scholarly journals A Case Report of Herpetic Whitlow with Positive Kanavel’s Cardinal Signs: A Diagnostic and Treatment Difficulty

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Milos Brkljac ◽  
Samer Bitar ◽  
Zafar Naqui
Keyword(s):  
Differential Diagnosis ◽  
Recurrent Infection ◽  
Middle Finger ◽  
History Taking ◽  
Oral Antibiotics ◽  
Acute Viral Infection ◽  
Diagnostic Confusion ◽  
Simplex Virus ◽  
Flexor Tenosynovitis ◽  
Herpetic Whitlow

Herpetic whitlow is an acute viral infection of the hand caused by either herpes simplex virus (HSV) 1 or 2. Its characteristic findings are significant pain and erythema with overlying nonpurulent vesicles. The differential diagnosis includes flexor tenosynovitis. We present a case of recurrent infection of the middle finger in an immunocompetent 19-year-old girl. Multiple painful pustules with tracking cellulitis were partially treated by oral antibiotics. A recurrence with positive Kanavel’s signs suggested flexor tenosynovitis at seven months. Her symptoms improved transiently following emergent surgical open flexor sheath exploration and washout however, she required two further washouts; at eleven and thirteen months to improve symptoms. Viral cultures were obtained from the third washout as HSV infection was disclosed from further history taking. These were positive for HSV2. Treatment with acyclovir at thirteen months after presentation led to a complete resolution of her symptoms with no further recurrences to date. This rare case highlights the similarity in presentation between flexor sheath infection and herpetic whitlow which can lead to diagnostic confusion and mismanagement. We emphasise the importance of careful past medical history taking as well as considering herpetic whitlow as a differential diagnosis despite the presence of strongly positive Kanavel’s signs.

Infeksi Herpes Simpleks Dalam Kehamilan

2017 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Fauzia Andrini Djojosugito
Keyword(s):  
Herpes Simplex ◽  
Caesarean Section ◽  
Sexually Transmitted Diseases ◽  
Recurrent Infection ◽  
Neonatal Infection ◽  
Sexually Transmitted ◽  
Caesarean Section Delivery ◽  
Common Causes ◽  
Pregnancy And Delivery ◽  
Simplex Virus

Herpes simplex virus is one the most common causes of sexually transmitted diseases. This infection is common inreproductive age women and can cause severe sequealae for fetus and neonates because this virus can be transmittedto the fetus during pregnancy and the newborn. Infection of Herpes simplex can occurs as first or primary infectionand recurrent infection. Most of the case is asymptomatic. Rarely during intrauterine, the risk of transmission ofmaternal-fetal can be increased during the last trimester of pregnancy and delivery. Based on type of infection,primary or recurrent, performing a treatment with antiviral drugs or caesarean section delivery can decrease the riskof neonatal infection

scholarly journals Machine learning approach for differentiating cytomegalovirus esophagitis from herpes simplex virus esophagitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jung Su Lee ◽  
Jihye Yun ◽  
Sungwon Ham ◽  
Hyunjung Park ◽  
Hyunsu Lee ◽  
...  
Keyword(s):  
Machine Learning ◽  
Differential Diagnosis ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Previous History ◽  
Clinical Factor ◽  
Endoscopic Images ◽  
Simplex Virus

AbstractThe endoscopic features between herpes simplex virus (HSV) and cytomegalovirus (CMV) esophagitis overlap significantly, and hence the differential diagnosis between HSV and CMV esophagitis is sometimes difficult. Therefore, we developed a machine-learning-based classifier to discriminate between CMV and HSV esophagitis. We analyzed 87 patients with HSV esophagitis and 63 patients with CMV esophagitis and developed a machine-learning-based artificial intelligence (AI) system using a total of 666 endoscopic images with HSV esophagitis and 416 endoscopic images with CMV esophagitis. In the five repeated five-fold cross-validations based on the hue–saturation–brightness color model, logistic regression with a least absolute shrinkage and selection operation showed the best performance (sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the receiver operating characteristic curve: 100%, 100%, 100%, 100%, 100%, and 1.0, respectively). Previous history of transplantation was included in classifiers as a clinical factor; the lower the performance of these classifiers, the greater the effect of including this clinical factor. Our machine-learning-based AI system for differential diagnosis between HSV and CMV esophagitis showed high accuracy, which could help clinicians with diagnoses.

The 6C model for accurately capturing the patient’s medical history

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Taro Shimizu
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Patient Safety ◽  
Information Processing ◽  
Safety Concern ◽  
Data Gathering ◽  
Diagnostic Errors ◽  
Accurate Diagnosis ◽  
History Taking ◽  
Novel Approach

Abstract Diagnostic errors are an internationally recognized patient safety concern, and leading causes are faulty data gathering and faulty information processing. Obtaining a full and accurate history from the patient is the foundation for timely and accurate diagnosis. A key concept underlying ideal history acquisition is “history clarification,” meaning that the history is clarified to be depicted as clearly as a video, with the chronology being accurately reproduced. A novel approach is presented to improve history-taking, involving six dimensions: Courtesy, Control, Compassion, Curiosity, Clear mind, and Concentration, the ‘6 C’s’. We report a case that illustrates how the 6C approach can improve diagnosis, especially in relation to artificial intelligence tools that assist with differential diagnosis.

Hand Infections

2018 ◽  
Author(s):  
Scott D Lifchez ◽  
Colton McNichols
Keyword(s):  
Differential Diagnosis ◽  
Acute Infection ◽  
Disease Process ◽  
Hand Surgery ◽  
Inpatient Setting ◽  
Timely Manner ◽  
Functional Deficit ◽  
Hand Infection ◽  
Patient Will ◽  
Flexor Tenosynovitis

Hand infections are a common concern in the emergency, outpatient, and inpatient setting. It is important to accurately diagnose and treat these infections to minimize the risk of spread or functional deficit that could be permanent if not addressed in a timely manner. In this chapter, we aim to cover the epidemiology and etiology of hand infections along with how they tend to present in the clinical setting. This chapter is written so that each encounter can be analyzed in a logical, step-wise fashion from formulating a differential diagnosis to treatment. Upon evaluation, it is important to perform a thorough clinical examination in addition to knowing which imaging modalities can help elucidate the pathology when the initial presentation is unclear. These and other diagnostic studies are covered so that the differential diagnosis can be narrowed down. Each of the possible scenarios is clarified further to help confirm the most likely diagnosis. Finally, we touch on each treatment (whether surgical or medical) recommended for the suspected disease process. Overall, it is important to discern whether the patient will need a small procedure, surgery, or medication alone so that the appropriate management is performed and optimal healing is possible. This review contains 25 Figures, 10 Tables and 26 references Key Words: acute infection, chronic infection, paronychia, felon, flexor tenosynovitis, septic joint, hand infection, hand surgery

Reasons for the Absence of a History of Recurrent Genital Infections in Mothers of Neonates Infected with Herpes Simplex Virus

PEDIATRICS ◽  
1984 ◽  
Vol 73 (2) ◽  
pp. 188-193
Author(s):  
Anne S. Yeager ◽  
Ann M. Arvin
Keyword(s):  
Herpes Simplex ◽  
Recurrent Infection ◽  
Perinatal Period ◽  
Neonatal Herpes ◽  
Genital Infections ◽  
Source Of Infection ◽  
History Of ◽  
Sources Of Infection ◽  
Neonatal Herpes Simplex ◽  
Simplex Virus

Thirty-one cases of neonatal herpes simplex (HSV) infection were evaluated to determine how often mothers of infected infants lacked a history of recurrent genital infections and the reasons for its absence. A history of recurrent genital infections was elicited from eight (26%) of the mothers. Nine (29%) of the mothers had primary infections; three of these were oral and six were genital. The mother was not the source of infection in three (9.6%) cases. In eleven (35%) cases, the mother had antibody to HSV but did not have a history or findings of primary or recurrent infection. Two of these mothers had positive cervical or vaginal cultures, but neither had genital lesions typical of HSV in the perinatal period. Two mothers had recurrent HSV infections documented later. The source of the HSV infection remained uncertain in 23% of cases including two in which only the father had a history of recurrent genital infection. When mothers with primary infections in the perinatal period were excluded, the HSV neutralization titers of the mothers of infected infants were similar to the titers of the mothers with recurrent genital infections whose infants were not infected. In contrast, the infected infants had titers fourfold lower than their mother's titer as well as fourfold lower than the 16 infants exposed to HSV who remained uninfected. This discrepancy suggests that the mothers may have had a rise in titer late in pregnancy or that placental transport of antibody was limited. Although 26% of the mothers of infected infants had recurrent genital infections, only three (9.6%) had an easily elicitable history. Most cases of neonatal HSV infection will not be avoidable until the epidemiology of primary maternal infection and of nonmaternal sources of infection is understood and the identification of women with HSV who are never symptomatic is improved.

scholarly journals Extensive Epidermal Skin Loss Secondary to HSV Type One: Neonatal Management Challenges

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Rebecca J Calthorpe ◽  
Emma Spencer ◽  
Jane C Ravenscroft ◽  
Ting S Tang ◽  
Anna E Martinez ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Epidermolysis Bullosa ◽  
Herpes Simplex Virus Type ◽  
Rare Case ◽  
Preterm Neonate ◽  
Skin Loss ◽  
Simplex Virus ◽  
Aplasia Cutis

We describe a rare case of a preterm neonate presenting at birth with extensive epidermal skin loss of over 90% due to disseminated herpes simplex virus type one infection. Differential diagnosis included aplasia cutis and epidermolysis bullosa. Serum PCR and mouth swabs confirmed HSV type one, and the patient required three weeks of treatment with intravenous aciclovir, followed by oral aciclovir. We describe the management challenges and give practical solutions applicable to the care of a neonate presenting with widespread skin loss due to any aetiology.

Delusional (Paranoid) Disorders

1988 ◽  
Vol 33 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Alistair Munro
Keyword(s):  
Effective Treatment ◽  
Psychotic Disorder ◽  
Mental Status ◽  
Affective Disorders ◽  
Paranoid Schizophrenia ◽  
History Taking ◽  
Appropriate Treatment ◽  
Inappropriate Treatment ◽  
Diagnostic Confusion ◽  
Mental Status Examination

The group of paranoid or delusional disorders, although not nearly as common as the mood and schizophrenic disorders, may be much more frequent than has usually been thought. DSM-III R has made a decisive step in recognizably defining at least one group of them. Interestingly, this change partly came about because the advent of an effective treatment helped to define that group more clearly. Nevertheless, DSM-III R's classification is too restrictive, and it was wrong to exclude the diagnosis of paraphrenia. Cases fitting this description will have to be consigned to the category of Psychotic Disorder NOS, which will inevitably be a grab-bag of mixed diagnoses. Also, DSM-III R does not emphasize the link between the delusional disorders and paranoid schizophrenia, and the somewhat less well defined overlap with affective disorders, both of which give rise to much diagnostic confusion and inappropriate treatment. Precise history taking and mental status examination and, above all, an up-to-date knowledge of their existence are essential to the recognition and appropriate treatment of the delusional disorders.

Pyoderma gangrenosum producing saddle nose deformity

1998 ◽  
Vol 112 (9) ◽  
pp. 870-871 ◽  
Author(s):  
George A. Worley ◽  
Michael J. Wareing ◽  
Robert J. Sergeant
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Pyoderma Gangrenosum ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Saddle Nose ◽  
Saddle Nose Deformity ◽  
Minor Surgery ◽  
Diagnostic Confusion ◽  
Nose Deformity

AbstractPyoderma gangrenosum affecting the nose is rare and this may lead to diagnostic confusion because of the large differential diagnosis. As diagnosis is made, largely, on the basis of exclusion the treatment of pyoderma gangrenosum may be unduly delayed. The condition is often disfiguring, particularly following inappropriate surgical intervention, and early diagnosis is therefore important.We present a case of pyoderma gangrenosum managed initially in the community with minor surgery and resulting in the rare complication of saddle nose deformity.

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