scholarly journals Pediatric Infectious Prepatellar Bursitis with Kingella kingae

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Charles C. Pitts ◽  
Walter R. Smith ◽  
Michael J. Conklin
Keyword(s):  
Pediatric Population ◽  
Kingella Kingae ◽  
Laboratory Methods ◽  
Fluid Analysis ◽  
Irrigation And Debridement ◽  
Prior Literature ◽  
Septic Bursitis ◽  
Polymerase Chain ◽  
High Index Of Suspicion ◽  
Prepatellar Bursitis

We present the first reported case of septic prepatellar bursitis with Kingella kingae in a 2-year-old female. Although it is a well-established cause of osteoarticular infections in the pediatric population, K. kingae has never been reported as the etiology for septic bursitis. A high index of suspicion is required for the diagnosis given that this organism is difficult to culture and isolate using standard laboratory methods. Our diagnosis was established through bursal fluid analysis, though oropharyngeal polymerase chain reaction (PCR) may be also be considered. Our case also builds upon prior literature suggesting that the pathophysiology of septic bursitis in children differs from that of the adult and may be more comparable to that of pediatric osteomyelitis. As an organism of increasing prevalence, K. kingae should remain high on the differential for osteoarticular or periarticular infections when cultures fail to isolate a distinct pathogen. Early diagnosis and a formal irrigation and debridement, if warranted, are crucial in preventing devastating complications of untreated septic bursitis.

scholarly journals Septic Bursitis in an 8-Year-Old Boy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Panagiotis Kratimenos ◽  
Ioannis Koutroulis ◽  
Dante Marconi ◽  
Jennifer Ding ◽  
Christos Plakas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Differential Diagnosis ◽  
Streptococcus Pyogenes ◽  
High Index ◽  
Puncture Wound ◽  
Septic Bursitis ◽  
High Index Of Suspicion ◽  
Prepatellar Bursitis

Background.The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children.Methods.We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis.Results.Wound cultures grewStreptococcus pyogenes, with the infection resolving with amoxicillin.Conclusions.A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

scholarly journals Pancreatico‑pleural Fistula: Case Series

2018 ◽  
Vol 09 (01) ◽  
pp. 026-031 ◽  
Author(s):  
Manoj Munirathinam ◽  
Pugazhendhi Thangavelu ◽  
Ratnakar Kini
Keyword(s):  
Magnetic Resonance ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Case Series ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Fluid Analysis ◽  
High Index Of Suspicion ◽  
Enhanced Computed Tomography ◽  
Acute And Chronic Pancreatitis ◽  
Pancreatic Pathology

ABSTRACTPancreatico‑pleural fistula is a rare but serious complication of acute and chronic pancreatitis. The pleural effusion caused by pancreatico‑pleural fistula is usually massive and recurrent. It is predominately left‑sided but right‑sided and bilateral effusion does occur. We report four cases of pancreatico‑pleural fistula admitted to our hospital. Their clinical presentation and management aspects are discussed. Two patients were managed by pancreatic endotherapy and two patients were managed conservatively. All four patients improved symptomatically and were discharged and are on regular follow‑up. Most of these patients would be evaluated for their breathlessness and pleural effusion delaying the diagnosis of pancreatic pathology and management. Hence, earlier recognition and prompt treatment would help the patients to recover from their illnesses. Pancreatic pleural fistula diagnosis requires a high index of suspicion in patients presenting with chest symptoms or pleural effusion. Extremely high pleural fluid amylase levels are usual but not universally present. A chest X‑ray, pleural fluid analysis, and abdominal imaging (magnetic resonance cholangiopancreatography/magnetic resonance imaging abdomen more useful than contrast‑enhanced computed tomography abdomen) would clinch the diagnosis. Endoscopic retrograde cholangiopancreatography with stent or sphincterotomy should be considered when pancreatic duct (PD) reveals a stricture or when medical management fails in patients with dilated or irregular PD. Surgical intervention may be indicated in patients with complete disruption of PD or multiple strictures.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Adolescent COVID-19-Associated Fatal Rhabdomyolysis

2020 ◽  
Vol 11 ◽  
pp. 215013272098564
Author(s):  
Huda Anwar ◽  
Anwaar Al Lawati
Keyword(s):  
Polymerase Chain Reaction ◽  
Global Health ◽  
Respiratory Tract ◽  
Sore Throat ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Chain Reaction ◽  
Viral Illness ◽  
Polymerase Chain ◽  
High Index Of Suspicion

Coronavirus disease 2019 (COVID-19) has become an urgent global health priority. Although most patients with COVID-19 manifest with fever and respiratory tract symptoms, COVID-19 infections may also involve other organs and extrarespiratory manifestations, including cardiac, gastrointestinal, hepatic, renal, and neurological symptoms. This case describes a 16-year-old boy who presented with fever, sore throat, myalgia, and subsequently with shortness of breath. A diagnosis of COVID-19 was confirmed by polymerase chain reaction. His condition deteriorated and he died within 3 days of admission. An evaluation of his past medical history confirmed an episode of viral illness which had progressed to myositis and rhabdomyolysis 1 year prior. Clinicians should be aware of this complication and maintain a high index of suspicion in cases of COVID-19 presenting with extrapulmonary symptoms.

scholarly journals MicroRNA-520a suppresses HBV replication in HepG2.2.15 cells by inactivating AKT

2018 ◽  
Vol 46 (11) ◽  
pp. 4693-4704 ◽  
Author(s):  
Wei Sun ◽  
Jinqian Zhang ◽  
Jinglong Chen
Keyword(s):  
Serine Threonine Kinase ◽  
Laboratory Methods ◽  
Threonine Kinase ◽  
Hbv Replication ◽  
B Virus ◽  
Hepatocellular Carcinoma Cell Line ◽  
Polymerase Chain ◽  
Novel Target ◽  
Interfering Rna ◽  
Transcription And Replication

Objective To investigate whether the mechanism by which a microRNA, miR-520a, suppresses the replication of hepatitis B virus (HBV) involves the regulation of the serine/threonine kinase ( AKT) gene. Methods The effects of miR-520a on the proliferation, mitotic index and apoptosis of the HBV-replicating human hepatocellular carcinoma cell line HepG2.2.15 were measured using standard laboratory methods including flow cytometry. The effects of miR-520a on HBV transcription and replication were assessed using methods including immunoassays and reverse transcription–polymerase chain reaction. The effect of small interfering RNA (siRNA) to AKT on the levels of AKT mRNA and protein were also evaluated. Results In HepG2.2.15 cells, miRNA-520a reduced HBV transcription and replication by reducing AKT levels. MiRNA-520a decreased cell proliferation and mitosis entry of cells and increased apoptosis in HepG2.2.15 cells. AKT levels were reduced significantly by its siRNA, which resulted in suppression of HBV replication in HepG2.2.15 cells. Conclusions MiRNA-520a inhibited AKT gene expression and suppressed HBV transcription and replication. These findings suggest that miRNA-520a may be a novel target for the treatment of HBV infection because miRNA-520a reduced HepG2.2.15 cell survival and inhibited HBV replication associated with the AKT signalling pathway.

Kingella kingae septic arthritis

2021 ◽  
Vol 103-B (3) ◽  
pp. 584-588
Author(s):  
Mohammed Khattak ◽  
Sujith Vellathussery Chakkalakumbil ◽  
Robert A. Stevenson ◽  
David J. Bryson ◽  
Michael J. Reidy ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Young Patients ◽  
Case Series ◽  
Blood Parameters ◽  
Pcr Analysis ◽  
Kingella Kingae ◽  
Patient Demographics ◽  
The Mean ◽  
Polymerase Chain ◽  
Prospective Case Series

Aims The aim of this study was to determine the extent to which patient demographics, clinical presentation, and blood parameters vary in Kingella kingae septic arthritis when compared with those of other organisms, and whether this difference needs to be considered when assessing children in whom a diagnosis of septic arthritis is suspected. Methods A prospective case series was undertaken at a single UK paediatric institution between October 2012 and November 2018 of all patients referred with suspected septic arthritis. We recorded the clinical, biochemical, and microbiological findings in all patients. Results A total of 160 patients underwent arthrotomy for a presumed septic arthritis. Of these, no organism was identified in 61 and only 25 of these were both culture- and polymerase chain reaction (PCR)-negative. A total of 36 patients did not undergo PCR analysis. Of the remaining 99 culture- and PCR-positive patients, K. kingae was the most commonly isolated organism (42%, n = 42). The knee (n = 21), shoulder (n = 9), and hip (n = 5) were the three most commonly affected joints. A total of 28 cases (66%) of K. kingae infection were detected only on PCR. The mean age of K. kingae-positive cases (16.1 months) was significantly lower than that of those whose septic arthitis was due to other organisms (49.4 months; p < 0.001). The mean CRP was significantly lower in the K. kingae group than in the other organism group (p < 0.001). The mean ESR/CRP ratio was significantly higher in K. kingae (2.84) than in other infections (1.55; p < 0.008). The mean ESR and ESR/CRP were not significantly different from those in the 'no organism identified' group. Conclusion K. kingae was the most commonly isolated organism from paediatric culture- and/or PCR-positive confirmed septic arthritis, with only one third of cases detected on routine cultures. It is important to develop and maintain a clinical suspicion for K. kingae infection in young patients presenting atypically. Routine PCR testing is recommended in these patients. Cite this article: Bone Joint J 2021;103-B(3):584–588.

Mucormycosis: Early Identification of a Deadly Fungus

2018 ◽  
Vol 35 (4) ◽  
pp. 257-266
Author(s):  
Ariel M. Brettholz ◽  
Sabrina Opiola Mccauley
Keyword(s):  
Risk Factors ◽  
Patient Outcomes ◽  
Pediatric Oncology ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Management Strategies ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Patients With Cancer ◽  
Polymerase Chain

Mucormycosis is a rare invasive fungal infection that affects immunocompromised patients and is fatal when not identified and treated early. Diagnosis is often delayed as the symptoms are nonspecific and frequently mimic other common diseases. Pediatric patients with cancer are at risk for the infection; however, there is limited research that applies directly to the pediatric population. An understanding of the risk factors and clinical presentation of mucormycosis is crucial for the pediatric oncology provider to initiate the workup and provide prompt treatment. The gold standard for diagnosing mucormycosis is biopsy; however, the use of polymerase chain reaction is a novel tool that is being investigated. The mainstays of treatment are antifungal medications, surgery, and reversal of predisposing risk factors, although, new therapies are also emerging. This article will review the pathophysiology, clinical manifestations, and diagnostics of mucormycosis and will discuss current treatment and management strategies for the pediatric oncology clinician to allow for timely diagnosis and intervention to optimize patient outcomes.

scholarly journals Comparison of polymerase chain reaction with other laboratory methods for the diagnosis of American cutaneous leishmaniasis

2006 ◽  
Vol 54 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Marcos J. Marques ◽  
Ângela C. Volpini ◽  
George L.L. Machado-Coelho ◽  
Jackson Machado-Pinto ◽  
Carlos A. da Costa ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Cutaneous Leishmaniasis ◽  
Chain Reaction ◽  
Laboratory Methods ◽  
American Cutaneous Leishmaniasis ◽  
Polymerase Chain
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