An unusual cause of meningitis

2005 ◽  
Vol 4 (3) ◽  
pp. 106-107
Author(s):  
T.M. Pasha ◽  
◽  
K. Trower ◽  
D. Bhatia ◽  
H.K. Thaker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Elbow Joint ◽  
Vital Signs ◽  
Left Elbow ◽  
Normal Limits ◽  
The Usa ◽  
History Of ◽  
Background History ◽  
Disease Modifying ◽  
One Year

A 57 year old man patient presented with fever and frontal headache. He had a background history of sero-positive rheumatoid arthritis which was well controlled on immunomodulatory disease modifying anti-rheumatoid drugs (DMARDS) including methotrexate and leflunomide. Six months earlier he had returned from Massachussetts in the USA after a one year period of residence there. On examination his vital signs were within normal limits and he was afebrile with a temperature of 36.1o C. His left elbow joint was warm, tender and swollen; examination was otherwise normal.

scholarly journals A case of periosteal proliferative polyarthritis in a cat

2017 ◽  
Vol 55 (1) ◽  
pp. 46
Author(s):  
M. KARAYANNOPOULOU (Μ. ΚΑΡΑΓΙΑΝΝΟΠΟΥΛΟΥ) ◽  
Z. S. POLIZOPOULOU (Ζ.Σ. .ΠΟΛΥΖΟΠΟΥΛΟΥ) ◽  
A. F. KOUTINAS (Α. Φ. ΚΟΥΤΙΝΑΣ) ◽  
M. N. PATSIKAS (Μ.Ν. ΠΑΤΣΙΚΑΣ) ◽  
G. KAZAKOS (Γ. ΚΑΖΑΚΟΣ) ◽  
...  
Keyword(s):  
Elbow Joint ◽  
Complete Blood Count ◽  
Weight Bearing ◽  
Serum Biochemistry ◽  
Adverse Side Effect ◽  
Left Elbow ◽  
Normal Limits ◽  
Thoracic Limb ◽  
History Of ◽  
The Right

In this paper a case of periosteal proliferative polyarthritis in an 11-year old, female Siamese cat, that was admitted to the Surgery Clinic of the Veterinary School, A.U.Th., with a 6-month history of non-weight bearing lameness of the left thoracic limb, is described. At physical examination, restricted range of motion of the left elbow joint, local swelling and pain were detected. In the radiological examination of the affected joint the main finding was a periarticular extensive and irregular periosteal new bone formation. The results of the complete blood count and routine serum biochemistry were within normal limits and the cat was serologically negative for FeLV and FIV. Synovial fluid examination showed a lymphoplasmacytic pleocytosis, while the bacterial culture was negative. Prednisolone given at an anti-inflammatory dose for two consecutive weeks resulted in a marked improvement of the clinical sings. However, two months after the end of the treatment lameness reappeared, but this time in the contralateral thoracic limb, due to the involvement of the same joint. Radiology revealed the same type of lesions in the right elbow joint, whereas the left became ankylosed. Again, prednisolone, given at an immunosuppressive dose for two weeks, did not improve but fairly the clinical condition of the animal and the radiological changes as well. For this reason azathioprine at the dose of 1 mg/kg BW, every 48 hours, was added to therapy that lasted for 5 months. Transient mild leukopenia, that resolved after decreasing the dose of azathioprine by 25%, was the only adverse side effect noticed. At the end of the treatment, regression of the radiographical lesions in both elbows enabled the cat to walk with a stilted gait, despite the development of joint ankylosis bilaterally. The disease was kept in remission during the 12-month follow up period.

scholarly journals The Role of Acetyl Cysteine in Cocaethylene (Non-Acetaminophen) Acute Liver Failure

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Getaw Worku Hassen ◽  
Amaninder Dhaliwal ◽  
Catherine Ann Jenninigs ◽  
Hossein Kalantari
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Liver Failure ◽  
Liver Transplant ◽  
Acute Liver Failure ◽  
Active Substance ◽  
Vital Signs ◽  
Normal Limits ◽  
History Of ◽  
Acetyl Cysteine

Background.Acute liver failure can result from acetaminophen overdose, viral infection, toxins, and other disease conditions. Liver transplant is available in limited fashion and the criteria are strict as to who should get an available liver. N- Acetyl Cysteine (NAC) has been used in non-acetaminophen induced liver failure with success. Here we report a case of acute liver failure from cocaethylene that was reversed with NAC along with other medical therapy.Case Presentation.A 50-year-old female patient presented to the Emergency Department (ED) with a two-day history of coffee ground vomiting and hematemesis. She reported occasional substance abuse and heavy alcoholism. She reported shortness of breath and chest pain from the recurrent forceful vomiting. The rest of the review of systems was unremarkable except a fall from intoxication. Physical examination revealed anicteric conjunctiva and nontender abdomen and her vital signs were within normal limits. Initial blood work revealed acute liver and renal failure. The patient was started with general medical management and liver transplant service rejected the case due to active substance abuse. She underwent brief hemodialysis and was started on NAC. Over the course of her hospital stay her liver function and kidney function improved significantly and patient was discharged to home.Conclusion.In cases where liver transplant is not an option for various reasons including active substance abuse, a trial of N-Acetyl Cysteine may be beneficial and should be considered in the Emergency Department.

scholarly journals A Rare Case of Vault Angiofibroma

2021 ◽  
Vol 10 (16) ◽  
pp. 1177-1178
Author(s):  
Jayanthi R. ◽  
Iysverya G.T ◽  
Nishanthi Chandru
Keyword(s):  
Female Patient ◽  
Rare Case ◽  
Vital Signs ◽  
Vaginal Vault ◽  
Vaginal Examination ◽  
Speculum Examination ◽  
Normal Limits ◽  
Surgical Menopause ◽  
History Of ◽  
Foul Smell

A 52-year-old female patient, para 2 live 2, who attained surgical menopause 10 years back, presented to the outpatient department (OPD) with complaints of white discharge per vagina for 6 months, which was watery in consistency and was not associated with foul smell or itching vulva. She had history of hysterectomy done for fibroid uterus 10 years back. On examination, she was afebrile and vital signs were within normal limits. Per abdomen examination, was normal, while, per speculum examination revealed a watery discharge per vaginum. The per vaginal examination revealed a firm, non-tender, globular mass felt arising from the vaginal vault and the mass did not bleed on touch. A globular mass of size 3 x 4 cms, pinkish white in colour, was seen occupying the whole of the vaginal vault with curdy white precipitates in the vaginal rugosities as well as over the mass.

scholarly journals Management in patient with rheumatoid arthritis and tuberculous arthritis: a case report

2021 ◽  
Vol 9 (10) ◽  
pp. 3206
Author(s):  
Thomas E. C. J. Huwae ◽  
Agung R. B. Santoso ◽  
Ahmad Heifan ◽  
Lasa D. Siahaan
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Immunosuppressive Drugs ◽  
Immunosuppressant Therapy ◽  
Joint Aspiration ◽  
Drug Of Choice ◽  
Left Elbow ◽  
One Year ◽  
Immunological System ◽  
Immunosuppressant Effect

Rheumatoid arthritis (RA) is mainly treated with immunosuppressive drugs, which affects the immunological system. Therefore, the risk of tuberculosis was increased two to ten times in RA patients. Moreover, immunosuppressant is contraindicated in patients with tuberculosis arthritis. A 51-year-old male was presented with pain in his left elbow after he slipped on the floor. He was diagnosed with RA for 16 years and only took prednisone for six years. Six months before, he came to a rheumatologist and was given corticosteroid for six months for RA. The left elbow radiograph and joint aspiration revealed a tuberculosis infection. The patient treated with chloroquine and oral antituberculosis for one year and showed good clinical outcomes. Other diseases should be suspected in RA with uncommon symptoms. Chloroquine is the drug of choice in RA patients with tuberculosis who are contraindicated in immunosuppressant therapy because chloroquine has no immunosuppressant effect.

scholarly journals Giant cyst of the antecubital fossa in a female patient with rheumatoid arthritis (A case report)

2018 ◽  
Vol 12 (3) ◽  
pp. 109-111
Author(s):  
A. A. Roskidailo
Keyword(s):  
Rheumatoid Arthritis ◽  
Female Patient ◽  
Elbow Joint ◽  
Soft Tissue Tumor ◽  
Surgical Intervention ◽  
Joint Capsule ◽  
Medical Advice ◽  
Resonance Imaging ◽  
Antecubital Fossa ◽  
Left Elbow

The paper describes a case of rheumatoid arthritis in a 58-year-old female patient who sought medical advice for complaints of a massive soft tissue tumor upon the anterior and lateral surfaces of the left elbow joint. Left elbow bursitis was suspected. Magnetic resonance imaging showed a relationship between the massive tumor (anastomoses) and the joint. A surgical intervention was undertaken. A cyst consisting of two components was excised; anterolateral synovectomy and plastic surgery of the anterior elbow joint capsule were performed. The patient was examined 6 months later; the result was satisfactory.

scholarly journals Active rheumatoid arthritis with multiple pulmonary nodules failure to multiple remissive therapy: Which is the solution?

2021 ◽  
Vol 30 (3) ◽  
pp. 125-128
Author(s):  
Ileana Cosmina Filipescu ◽  
◽  
Milena Man ◽  
Simona Rednic ◽  
◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Pulmonary Nodules ◽  
Lung Nodules ◽  
Imaging Studies ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
History Of ◽  
Disease Modifying ◽  
Anti Fungal

We describe the case of a 63-year-old nonsmoker woman, with a long history of active seropositive rheumatoid arthritis, failure to multiple disease-modifying antirheumatic drugs due to both loss of efficacy and adverse drug reaction. She was exposed to silicon dust some years ago and has many pulmonary nodules, revealed by imaging studies as multiple cavitary lung nodules. Her initial pathological samples were negative for any infections and treatment against tuberculosis and anti-fungal therapy did not improve the appearance of the nodules. After an extensive reevaluation of pulmonary nodules, the Baricitinib treatment was started.

Spontaneous hemoperitoneum in pregnancy due to endometriosis

2020 ◽  
Vol 12 (3-4) ◽  
pp. 124-127
Author(s):  
Tesia G Kim ◽  
Leanna S Sudhof ◽  
Fong W Liu ◽  
Scott A Shainker
Keyword(s):  
Vital Signs ◽  
Exploratory Laparotomy ◽  
Free Fluid ◽  
Bilateral Oophorectomy ◽  
Normal Limits ◽  
Pelvic Hemorrhage ◽  
Spontaneous Hemoperitoneum ◽  
History Of ◽  
Intraperitoneal Bleeding ◽  
In Pregnancy

Background: Hemoperitoneum in pregnancy requires urgent evaluation. While spontaneous intraperitoneal bleeding is rare, ectopic endometrial tissue is a frequent cause of this event. Case: A 38-year-old woman with a history of endometriosis presented at 26 weeks gestation with 1 week of vague abdominal pain. Vital signs were within normal limits, and physical exam was notable for left-sided abdominal tenderness. Imaging demonstrated simple free fluid in her pelvis, concern for a uterine fundal defect and an adjacent hematoma. Exploratory laparotomy revealed hemoperitoneum secondary to highly vascularized stage 4 endometriosis. After classical cesarean delivery, a supracervical hysterectomy with bilateral oophorectomy was performed due to ongoing global pelvic hemorrhage. Conclusion: Consider endometriosis as a cause of spontaneous hemoperitoneum in pregnancy. Obstetricians should be prepared for significant maternal morbidity when encountering such pathology.

Osteochondroma of the Radial Tuberosity in Child

2016 ◽  
Vol 21 (01) ◽  
pp. 103-108
Author(s):  
Sang Rim Kim ◽  
Tae Jung Kim ◽  
Kyu Bum Seo
Keyword(s):  
Elbow Joint ◽  
Full Range ◽  
Bone Lesion ◽  
Long Bone ◽  
Malignant Degeneration ◽  
Posterior Aspect ◽  
Palpable Mass ◽  
Left Elbow ◽  
One Year ◽  
Radial Tuberosity

Osteochondromas are common benign bone tumors. They may occur on any bone preformed in cartilage, but usually are found on the metaphysis of a long bone near the physis. In this article, we report a case of the subluxation of the radial head caused by osteochondroma on the radial tuberosity. A 9-year-old female patient presented with a hard palpable mass and pain in her posterior aspect of left elbow joint. Preoperative radiography and MRI demonstrated an expansile bone lesion arising in the left radial tuberosity of the proximal radius. Resection of the bone tumor was done without any complications. Biopsy confirmed the diagnosis of osteochondroma without malignant degeneration. A one year after surgery, the elbow had full range of motion without any discomfort and complication.

scholarly journals E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) Mimicking COVID-19 Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Jose A. Rodriguez ◽  
Alejandra A. Roa ◽  
Juan C. Lemos-Ramirez
Keyword(s):  
White Blood Cells ◽  
Vital Signs ◽  
South Florida ◽  
Respiratory Pathogen ◽  
High Dose ◽  
Reactive Protein ◽  
Patient Reported ◽  
Empiric Antibiotic ◽  
The Usa ◽  
History Of

Background. Coronavirus 2 (SARS-CoV-2) is the virus associated with the coronavirus disease (COVID-19) causing a pandemic worldwide in 2020. There are other noninfectious diseases that can present exactly as COVID-19, and the management and approach are completely different, hence the importance of understanding and having a wide differential in patients presenting with similar characteristics. Case Report. A 23-year-old male, with a history of childhood asthma, presented to the Emergency Department in a hospital in south Florida in the USA with complaints of a 2-day duration of subjective fever, chills, dry cough, dyspnea, and myalgia. His vital signs were blood pressure 135/65 mmHg, temperature 39°C, pulse 134 bpm, respiratory rate 22 breaths per minute, and saturation of oxygen 96% in room air. Laboratory analysis was significant for white blood cells 15.3 × 10 3 /μL, ALT 69 U/L, AST 66 U/L, ferritin 375.6 ng/mL, C-reactive protein 27.70 mg/dL, and procalcitonin 1.43 ng/mL. A respiratory pathogen panel (RPP) and a SARS-CoV-2 test were both negative. The patient was given empiric antibiotic treatment and hydroxychloroquine. Two more tests for SARS-CoV-2 were negative, and the patient reported that he smoked marijuana through an e-cigarette. The patient was started on high-dose steroids, and symptoms improved. Conclusion. COVID-19 is an emergent lung disease that is affecting the population worldwide; many other noninfectious diseases can mimic its presentations and laboratory characteristics; the importance of having a broad differential diagnosis especially in causing confusion during pandemic times is valuable in the management of patients with such presentations, such as EVALI, and glucocorticoids will be indicated in this circumstances.

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