scholarly journals Long-Term Clinical and Multimodal Imaging Findings in Patients with Disseminated Mycobacterium Chimaera Infection

2021 ◽  
Vol 10 (18) ◽  
pp. 4178
Author(s):  
Sandrine Anne Zweifel ◽  
Maximilian Robert Justus Wiest ◽  
Mario Damiano Toro ◽  
Pascal Hasler ◽  
Peter Maloca ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Systemic Infection ◽  
Vascular Occlusion ◽  
Clinical Findings ◽  
Imaging Findings ◽  
Outcomes Measures ◽  
Ophthalmic Imaging ◽  
Ocular Imaging ◽  
Optic Disc Swelling

Background: To analyze long-term ophthalmic clinical and multimodal imaging findings of disseminated Mycobacterium (M.) chimaera infection after cardiothoracic surgery among the Swiss Cohort. Methods: Systemic and multimodal ophthalmic imaging and clinical findings including rate of recurrence were reviewed and correlated to a previously proposed classification system of choroidal lesions and classification of ocular disease. Main Outcomes Measures: long-term clinical and multimodal ocular imaging findings of M. chimaera. Results: Twelve patients suffering from systemic infection from M. chimaera were included. Mean age at the first ophthalmic examination was 59 years (range from 48 to 66 years). Mean duration of the follow-up was 22.63 ± 17.8 months. All patients presented with bilateral chorioretinal lesions at baseline; 5 patients had additional signs, including optic disc swelling (2), choroidal neovascularization (1), retinal neovascularization (1) and cilioretinal vascular occlusion (1). Four recurrence events after discontinuation or adjustment of the antibiotic treatment were observed. Progressive choroiditis was seen in 5 patients under treatment, 4 of them deceased. Conclusions: Expertise from ophthalmologists is not only relevant but also critical for the assessment of the adverse drug effect of antimycobacterial treatment along with monitoring therapeutic response and identifying recurrences.

scholarly journals Typical and atypical CT chest imaging findings of novel coronavirus 19 (COVID-19) in correlation with clinical data: impact on the need to ICU admission, ventilation and mortality

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doaa M. Emara ◽  
Nagy N. Naguib ◽  
M. A. Moustafa ◽  
Salma M. Ali ◽  
Amr Magdi El Abd
Keyword(s):  
Pleural Effusion ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Mediastinal Lymphadenopathy ◽  
Imaging Features ◽  
Imaging Findings ◽  
Icu Admission ◽  
Mortality Outcome ◽  
Novel Coronavirus ◽  
Contrast Ct

Abstract Background The aim of this study was to highlight the typical and atypical chest CT imaging features at first presentation in 120 patients who were proved to be COVID-19 by PCR and to correlate these findings with the need for ICU admission, ventilation, and mortality. We retrospectively included 120 patients 71 males (59.2%) and 49 females (40.8%) with a mean age of 47.2 ± 14.4 years. Patients subjected to clinical assessment, CBC, PCR for COVID-19, and non-contrast CT chest at first presentation. Typical and atypical imaging findings were reported and correlated with the clinical findings of the patients, the need for ICU admission, ventilation, and mortality. Results Clinically, fever was seen in 112 patients followed by dry cough in 108 patients and malaise in 35 patients. The final outcome was complete recovery in 113 cases and death in 7 cases. Typical CT findings included bilateral peripheral ground-glass opacities (GGO) in 74.7%, multilobar affection in 92.5% while atypical findings such as homogeneous consolidation, pleural effusion, mediastinal lymphadenopathy, and single lobar affection were found in 13.4, 5, 6.7, and 7.5% respectively. A statistically significant association between the presence of white lung, pleural effusion, peripheral GGO, and the need for ICU admission as well as mechanical ventilation was noted. The death was significantly higher among elderly patients; however, no significance was found between the imaging features and mortality. Conclusion CT features at first presentation can predict the need for ICU admission and the need for ventilation but cannot predict the mortality outcome of the patients.

Technical implementation and clinical findings/results of monitoring oxygen saturation in patients referred for long term EEG monitoring

1996 ◽  
Vol 99 (5) ◽  
pp. 432-439 ◽  
Author(s):  
J.R. Ives ◽  
N.R. Mainwaring ◽  
K.B. Krishnamurthy ◽  
A.S. Blum ◽  
F.W. Drislane ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Clinical Findings ◽  
Eeg Monitoring

scholarly journals Idiopathic intracranial hypertension presenting as iron deficiency anemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Peng Yong Sim ◽  
Priyal Taribagil ◽  
Ione O. C. Woollacott ◽  
Safina Rashid ◽  
Desmond P. Kidd
Keyword(s):  
Case Report ◽  
Iron Deficiency ◽  
Intracranial Hypertension ◽  
Iron Deficiency Anemia ◽  
Idiopathic Intracranial Hypertension ◽  
Deficiency Anemia ◽  
Visual Deficits ◽  
Fluid Analysis ◽  
Optic Disc Swelling

Abstract Background The presentation of idiopathic intracranial hypertension (IIH) in association with iron deficiency anemia (IDA) is rare. Case presentation This case report depicts the unusual case of a 31-year-old woman of mixed Jamaican and English heritage with IIH who presented initially as IDA in the context of menorrhagia. Subsequent ophthalmic review, lumbar puncture, cerebrospinal fluid analysis and neuroimaging studies revealed severe bilateral optic disc swelling and raised intracranial pressure in keeping with IIH. Prompt treatment of IDA with blood transfusion and orally administered iron supplements, in addition to medical treatment for IIH, contributed to significant improvement of symptoms and prevented long-term visual deficits. Conclusion The possibility of IDA, albeit rare, should always be considered and investigated appropriately in all patients with IIH, as the treatment of the anemia alone may be sight-saving.

Specificity and Sensitivity of Hemosiderin-Laden Macrophages in Routine Bronchoalveolar Lavage in Children

2006 ◽  
Vol 130 (11) ◽  
pp. 1684-1686 ◽  
Author(s):  
Zeynep N. Salih ◽  
Afreen Akhter ◽  
Javeed Akhter
Keyword(s):  
Bronchoalveolar Lavage ◽  
Sensitivity And Specificity ◽  
Pediatric Population ◽  
Strong Association ◽  
Clinical Findings ◽  
Clinical Syndrome ◽  
Pulmonary Hemosiderosis ◽  
Specificity And Sensitivity ◽  
Long Term Prognosis

Abstract Context.—The presence of iron or hemosiderin in macrophages obtained in routine bronchoalveolar lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in bronchoalveolar lavage in children. Objective.—To review data from bronchoalveolar lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. Design.—One hundred ten bronchoalveolar lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and bronchoalveolar lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Results.—Six patients were diagnosed with hemosiderosis by clinical findings, lung biopsy, or autopsy. There were no statistical differences in pneumonia (P > .99), anemia (P > .99), or coughing (P = .08) between patients with hemosiderosis and other patients. Hemoptysis was the only symptom that was significantly different between the 2 groups (P = .04). The mean HLM index for patients with hemosiderosis was 56% ± 16.17% and for other patients, 7.5% ± 10.74% (P < .001). A HLM index of 35% gave a sensitivity of 1% and a specificity of .96%. Conclusions.—These results confirm a strong association between HLM index and diagnosis of hemosiderosis in a pediatric population. Availability of this HLM index will result in accurate and timely diagnosis of pulmonary hemosiderosis, which may influence treatment and long-term prognosis.

Clinical and Multimodal Imaging Findings in Disseminated Mycobacterium Chimaera

2020 ◽  
Author(s):  
Jordan D. Deaner ◽  
Careen Y. Lowder ◽  
Francesco Pichi ◽  
Steven Gordon ◽  
Nabin Shrestha ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Imaging Findings

scholarly journals Multimodal imaging findings in an adult case of Swyer-James-MacLeod syndrome

2017 ◽  
Vol 5 (4) ◽  
pp. e00236
Author(s):  
Hitoshi Kawasuji ◽  
Kensuke Suzuki ◽  
Hideaki Furuse ◽  
Takeshi Tsuda ◽  
Yasuaki Masaki ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Imaging Findings ◽  
Adult Case

scholarly journals Heat stroke during long-term clozapine treatment: should we be concerned about hot weather?

2016 ◽  
Vol 38 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Maurício Scopel Hoffmann ◽  
Lucas Mendes Oliveira ◽  
Maria Inês Rodrigues Lobato ◽  
Paulo Belmonte-de-Abreu
Keyword(s):  
Heat Stroke ◽  
Systemic Infection ◽  
Accurate Diagnosis ◽  
Pharmacological Intervention ◽  
Case Description ◽  
Clozapine Treatment ◽  
Improve Treatment ◽  
Clinical Events ◽  
Hot Weather

Objective To describe the case of a patient with schizophrenia on clozapine treatment who had an episode of heat stroke. Case description During a heat wave in January and February 2014, a patient with schizophrenia who was on treatment with clozapine was initially referred for differential diagnose between systemic infection and neuroleptic malignant syndrome, but was finally diagnosed with heat stroke and treated with control of body temperature and hydration. Comments This report aims to alert clinicians take this condition into consideration among other differential diagnoses, especially nowadays with the rise in global temperatures, and to highlight the need for accurate diagnosis of clinical events during pharmacological intervention, in order to improve treatment decisions and outcomes.

scholarly journals Thunderclap Headache in HIV Positive Patients: Aetiology, Clinical Findings and Long Term Follow-up of a Series of 5 Cases

2015 ◽  
Vol 2 (1) ◽  
pp. 37-40
Author(s):  
Yacouba Njankouo Mapoure ◽  
◽  
Namme Henry Luma ◽  
Cyrille Nkouonlack ◽  
Ariane Vanessa Pokossy ◽  
...  
Keyword(s):  
Clinical Findings ◽  
Thunderclap Headache ◽  
Hiv Positive ◽  
Long Term Follow Up

scholarly journals Highly Resistant Salmonella enterica Serovar Typhi with a NovelgyrAMutation Raises Questions about the Long-Term Efficacy of Older Fluoroquinolones for Treating Typhoid Fever

2012 ◽  
Vol 56 (5) ◽  
pp. 2761-2762 ◽  
Author(s):  
Kanika Deshpande Koirala ◽  
Duy Pham Thanh ◽  
Sudeep Dhoj Thapa ◽  
Amit Arjyal ◽  
Abhilasha Karkey ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Typhoid Fever ◽  
Treatment Failure ◽  
Salmonella Enterica ◽  
Systemic Infection ◽  
Resistant Isolate ◽  
Content Type ◽  
Salmonella Enterica Serovar Typhi ◽  
Term Efficacy

ABSTRACTAs a consequence of multidrug resistance, clinicians are highly dependent on fluoroquinolones for treating the serious systemic infection typhoid fever. While reduced susceptibility to fluoroquinolones, which lessens clinical efficacy, is becoming ubiquitous, comprehensive resistance is exceptional. Here we report ofloxacin treatment failure in typhoidal patient infected with a novel, highly fluoroquinolone-resistant isolate ofSalmonella entericaserovar Typhi. The isolation of this organism has serious implications for the long-term efficacy of ciprofloxacin and ofloxacin for typhoid treatment.

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