Clinical signs in differential diagnosis of bacterial infections

1972 ◽  
Vol 62 (8) ◽  
pp. 287-297
Author(s):  
CJ Cortese
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Infections ◽  
Clinical Signs

COVID-19: how nuclear medicine can provide a differential diagnosis in very dubious case

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Maria Silvia De Feo ◽  
Viviana Frantellizzi ◽  
Giuseppe De Vincentis
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Ct Scan ◽  
Imaging Technique ◽  
False Negative ◽  
Clinical Signs ◽  
Negative Results ◽  
Infectious Disease Department ◽  
False Negative Results ◽  
99Mtc Hmpao

Background: We present the case of a 55-year-old woman, admitted to the Infectious Disease Department of Policlinico Umberto I, Rome, in mid-March 2020, with suspicion of COVID-19 infection. Objective: The rRT-PCR was negative and the following CT scan, performed to exclude false-negative results and help diagnosis, was inconclusive. Methods: It was decided to submit the patient to 99mTc-HMPAO-labelled leukocyte scan. Results: This exam led to the diagnosis of infective endocarditis. Conclusion: In the present pandemic scenario, 99mTc-HMPAO-labelled leukocyte scan represents a reliable imaging technique for differential diagnosis with COVID-19 in patients with confusing clinical signs, possible false-negative rRT-PCR results and inconclusive CT scan.

scholarly journals Uptake of exogenous estrogen as a differential diagnosis of ovarian-remnant-syndrome in a bitch: a case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Sebastian Ganz ◽  
Axel Wehrend
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Luteinizing Hormone ◽  
Clinical Signs ◽  
Menopausal Symptoms ◽  
Case Presentation ◽  
Estrogen Exposure ◽  
Exogenous Estrogen ◽  
Endocrine Parameters

Abstract Background Clinical signs of heat in bitches that have been previously spayed are often associated with the presence of ovarian remnant syndrome. The inclusion of exogenous estrogens as a differential diagnosis in this regard is often ignored and may lead to misinterpretation of the case. Case presentation Herein, we report a case of exogenous estrogen exposure over several months to a 6.5-year-old spayed crossbred bitch, weighing 8.4 kg. The bitch presented in the clinic because of suspected ovarian remnant syndrome. Castration was performed within the first 6 months after birth. Important endocrine parameters measured at the first appointment were Anti-Müllerian hormone (< 0.01 ng/mL), progesterone (0.36 ng/mL), estradiol-17ß (20.7 pg/mL), and luteinizing hormone (< 0.1 ng/mL). After an extensive conversation with the owner, it was revealed that she was using an estrogen spray because of severe menopausal symptoms. After the owner stopped using this spray, the symptoms of the bitch disappeared. Conclusion Therefore, the uptake of estrogens should be a differential diagnosis for symptoms of the ovarian remnant syndrome. A detailed anamnesis is crucial to identify the source of estrogen in the environment of the affected bitch.

Excellent Outcome of Acute Necrotizing Encephalopathy in an Adult With Bacterial Infections, Case Report

2021 ◽  
pp. 194187442199137
Author(s):  
Yan Wang ◽  
John R. Younce ◽  
Joel S. Perlmutter ◽  
Soe S. Mar
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Infections ◽  
Vasogenic Edema ◽  
Brain Magnetic Resonance Imaging ◽  
Acute Necrotizing Encephalopathy ◽  
Excellent Outcome ◽  
Intravenous Antibiotics ◽  
Acute Necrotizing ◽  
Supportive Management

Acute necrotizing encephalopathy (ANE) is a rare para-infectious encephalopathy that classically occurs in children. However, ANE should be considered in the differential diagnosis of adults with symmetric brain lesions after a prodromal illness given recent reports of coronavirus disease of 2019 (COVID-19) to presumably cause ANE in adults. We report a case of a 29-year-old male presenting with fever, malaise, and rapid deterioration into coma. Brain magnetic resonance imaging revealed multifocal symmetric areas of diffusion restriction and surrounding vasogenic edema involving bilateral thalami, pons and cerebellar hemispheres with a core of susceptibility artifact, and minimal thalamic contrast enhancement, most consistent with ANE. Extensive infectious workup revealed isolated Escherichia coli and Neisseria gonorrhoeae in his urine. Despite the severe encephalopathy on initial presentation, the patient improved with intravenous antibiotics and supportive management with minimal residual deficits at 9 months follow-up. We aim to provide an overview of the radiological features, differential diagnosis, treatment and prognosis of ANE. Becoming familiarized with this rare but devastating disease will improve detection, treatment, and ultimately prognosis, especially in the era of a new pandemic.

scholarly journals Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

scholarly journals Clinical Evidence of Lyme Disease in Dogs and Disease Awareness Among Students and Veterinarians in Veracruz, Mexico

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Blanca Paola Boria-Gamboa ◽  
José Alfredo Villagómez-Cortés ◽  
David Itzcoatl Martínez-Herrera
Keyword(s):  
Differential Diagnosis ◽  
Lyme Disease ◽  
Professional Practice ◽  
Clinical Evidence ◽  
Clinical Signs ◽  
Small Animal ◽  
Apparent Absence ◽  
Veterinary Students ◽  
Disease Awareness ◽  
Veterinary Curriculum

Background: Lyme disease is a relatively new and zoonotic canine pathology mostly unknown by people involved in the management and care of dogs.  Objective: to assess the knowledge about Lyme disease by veterinarians and veterinary students in Veracruz, Mexico. Methodology: three questionnaires were designed and applied to 290 individuals (40 small animal veterinarians, 50 in other professional practice and 200 veterinary students). Results and discussion: in general, the three groups were unaware about the disease, although there is a high interest in learning about this problem. Graduates from seven universities included in this study stated that Lyme disease was not part of the veterinary curriculum in their schools. Five clinical cases suggestive of Lyme disease occurring in dogs in the area were detected at the time of this research. Conclusion: although the presence of the agent causing Lyme disease has not been demonstrated in the studied area due to the lack of laboratory support and the apparent absence of the vector, it cannot be ruled out; furthermore, it is important that veterinary practitioners and student alike be aware of the potential presence of Lyme disease, paying particular attention to differential diagnosis when resembling clinical signs are observed.

The clinical course of bartonellosis in 24 cats

2021 ◽  
Vol 77 (04) ◽  
pp. 65146-2021
Author(s):  
ŁUKASZ MAZUREK ◽  
OLIWIER TEODOROWSKI ◽  
PIOTR DĘBIAK ◽  
KLAUDIUSZ SZCZEPANIAK ◽  
ANNA WILCZYŃSKA ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Medical Records ◽  
Clinical Course ◽  
Bartonella Henselae ◽  
Clinical Signs ◽  
Course Of Disease ◽  
Laboratory Abnormality ◽  
Allergic Dermatitis ◽  
Time Of Presentation ◽  
Common Laboratory

The aim of this study was to analyse clinical cases of bartonellosis. Medical records of cats naturally infected with Bartonella henselae were retrospectively evaluated with regard to clinical signs and laboratory abnormalities at the time of presentation, therapy and course of disease. The most common clinical abnormalities in B. henselae-positive cats included in the study were flea allergic dermatitis (29.5%), fever (25%) and diarrhoea (12.5%). Thrombocytopenia was the most common laboratory abnormality (50%).The results of the study indicate that B. henselae infection must be considered in differential diagnosis in patients with thrombocytopenia and flea invasion.

Fibrinolysis of an Acute Myocarditis Mimicking an Acute Myocardial Infarction

2020 ◽  
Author(s):  
Safir Soukaina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Myocarditis ◽  
Clinical Signs ◽  
Acute Onset ◽  
St Segment Elevation ◽  
The Difference

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.

scholarly journals Salmonella enterica subspecies houtenae as an opportunistic pathogen in a case of meningoencephalomyelitis and bacteriuria in a dog

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Melissa N. Andruzzi ◽  
Mary L. Krath ◽  
Sara D. Lawhon ◽  
Beth Boudreau
Keyword(s):  
Salmonella Enterica ◽  
Bacterial Infections ◽  
Opportunistic Infections ◽  
Treatment Success ◽  
Immunosuppressive Treatment ◽  
Clinical Signs ◽  
Opportunistic Pathogen ◽  
First Case ◽  
Disease Diagnostics ◽  
Infectious Disease Diagnostics

Abstract Background We report the first case of canine Salmonella meningoencephalomyelitis and second case of canine Salmonella bacteriuria, as well as the first reported case of Salmonella enterica subspecies houtenae in a dog. Case presentation Immunosuppressive treatment in a dog for a relapse of steroid-responsive meningitis and arteritis (SRMA) allowed for the opportunistic establishment of a bacteremia with Salmonella enterica subsp. houtenae, ultimately causing meningoencephalomyelitis and subclinical bacteriuria. The bacterial infections were treated with a four-month course of amoxicillin; clinical treatment success was determined by serial negative urine cultures and lack of clinical signs correlated to the meningoencephalomyelitis. Conclusions Both the bacteriuria and meningoencephalomyelitis represented opportunistic infections in a dog immunosuppressed for SRMA. The clinical course of this infectious meningoencephalitis emphasizes the importance of differentiating relapse of initial disease from opportunistic infection occurring in a compromised central nervous system. The novel Salmonella species identified in this case acts as a reminder that infectious disease diagnostics should not be curbed by anecdotal prediction of routine pathogenic suspects.

Serum Pentraxin 3 Concentration in Neonatal Sepsis

2019 ◽  
Vol 14 (05) ◽  
pp. 219-222
Author(s):  
Fatih Battal ◽  
Özgül Emel Bulut ◽  
Şule Yıldırım ◽  
Hakan Aylanç ◽  
Nazan Kaymaz ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Bacterial Infections ◽  
Clinical Signs ◽  
Neonatal Morbidity ◽  
Gene Organization ◽  
Control Group ◽  
Case Group ◽  
Pentraxin 3 ◽  
Suspected Sepsis ◽  
Reactive Protein

Objective Neonatal sepsis is one of the most important causes of neonatal morbidity and mortality. Symptoms and signs of neonatal sepsis can be silent; therefore, laboratory investigation is necessary in cases of doubt or if there are risk factors. Early diagnosis is important for early intervention and treatment. The most valuable method for diagnosis is blood culture; however, false positivity due to contamination or false negativity despite ongoing fatal bacterial infections can be seen. Pentraxin 3 is a prototype of the long pentraxin family. It has some differences from C-reactive protein (CRP) in terms of gene organization and localization and production site. It is effective in the early phase of inflammation and it is detected as an early marker of sepsis in adults. The aim of this study was to investigate whether pentraxin 3 can be used as a marker in neonatal sepsis. Materials and Methods Thirty newborns with suspected sepsis with antenatal history or the presence of clinical signs of sepsis, such as hypo/hyperthermia, feed intolerance, lethargy, hypotonia, irregular cardiac rhythms, bradycardia, cyanosis, apnea, respiratory distress, or metabolic acidosis, were enrolled in the study as a case group, and 28 healthy newborns were included as a control group. Serum pentraxin 3, procalcitonin, CRP, and hemogram in the study group and serum procalcitonin and pentraxin in the control group were examined. Results Serum pentraxin 3 (pg/mL) and serum procalcitonin (ng/mL) levels were 2,273.82 ± 1,260.75 and 0.86 ± 0.52 in the case group and 957.41 ± 268.00 and 0.19 ± 0.18 in the control group (p < 0.001 for both), respectively. Conclusion The present study showed that serum pentraxin 3 levels may be a useful marker in the diagnosis of neonatal sepsis.

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