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Leukocytosis and infection

Sergio Pina-Oviedo, Carlos A Torres-Cabala, Roberto N Miranda, Michael T Tetzlaff, Selina Singh, Ronald P Rapini, Victor G Prieto, Phyu P Aung
Leukemia cutis develops in <4% of all acute leukemias. Concurrent acute myeloid leukemia (AML) and Langerhans cell histiocytosis (LCH) is rare, with most cases involving lymph nodes or spleen, and no cutaneous involvement. We report the case of a 59-year-old man who presented with fever, malaise, and fatigue. The CBC showed leukocytosis (30.4 × 10/L, 9% blasts), anemia, and thrombocytopenia. Bone marrow biopsy was diagnosed with AML, not otherwise specified, with mutations of FLT3 and IDH2 (R140Q). The patient developed skin rash on the right flank with the clinical differential diagnosis of herpes simplex virus or varicella-zoster virus infection/reactivation versus leukemia cutis...
October 18, 2016: American Journal of Dermatopathology
Ula Khatib, Diederik van de Beek, John A Lees, Matthijs C Brouwer
OBJECTIVES: To study the diagnostic accuracy of clinical and laboratory features in the diagnosis of central nervous system (CNS) infection and bacterial meningitis. METHODS: We included consecutive adult episodes with suspected CNS infection who underwent cerebrospinal fluid (CSF) examination. The reference standard was the diagnosis classified into 5 categories: 1) CNS infection; 2) CNS inflammation without infection; 3) other neurological disorder; 4) non-neurological infection; and 5) other systemic disorder...
October 13, 2016: Journal of Infection
Glenn J Rapsinski, Jina Makadia, Nitin Bhanot, Zaw Min
BACKGROUND: Gram-negative microorganisms are uncommon pathogens responsible for infective endocarditis. Pseudomonas mendocina, a Gram-negative water-borne and soil-borne bacterium, was first reported to cause human infection in 1992. Since then, it has rarely been reported as a human pathogen in the literature. We describe the first case of native valve infective endocarditis due to P. mendocina in the USA. CASE PRESENTATION: A 57-year-old white man presented with bilateral large leg ulcers, fever, and marked leukocytosis...
October 4, 2016: Journal of Medical Case Reports
Abdullah Alakeel, Marie Ferneiny, Nicole Auffret, Christine Bodemer
Acne fulminans (AF) is a rare manifestation and the most severe form of the entire clinical spectrum of acne. The disease is destructive and is characterized by the sudden onset of painful and ulcerative pustules and systemic symptoms including high fever, hepatomegaly, polyarthralgia, leukocytosis, plaquetose, and increased inflammatory markers and transaminases. Osteolytic lesions in multiple skeletal sites could also be associated. The use of isotretinoin is considered a related trigger, as well as the use and cessation of testosterone, although a bacterial infection, a drug-induced disease, or an intake of anabolic androgenic steroids has been suggested...
October 4, 2016: Pediatric Dermatology
Pranit N Chotai, Mark S Hsiao, Indu Pathak, Diem Banh, Marwa Abdou, Amr A Abdelgawad
Pelvic pyomyositis is an infection of the skeletal muscles around the hip joint. Fever, hip pain, limp, and leukocytosis are common; however, the clinical picture is often vague. MRI is the current gold-standard imaging for pyomyositis. No studies in the current literature have reported an unremarkable initial MRI in a patient with symptomatic pyomyositis. An adolescent female presented with symptomatic pelvic pyomyositis, but admission MRI was normal. A follow-up MRI indicated development of pelvic pyomyositis...
November 2016: Journal of Pediatric Orthopedics. Part B
Öznur Küçük, Suat Biçer, Meltem Ugraş, Defne Çöl, Tuba Giray, Gülay Çiler Erdag, Yeşim Gürol, Gülden Yilmaz, Zerrin Yalvaç, Ayça Vitrinel, Çigdem Kaspar
The purpose of this study was to evaluate the clinical and laboratory data of children with acute gastroenteritis caused by non-typhoid Salmonella spp. infections. Clinical (demographic data, symptoms and findings) and laboratory data (stool microscopy, rapid antigen tests, culture, multiplex polymerase chain reaction and blood test results) of children with acute gastroenteritis caused by non-typhoid Salmonella spp. between January 2010 and October 2012 were evaluated. Differences between the groups for categorical variables were estimated with a chi-square or Fisher exact test; for continuous variables with two independent samples a t test was used...
September 1, 2016: Le Infezioni in Medicina
Yaara Leibovici-Weissman, Alaa Atamna, Agata Schlesinger, Noa Eliakim-Raz, Jihad Bishara, Dafna Yahav
AIM: Most cases of Clostridium difficile infections (CDI) occur in patients aged 65 years and older. Older age is associated with increased mortality. Risk factors for mortality in patients aged 80 years and older are not well recognized. METHODS: We analyzed retrospective data including 184 patients aged 80 years and older hospitalized with CDI during 2009-2014. We aimed to delineate risk factors for short- and long-term mortality. RESULTS: The 30-day mortality was 33...
September 20, 2016: Geriatrics & Gerontology International
Brit Long, Alex Koyfman
BACKGROUND: Bacteremia affects 200,000 patients per year, with the potential for significant morbidity and mortality. Blood cultures are considered the most sensitive method for detecting bacteremia and are commonly obtained in patients with fever, chills, leukocytosis, focal infections, and sepsis. OBJECTIVE: We sought to provide emergency physicians with a review of the literature concerning blood cultures in the emergency department. DISCUSSION: The utility of blood cultures has been a focus of controversy, prompting research evaluating effects on patient management...
September 14, 2016: Journal of Emergency Medicine
P Cuny, M Houot, S Ginisty, S Horowicz, F Plassart, H Mentec, P Eftekhari
INTRODUCTION: The aim of this paper is to underline the need for systematic monitoring of patients treated with anticholinergic antipsychotic drugs. We present the clinical history of a 34-year-old adult, treated with quetiapine in combination with other drugs with anticholinergic effects. CASE REPORT: A 34-year-old male adult had been suffering from bipolar disorder since 2001. He was treated with risperidone, but he was not compliant due to adverse effects, including decreased libido and erectile dysfunction...
September 13, 2016: L'Encéphale
Amber C Beckett, M Blanca Piazuelo, Jennifer M Noto, Richard M Peek, M Kay Washington, Holly M Scott Algood, Timothy L Cover
Epidemiologic studies have provided conflicting data regarding an association between H. pylori infection and iron deficiency anemia (IDA) in humans. Here, a Mongolian gerbil model was used to investigate a potential role of H. pylori infection, as well as a possible role of diet, in H. pylori-associated IDA. Mongolian gerbils (either H. pylori-infected or uninfected) received a normal diet or one of three diets associated with increased H. pylori virulence: high salt, low iron, or combination high salt/low iron...
September 12, 2016: Infection and Immunity
Jaime R Torres, Luiza H Falleiros-Arlant, Lourdes Dueñas, Jorge Pleitez-Navarrete, Doris M Salgado, José Brea-Del Castillo
BACKGROUND: During the years 2014 and 2015, the Region of the Americas underwent a devastating epidemic of chikungunya virus (CHIKV) of the Asian genotype, resulting in millions of affected individuals. However, epidemiological and clinical information on this experience is scarce. Prior knowledge of congenital and neonatal illness caused by CHIKV is limited and almost exclusively based on data obtained from a single outbreak of the East/Central/South African (ECSA) genotype. The effect of chikungunya fever (CHIKF) on pregnancy outcomes and its consequences for infants born to infected mothers at the peak of the epidemic wave in Latin America are reviewed herein...
September 13, 2016: International Journal of Infectious Diseases: IJID
Raafia Memon, WuQiang Fan, Richard Snyder, Mahesh Krishnamurthy
INTRODUCTION: While extremely uncommon, diabetic ketoacidosis (DKA) and thyroid storm (TS) are endocrine emergencies that can coexist. We describe a case with a confounding clinical presentation that identifies these two emergencies within the setting of sepsis and influenza. CASE: A 69-year-old diabetic female was found by the paramedic staff to be disoriented. She demonstrated tachycardia and had a foul-smelling abdominal wound. Laboratory evaluation revealed DKA, leukocytosis, influenza B, and urinary tract infection...
2016: Journal of Community Hospital Internal Medicine Perspectives
Nicholas H Carbonetti
The significant and sometimes dramatic rise in the number of circulating white blood cells (leukocytosis) in infants suffering from pertussis (whooping cough) has been recognized for over a century. Although pertussis is a disease that afflicts people of all ages, it can be particularly severe in young infants, and these are the individuals in whom leukocytosis is most pronounced. Very high levels of leukocytosis are associated with poor outcome in infants hospitalized with pertussis and modern treatments are often aimed at reducing the number of leukocytes...
October 2016: Pathogens and Disease
Neea Laaksonen, Lilja Rintamäki, Matti Korppi
AIM: The occurrence of blood culture-positive pneumococcal bacteraemia and bacteraemic pneumonia decreased after large-scale pneumococcal vaccinations were introduced. The aim of this study was to evaluate the effect of pneumococcal vaccinations on hospitalisations due to blood culture-negative infections with fever and leucocytosis, without any other focus than pneumonic infiltration. MATERIAL: This was a retrospective hospital chart review covering the pre-vaccination era of 2008-2009 and post-vaccination era of 2012-2013...
September 8, 2016: Acta Paediatrica
F Frenzen, C Röder, B Wollschläger, E Großer, K Krohe, B Schmidt
UNLABELLED: A patient presented himself with pungent, breath-dependent right chest pain and dyspnea at rest in our emergency department. The physical examination and the ECG revealed no relevant findings. The laboratory results showed an increased CRP, leukocytosis, elevated D-dimers and a respiratory partial insufficiency. In the thoracic CT angiography unclear pulmonary nodules (PN) were seen. The bronchoscopy was macroscopically normal. In the BAL yeasts and a high proportion of immune senescence cells (CD57+) were identified...
September 2016: Pneumologie
Daniel J Niven, Kevin B Laupland
Elevation in core body temperature is one of the most frequently detected abnormal signs in patients admitted to adult ICUs, and is associated with increased mortality in select populations of critically ill patients. The definition of an elevated body temperature varies considerably by population and thermometer, and is commonly defined by a temperature of 38.0 °C or greater. Terms such as hyperthermia, pyrexia, and fever are often used interchangeably. However, strictly speaking hyperthermia refers to the elevation in body temperature that occurs without an increase in the hypothalamic set point, such as in response to specific environmental (e...
2016: Critical Care: the Official Journal of the Critical Care Forum
Ellen K Wagner, Xianzhe Wang, Andre Bui, Jennifer A Maynard
Bispecific antibodies are a rapidly growing class of therapeutic molecules, originally developed for the treatment of cancer but recently explored for the treatment of autoimmune and infectious diseases. B. pertussis is a re-emerging pathogen, with several key symptoms caused by the pertussis toxin (PTx). Two humanized antibodies, hu1B7 and hu11E6, bind distinct epitopes on PTx and mitigate disease severity in murine and baboon models of infection when co-administered. Herein, we describe generation of a bispecific human IgG1 molecule combining the hu1B7 and hu11E6 binding sites via a knobs-in-holes design...
August 31, 2016: Clinical and Vaccine Immunology: CVI
I Henriot, E Launay, M Boubaya, L Cremet, M Illiaquer, H Caillon, A Desjonquères, B Gillet, M C Béné, M Eveillard
INTRODUCTION: Complete blood counts (CBC) performed for infected children admitted for fever mostly disclose leukocytosis. Yet, the recently developed XN-10(®) provides novel CBC parameters which could be useful to ascertain infection and discriminate between bacterial and viral etiologies. These were the main objectives of the study presented here. METHODS: Blood samples from 90 children, 1 month to 5 years old, admitted to an emergency unit for fever benefited from a CBC, C-reactive protein, and procalcitonin assays...
August 30, 2016: International Journal of Laboratory Hematology
Ivan Rocha Ferreira da Silva, Gabriel Rodriguez de Freitas
BACKGROUND: Fever is commonly observed in patients who have had aneurysmal subarachnoid hemorrhage (SAH), and it has been associated with the occurrence of delayed cerebral ischemia and worse outcomes in previous studies. Frequently, fever is not the result of bacterial infections, and distinction between infection-related fever and fever secondary to brain injury (also referred as central fever) can be challenging. OBJECTIVES: The current study aimed to identify risk factors on admission for the development of central fever in patients with SAH...
August 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Alejandra Albarrán-Sánchez, Claudia Ramírez-Rentería, Fernando Huerta-Montiel, Angélica Martínez-Jerónimo, Alejandro Herrera-Landero, José Luis García-Álvarez, Elia Ortiz-Rodríguez, Lorena Palmas-Pineda
BACKGROUND: Between October 2013 and April 2014, the Centers for Disease Control and Prevention reported a high incidence of AH1N1 influenza cases. Not all suspicious cases of influenza are confirmed; however, all patients need treatment and generate additional costs to the institutions. Our objective was to describe the characteristics of the patients treated for influenza suspicion at Hospital de Especialidades in Centro Médico Nacional Siglo XXI during a new epidemic. METHODS: Cross-sectional study of all cases admitted at the Emergency Service (of the aforementioned hospital) for influenza-like illness, defined according to current guidelines...
2016: Revista Médica del Instituto Mexicano del Seguro Social
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