scholarly journals Non-tuberculous Mycobacterium Disease: Radiologic Manifestation in an Infant presenting with Respiratory Distress

2017 ◽  
Vol 5 (1-2) ◽  
pp. 13-20
Author(s):  
Rupesh Gautam ◽  
Maria Isabel Atienza ◽  
Maika Noda ◽  
Mariaem Andres
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Pulmonary Infection ◽  
Clinical Manifestations ◽  
Distinct Group ◽  
Middle Lobe ◽  
Air Trapping ◽  
Pulmonary Tb ◽  
Radiologic Findings ◽  
The Common ◽  
Common Manifestation

Non-tuberculous mycobacterium (NTM) comprises distinct group of organisms with lymphadenitis and pulmonary infection as the common manifestation. The diagnosis of pulmonary disease is based on clinical manifestations, radiologic findings and microbiologic culture. The classic NTM infection may be indistinguishable from pulmonary TB. Non-classic infection has predilection to the middle lobe and lingula unlike tuberculosis which is commonly seen in the upper lobes. The disease may also present as hypersensitivity pneumonitis with ground glass like opacities, centrilobular nodules and air trapping on imaging. The knowledge of imaging manifestations of NTM will aid in timely diagnosis and treatment of the disease.Nepal Journal of Radiology Vol.5(1-2) 2015: 13-20

scholarly journals Importance of The Medical History in The Diagnosis of Hypersensitivity Pneumonitis: A Case Report

Acta Medica ◽  
2020 ◽  
Vol 51 (3) ◽  
pp. 50-56
Author(s):  
Seval Müzeyyen Ecin ◽  
Abdulsamet Sandal ◽  
Adem Koyuncu ◽  
Şerife Gül Öz
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Welding Fumes ◽  
Radiological Findings ◽  
Air Trapping ◽  
Radiologic Findings ◽  
Bird Breeding ◽  
Chest X Ray ◽  
Lavage Cytology ◽  
Restrictive Pattern ◽  
Ground Glass Nodules

Introduction: Hypersensitivity pneumonitis, most frequent types are those related to farming and bird breeding. In this paper, a patient with occupational exposure to metal dusts and welding fumes but diagnosed with HP thanks to the guidance of detailed anamnesis revealing inhalational exposure to pigeon antigens both at home and in workplace Case: 32-year-old male. He applied with shortness of breath, dry cough. He has been working production of kitchen equipment made from stainless steel. When environmental exposures questioned, he declared that he bred up to ten pigeons at the basement of his house and up to fifteen pigeons at a coop next to workplace building. Spirometry revealed restrictive pattern. In patient’s chest X-ray, bilateral increased reticular densities were observed. Computed tomography of thorax revealed radiological findings supporting subacute hypersensitivity pneumonitis such as bilateral diffuse millimetric centrilobular ground-glass nodules which are coalescing in some areas, mosaic perfusion and air trapping in basal areas. Bronchoalveolar lavage cytology revealed percentages of lymphocytes as 85%. Discussion: Detailed anamnesis revealing environmental and occupational inhalational exposures guides the physician in diagnosis of HP. After initial suspicion, supporting laboratory and radiologic findings confirm the diagnosis to provide appropriate management.

scholarly journals Excited delirium syndrome from psychostimulant abuse can mimic a violent scene of death

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shatishraj Jothee ◽  
Mohamed Swarhib Shafie ◽  
Faridah Mohd Nor
Keyword(s):  
Clinical Manifestations ◽  
The Body ◽  
Law Enforcement Agencies ◽  
Manner Of Death ◽  
Case Presentation ◽  
Excited Delirium ◽  
The Common ◽  
Violent Scene ◽  
Naked Body ◽  
Psychostimulant Abuse

Abstract Background Previous reported cases on excited delirium syndrome studied on the common clinical manifestations of the syndrome. The usual forensics implication for the syndrome is that death commonly is associated with restraint procedures by law enforcement agencies; however, not many cases reported highlights the difficulties in attributing a violent scene of death to the syndrome. Case presentation We present a case of a partially naked body found in an apartment unit under suspicious circumstances with multiple injuries. The scene of death was violent, and the body was found with blood wiped all over the floor and walls. Investigators believed a violent crime had occurred, and a suspect was reprimanded. However, upon autopsy, it was found that all injuries were superficially inflicted and were unlikely to have been part of an act of commission or caused his death. Internal examination found no remarkable pathology. Toxicology revealed a presence of psychostimulants, that is, methamphetamine, MDMA, and ethyl alcohol. Reconstruction of events by the witness, who was initially suspected of the ‘murder’, revealed that the injuries and his death could likely be explained by an episode of excited delirium. Conclusion The case highlights the challenges faced when attributing excited delirium syndrome as a cause of death. The syndrome can present with injuries from aggressive or bizarre behaviour, coupled with the destruction of property, which may confuse investigators on the possible manner of death.

scholarly journals 1632. Comparing the epidemiology and clinical characteristics of childhood tuberculosis through active and passive case finding

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S807-S808
Author(s):  
Saki Ikeda ◽  
Andrea T Cruz ◽  
Jeffrey R Starke
Keyword(s):  
Clinical Manifestations ◽  
Central Nervous System Disease ◽  
Data Safety Monitoring Board ◽  
Case Finding ◽  
Childhood Tuberculosis ◽  
Contact Tracing ◽  
System Disease ◽  
Radiologic Findings ◽  
Mediastinal Adenopathy ◽  
Epidemiological Characteristics

Abstract Background Childhood tuberculosis can be found via passive case finding (PCF), diagnosing a symptomatic child, and active case finding (ACF), discovering a child through contact tracing. Most high prevalence areas perform PCF, but as ACF is introduced, the clinical and radiologic findings may differ. We compare clinical, radiographic, microbiologic and epidemiological characteristics of children diagnosed through PCF and ACF. Methods A retrospective cohort study of all patients diagnosed with TB from 01/01/2012-12/31/2019 at Texas Children’s Hospital. ACF is TB in a child who had not previously sought care before identified via contact tracing, immigration screening, or screening for incarceration. Severity of disease was based on location of illness, imaging and bacteriology/histopathology. Associations between PCF/ACF and demographics, disease severity, and microbiology were analyzed. Results Of 178 patients, 80 (45%) were diagnosed via ACF. ACF patients were more likely to be US-born (OR: 2.29, [95% Confidence interval (CI): 1.12-4.67]) and younger (mean 6.18 vs 8.84 years, p= 0.016). Only 2.5% of ACF patients had extrapulmonary disease, compared to 45% of the PCF group (p< 0.0001). All 14 severe extrathoracic cases were in the PCF group (10 central nervous system disease, 3 ocular disease, 1 spondylitis). Fewer patients in the ACF group had severe intrathoracic findings (11% vs 39%, p< 0.001): miliary disease (0% vs 10%, p=0.006), cavity (1% vs 9%, p=0.04), and multilobar involvement (7.5% vs 22.4%, p=0.006). ACF patients had more hilar/mediastinal adenopathy (OR: 2.51, [CI: 1.34-3.72], p=0.004). ACF patients were less often cultured (38% vs 89%, p< 0.0001) and had less microbiological confirmation by cultures or PCR (21% vs 52%, p=< 0.0001). Conclusion Patients in the ACF group were younger, had less severe clinical manifestations, and had almost no extrathoracic disease. Clinicians need to be aware that the common clinical and radiographic presentations in children differ between PCF and ACF. Disclosures Jeffrey R. Starke, MD, Otsuka Pharmaceuticals (Other Financial or Material Support, Member, Data Safety Monitoring Board)

scholarly journals Mucormycosis in diabetes mellitus

2012 ◽  
Vol 1 (2) ◽  
pp. 73-75 ◽  
Author(s):  
Prashant Khatiwada ◽  
Aditi Giri ◽  
Prasana Khatiwoda
Keyword(s):  
Diabetes Mellitus ◽  
Fungal Infection ◽  
Pulmonary Infection ◽  
Fungal Spores ◽  
Multifaceted Approach ◽  
Patients With Diabetes ◽  
Nose And Paranasal Sinuses ◽  
Anti Fungal ◽  
Lipid Formulations ◽  
Common Manifestation

Mucormycosis is an opportunistic fulminant fungal infection, which mainly infects immunocompromised patients. Infection with mucormycosis can cause devastating rhino-orbital-cerebral and pulmonary infection with an extremely poor prognosis. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. We report a case of mucormycosis in an uncontrolled diabetic patient to emphasize early diagnosis of this potentially fatal fungal infection. Rhino-orbitalcerebral mucormycosis is the most common manifestation in patients with diabetes mellitus. We also review the current concepts in management of mucormycosis. Mucormycosis remains difficult to treat and requires a multifaceted approach involving elimination of predisposing factors, surgical debridement, and anti-fungal therapy. Lipid formulations of Amphotericin B are the treatments of choice. DOI: http://dx.doi.org/10.3126/jaim.v1i2.6531 Journal of Advances in Internal Medicine 2012;01(02):73-75

scholarly journals An alien in the gallbladder. A rare case of biliary ascariasis in an Italian emergency department

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Enrico Ferri ◽  
Angelo Ianni ◽  
Laura Magrini ◽  
Salvatore Di Somma
Keyword(s):  
Rare Case ◽  
Clinical Manifestations ◽  
Intestinal Lumen ◽  
Emergency Setting ◽  
Abdominal Ultrasonography ◽  
Biliary Ascariasis ◽  
Radiologic Findings ◽  
Perforation Peritonitis ◽  
Sanitary Conditions ◽  
Common Infection

Ascariasis is a common infection in many developing countries. The prevalence of ascariasis is related to poverty, poor hygienic and sanitary conditions. The adult form of <em>Ascaris lumbricoides</em> usually resides in the human intestinal lumen (more frequently in the jejunum and middle ileum) and does not cause symptoms. However, it can occasionally cause severe complications such as intestinal obstruction or perforation peritonitis. Its migration into the biliary tract is not uncommon but gallbladder involvement is very rare. Abdominal ultrasonography is essential to detect the presence of this parasite. In this article, we describe the radiologic findings, clinical manifestations and successful medical treatment of a patient with gallbladder ascariasis diagnosed in an emergency setting.

scholarly journals Hypersensitivity pneumonitis complicated by acute respiratory viral infection

2020 ◽  
Vol 9 (3) ◽  
pp. 68-73
Author(s):  
A.S. Kontorshchikov ◽  
A.L. Chernyaev ◽  
O.A. Vasyukova ◽  
Zh.R. Omarova
Keyword(s):  
Viral Infection ◽  
Hypersensitivity Pneumonitis ◽  
Interstitial Fibrosis ◽  
Clinical Manifestations ◽  
Giant Cells ◽  
Lung Damage ◽  
Allergic Alveolitis ◽  
Multinucleated Cells ◽  
Lung Scan ◽  
Exogenous Allergic Alveolitis

The article presents a clinical case of hypersensitivity pneumonitis complicated by a viral infection in a 72-year-old woman. The introductory part provides a concise literature review on the etiology, classification, frequency, and possible complications of hypersensitivity pneumonitis. The patient’s computed tomography (CT) lung scan showed bilateral interstitial lesions. The patient was diagnosed with idiopathic pulmonary fibrosis based on the clinical manifestations and radiological findings. The autopsy revealed morphological signs of hypersensitivity pneumonitis (obliterative bronchiolitis, moderate interstitial fibrosis with honey-combing, nonspecific interstitial pneumonia, giant multinucleated cells) and viral lung damage (exudative stage of acute respiratory distress syndrome with interalveolar edema, hyaline membranes lining the alveoli, pneumocyte desquamation, and ugly giant cells). Keywords: hypersensitivity pneumonitis, exogenous allergic alveolitis, viral infection, lungs

scholarly journals Diagnosis Based on Detection of CXCL10 in Urine as Biomarker for The Determining Diagnosis of Active Lung Tuberculosis

2021 ◽  
Vol 9 (1) ◽  
pp. 57
Author(s):  
Ni Made Mertaniasih ◽  
I Gede Yogi Prema Ananda ◽  
Soedarsono Soedarsono ◽  
Deby Kusumaningrum
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Urine Samples ◽  
Laboratory Research ◽  
Future Research ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Lung Tuberculosis ◽  
History Of ◽  
Tuberculosis Diagnosis

Tuberculosis diagnosis is an important component in decreasing TB incidence and prevalence. Because of the difficulty to collect sputum in some cases, urine specimens are used as it is easier to garner. One of the biomarkers in urine that can be used to diagnose pulmonary TB is IP-10, which can be represented by the CXCL10 gene. The study aims to determine the accuracy of diagnosis based on detection of the CXCL10 gene in urine as a biomarker for the patients with suspected pulmonary TB in Dr. Soetomo Hospital in Surabaya from November 2019 until March 2020. Thus, this is an observative laboratory research with a cross-sectional study. CXCL10 gene was examined using PCR for 36 urine samples, and then, the data, together with the medical records of clinical manifestations of pulmonary TB, GeneXpert MTB /RIF, blood count, and thorax radiograph, were processed using IBM SPSS Statistics 26. The results of the GeneXpert MTB/RIF and thorax radiograph criteria show positive results of pulmonary TB, which were 44.4% and 69.4% respectively. CXCL10 gene was not found in all urine of healthy people (negative), while 2.8% (1/36 samples) positive CXCL10 gene was found in a patient with positive GeneXpert, also with negative clinical manifestations and urine culture. In this study, the accuracy of diagnosis based on detection of the CXCL10 gene in urine for diagnosis of active pulmonary TB was 2.8%. Future research is needed to improve the methods, among them are bigger size of urine samples and clearer medical history of patients. 

scholarly journals Dynamic neuropathy of the common peroneal nerve at the level of the fibular head (literature review and case report)

2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev
Keyword(s):  
Ankle Joint ◽  
Peroneal Nerve ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Common Peroneal Nerve ◽  
Diagnostic Methods ◽  
Fibular Head ◽  
Study Objective ◽  
The Common ◽  
The Right

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.

scholarly journals Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China

2021 ◽  
Author(s):  
Judith Ju Ming Wong ◽  
Qalab Abbas ◽  
Soo Lin Chuah ◽  
Ririe Fachrina Malisie ◽  
Kah Min Pon ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Asia ◽  
Cultural Practices ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Logistic Regression Models ◽  
Clinical Presentations ◽  
The Common ◽  
Health Organization

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.

scholarly journals Clinical spectrum, geographical variability of COVID-19 and its implications

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Md. Hasanul Banna Siam ◽  
Abdullah Al Mosabbir ◽  
Nahida Hannan Nishat ◽  
Ahsan Ahmed ◽  
Mohammad Sorowar Hossain
Keyword(s):  
Coming Out ◽  
Clinical Manifestations ◽  
Vital Role ◽  
Clinical Spectrum ◽  
Surveillance Strategy ◽  
Health Crisis ◽  
Atypical Symptoms ◽  
Public Health Crisis ◽  
Number Of Patients ◽  
The Common

: The coronavirus disease 2019 (COVID-19) pandemic has triggered a worldwide unprecedented public health crisis. Initially, COVID-19 was considered as a disease of the respiratory system as fever and at least one respiratory symptom was used to identify a suspected COVID-19 case. But there are now numerous reports of COVID-19 patients presenting with myriads of extrapulmonary symptoms and a substantial number of patients are asymptomatic as well. Additionally, there are significant clinical and epidemiological variations of severe acute respiratory syndrome coronavirus 2 (SARSCOV-2) infection across different geographical locations. The updated research thus challenges the existing surveillance system that is mainly based on fever and respiratory symptoms. As countries are coming out of lockdown to save economic fallout, a revised surveillance strategy is required to effectively identify and isolate the correct patients. Besides, since developing countries are becoming the new epicenters of pandemic and there are limited resources for RT-PCR based tests, so documenting the clinical spectrum can play a vital role in the syndromic clinical diagnosis of COVID-19. A plethora of atypical symptoms also aids in guiding better treatment and remains as a source for further research. It is therefore crucial to understand the common and uncommon clinical manifestations of SARS-COV-2 infection and its variability across different geographic regions.

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