scholarly journals Infectious Proctitis in Ulcerative Colitis: The Importance of an Accurate Differential Diagnosis

Author(s):  
Miguel Mascarenhas Saraiva ◽  
Tiago Filipe Ribeiro ◽  
Guilherme Macedo

The authors present the case of a 62-year-old male presenting with a relapse of ulcerative colitis. He had unprotected anal intercourse with other men and his medical record was remarkable for HIV infection. He was admitted to the emergency department with bloody diarrhea, tenesmus, urgency, and recent weight loss. Laboratory workup revealed de novo mild anemia and mild elevation of inflammation parameters. Endoscopic evaluation displayed loss of normal vascular pattern, edema, erythema, exudation, and superficial ulceration in the distal rectum. Biopsies showed chronic proctitis with mild to moderate activity. The patient was treated with intravenous glucocorticoids, but symptoms persisted. Extensive microbial study allowed the identification of multiple infectious agents with potential for infectious proctitis: cytomegalovirus, <i>Chlamydia trachomatis</i>, and <i>Blastocystis hominis</i>. This case highlights the importance of careful microbial investigation, supporting a detailed clinical history, in patients presenting with symptoms of inflammatory bowel disease flare, particularly in risk groups such as that with sexual risk.

2014 ◽  
Vol 44 (2) ◽  
pp. 375-387 ◽  
Author(s):  
Heng Zhang ◽  
Hongyan Lu ◽  
Stephen W. Pan ◽  
Dongyan Xia ◽  
Yuejuan Zhao ◽  
...  

Author(s):  
Linet Njue ◽  
Cesare Medri ◽  
Peter Keller ◽  
Miriam Diepold ◽  
Behrouz Mansouri Taleghani ◽  
...  

AbstractHb Mizuho is a very rare unstable hemoglobin; here, we describe the clinical history of three Swiss family members with Hb Mizuho together with a systematic review of the previously six published cases. The clinical history of the adult woman we report here is unique since this is the first Hb Mizuho presenting with Moyamoya complications and the first case reported with long-term erythrocyte exchange. The literature review showed that Hb Mizuho was mainly reported as a de novo mutation, with the exception of children descended from known cases. All published patients with this unstable hemoglobin showed severe hemolytic anemia with the exception of one; all were regularly transfused. Patients with higher HbF levels might require fewer transfusions. All patients underwent splenectomy at a median age of 4 years and had variable clinical improvement; some achieved complete resolution of transfusion dependency after splenectomy. Iron overload in Hb Mizuho patients seems to be mainly attributed to transfusions and has less to do with ineffective erythropoiesis. Diagnosis might be challenging; a normal hemoglobin electrophoresis should not rule out the diagnosis of unstable hemoglobin in patients with otherwise unexplained hemolytic anemia. This series shows the enormous utility of using molecular techniques for diagnosis.


2013 ◽  
Vol 1 (2) ◽  
pp. 70-73
Author(s):  
Alina M Gridjac ◽  
Cristian Daniel Pirlog ◽  
Anca Simona Bojan

Background: Acute myeloid leukemia (AML) is a malignant disease with significant identified prognostic factors. Therefore our aim was to develop an Assessment Scheme of Prognosis in AML based on prognostic factors. In some counties, such as Romania or other less-highly developed countries, this scheme would be beneficial particularly when cytogenetic testing is unavailable or time-intensive. Methods: We analyzed 119 adult patients with AML during a five year-period from a single-center in Romania. We retrospectively collected and analyzed data with Epi Info and Excel using patient medical records. Results: According to age, the group A1 (<60 years) had a 40 months survival, in contrast with the group B1 (≥60 years) with a survival of 19 months (p=0,0063). The group A2 (secondary AML) survived 15 months, whereas the group B2 (AML de novo) survived 40 months (p=0.0021). Additionally, the group A3 (mild comorbidities) achieved a 40 months survival, the group B3 (moderate comorbidities) survived 19 months, whereas the group C3 (severe comorbidities) survived 7 months (p=0,0059). According to WBC and blast number, the group A4 (high levels) had a 25 months survival, whereas the group B4 (low levels) survived 40 months (p=0,0057). Conclusion: The prognostic factors studied are useful to identify the risk level of AML disease for each patient at diagnosis. We developed an assessment scheme of prognosis with three risk groups according to age, secondary AML, comorbidity, WBC and blasts and cytogenetic examination.


Author(s):  
D. Chandrika ◽  
Anantharaju G. S.

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis is an extremely prevalent disorder which has significant effect on quality of life of affected individual. Varied symptomatology and varied etiology of unilateral chronic maxillary rhinosinusitis requires a comprehensive approach by otorhinolaryngologist. The objectives of the study were to evaluate the causative factor of unilateral chronic maxillary sinusitis and to study clinical presentation of unilateral chronic maxillary sinusitis<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 patients with symptoms and signs suggestive of unilateral chronic maxillary sinusitis were evaluated. All were subjected to detailed clinical history, ENT examination including complete orodental examination, diagnostic nasal endoscopy, intra oral peri apical radiographs, CT scan of para nasal sinuses<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Of total of 50 patients studied, gross deviated nasal septum (DNS) is commonest cause of chronic unilateral maxillary sinusitis followed by dental infection of upper premolars<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study was carried out with an effort to find out etiology of unilateral chronic maxillary sinusitis as identification of etiology will help in successful outcome of the treatment<span lang="EN-IN">.</span></p>


Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.


Author(s):  
Mohammed Thoyyib ◽  
Roshni Menon ◽  
Brinda G. David

<p class="abstract"><strong>Background:</strong> Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.</p><p class="abstract"><strong>Methods:</strong> This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.<strong></strong></p><p class="abstract"><strong>Results:</strong> The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.</p><p><strong>Conclusions:</strong> FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.</p>


2006 ◽  
Vol 43 (3) ◽  
pp. 344-350 ◽  
Author(s):  
Lydia N Drumright ◽  
Susan J Little ◽  
Steffanie A Strathdee ◽  
Donald J Slymen ◽  
Maria Rosario G Araneta ◽  
...  

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