Vincristine induced fever in a child with embryonal rhadbomyosarcoma

Introduction: Febrile episodes in oncology is common are mostly of infectious etiology requiring repeated investigations and escalation of antibiotics. But, drug induced fever occur more often than we think in oncological set-up. Case Report: A 5 year old male child with rhabdomyosarcoma, developed high grade fever spikes following Vincristine monotherapy. Infective etiology work up was negative and the fever responded to corticosteroids. Management and Outcome: He was treated with corticosteroids as premedication considering vincristine induced fever. The further courses of VCR- monotherapy were uneventful with steroids as premedication. Discussion: We present the case of vincristine induced fever in a child with embryonal rhabdomyosarcoma. Clinician’s should consider drug induced fever at appropriate conditions, to avoid leading to antibiotic resistance.

Steroid-Responsive Post-Traumatic Persistent Neutrophilic Meningitis

Post-traumatic meningitis is a potentially fatal condition that presents as a diagnostic and therapeutic challenge. The vast majority of post-traumatic meningitides are caused by infectious pathogens, most commonly multi-drug-resistant (MDR) bacterial pathogens. However, aseptic meningitis occurs less frequently due to tissue response to injury or stimulation by noninfectious agents, such as blood breakdown products or chemicals. Here, we present a case of post-traumatic persistent neutrophilic meningitis who was found to be steroid responsive. Diagnostic evaluation in our patient did not reveal any infectious pathogen, and the patient did not respond to broad-spectrum antimicrobial treatment. We suggest that physicians who treat patients with post-traumatic meningitis should consider steroid-responsive post-traumatic persistent neutrophilic meningitis (SPNM) in the list of differential diagnosis particularly when no infectious etiology is found and the patient does not respond to empirical antimicrobial treatment. Brain injury-induced immune dysregulation causing exaggerated inflammatory reaction might play a role in the pathogenesis of SPNM; however, further neuropathological studies are absolutely necessary to evaluate and characterize trauma-induced immune dysregulation.

Immunocorregating properties of propolis and their composite forms

Gastrointestinal and respiratory diseases of young farm animals account for the largest percentage of all diseases. Currently, vaccines have been developed and successfully used for the specific prevention of diseases of infectious etiology, but it is not always possible to develop immunity of sufficient intensity, since vaccination without immunostimulation does not contribute to sufficient antibody formation. One of the important tasks of practical veterinary medicine was to find environmentally safe immunocorregulating substances that do not have a suppressive effect on the body. It was established that the drug ferran activated hematopoietic reactions of the body. Ferran in combination with enterozyme restores immunopoiesis and erythropoiesis to the indicators of physiological norms. The combined use of enterozyme with propolis hasda high immunostimulating effect, enhanced the productive phase of the immune response, removed the suppressive effect of the vaccine and increased the factors of natural and colonization resistance of the intestine.

Hodgkin’s Lymphoma Presenting as Multiple Cavitary Lung Lesions

Hodgkin Lymphoma (HL) typically presents similarly to an infectious etiology, thus awareness of its atypical presentations is essential. We present a case of an adult woman who was found to have HL after presenting with a dry, non-productive cough and showing cavitary lesions on chest computed tomography (CT). We also describe the clinical, laboratory, and radiological workup done leading to the diagnosis and management of HL in a critical care setting.

Management of Septic Arthritis in Emergency Department

Bacterial arthritis is an inflammation of the joints caused by an infectious etiology, usually bacterial, but there are also fungi, mycobacteria, viruses, or other rare pathogens. Both healthy and predisposed people can be infected. Nongonococcal infectious arthritis, usually a monoarticular disease, affects multiple joints in about 10% of patients and is a new form of septic arthritis. Without treatment, it can progress rapidly and cause irreversible damage to the joints. The overall incidence of bacterial arthritis is 2 to 6 per 100,000, depending on the presence of risk factors. Bacterial arthritis is more common in children than in adults. The incidence of septic arthritis peaks between the ages of 2 and 3 and is predominantly male (2: 1). Most septic joints develop as a result of hematogenous dissemination of the vascular synovium due to bacterial episodes. Osteoarthritis, rheumatoid arthritis, and corticosteroid therapy are the most common predisposing conditions. Typical symptoms of acute septic arthritis without gonorrhea include recent fever, malaise, and local findings of pain, warmth, swelling, and restricted mobility of the affected joint. Accurate history and assessment of risk factors can provide important clues for diagnosis. Careful assessment of risk factors can significantly change the likelihood of a provider developing septic arthritis prior to testing. Laboratory findings, diagnostic imaging, and synovial fluid assessment are all useful for diagnosis. Management components include early detection and treatment with joint aspiration, antibiotics, and orthopedic advice for possible surgical management. Widespread antibiotics are often needed due to the potential for rapid joint destruction. A combination of cefepime or anti-Pseudomonas aeruginosa beta-lactams and vancomycin is recommended to cover both Gram-negative and MRSA bacteria.

Lip Lumps Need not be mucocele

Lip lesions are the most common oral mucosal lesions. Mucocele is the second most common benign soft tissue masses of the lips only next to infectious etiology. Tumors of the minor salivary glands of the lip were a rare diagnosis made clinically. Excision and histopathological examination must be done for all the lip lumps as this remains the gold standard for the diagnosis. In this article, we discuss three lip lumps which were clinically suspected as mucocoele turned out to be an unexpected diagnosis which only became clear following excision and histological examination.

SILICON-VALUE AND USE IN A LIVING ORGANISM

Results of clinical practice demonstrate that concerning of silicon the mistake in assessment of the importance of this element in food of animals was made. The silicon concentration in foodstuffs considered being a great deal and its requirements of animals are fully satisfied. Therefore, even in norms (2002) consists no any information about silicon. Accordingly, specialists of cattle breeding also do not control silicon concentration in diets. The last years established its influence on many aspects of metabolism in organism and animal productivity. Established factors of influence on element assimilation that is very important at phone of spreading cattle collogenosis, that promote emergence and spread of various diseases of a noncontagious and infectious etiology, including diseases of fingers and hooves.