Mild Botulism From Illicitly Brewed Alcohol in a Large Prison Outbreak in Mississippi

Botulism is typically described as a rapidly progressing, severe neuroparalytic disease. Foodborne botulism is transmitted through consuming food or drink that has been contaminated with botulinum toxin. During a botulism outbreak linked to illicitly brewed alcohol (also known as “hooch” or “pruno”) in a prison, 11 (35%) of 31 inmates that consumed contaminated hooch had mild illnesses. This includes 2 inmates with laboratory confirmed botulism. The most frequently reported signs and symptoms among the 11 patients with mild illness included dry mouth (91%), hoarse voice (91%), difficulty swallowing (82%), fatigue (82%), and abdominal pain (82%). Foodborne botulism is likely underdiagnosed and underreported in patients with mild illness. Botulism should be considered on the differential diagnosis for patients with cranial nerve palsies.

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Signs and Symptoms in Pediatrics

10.1542/9781581108552 ◽

2015 ◽

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Back Pain ◽

Sleep Disturbances ◽

Signs And Symptoms ◽

Diagnostic Procedures ◽

Heart Murmurs ◽

Physical Examinations ◽

Ongoing Care

This convenient handbook is a comprehensive guide to the evaluation and treatment of more than 80 signs and symptoms. It is organized alphabetically, and each entry includes history and physical examinations; causes; differential diagnosis; diagnostic procedures; treatment approaches including when to refer and when to admit; ongoing care and follow-up; and prevention. Contents include: Abdominal pain Anxiety Back pain Chest pain Depression Diarrhea and steatorrhea Dizziness and vertigo Fatigue and weakness Fever Headache Heart murmurs Jaundice Rash Red eye/pink eye Sleep disturbances Speech and language concerns Vomiting Wheezing And more!

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Irritable Bowel Syndrome with Diarrhea

10.2310/gastro.5445 ◽

2018 ◽

Author(s):

Judy Nee ◽

Jacqueline L. Wolf

Keyword(s):

Irritable Bowel Syndrome ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Treatment Options ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Dietary Advice ◽

Emerging Therapies ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal condition characterized by abdominal pain and alteration in bowel habits without an organic cause. One of the subcategories of this disorder is IBS with diarrhea (IBS-D). Clinically, patients who present with more than 3 months of abdominal pain or discomfort associated with an increase in stool frequency and/or loose stool form are defined as having IBS-D. This review addresses IBS-D, detailing the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, clinical manifestations and physical examination findings, differential diagnosis, treatment, emerging therapies, complications, and prognosis. Figures show potential mechanisms and pathophysiology of IBS, IBS-D suspected by clinical assessment and Rome III criteria, pharmacologic and nonpharmacologic treatment options, potential mechanisms of action of probiotics, and potential treatment modalities. Tables list the Rome criteria for IBS, alarm signs and symptoms suggestive of alternative diagnoses, IBS criteria, differential diagnosis of IBS-D, dietary advice options for IBS-D, and alternative and emerging therapies in IBS-D. This review contains 5 figures, 6 tables and 42 references KEYWORDS: IBS-D, eluxadoline, rifaximin, probiotics, bloating, antidepressants, bile acid malabsorption, microscopic colitis, celiac

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Myeloid Sarcomas Causing Unilateral Cranial Nerve Palsies in a Patient with Relapsed Acute Myeloblastic Leukemia

Case Reports in Hematology ◽

10.1155/2020/3749565 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

A. Mendez-Hernandez ◽

X. A. Andrade ◽

S. Upadhyay ◽

L. M. Parra-Rodriguez ◽

E. Caldeira ◽

...

Keyword(s):

Complete Remission ◽

Cranial Nerve ◽

De Novo ◽

Signs And Symptoms ◽

Acute Myeloblastic Leukemia ◽

Neurological Deficits ◽

Timely Diagnosis ◽

High Clinical Suspicion ◽

Cranial Nerve Palsies ◽

Rare Manifestation

Myeloid sarcomas (MS) are a rare manifestation of myeloid malignancies and can often be misdiagnosed, leading to a delay in treatment. The objective of this clinical case is to highlight the challenges of the clinical presentation and to emphasize the importance of this manifestation ensuring timely diagnosis and therapy. Here, we present a 43-year-old man who was diagnosed with acute myeloblastic leukemia (AML) after being evaluated for unintentional weight loss, subcutaneous nodules, thrombocytopenia, and anemia. The patient underwent chemotherapy with complete remission and presented 4 months later with dysphagia and cranial nerve palsies. Appropriate imaging and biopsy led to a diagnosis of myeloid sarcoma, and a decision was made to begin reinduction chemotherapy for AML achieving a second complete remission although his neurological deficits did not improve. Our case illustrates the protean presentation of myeloid sarcomas; clinicians should have a high suspicion for MS and remain vigilant when unexplained signs and symptoms arise in the background of a myeloid malignancy although challenges still remain when presentation is de novo. Advancements in understanding the pathophysiology of MS have been performed but remain not completely understood. High clinical suspicion, appropriate imaging, biopsy techniques, and expertise are paramount for timely diagnosis and treatment.

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SYSTEMIC MANIFESTATIONS DUE TO ALLERGY

PEDIATRICS ◽

10.1542/peds.27.5.790 ◽

1961 ◽

Vol 27 (5) ◽

pp. 790-799

Author(s):

William G. Crook ◽

Walton W. Harrison ◽

Stanley E. Crawford ◽

Blanche S. Emerson

Keyword(s):

Nervous System ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Nasal Congestion ◽

Signs And Symptoms ◽

Tabular Form ◽

Case Histories ◽

The Past ◽

Systemic Manifestations ◽

Symptoms And Signs

The data on 50 patients with systemic manifestations due to allergy seen at the Children's Clinic, Jackson, Tennessee, during the period 1956 through 1960 is presented. Detailed case histories are recorded for four of these patients. The findings on the remainder are given in tabular form. Uniformly, the symptoms and signs in these children were fatigue, irritability, pallor in the absence of anemia, and infraorbital circles. Most of them also had nasal congestion, abdominal pain and headache. A variety of other signs and symptoms, including those of nervous system involvement, may also be present. The literature on this condition is reviewed in detail showing that this condition has been described under several different names by many observers during the past 40 years. In spite of these descriptions, few physicians are aware that allergy causes such systemic manifestations. In conclusion, it is suggested that allergy be included in the differential diagnosis of any child with generalized body symptoms of undetermined cause.

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Erythromycin Estolate Induced Hepatotoxicity

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002807701100102 ◽

1977 ◽

Vol 11 (1) ◽

pp. 22-25 ◽

Cited By ~ 11

Author(s):

Larry G. Cacace ◽

Byron F. Schweigert ◽

Andrew M. Gildon

Keyword(s):

Adverse Drug Reaction ◽

Differential Diagnosis ◽

Drug Reaction ◽

Abdominal Pain ◽

Liver Disease ◽

Diagnostic Tests ◽

Liver Toxicity ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Erythromycin Estolate

A case of erythromycin estolate induced hepatotoxicity is presented and 65 previous cases reported are reviewed. In spite of numerous reports of liver toxicity from erythromycin estolate, this potentially serious adverse drug reaction is not always recognized by the clinician. The frequency of signs and symptoms and a summary of the laboratory test abnormalities has been prepared to assist the clinician in the differential diagnosis of erythromycin estolate-induced liver disease. The most common clinical manifestations of erythromycin estolate-induced liver disease were severe abdominal pain, nausea and fever which preceded the development of jaundice in most cases. Eosinophilia was frequently present. It is important to consider erythromycin estolate as a potential cause of acute abdomen to avoid unnecessary and potentially dangerous diagnostic tests or surgery. When considering the use of erythromycin, the risk of intrahepatic cholestasis and/or abdominal pain should be weighed against any theoretical benefit to be derived from using the estolate salt.

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Irritable Bowel Syndrome with Diarrhea

10.2310/fm.5445 ◽

2018 ◽

Author(s):

Judy Nee ◽

Jacqueline L. Wolf

Keyword(s):

Irritable Bowel Syndrome ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Treatment Options ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Dietary Advice ◽

Emerging Therapies ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal condition characterized by abdominal pain and alteration in bowel habits without an organic cause. One of the subcategories of this disorder is IBS with diarrhea (IBS-D). Clinically, patients who present with more than 3 months of abdominal pain or discomfort associated with an increase in stool frequency and/or loose stool form are defined as having IBS-D. This review addresses IBS-D, detailing the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, clinical manifestations and physical examination findings, differential diagnosis, treatment, emerging therapies, complications, and prognosis. Figures show potential mechanisms and pathophysiology of IBS, IBS-D suspected by clinical assessment and Rome III criteria, pharmacologic and nonpharmacologic treatment options, potential mechanisms of action of probiotics, and potential treatment modalities. Tables list the Rome criteria for IBS, alarm signs and symptoms suggestive of alternative diagnoses, IBS criteria, differential diagnosis of IBS-D, dietary advice options for IBS-D, and alternative and emerging therapies in IBS-D. This review contains 5 highly rendered figures, 6 tables, and 99 references.

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Isolated Abducens Palsy as the First Presenting Sign of Multiple Sclerosis

Case Reports in Neurology ◽

10.1159/000455023 ◽

2017 ◽

Vol 8 (3) ◽

pp. 272-275 ◽

Cited By ~ 4

Author(s):

Sargon Bet-Shlimon ◽

Mill Etienne

Keyword(s):

Multiple Sclerosis ◽

Differential Diagnosis ◽

Brain Stem ◽

Cranial Nerve ◽

Prior History ◽

Abducens Palsy ◽

Cranial Nerve Palsies ◽

Pontine Lesion ◽

History Of ◽

New Diagnosis

While brain stem involvement in multiple sclerosis (MS) is relatively common, isolated cranial nerve palsies are rare, especially when they represent the initial presenting sign of a new diagnosis of MS. This report describes a patient with no prior history of MS whose sole presenting sign was an isolated abducens palsy. An enhancing pontine lesion was found on MRI which correlated with his abducens palsy, and additional nonactive lesions on MRI led to a diagnosis of MS. This case demonstrates the importance of considering MS as part of the differential diagnosis of patients with isolated cranial nerve palsies.

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Over-The-Counter Oral Hygiene Products Misuse: A Case Report

Bioscience Biotechnology Research Communications ◽

10.21786/bbrc/14.4.5 ◽

2021 ◽

Vol 14 (4) ◽

pp. 1413-1416

Author(s):

Ashwag Yagoub Aloyouny

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Side Effects ◽

Oral Hygiene ◽

English Literature ◽

Signs And Symptoms ◽

Dry Mouth ◽

Over The Counter ◽

First Case ◽

Oral Condition

Oral hygiene products (OHP) are recommended to maintain the teeth and health of the oral cavity tissues by assisting in lowering the plaque level as well as the opportunistic flora. Oral hygiene products could cause oral health problems that may vary in severity. Due to the availability of over-the-counter (OTC) medications and lack of knowledge, customers may misuse these products. An oral hygiene product is a double-edged sword; a customer would develop side effects from it without even knowing or correlating the source. Many signs and symptoms may appear on the patients such as oral and perioral burning sensations, swelling, erythema, dysgeusia, and dysphagia. To our knowledge and based on the review of English literature through PubMed Midline, this is the first case report of misuse because of an over-the-counter oral hygiene product in which the patient used a mouthwash continuously and aggressively for 15 days without knowing of its side effects. This case report presents an eighty-two-year-old, male patient who complained of pain, burning, swollen, and dry mouth and lips. The author discussed the most common ingredients of oral mouthwashes. Some active ingredients may irritate the oral mucosa and lips. Also, the author discussed the possible differential diagnosis of painful, sensitive, burning, swollen, and dry mouth and lips. This report is intended as an overview of a rare and unusual oral condition associated with the misuse of OTC oral hygiene products. The findings of the present study necessitated the need for clear verbal and written instructions to be provided to the patients before recommending or prescribing any type of medication.

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[A case of foodborne botulism in the province of Viterbo]

Clinical Management Issues ◽

10.7175/cmi.v10i2.1248 ◽

2016 ◽

Vol 10 (2) ◽

pp. 27-31

Author(s):

Flavia Verginelli ◽

Silvia Dari ◽

Silvia Aquilani

Keyword(s):

Botulinum Toxin ◽

General Population ◽

Present Article ◽

Critical Points ◽

Clostridium Botulinum ◽

Dry Mouth ◽

Foodborne Botulism ◽

At Home

A 57 years-old woman with gastrointestinal pain, dysphagia, diplopia, dry mouth, was diagnosed with foodborne botulism caused by Clostridium Botulinum toxin. In this case, a jar of vegetables preserved in oil was identified as the source of the intoxication. Canned peppers were produced at home by the patient according to traditional techniques, deemed appropriate as established use. Despite this, the procedure proved to be a health hazard.The present article follows the diagnostic therapeutic pathway of the patient, highlighting the critical points not only related to the clinic but also to the ministerial procedures for reporting a case of botulism. This case provides an opportunity to emphasize the need for greater awareness about how to prevent and correctly manage the cases of botulism, both by the general population and by physicians who faced a patient with suspected poisoning by Botulinum toxin.[Article in Italian]

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Irritable Bowel Syndrome with Diarrhea

10.2310/tywc.5445 ◽

2018 ◽

Author(s):

Judy Nee ◽

Jacqueline L. Wolf

Keyword(s):

Irritable Bowel Syndrome ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Treatment Options ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Dietary Advice ◽

Emerging Therapies ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal condition characterized by abdominal pain and alteration in bowel habits without an organic cause. One of the subcategories of this disorder is IBS with diarrhea (IBS-D). Clinically, patients who present with more than 3 months of abdominal pain or discomfort associated with an increase in stool frequency and/or loose stool form are defined as having IBS-D. This review addresses IBS-D, detailing the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, clinical manifestations and physical examination findings, differential diagnosis, treatment, emerging therapies, complications, and prognosis. Figures show potential mechanisms and pathophysiology of IBS, IBS-D suspected by clinical assessment and Rome III criteria, pharmacologic and nonpharmacologic treatment options, potential mechanisms of action of probiotics, and potential treatment modalities. Tables list the Rome criteria for IBS, alarm signs and symptoms suggestive of alternative diagnoses, IBS criteria, differential diagnosis of IBS-D, dietary advice options for IBS-D, and alternative and emerging therapies in IBS-D. This review contains 5 highly rendered figures, 6 tables, and 99 references.

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