Infectious mononucleosis - not always a benign condition: a case report of infectious mononucleosis–associated acute acalculous cholecystitis

CJEM ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 154-156 ◽  
Author(s):  
Andrew Cameron ◽  
Kosalan Akilan ◽  
David Carr
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Critical Illness ◽  
Infectious Mononucleosis ◽  
Early Adulthood ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Benign Condition ◽  
Emergency Department Patients

AbstractInfectious mononucleosis is typically a self-limited viral infection of adolescence and early adulthood that resolves in a period of weeks, causing no major sequelae. We describe a case of a healthy 18-year-old female diagnosed with infectious mononucleosis who also presented with right upper quadrant abdominal pain, moderate transaminitis, and cholestatic biochemistry. An ultrasound revealed acute acalculous cholecystitis, generally a condition seen in the context of critical illness. Further investigating emergency department patients with infectious mononucleosis is often not indicated, but may be important for those who present atypically.

scholarly journals Acute Acalculus Cholecystitis in Dengue Hemorrhagic Fever-A Case Report

2017 ◽  
Vol 35 (3) ◽  
pp. 155-157
Author(s):  
Md Abdul Ali Mia ◽  
Mamun Mostafi ◽  
Shaila Perveen ◽  
Niamul Gani Chowdhury ◽  
Mir Azimuddin Ahmed ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Gall Bladder ◽  
Liver Enzymes ◽  
Acalculous Cholecystitis ◽  
Antibody Test ◽  
Hemorrhagic Fever ◽  
Military Hospital ◽  
Acute Acalculous Cholecystitis ◽  
Altered Liver

Presently Dengue appears with its varied features of presentation and progression. We report a case of acalculus cholecystitis in DHF from department of medicine, Combined Military Hospital, Dhaka. The patient presented with fever and diarrhea later developing abdominal pain. Her platelet counts were low and Dengue antibody test (Ig M) was positive with altered liver enzymes. Ultrasound showed thick walled gall bladder with clear lumen without stone or sluge, a feature of acute acalculous cholecystitis. The patient was successfully managed conservatively.J Bangladesh Coll Phys Surg 2017; 35(3): 155-157

scholarly journals Acute Acalculous Cholecystitis Due to a Primary Epstein Barr Virus Infection in a Pediatric Patient

2021 ◽  
Vol 13 (1) ◽  
pp. 86-90
Author(s):  
Carlos Leganés Villanueva ◽  
Ilaria Goruppi ◽  
Nuria Brun Lozano ◽  
Federica Bianchi ◽  
María Quinteiro González ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Epstein Barr Virus Infection ◽  
Barr Virus ◽  
Acute Complications ◽  
Epstein Barr ◽  
Barr Virus Infection ◽  
Human Viruses

Epstein–Barr virus (EBV) is estimated to infect more than 98% of adults worldwide and is one of the most common human viruses. Acute acalculous cholecystitis (AAC) of the gallbladder is an atypical complication of infectious mononucleosis caused by EBV. Conservative management has been described in the context of AAC caused by EBV. A surgical approach must be considered in the case of acute complications such as perforation or gallbladder gangrene. We present the case of a 10-year-old female patient with AAC due to infectious mononucleosis syndrome caused by primary EBV infection.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

Predictors of Delayed Recognition of Critical Illness in Emergency Department Patients and Its Effect on Morbidity and Mortality

2020 ◽  
pp. 088506662096790
Author(s):  
Neha N. Goel ◽  
Matthew S. Durst ◽  
Carmen Vargas-Torres ◽  
Lynne D. Richardson ◽  
Kusum S. Mathews
Keyword(s):  
Emergency Department ◽  
Critical Illness ◽  
Census Data ◽  
Severity Of Illness ◽  
Improved Outcomes ◽  
Chart Abstraction ◽  
System Factors ◽  
Delayed Recognition ◽  
Emergency Department Patients ◽  
Operational Metrics

Purpose: Timely recognition of critical illness is associated with improved outcomes, but is dependent on accurate triage, which is affected by system factors such as workload and staffing. We sought to first study the effect of delayed recognition on patient outcomes after controlling for system factors and then to identify potential predictors of delayed recognition. Methods: We conducted a retrospective cohort study of Emergency Department (ED) patients admitted to the Intensive Care Unit (ICU) directly from the ED or within 48 hours of ED departure. Cohort characteristics were obtained through electronic and standardized chart abstraction. Operational metrics to estimate ED workload and volume using census data were matched to patients’ ED stays. Delayed recognition of critical illness was defined as an absence of an ICU consult in the ED or declination of ICU admission by the ICU team. We employed entropy-balanced multivariate models to examine the association between delayed recognition and development of persistent organ dysfunction and/or death by hospitalization day 28 (POD+D), and multivariable regression modeling to identify factors associated with delayed recognition. Results: Increased POD+D was seen for those with delayed recognition (OR 1.82, 95% CI 1.13-2.92). When the delayed recognition was by the ICU team, the patient was 2.61 times more likely to experience POD+D compared to those for whom an ICU consult was requested and were accepted for admission. Lower initial severity of illness score (OR 0.26, 95% CI 0.12-0.53) was predictive of delayed recognition. The odds for delayed recognition decreased when ED workload is higher (OR 0.45, 95% CI 0.23-0.89) compared to times with lower ED workload. Conclusions: Increased POD+D is associated with delayed recognition. Patient and system factors such as severity of illness and ED workload influence the odds of delayed recognition of critical illness and need further exploration.

scholarly journals Comparison of Saliva and Nasopharyngeal Swabs for SARS-CoV-2 Detection in an Emergency Department and Ambulatory Testing Locations

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S126-S126
Author(s):  
C Attaway ◽  
F El-Sharkawy Navarro ◽  
M Richard-Greenblatt ◽  
S Herlihy ◽  
C Gentile ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Saliva Sample ◽  
Respiratory Viruses ◽  
Routine Clinical Practice ◽  
Limited Data ◽  
Potential Benefits ◽  
Emergency Department Patients ◽  
Positive Agreement

Abstract Introduction/Objective Nasopharyngeal (NP) swabs have been the traditional specimen source used for testing for respiratory viruses. However, at the start of the COVID-19 pandemic, several studies suggested that saliva could also be used as a specimen source for testing for SARS-CoV-2. Despite potential benefits, there was limited data on the characteristics of this specimen type and few commercial assays with FDA emergency use authorization allowed saliva as a specimen source. In order to explore the feasibility and validate using saliva as a specimen source for ambulatory and emergency department patients we designed a study to compare saliva to NP swabs for SARS-CoV-2 testing. Methods/Case Report Specimens were collected in the emergency department and ambulatory testing sites between May 6, 2020-July 7, 2020. Nasopharyngeal swabs were collected as part of routine clinical practice and patients were given written instructions to self-collect 1mL of saliva into a sterile specimen cup with or without a straw. SARS-CoV-2 testing was performed in parallel with both specimen types using the TaqPath COVID-19 Combo Kit (Thermo Fisher Waltham, MA). Saliva was diluted 1:1 in saline prior to testing. Specimens were transported to the lab at 4C and frozen at -80C prior to testing. Results (if a Case Study enter NA) Seventy-four patients had both an NP swab and saliva tested in this study. Thirty of the 74 patients (41%) were unable to produce the full 1mL of saliva requested, but all samples had sufficient volume for testing after dilution. There were 34 positive samples obtained with an 82% positive agreement between the NP swabs and saliva. In 6 cases, the NP swab was positive, and the paired saliva was negative. In 1 case, only the saliva was positive. The average Ct of the positive NP swabs with a paired negative saliva sample was 39.6. There was only a single invalid test for one of the saliva samples. Conclusion Saliva was a straightforward sample to collect and test for SARS-CoV-2. Challenges included obtaining sufficient sample and a less predictable matrix that required dilution to ensure proper pipeting. In this study, NP swabs were more sensitive for detection of SARS-CoV-2. Paired saliva was more often negative in patients shedding small amounts of SARS-CoV-2 based on a high Ct of the positive NP sample.

scholarly journals Genotype 1 hepatitis E virus infection with acute acalculous cholecystitis as an extrahepatic symptom: a case report

2016 ◽  
Vol 44 (1) ◽  
Author(s):  
Ken Fujioka ◽  
Toshiki Nishimura ◽  
Masayuki Seki ◽  
Masanori Kinoshita ◽  
Nobuyuki Mishima ◽  
...  
Keyword(s):  
Case Report ◽  
Virus Infection ◽  
Hepatitis E Virus ◽  
Acalculous Cholecystitis ◽  
Hepatitis E ◽  
Acute Acalculous Cholecystitis ◽  
Genotype 1
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