ◽  
Arab Descent

Splenic abscess is a rarity in immune competent individuals. Salmonella, Pasteurella multocida, M. tuberculosis and actinomycosis have been implicated. A 63-year old immune competent female with an arab descent presented with fever, nausea and vomiting. Polymorph leucocytosis, high ESR and markedly high C-reactive protein (CRP) were reported. Chest x-ray and CT scan pointed to the diagnosis. She was managed uneventfully by splenectomy. Enterobacter Spp was grown from operative samples. The patient was well and asymptomatic when seen six months post-operatively. Splenic abscess should be considered even in the absence of co- morbidities in individuals with fever, non-specific abdominal symptoms, polymorphs leucocytosis and high CRP.

Sign in / Sign up

Export Citation Format

Share Document