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https://www.readbyqxmd.com/read/29685474/the-evaluation-and-management-of-rocky-mountain-spotted-fever-in-the-emergency-department-a-review-of-the-literature
#1
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Rocky Mountain spotted fever (RMSF) is potentially deadly and can present subtly with signs and symptoms overlapping with other clinical conditions. Delayed diagnosis can be fatal. OBJECTIVE: This review provides an evidence-based summary of the current data for the evaluation and management of RMSF in the emergency department. DISCUSSION: RMSF occurs through transmission of Rickettsia rickettsii by an infected tick. Exposure in the United States occurs most commonly from April to September, and high-risk locations include wooded, shrubby, or grassy areas...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29668136/-a-fatal-case-series-of-rocky-mountain-spotted-fever-in-sonora-m%C3%A3-xico
#2
Jesús Delgado-De la Mora, Jesús David Licona-Enríquez, Marcia Leyva-Gastélum, David Delgado-De la Mora, Adela Rascón-Alcantar, Gerardo Álvarez-Hernández
INTRODUCTION: Rocky Mountain spotted fever is a highly lethal infectious disease, particularly if specific treatment with doxycycline is given belatedly. OBJECTIVE: To describe the clinical profile of fatal Rocky Mountain spotted fever cases in hospitalized patients in the state of Sonora, México. MATERIALS AND METHODS: We conducted a cross-sectional study on a series of 47 deaths caused by Rickettsia rickettsii from 2013 to 2016. The diagnosis of Rocky Mountain spotted fever was confirmed in a single blood sample by polymerase chain reaction (PCR) or by a four-fold increase in immunoglobulin G measured in paired samples analyzed by indirect immunofluorescence...
March 15, 2018: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/29600926/-challenges-in-the-diagnostic-management-of-fat-embolism-syndrome-from-divergence-in-clinical-presentation-to-diagnosis
#3
R Rozema, P J van der Mast, M El Moumni, E A Boonstra, B Jacobs, H P A M Poos
This article discusses the diagnosis and management of two patients with cerebral fat embolism syndrome after traumatic femoral fractures. Fat embolism syndrome is a condition which is caused by fat globules in the systemic circulation; it most often occurs in patients with femoral fractures. Patients develop systemic dysfunction, particularly a triad of a petechial rash, respiratory and neurological dysfunction. The syndrome is characterized by a diverse clinical presentation which often necessitates a wide differential diagnosis...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29568848/clinics-in-diagnostic-imaging-184-fat-embolism-syndrome-fes
#4
Dinesh R Singh, Ashish Chawla, Wilfred Cg Peh
A 23-year-old Indian man presented with shortness of breath and new-onset confusion along with a rash on his chest on Postoperative Day 2, following internal fixation of his femur fracture. Although computed tomography pulmonary angiography was negative for filling defects in the pulmonary vasculature, it showed mosaic attenuation changes with some interlobular septal thickening. Magnetic resonance imaging of the brain showed patchy signal abnormalities, predominantly in the grey-white matter junction region with extensive susceptibility artefacts, consistent with petechial haemorrhages...
March 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/29550758/thrombotic-microangiopathy-associated-with-mycoplasma-pneumoniae-infection
#5
Filipa Caeiro Alves, Rute Aguiar, Pedro Pessegueiro, Carlos Pires
Thrombotic microangiopathy (TMA) comprises a process of sequential endothelial damage, microvascular thrombosis, consumptive thrombocytopenia and microangiopathic haemolytic anaemia that can affect several organs, including the kidney. A 36-year-old woman was presented with a petechial rash 3 weeks after an upper respiratory tract infection. Laboratory results showed normocytic normochromic anaemia, thrombocytopenia and evidence of TMA with decreased haptoglobin, elevated serum lactate dehydrogenase and a peripheral blood smear with numerous schistocytes...
March 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29381832/do-not-disregard-diagnostic-clues-of-endocarditis-comment-on-the-article-by-garg-et-al
#6
Claude Bachmeyer, Victoire Dubourdieu, Barthélémy Poignet
We read with great interest the Clinicopathologic Conference by Garg et al. published recently in Arthritis Care & Research about a patient with Bartonella-related endocarditis (1). However, we regret that the 'petechial pruritic rash' on the lower extremities and the presence of elevated rheumatoid factor were initially neglected in a context of glomerulonephritis. Indeed the rash was poorly described. This article is protected by copyright. All rights reserved.
January 30, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29260625/immune-mediated-thrombocytopenia-and-hypothyroidism-in-a-lung-cancer-patient-treated-with-nivolumab
#7
Takanobu Jotatsu, Keishi Oda, Yudai Yamaguchi, Shingo Noguchi, Toshinori Kawanami, Takashi Kido, Minoru Satoh, Kazuhiro Yatera
Patients treated with immune checkpoint inhibitors can develop various immunological complications; however, few cases of immune thrombocytopenia occurring in association with the administration of these agents have so far been reported. We herein report the case of a 62-year-old Japanese man with non-small-cell lung cancer who developed immune thrombocytopenia and hypothyroidism during nivolumab therapy. After the second administration of the drug, his peripheral blood platelet count rapidly decreased to 1...
February 2018: Immunotherapy
https://www.readbyqxmd.com/read/29170349/52-loop-mediated-isothermal-amplification-pcr-lamp-for-the-rapid-identification-of-invasive-meningococcal-disease-in-the-emergency-department
#8
Thomas Waterfield, Bethany Patenall, James McKenna, Derek Fairley
BACKGROUND: Despite successful vaccination programmes meningococcal disease (MD) remains the leading infectious cause of septicaemia and death in children in the UK and Ireland.1,2 The early diagnosis of MD significantly improves outcomes with reduced morbidity and mortality.1,2 The early stages of MD are often indistinguishable from a simple viral illness making an early positive diagnosis of MD difficult.1 Hibergene have developed a commercially available bedside Loop-mediated isothermal AMPlification PCR (LAMP-MD) test that is a highly sensitive 0...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29123567/neurological-effects-of-fat-embolism-syndrome-a-case-report
#9
Emma Shacklock, Andrew Gemmell, Nigel Hollister
Fat embolism syndrome is a serious multi-system pathology which classically affects the respiratory system, neurological system and causes a petechial rash. We present the case of a 20-year-old farmer who developed fat embolism syndrome following a traumatic femoral fracture. Features developed within 24 h of injury and necessitated a prolonged stay in Intensive Care. He exhibited significant signs of cerebral fat embolism syndrome including coma and seizures but went on to make full functional recovery. Magnetic resonance imaging is the recommended imaging modality for patients with suspected cerebral fat embolism...
November 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/28974509/resolution-of-acute-hepatitis-b-associated-aplastic-anaemia-with-antiviral-therapy
#10
Nicholas Hendren, Joseph Moore, Sandra Hofmann, Siayareh Rambally
A previously healthy 44-year-old woman presented with 3 days of worsening petechial rash, epistaxis and fatigue. Admission labs revealed pancytopenia, low reticulocyte index and elevated liver enzymes. Bone marrow biopsy demonstrated a profoundly hypocellular bone marrow without dysplasia and additional testing demonstrated an acute hepatitis B infection. In the context of an acute hepatitis B infection, elevated liver enzymes and aplastic anaemia, our patient was diagnosed with severe hepatitis-associated aplastic anaemia due to an acute hepatitis B infection...
October 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28956547/acute-localized-exanthem-due-to-coxsackievirus-a4
#11
Francesco Drago, Giulia Ciccarese, Lodovica Gariazzo, Margherita Cioni, Aurora Parodi
Enteroviruses are the leading cause of exanthems in children, especially during summer and autumn. Enterovirus infections may occur in epidemics or small outbreaks. A 30-year-old woman presented with a three-day history of an erythematous maculopapular skin rash with petechiae localized exclusively under the nipple of the right breast. The skin eruption was associated with an erythematous-petechial enanthem. The patient complained of low-grade fever, headache, asthenia, sore throat and arthromyalgias. IgM (1:128) and IgG (1:640) antibodies against Coxsackievirus A4 were detected by the virus neutralization test...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28947428/fat-attacks-a-case-of-fat-embolisation-syndrome-postliposuction
#12
Adam Ali, George Theobald, Mohammed Asif Arshad
Liposuction is a procedure commonly performed in the UK usually with a low incidence of serious sequelae; however with larger patients and increased volumes of lipoaspirate, complications have been reported more frequently. One of the rare but very serious complications postliposuction is fat embolism syndrome (FES), a life-threatening condition difficult to diagnose and limited in treatment.The authors present the case of a 45-year-old woman who was admitted to the intensive care unit postelective liposuction for bilateral leg lipoedema...
September 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28943573/postictal-periorbital-petechial-rash
#13
Akioh Yoshihara, Hiroshi Mishima, Naoshi Saito, Yoshikazu Ugawa
No abstract text is available yet for this article.
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28932982/cerebral-fat-embolism-recognition-complications-and-prognosis
#14
Daniel Agustín Godoy, Mario Di Napoli, Alejandro A Rabinstein
Fat embolism syndrome (FES) is a rare syndrome caused by embolization of fat particles into multiple organs including the brain. It typically manifests with petechial rash, deteriorating mental status, and progressive respiratory insufficiency, usually occurring within 24-48 h of trauma with long-bone fractures or an orthopedic surgery. The diagnosis of FES is based on clinical and imaging findings, but requires exclusion of alternative diagnoses. Although there is no specific treatment for FES, prompt recognition is important because it can avoid unnecessary interventions and clarify prognosis...
September 20, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28892964/dengue-haemorrhagic-encephalitis-rare-case-report-with-review-of-literature
#15
Aditya Singh Kutiyal, Chetanya Malik, Gitika Hyanki
Dengue is an endemic arboviral infection prevalent especially in tropical countries including Southern and Southeast Asia. Central Nervous System (CNS) involvement in dengue infection is uncommon. Haemorrhagic encephalitis is a rare presentation in dengue. This is a case of a 58-year-old male who presented with fever, petechial rash and altered sensorium. Dengue serology IgM was reactive and MRI brain was suggestive of haemorrhagic encephalitis. Patient was managed in Intensive Care Unit (ICU) but eventually succumbed to his illness...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28881419/a-55-year-old-male-presenting-with-altered-mental-status-a-complicated-case-of-intracranial-aneurysm
#16
Shivani Garg, Arezou Khosroshahi
No abstract text is available yet for this article.
December 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28872552/pancreatoblastoma-with-metastatic-retroperitoneal-lymph-node-and-pet-ct
#17
Giuseppe Corrias, Monica Ragucci, Olca Basturk, Luca Saba, Lorenzo Mannelli
A previously healthy 4-year-old girl presented with petechial rash and low platelet count. There were no other symptoms. On abdominal ultrasound, a 4.7-cm heterogeneous mass was demonstrated anterior to the left kidney. An abdominal MRI subsequently performed demonstrated a heterogeneously enhancing mass at the same location extending to the pancreas and spleen. A surgical biopsy of the mass was obtained. Pathology reported a malignant epithelioid neoplasm consistent with pancreatoblastoma. The mass demonstrated intense FDG uptake on PET and an FDG avid retrocaval lymph node...
September 1, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28722584/rocky-mountain-spotted-fever-and-pregnancy-four-cases-from-sonora-mexico
#18
Jesus David Licona-Enriquez, Jesus Delgado-de la Mora, Christopher D Paddock, Carlos Arturo Ramirez-Rodriguez, María Del Carmen Candia-Plata, Gerardo Álvarez Hernández
We present a series of four pregnant women with Rocky Mountain spotted fever (RMSF) that occurred in Sonora, Mexico, during 2015-2016. Confirmatory diagnoses were made by polymerase chain reaction or serological reactivity to antigens of Rickettsia rickettsii by using an indirect immunofluorescence antibody assay. Each patient presented with fever and petechial rash and was treated successfully with doxycycline. Each of the women and one full-term infant delivered at 36 weeks gestation survived the infection...
September 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28714381/gemcitabine-associated-pseudocellulitis-a-missed-diagnosis
#19
Dalvir Gill, Josh Schrader, Matthew Kelly, Fidel Martinez, Wajihuddin Syed, Jonathan Wright
We report a case of a 51-year-old male with past medical history significant for cholangiocarcinoma presented with two weeks of worsening bilateral lower extremity swelling and erythema. Patient has been on active chemotherapy for his cholangiocarcinoma with Gemcitabine weekly infusions. Physical exam was significant for bilaterally petechial rash coalescing into ecchymoses over the dorsum of the feet, sparing soles and toes, which dissipated into thinning petechiae more proximally. On labs he did not have any leukocytosis, his platelet count was 50 × 10(3)/µL and basic metabolic panel was benign...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28555248/fat-emboli-syndrome-and-the-orthopaedic-trauma-surgeon-lessons-learned-and-clinical-recommendations
#20
Robin Hall Dunn, Trevor Jackson, Clay Cothren Burlew, Fredric M Pieracci, Charles Fox, Mitchell Cohen, Eric M Campion, Ryan Lawless, Cyril Mauffrey
PURPOSE: Fat emboli syndrome is a rare but well-described complication of long-bone fractures classically characterised by a triad of respiratory failure, mental status changes and petechial rash. In this paper, we present the case of a patient who sustained bilateral femoral fractures and subsequently developed FES. Our aim was to review and summarise the current literature regarding the pathophysiology and management of fat emboli syndrome (FES) and propose an algorithm for treating patients with bilateral femoral fractures to reduce the risk of FES...
September 2017: International Orthopaedics
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