scholarly journals Acute serous meningitis in a patient with erythema infectiosum

2006 ◽  
Vol 63 (1) ◽  
pp. 73-75 ◽  
Author(s):  
Predrag Canovic ◽  
Ana Ravic-Nikolic
Keyword(s):  
Case Report ◽  
Parvovirus B19 ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Symptomatic Therapy ◽  
Igg Antibodies ◽  
Erythema Infectiosum ◽  
Serological Examination ◽  
Clinical Syndromes ◽  
Typical Skin

Bacground. Clinical manifestations caused by parvovirus B19 (PVB19) are various and depend on the age and immunity of an infected person. In children, the most frequent clinical manifestation of parvovirus B19 primary infection is erythema infectiosum (EI). Case report. In this case report we presented a 12-year-old patient with 2 clinical syndromes: erythema infectiosum and serous meningitis. Erythema infectiosum was manifested as fever, typical skin lesions (?slapped cheeks?), erythematous macules and papules confluent with reticular appearance on the extremities and the trunk. Serous meningitis had a mild course with an increased number of lymphocytes (120/ mm?) and the mildly increased level of proteins (0.75 g/l). The serological examination showed the presence of IgM and IgG antibodies against parvovirus B19 in serum, as well as in cerebrospinal fluid (CSF). The reduction of serum/CSF ratio of IgG antibodies was present. The symptomatic therapy was used in the treatment. The course and the prognosis were benign. Conclusion. Human PVB19, although non-specifically associated with CNS diseases could be an etiological factor that might cause serous meningitis. So, it should be considered in different diagnosis in patients with aseptic meningitis, especially during the outbreaks of erythema infectiosum.

scholarly journals Weil’s syndrome (Leptospiral infection): A case report

2007 ◽  
Vol 60 (9-10) ◽  
pp. 493-496
Author(s):  
Zeljko Mijailovic ◽  
Predrag Canovic ◽  
Olgica Gajovic
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Severe Form ◽  
The Body ◽  
Symptomatic Therapy ◽  
Clinical Syndromes ◽  
Febrile Condition ◽  
Therapeutic Measures

Introduction. Leptospirosis is an acute zoonotic infection, caused by spirochetes of the genus Leptospira. It is characterized by extensive vasculitis. It is usually transmitted indirectly, per contaminated water, rarely directly, through contact with infected animals. Leptospira bacteria commonly enter the body through damaged skin or mucous membranes. The clinical syndromes may vary from a subclinical infection and mild febrile condition to severe clinical symptoms with jaundice and renal failure. Case report. This is a case report of a patient with leptospirosis (Weil's disease) whose clinical manifestations included: icterus, renal failure, hemorrhagic syndrome and disturbances of consciousness. After the use of antibiotics, symptomatic and substitution therapy, all symptoms resolved completely. However, in our patient, hemodialysis was necessary due to renal failure, as a palliative measure. Discussion. Weil?s syndrome is a severe form of leptospirosis, which can be fatal. Early clinical diagnosis of the disease, as well as serologic verification of infection, are very important prerequisites, followed by antibiotic and other symptomatic therapy, as soon as possible. Conclusion. This is a case report of a patient with rare clinical manifestations of leptosirosis. Although presenting with severe symptoms, thanks to palliative therapeutic measures, complete and fast recovery was achieved. We especially point out the role of hemodialysis in the treatment of this patient. .

scholarly journals Grover’s disease in a patient with atopic dermatitis - a case report

2021 ◽  
Vol 74 (1-2) ◽  
pp. 33-37
Author(s):  
Sanja Jakovljevic ◽  
Ljuba Vujanovic ◽  
Dejan Ogorelica ◽  
Aleksandra Fejsa-Levakov ◽  
Jasmina Sekulic
Keyword(s):  
Case Report ◽  
Immunoglobulin E ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Elevated Serum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Complete Regression ◽  
Laboratory Findings ◽  
Topical Corticosteroids

Introduction. Grover?s disease is characterized by pruriginous polymorphic rash with a variable course and duration. Although the etiology is still unknown, the disease is often associated with other dermatoses, malignant diseases, use of certain medications, as well as immunosuppression. Case Report. We report a case of a 70-year-old male patient who was referred for examination to the Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, due to a rash that lasted for nine months. The first lesions on the skin appeared around the nipples as exudative eczematous plaques. A few months later, identical lesions appeared on the lower legs. During treatment with systemic antihistamines and topical corticosteroids, there were episodes of transient improvements and re-exacerbations. In the meantime, erythematous brownish, round and oval papules appeared on the abdomen and the back, accompanied by intense itch. Laboratory findings revealed eosinophilia and elevated serum immunoglobulin E levels. A skin biopsy of the back lesion was performed and the histopathological examination confirmed the diagnosis of Grover?s disease. After the systemic treatment using corticosteroids and antihistamines, with gradual dose reduction and application of topical corticosteroids and emollients, complete regression of the skin lesions was achieved. Conclusion. Since the clinical manifestations of the disease may be nonspecific and discrete, dermatopathological analysis is of crucial importance in making the correct diagnosis. In patients with atopy, the treatment with systemic corticosteroids, antihistamines and topical agents may lead to regression of skin lesions with a significant improvement in the quality of life.

scholarly journals Lichen Planus in the Lines of Blaschko – A Case Report / Blaschko linearni lichen planus – prikaz slučaja

2011 ◽  
Vol 3 (4) ◽  
pp. 153-158
Author(s):  
Zorica Perić-Hajzler ◽  
Lidija Zolotarevski ◽  
Dušan Šofranac ◽  
Lidija Kandolf Sekulović
Keyword(s):  
Case Report ◽  
Lichen Planus ◽  
Clinical Manifestations ◽  
Lichen Sclerosus ◽  
Skin Lesions ◽  
Linear Distribution ◽  
Blaschko Lines ◽  
Genetic Mosaicism ◽  
Mucous Membranes ◽  
Lines Of Blaschko

Abstract Lichen planus is an acquired inflammatory disease of the skin, mucous membranes and nails. It is characterized by pruritic polygonal livid papules. The disease was first described by Erasmus Wilson in 1869. It is primarily a disease of adults, and it usually occurs between the ages of 30 and 60, without gender predominance. The exact incidence and prevalence of this disease are unknown, but it is thought to affect less than 1% of the general population (0.14 to 0.80%) (1). A 63-year old male patient was admitted to our Department with itchy erythematous papules and plaques which appeared a month before admission. On admission, numerous erythematous and livid papules and plaques of polygonal shape up to 5 mm in diameter were present in the lines of Blaschko, along the left lower extremity, left side of the trunk and the left upper arm (Figures 1-3), while mucous membranes, nails and scalp were spared. Blaschko-linear distribution of skin lesions was first described by a German dermatologist Alfred Blaschko in 1901 in his work ”The distribution of nerves in the skin and their relationship to diseases of the skin”. In 1978, Happle first published that genetic mosaicism was the cause of these peculiar skin changes (1,4,6). Although knowledge of mosaicism in the skin was further elucidated in articles of several authors (Taieb in 1994, Bolognia in 1994, Heide 1996), the exact mechanism and molecular basis for the development of Blashcko linear distribution has not been fully clarified yet (5). Blaschko lines may be related to X-linked, congenital and inflammatory dermatoses, and they may be found in several skin conditions like segmental forms of atopic dermatitis, erythema multiforme, pemphigus vulgaris, vitiligo, and granuloma annulare. This is a case report of a patient with a rare form of lichen planus, with typical clinical manifestations and with Blaschko-linear distribution. Lichen planus in the lines of Blaschko was also described in several other dermatoses: lichen striatus, lichen sclerosus, morphea, porokeratosis of Mibelli, mucinosis follicularis and psoriasis vulgaris. The treatment included topical corticosteroids under occlusion, due to comorbidities, with satisfactory response. Other options include, topical calcineurin inhibitors, intralesional and systemic corticosteroids, retinoids, phototherapy and in resistant cases that severely affect the quality of life methotrexate, cyclosporine and thalidomide.

scholarly journals Papular-purpuric gloves and socks syndrome: A case report

2006 ◽  
Vol 59 (7-8) ◽  
pp. 380-383
Author(s):  
Zorica Gajinov ◽  
Sonja Prcic ◽  
Milan Matic ◽  
Verica Djuran ◽  
Milana Ivkov-Simic
Keyword(s):  
Case Report ◽  
Parvovirus B19 ◽  
Abdominal Ultrasound ◽  
Skin Lesions ◽  
Dorsal Side ◽  
Moderate Increase ◽  
Left Hand ◽  
Normal Limits ◽  
Rare Manifestation ◽  
Viral Diagnosis

Introduction. Papular-purpuric gloves and socks syndrome is a rare manifestation associated with acute seronegative arthritis and skin lesions. It is triggered by a viral infection, most commonly by Human parvovirus B19 or Coxsackie group of viruses, but precise viral diagnosis is not obtained in all cases. Case report. A 54-year old male patient experienced sudden, intense pain and swelling in the carpal area of his left hand. He also presented with unusual skin lesions, and grouped small purpuric-papules on the dorsal side of the left hand. During the next few days, both feet were similarly affected. In the next four weeks, a transient liver damage occurred, with a moderate increase in liver enzymes. Apart from elevated erythrocyte sedimentation rate and fibrinogen levels, other findings were within normal limits (complete blood and reticulocyte count, parameters of rheumatic and autoimmune diseases, abdominal ultrasound scan, radiographs of the chest and of affected hand and feet joints, urethral smears for isolation of trichomonas, yeasts and chlamydia trachomatis, and Syphilis, Borrelia, Toxoplasmosis, and Mycoplasma pneumoniae serology). Apart from positive tests for HPvB19, other viral serology tests were all negative (Coxsackievirus, Adenovirus, Influenza, Hepatitis B and C virus, HIV). The skin lesions resolved in about three weeks: the intensity of joint pain decreased, but lasted for the next 6 months. Conclusion. The diagnosis of papular-purpuric gloves and socks syndrome was made on the basis of the characteristic clinical picture, and confirmed by virus serology. .

scholarly journals Advances in Human B19 Erythrovirus Biology

2010 ◽  
Vol 84 (19) ◽  
pp. 9658-9665 ◽  
Author(s):  
Annabelle Servant-Delmas ◽  
Jean-Jacques Lefrère ◽  
Frédéric Morinet ◽  
Sylvie Pillet
Keyword(s):  
Genomic Organization ◽  
Parvovirus B19 ◽  
Clinical Manifestations ◽  
Cell Entry ◽  
Human Parvovirus B19 ◽  
Molecular Tools ◽  
Erythema Infectiosum ◽  
Apoptosis Pathways ◽  
Shed Light

ABSTRACT Since its discovery, human parvovirus B19 (B19V), now termed erythrovirus, has been associated with many clinical situations (neurological and myocardium infections, persistent B19V DNAemia) in addition to the prototype clinical manifestations, i.e., erythema infectiosum and erythroblastopenia crisis. In 2002, the use of new molecular tools led to the characterization of three different genotypes of human B19 erythrovirus. Although the genomic organization is conserved, the geographic distribution of the different genotypes varies worldwide, and the nucleotidic divergences can impact the molecular diagnosis of B19 virus infection. The cell cycle of the virus remains partially unresolved; however, recent studies have shed light on the mechanism of cell entry and the interactions of B19V proteins with apoptosis pathways.

scholarly journals Genetic variants of parvovirus B19 circulating in Belarus during the epidemic cycle of infection (2005–2016)

2019 ◽  
Vol 16 (1) ◽  
pp. 35-45 ◽  
Author(s):  
M. A. Yermalovich ◽  
G. V. Semeiko ◽  
E. O. Samoilovich
Keyword(s):  
Genetic Variants ◽  
Parvovirus B19 ◽  
Clinical Manifestations ◽  
Average Genetic Distance ◽  
Erythema Infectiosum ◽  
Dominant Position ◽  
Genotype 1A ◽  
Aplastic Crisis ◽  
Before And After ◽  
Low Incidence

Human parvovirus infection is characterized by a variety of clinical manifestations. Based on the genetic analysis, genotypes 1a, 1b, 2, 3a, 3b of parvovirus B19 are distinguished, which have different geographical distribution. In the period 2005–2016, in Belarus 210 strains of parvovirus B19 isolated from the patients with various forms of parvovirus infection, mainly erythema infectiosum, were genotyped. All strains, except one, belonged to genotype 1a. One strain belonged to genotype 3b and was isolated from a child with aplastic crisis who arrived in Belarus from Kazakhstan for medical care. On the phylogenetic tree, the strains of genotype 1a formed two groups related to the subtypes 1a1 and 1a2. During the 12-year observation, both subtypes circulated in Belarus, but with varying intensity. In the highest incidence years, as well as one or two years before and after this (2005–2008 and 2013–2016), strains of subtype 1a2 predominated in circulation. During the period of low incidence (2009–2012), the dominant position belonged to subtype 1a1. The average genetic distance inside each subtype was 0.51 % for 1a1 and 0.56 % for 1a2. Between subtypes it was also small – 1.32 %. It can be assumed that subtype 1a2 is more new for Belarus and therefore might be connected with the increase of morbidity.

scholarly journals An 8-year-old-girl with juvenile dermatomyositis and autoimmune thyroiditis in Tanzania: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Fatima Mussa ◽  
Neema Nalitolela ◽  
Francis Fredrick
Keyword(s):  
Case Report ◽  
Autoimmune Thyroiditis ◽  
Juvenile Dermatomyositis ◽  
Female Child ◽  
Skin Lesions ◽  
Limited Resources ◽  
Case Presentation ◽  
Rare Association ◽  
High Index Of Suspicion ◽  
Typical Skin

Abstract Background Juvenile dermatomyositis is an inflammatory disease of muscles, skin, and blood vessels of unknown cause affecting all age and ethnic groups, with a reported incidence of 1.9–4.1 per million. It manifests with weakness in axial and proximal muscles and typical skin lesions. Historically, the Bohan and Peter classification schema has been used to diagnose juvenile dermatomyositis. Case presentation We report an 8-year-old African female child, who presented with features of juvenile dermatomyositis and a rare association with subclinical autoimmune thyroiditis. This case illustrates the typical presentation, diagnosis, and treatment outcomes of this highly misdiagnosed condition. Conclusion Due to the limited resources and knowledge about this under-reported disease in resource-constrained settings, the characteristic manifestations of juvenile dermatomyositis can be easily missed and thus requires a high index of suspicion for earlier diagnosis and management.

scholarly journals The frequency of human parvovirus B19 infections in Vojvodina

2007 ◽  
Vol 60 (11-12) ◽  
pp. 575-579
Author(s):  
Vesna Milosevic ◽  
Vera Jerant-Patic ◽  
Ivana Hrnjakovic-Cvjetkovic ◽  
Marija Vukmanovic-Papuga ◽  
Jelena Radovanov-Tadic ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Parvovirus B19 ◽  
Acute Infection ◽  
Intrauterine Fetal Death ◽  
Human Parvovirus B19 ◽  
Igg Antibodies ◽  
Erythema Infectiosum ◽  
Erythroid Precursor ◽  
Small Children ◽  
Specific Antibodies

Introduction. Human parvovirus B19 is found worldwide. It causes various infections, including fifth disease (erythema infectiosum) in small children, acute arthropathy in adults, transient aplastic crisis and chronic anemia in immmunocompromised patients and even fetal infection, which may result in intrauterine fetal death or fetal hydrops. Many of these manifestations of B19 infection are caused by infection of erythroid precursor cells in bone marrow. Material and Methods. The aim of this paper was to establish the frequency of parvovirus B19 infection in the population of Vojvodina, as well as to indicate the significance of further investigations particularly in highly vulnerable population groups such as small children, pregnant women and immune deficient persons. A total of 244 serum samples of out- and in-patients of different age were analyzed using SERION ELISA classic parvovirus B19 IgG/IgM quantitative and qualitative tests for identification of specific antibodies against human parvovirus B19. Results. Acute infection was found in 35% of examinees, whereas parvoviurs B19 was identified in 32% of examined persons. Our tests results proved that 20% of examined pregnant women in our surroundings have acute HPB19 infection. At the same time, 45% of pregnant women have no specific antibodies, so they are at risk of infection during pregnancy. Acute infection was diagnosed in 41 children (43%): 22 samples (23%) were positive only to IgG antibodies and in 32 samples (34%) neither IgM nor IgG antibodies were identified. Acute infection was more frequently found in preschool children, i.e. in children aged 4 to 6 years (29%). Conclusion. In the absence of complete data on the frequency of particular diseases caused by this virus in our population, tests for human parvovirus B19 are strongly recommended.

Failure of Single-Agent Rituximab for Treatment of Subcutaneous Intravascular Lymphomatosis (IVL): A Case Report.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4693-4693
Author(s):  
Steven C. Pirog ◽  
David M. Aboulafia
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Wide Spectrum ◽  
Single Agent ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Neurological Dysfunction ◽  
Whole Body ◽  
Medline Search ◽  
Multi Agent

Abstract IVL is an uncommon large-cell lymphoma, usually of B-cell origin. Typically, the CD20+ lymphoma cells possess defects in homing receptors. This leads to limited cell migration from the vessel endothelium, resulting in cell crowding and blockage of intravascular lumens. Patients frequently present with skin lesions, fever, and neurological dysfunction, reflecting the ability of malignant cells to infiltrate various organs. The wide spectrum of clinical manifestations of IVL, along with its propensity to afflict elderly patients with multiple comorbidities, presents a diagnostic and therapeutic challenge; most cases are discovered post-mortem. Anthracycline-based chemotherapy is the standard treatment for this malignancy, but outcomes are disappointing, with most patients destined to die from progressive lymphoma and, less commonly, chemotherapy-induced complications. An 86-year-old female underwent a lesion biopsy after bilateral thigh plaques (the largest of which measured 8 × 13 cm) became increasingly erythematous and painful, despite treatment with antibiotics and corticosteroids. She was diagnosed with subcutaneous CD20+ IVL. Laboratory studies were notable for hematocrit 29% with iron indices consistent with inflammatory block, lactate dehydrogenase 950 IU/L (normal < 240 IU/L) and β2-microglobulin 1.8 mg/mL (normal < 2.0mg/mL). Whole-body computed tomography and positron emission tomography fusion studies did not suggest lymphoma elsewhere. She received rituximab (375 mg/m2/week × 8 weeks) and achieved a complete remission (CR), with the disappearance of thigh discomfort and resolution of her medial thigh plaques. Three months after completion of rituximab treatment, a new left posterior chest wall mass was biopsied and proved to be recurrent IVL. She declined further treatment and was referred to hospice care. Through a Medline search we were able to identify 12 additional patients who were treated with multi-agent chemotherapy and rituximab (n=10) or rituximab monotherapy (n=2). The patients’ ages ranged from 42 to 86 years. The most common clinical presentations in these cases included fever (n=5), nervous system involvement (n=3), and skin rash (n=2). Excluding one multi-agent therapy patient who died during treatment, all patients in our search achieved CRs, with a median follow-up duration of 14 months (range, 6–36 months). Among various lymphoma subgroups (including elderly patients with high-risk features and those with IVL), rituximab has been used as a single agent and to augment the anti-lymphoma properties of multi-agent chemotherapy. Our case report is the first to describe IVL recurrence following rituximab monotherapy, and highlights the need for further investigation on the use of rituximab in the treatment of this rare lymphoma.

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