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https://www.readbyqxmd.com/read/28714381/gemcitabine-associated-pseudocellulitis-a-missed-diagnosis
#1
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
#2
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...
May 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28501041/trauma-patient-with-fat-embolism-detected-on-computed-tomography
#3
Isabel Sousa, João Janeiro, Paula Campos, Isabel Távora
Fat embolism is frequent following fractures of long bones, however the development of the clinical syndrome of fat embolism (characterized by progressive respiratory distress, mental status depression and petechial rash) is rare, but relevant because of its potential severity. We report a case of a trauma patient with multiple fractures of the right lower limb in whom an emergency computed tomography scan showed fat emboli within the lumen of the homolateral common femoral vein. The imaging detection of macroscopic fat emboli should alert the clinician to the potential for subsequent fat embolism syndrome...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28441217/an-unusual-case-of-sepsis-and-petechial-rash
#4
Christina Gardner
This article describes a man who presented to the ED in acute distress with signs and symptoms of sepsis, pneumonia, and a new petechial rash on his chest. He was eventually diagnosed with Rocky Mountain spotted fever. Aggressive treatment of sepsis and timely administration of empiric antibiotics were lifesaving in this situation.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28196318/common-skin-conditions-in-children-skin-infections
#5
REVIEW
Brian Z Rayala, Dean S Morrell
Skin infections account for a significant subset of dermatologic conditions of childhood. Common cutaneous viral infections in children include warts, molluscum contagiosum, hand-foot-and-mouth disease, and herpes simplex. Although viral infections are self-limited and often only mildly symptomatic, they can cause anxiety, embarrassment, and health care use. Recognition of their common and atypical presentations is necessary to differentiate them from other skin conditions of similar morphology. Impetigo, cellulitis, and abscess comprise the majority of childhood bacterial skin infections and are treated with topical or systemic antibiotics that cover group A Streptococcus and Staphylococcus aureus...
February 2017: FP Essentials
https://www.readbyqxmd.com/read/28018064/cortical-blindness-along-with-motor-aphasia-an-unusual-presentation-of-fat-embolism-syndrome
#6
Umesh Kumar Meena, Ravinder Kumar Lamoria, Ravi Kant Millan, Piyush Agarwal, Mahendra Singh, Mahesh Chand Bansal
Fat embolism syndrome presented with the classical triad of respiratory manifestations (95%), cerebral effects (60%) and Petechial rash (33%). Focal neurological symptoms in the form of combined bilateral cortical blindness and motor aphasia even prior to respiratory symptoms have been never reported in previous literature. We describe a case of these rare focal neurological symptoms secondary to the fat embolism syndrome in a young adult male following closed femur fracture.
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27976688/a-hamster-model-for-marburg-virus-infection-accurately-recapitulates-marburg-hemorrhagic-fever
#7
Andrea Marzi, Logan Banadyga, Elaine Haddock, Tina Thomas, Kui Shen, Eva J Horne, Dana P Scott, Heinz Feldmann, Hideki Ebihara
Marburg virus (MARV), a close relative of Ebola virus, is the causative agent of a severe human disease known as Marburg hemorrhagic fever (MHF). No licensed vaccine or therapeutic exists to treat MHF, and MARV is therefore classified as a Tier 1 select agent and a category A bioterrorism agent. In order to develop countermeasures against this severe disease, animal models that accurately recapitulate human disease are required. Here we describe the development of a novel, uniformly lethal Syrian golden hamster model of MHF using a hamster-adapted MARV variant Angola...
December 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27929218/emerging-vector-borne-diseases
#8
REVIEW
Mark K Huntington, Jay Allison, Dilip Nair
Several mosquito-borne viral infections have recently emerged in North America; West Nile virus is the most common in the United States. Although West Nile virus generally causes a self-limited, flulike febrile illness, a serious neuroinvasive form may occur. Dengue is the most common vector-borne viral disease worldwide, and it has been a significant public health threat in the United States since 2009. Known as breakbone fever for its severe myalgias and arthralgias, dengue may cause a hemorrhagic syndrome...
October 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27913079/rash-decisions-an-approach-to-dangerous-rashes-based-on-morphology
#9
Jamie Santistevan, Brit Long, Alex Koyfman
BACKGROUND: Rash is a common complaint in the emergency department. Many causes of rash are benign; however, some patients may have a life-threatening diagnosis. OBJECTIVE: This review will present an algorithmic approach to rashes, focusing on life-threatening causes of rash in each category. DISCUSSION: Rash is common, with a wide range of etiologies. The differential is broad, consisting of many conditions that are self-resolving. However, several conditions associated with rash are life threatening...
April 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27831908/diagnosing-haemophagocytic-syndrome
#10
REVIEW
Ethan S Sen, Colin G Steward, Athimalaipet V Ramanan
Haemophagocytic syndrome, or haemophagocytic lymphohistiocytosis (HLH), is a hyperinflammatory disorder characterised by uncontrolled activation of the immune system. It can result from mutations in multiple genes involved in cytotoxicity or occur secondary to a range of infections, malignancies or autoimmune rheumatic diseases. In the latter case, it is also known as macrophage activation syndrome (MAS). Characteristic features are persistent fever, hepatosplenomegaly, petechial/purpuric rash, progressive cytopenias, coagulopathy, transaminitis, raised C reactive protein, falling erythrocyte sedimentation rate, hypertriglyceridaemia, hypofibrinogenaemia and extreme hyperferritinaemia often associated with multi-organ impairment...
March 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27752403/softball-petechiae-a-novel-cutaneous-finding-in-a-patient-participating-in-post-exercise-massage
#11
Talayesa Buntinx-Krieg, Jeffrey Greenwald
We report a case of a 39-year-old healthy male presenting with an eruption consisting of evenly spaced, well-circumscribed, round, petechial macules over a discrete region on his back. A detailed history revealed that the man participated in a high-intensity combination workout routine and post-exercise massage. He reported using a regulation-sized dimpled softball in order to massage the musculature of his back. A diagnosis of traumatic petechiae was established. A growing fitness culture encouraging high-intensity training and post-exercise massage coupled with the high costs of professional masseuse services has led to the increased use of self-massage techniques using both traditional and non-traditional massage equipment...
September 12, 2016: Curēus
https://www.readbyqxmd.com/read/27723622/-severe-spotted-fever-by-rickettsia-rickettsii-in-tourist-in-the-argentine-northwest
#12
Alfredo Seijo, Sergio Giamperetti, Sonia M Ortiz Mayor, María B González, Eugenia S Ortega, Rossana C González
On the fifth day after leaving the Parque Nacional El Rey, province of Salta, Argentina, where she made rural tourism, a woman of Italian origin, aged 47, developed an acute fever followed by a petechial and purpuric rash that progressed rapidly to multiorgan failure. She died on the sixth day after hospitalization. There were references to tick bites and a skin lesion similar to tache noire was found. The autopsy showed generalized vasculitis, ascites, pulmonary edema, acute tubular necrosis and portal centrilobular necrosis...
2016: Medicina
https://www.readbyqxmd.com/read/27668905/atypical-clinical-presentation-of-meningococcal-meningitis-a-case-report
#13
Ilaria Izzo, Paola Pileri, Maria Merello, Paolo Gnesin, Enrico Cogi, Carlo Aggiusti, Laura Giacomelli, Stefano Ettori, Paolo Colombini, Andrea Collidá
A young woman was examined in the Emergency Department for fever, pharyngitis and widespread petechial rash. Physical examination, including neurological evaluation, did not show any other abnormalities. Chest X-ray was negative. Blood exams showed leukocytosis and CPR 20 mg/dL (nv<0.5 mg/dL). On the basis of these results and petechial rash evidence, lumbar puncture was performed. CSF was opalescent; physico-chemical examination showed: total proteins 2.8 (nv 0.15-0.45), glucose 5 (nv 59-80), WBC 7600/μL (nv 0-4/ μL)...
September 1, 2016: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/27631124/neisseria-meningitidis-presenting-as-acute-abdomen-and-recurrent-reactive-pericarditis
#14
Karolina Akinosoglou, Angelos Alexopoulos, Nikolaos Koutsogiannis, Charalampos Gogos, Aleksandra Lekkou
Meningococcal meningitis is a well established potential fatal infection characterized by fever, headache, petechial rash, and vomiting in the majority of cases. However, protean manifestations including abdominal pain, sore throat, diarrhea and cough, even though rare, should not be overlooked. Similarly, although disseminated infection could potentially involve various organ-targets, secondary immune related complications including joints or pericardium should be dealt with caution, since they remain unresponsive to appropriate antibiotic regimens...
November 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27609730/an-improbable-and-unusual-case-of-thrombotic-thrombocytopenia-purpura
#15
Jaymon Patel, Preeti Patel, Zohair Ahmed
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening medical emergency which may be difficult to recognize given the wide spectrum in which it presents. A delay in treatment may be catastrophic as untreated cases of TTP have a mortality rate exceeding 90%. Given the high fatality rate of untreated TTP and its range of presenting symptoms, we present our unusual case of TTP in a post-splenectomy patient with early treatment and positive outcome. This case describes a 54-year-old female who presented with hematuria and gingival bleeding, followed by the development of a bilateral lower extremity petechial rash...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27493985/a-study-to-determine-if-addition-of-palatal-petechiae-to-centor-criteria-adds-more-significance-to-clinical-diagnosis-of-acute-strep-pharyngitis-in-children
#16
Kumara V Nibhanipudi
Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study...
2016: Global Pediatric Health
https://www.readbyqxmd.com/read/27489269/ferrets-infected-with-bundibugyo-virus-or-ebola-virus-recapitulate-important-aspects-of-human-filovirus-disease
#17
Robert Kozak, Shihua He, Andrea Kroeker, Marc-Antoine de La Vega, Jonathan Audet, Gary Wong, Chantel Urfano, Kym Antonation, Carissa Embury-Hyatt, Gary P Kobinger, Xiangguo Qiu
UNLABELLED: Bundibugyo virus (BDBV) is the etiological agent of a severe hemorrhagic fever in humans with a case-fatality rate ranging from 25 to 36%. Despite having been known to the scientific and medical communities for almost 1 decade, there is a dearth of studies on this pathogen due to the lack of a small animal model. Domestic ferrets are commonly used to study other RNA viruses, including members of the order Mononegavirales To investigate whether ferrets were susceptible to filovirus infections, ferrets were challenged with a clinical isolate of BDBV...
October 15, 2016: Journal of Virology
https://www.readbyqxmd.com/read/27393104/clinical-significance-of-skin-rash-in-dengue-fever-a-focus-on-discomfort-complications-and-disease-outcome
#18
Hsin-Wei Huang, Han-Chi Tseng, Chih-Hung Lee, Hung-Yi Chuang, Shang-Hung Lin
OBJECTIVES: To assess whether the cutaneous features in patients with dengue fever are associated with abnormal blood biochemistry, complications, and poor disease outcome. METHODS: Forty five patients with dengue fever were identified at a medical center in Kaohsiung, Taiwan, from September to November 2014. All cases were exclusively caused by type 1 dengue virus. Patients were classified into two groups, based on the presence or absence of skin rash, and their rash was subclassified into maculopapular, morbilliform, and petechial types...
July 2016: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/27262286/rumpel-leede-phenomenon-in-a-hypertensive-patient-due-to-mechanical-trauma-a-case-report
#19
Adam Hartley, Phang B Lim, Sajad A Hayat
BACKGROUND: In this report, we present an interesting case of a patient with Rumpel-Leede phenomenon, a rare occurrence that can result in significant delays in medical treatment. This phenomenon is characterized by the presence of a petechial rash that results from acute dermal capillary rupture. In our patient, it occurred secondary to raised pressure in the dermal vessels caused by repeated inflation of a sphygmomanometer cuff. Contributory factors in Rumpel-Leede phenomenon include prevalent conditions such as diabetes mellitus, hypertension, thrombocytopenia, chronic steroid use, antiplatelets, and anticoagulants...
June 5, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27195603/clinical-predictors-of-sensorineural-hearing-loss-and-cognitive-outcome-in-infants-with-symptomatic-congenital-cytomegalovirus-infection
#20
Swetha G Pinninti, Mackenzie D Rodgers, Zdenek Novak, William J Britt, Karen B Fowler, Suresh B Boppana, Shannon A Ross
The objective of this study was to determine newborn clinical findings predictive of adverse clinical outcomes in infants with symptomatic congenital cytomegalovirus infection. Of 160 infants, significantly more children with central nervous system involvement had sensorineural hearing loss (P = 0.0007) and an IQ ≤70 (P < 0.0001) compared with infants with transient findings or only a petechial rash.
August 2016: Pediatric Infectious Disease Journal
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