scholarly journals Life-Threatening Microangiopathy or Vitamin Deficiency: A Case Report of the Clinical Manifestations of Pseudo-Thrombotic Microangiopathic Anemia

Cureus ◽  
2021 ◽  
Author(s):  
Ian Landry ◽  
Tapati Chowdhury ◽  
Suemaya Hussein ◽  
Leno Thomas
Keyword(s):  
Case Report ◽  
Clinical Manifestations ◽  
Vitamin Deficiency ◽  
Life Threatening ◽  
Microangiopathic Anemia

scholarly journals Veillonella Bacteremia in Alcoholic Hepatitis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Patrick Lee ◽  
Brandon K. K. Fields ◽  
Tom Liang ◽  
Michael P. Dubé ◽  
Seth Politano
Keyword(s):  
Case Report ◽  
Early Identification ◽  
Liver Diseases ◽  
Alcoholic Hepatitis ◽  
Clinical Manifestations ◽  
Commensal Bacteria ◽  
Gut Dysbiosis ◽  
Severe Alcoholic Hepatitis ◽  
Life Threatening ◽  
Susceptible Populations

Veillonella species are commensal bacteria of the human oral, gut, and vaginal microbiota that are rarely identified as clinically relevant pathogens. Here, we describe a novel case of Veillonella atypica bacteremia in a patient with biopsy-proven alcoholic hepatitis. Veillonella species have been correlated with disease severity and hepatic encephalopathy in liver diseases such as autoimmune hepatitis and cirrhosis. Their abundance has also been recently observed to be increased in alcoholic hepatitis, where postinflammatory infections are known to impact mortality. This case report highlights the possible clinical manifestations that result from significant gut dysbiosis in patients with severe alcoholic hepatitis. Early identification and treatment of Veillonella bacteremia in susceptible populations could be crucial to survival given this organism’s predilection for causing life-threatening infections, including meningitis, endocarditis, and osteomyelitis.

scholarly journals Vitamin B12 deficiency masquerading Addison’s disease: a case report of an adolescent male

2020 ◽  
Vol 8 (5) ◽  
pp. 1932
Author(s):  
Sudhaa Mani M. ◽  
Yasmeen Ahamed S. ◽  
Nanitha Lakshmi Kavitha Giri ◽  
Jesudasan A.
Keyword(s):  
Case Report ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
Ultra Violet ◽  
Adolescent Male ◽  
Drug Induced ◽  
Ultra Violet Radiation ◽  
Life Threatening ◽  
B12 Deficiency ◽  
Violet Radiation

Intraoral pigmentations range from innocuous physiologic pigments to life-threatening malignant conditions. It is at the discretion of the observing clinician to identify the abnormal clinical manifestations and provide necessary intervention. There are controversies about delineating the definite etiology of the pigmentation such as race, exposure to ultra-violet radiation, drug-induced pigmentation post-inflammatory pigments of the oral cavity.

scholarly journals Is COVID-19 infection triggering oral herpes zoster? A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110657
Author(s):  
Wafaa Saleh ◽  
Fatma Ata ◽  
Mohamed M Elashry
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Clinical Symptoms ◽  
Oral Care ◽  
Clinical Manifestations ◽  
Oral Lesion ◽  
System A ◽  
Oral Herpes ◽  
Life Threatening ◽  
Rapid Appearance

Patients affected with COVID-19 are at risk of developing serious and life-threatening conditions. The clinical manifestations of COVID-19 were detected in asymptomatic cases to severe clinical symptoms with a major impact on the respiratory system. A few cases of cutaneous as well as an oral lesion of herpes zoster in patients with COVID-19 were reported in the literature. We present a case of the rapid appearance of the oral lesion as a manifestation of herpes zoster associated with COVID-19 infection. Our case highlights the importance of oral examination as well as oral care in patients with COVID-19 infection.

Severe Acute Thromboinflammation: Case Report of Individualized Homeopathic Treatment

Homeopathy ◽  
2021 ◽  
Vol 110 (02) ◽  
pp. 132-136
Author(s):  
Silvia Waisse
Keyword(s):  
Case Report ◽  
Clinical Manifestations ◽  
Acute Phase Reactants ◽  
Present Case Report ◽  
Homeopathic Treatment ◽  
Accurate Picture ◽  
Life Threatening ◽  
Very High ◽  
Suspect Case

AbstractThromboinflammation is a still not well-understood phenomenon, which has recently come to the foreground as a function of its relevance in the pathophysiology of coronavirus disease 2019 (COVID-19). The patient described in the present case report exhibited acute fever, giant urticaria, elevated acute phase reactants, and very high d-dimer levels, thus characterizing thromboinflammation. She was diagnosed as a COVID-19 suspect case, which was not confirmed; urticarial vasculitis was ruled out. Homeopathic treatment was started with the earliest clinical manifestations, resulting in rapid and drastic reduction of inflammation and hypercoagulability within the first 12 hours, and full recovery on 10-day follow-up assessment. This case demonstrates the effectiveness of homeopathy in a severe acute disorder, and points to the need to include laboratory testing in homeopathic clinical assessment to achieve an accurate picture of disease, and to avoid the risk of passing over life-threatening disorders.

scholarly journals Life-threatening rocuronium-induced anaphylactic shock without cutaneous manifestations successfully reversed with sugammadex: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshiaki Takise ◽  
Jungo Kato ◽  
Tomohiro Suhara ◽  
Takashige Yamada ◽  
Takeru Funakoshi ◽  
...  
Keyword(s):  
Case Report ◽  
Anaphylactic Shock ◽  
Clinical Manifestations ◽  
Skin Grafting ◽  
Basophil Activation Test ◽  
Circulatory Collapse ◽  
Cutaneous Manifestations ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Life Threatening

Abstract Background Recognition of rocuronium-induced anaphylaxis is often challenging, owing to its diverse clinical manifestations. Regarding treatment, several reports have described the efficacy of sugammadex, while conflicting reports have also been published. Case A 71-year-old man was scheduled to undergo split-thickness skin grafting surgery on his hip. During the induction of general anesthesia, the patient developed profound circulatory collapse without any cutaneous manifestations, which required 40 min of cardiopulmonary resuscitation. Later, the patient developed circulatory collapse again during the induction of anesthesia for tracheostomy surgery, which apparently coincided with the administration of rocuronium. Rocuronium-induced anaphylactic shock was suspected, and the administration of sugammadex resulted in swift recovery of hemodynamics. The basophil activation test revealed a positive reaction to rocuronium. Conclusion The possibility of rocuronium-induced anaphylaxis should be considered when the circulatory collapse coincides with rocuronium administration, even though cutaneous manifestation is absent. Sugammadex can be a treatment option in such atypical cases.

scholarly journals Acute Mesenteric Ischemia in a Patient with COVID-19: A Case Report

2020 ◽  
Vol 23 (9) ◽  
pp. 639-643
Author(s):  
Siavoush Sehhat ◽  
Hamid Talebzadeh ◽  
Atousa Hakamifard ◽  
Hamid Melali ◽  
Somayeh Shabib ◽  
...  
Keyword(s):  
Case Report ◽  
Middle East ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Significance ◽  
Mesenteric Ischemia ◽  
Vascular System ◽  
Clinical Manifestations ◽  
Acute Mesenteric Ischemia ◽  
Medical Sciences ◽  
Life Threatening

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) presents clinical manifestations similar to the influenza, severe acute respiratory syndrome (SARS-CoV), and Middle East respiratory syndrome (MERS-CoV). However, in the course of the coronavirus disease 2019 (COVID-19), various pathological complications of high clinical significance have remained unknown. Impaired blood supply to the visceral vascular system can cause serious life-threatening acute damage. We report a case of extensive acute mesenteric ischemia associated with SARS-CoV-2 infection confirmed in a patient hospitalized in Amin Hospital – a COVID-19 referral center in Isfahan University of Medical Sciences, Isfahan, Iran. This case highlights the importance of paying attention to serious and less common or less known clinical manifestations other than fever, dry cough, dyspnea, and myalgia.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

Alergia à Proteína do Leite de Vaca Persistente em Adulto: Relato de Caso / Persistent Cow’s Milk Allergy in Adult: Case Report

1970 ◽  
Vol 5 (4) ◽  
pp. 51-60
Author(s):  
José Henrique Pereira Pinto ◽  
Renan Lemos de Toledo ◽  
William do Prado Franquelo
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Inflammatory Disease ◽  
Clinical Manifestations ◽  
Milk Proteins ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Current Prevalence ◽  
Keywords Allergy ◽  
Ige Mediated

RESUMOIntrodução: Alergia à Proteína do Leite de Vaca (APLV) é uma doença inflamatória secundária à reação imunológica contra uma ou mais proteínas do leite de vaca (LV) que afeta principalmente a faixa pediátrica. A real prevalência é discutida em muitos estudos. As manifestações clínicas dependem do tipo da resposta imunológica, ser IgE mediada ou não. Os sintomas se iniciam por volta dos 06 meses de vida e na maioria dos casos, esse processo alérgico regride, com o paciente desenvolvendo tolerância até a adolescência. Casuística: Relata-se um caso de um paciente do sexo masculino, apresentando desde os 6 meses de idade de anafilaxia e broncoespasmo. Nesta época foi levado em hospitais e ambulatórios sendo diagnosticado e tratado como asma apenas, porém sem sucesso. Aos 18 anos, em consulta com especialista foi diagnosticado com APLV, apesar da dieta de exclusão, apresentou diversas reações anafiláticas, devido a ingestão acidental do alérgeno. Discussão: O paciente iniciou os primeiros sintomas quando houve contato com LV e apresentou teste laboratorial com valores compatíveis a patologia. Segundo a literatura a prevalência de APLV cai para menos de 1% aos 6 anos de vida e está persistência pode estar associada a múltiplos fatores, no caso relatado, o paciente não apresentou tolerância até o presente momento. Conclusão: APLV é uma doença usualmente de criança em que, se estas não adquirirem tolerância, complicações podem perdurar indefinidamente. O Diagnóstico precoce e o manejo adequado desta condição, revela grande importância na qualidade de vida e na prevenção de anafilaxia.Palavras chave: Alergia, Proteína do leite de vaca, Anafilaxia. ABSTRACT Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease secondary to immune response against one or more cow's milk proteins (LV) which primarily affects pediatric patients. The current prevalence is discussed in many studies. The clinical manifestations depend on the type of immune response, being IgE mediated or not. Symptoms start at about 06 months of life and in most cases, the allergic process subsides, and the patient develops tolerance through adolescence. Case Report: We report the case of a male patient, who was presenting, since his 06 months of age, anaphylaxis and bronchospasm. At that time he was taken into hospitals and clinics being diagnosed and treated as asthma, but without success. At 18, in consultation with expert was diagnosed with CMPA, and despite the exclusion diet, presented several anaphylactic reactions due to accidental ingestion of the allergen. Discussion: The patient began the first symptoms when there was contact with LV and presented laboratory test values compatible with the pathology. According to the literature the prevalence of CMPA drops to less than 1% to 6 years of life and this persistence can be associated with multiple factors, in our case, the patient did not develop tolerance to date. Conclusion: CMPA is usually a child disease but ,if they do not acquire tolerance, complications can last indefinitely. Early diagnosis and appropriate management of this condition, reveals a great deal on quality of life and prevention of anaphylaxis. Keywords: Allergy, Cow’s milk protein, Anaphylaxis. 

Apresentação e Evolução Atípicas da Granulomatose de Wegener: Relato de Caso/Atypical Presentation and Evolution of Wegener's Granulomatosis: Case Report

1970 ◽  
Vol 5 (3) ◽  
pp. 53-67
Author(s):  
Aline Dos Santos ◽  
Ana Caroline Balducci Scafi ◽  
Luciene Azevedo Morais ◽  
Pablo Girardelli Mendonça Mesquita
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Case Report ◽  
Chronic Renal Failure ◽  
Early Diagnosis ◽  
Wegener’S Granulomatosis ◽  
Immunosuppressive Treatment ◽  
Clinical Manifestations ◽  
Wegener's Granulomatosis ◽  
Creatinine Concentration

RESUMOIntrodução: A Granulomatose de Wegener (GW) é uma vasculite rara e idiopática associada à presença do anticorpo Anticitoplasma de Neutrófilo (ANCA) que acomete, preferencialmente, os pequenos vasos. As manifestações clínicas são diversas, ocorrendo em mais de 90% dos casos, sintomas do trato respiratório. O comprometimento renal é tardio e preditor de mau prognóstico.  Sua morbidade a médio e longo prazo inclui insuficiência renal crônica. A probabilidade de sucesso de manutenção da função renal depende da concentração sérica de creatinina ao início do tratamento, o que indica a importância do diagnóstico e terapêutica adequada precoces. Casuística: Relata-se o caso de uma paciente do sexo feminino, 61 anos, portadora de GW com comprometimento renal avançado à apresentação não precedido por sintomas pulmonares esperados. O tratamento imunossupressor associado a plasmaferese permitiu a melhora da função renal da paciente poupando-a de tornar-se dialítica- dependente. Discussão: A paciente iniciou a doença através de insuficiência renal assintomática, com valores de função renal compatíveis com o estágio mais avançado de doença renal crônica, ultrassonografia dos rins sem alterações compatíveis e sem os sintomas respiratórios esperados. Segundo a literatura, a combinação de imunossupressores e plasmaferese associa-se à recuperação renal em três meses com sobrevivência sem necessidade de diálise por 12 meses, no caso relatado, obteve-se tal resultado em 22 dias sem a necessidade de diálise após um ano. Conclusão: Devido ao diagnóstico precoce, o tratamento adequado foi instalado rapidamente proporcionando à paciente um aumento da expectativa e da qualidade de vida, evitando dependência de terapia renal substitutiva.Palavras-Chave: Granulomatose de Wegener, Plasmaferese, Doença renal crônica.  ABSTRACTIntroduction: The Wegener's Granulomatosis (WG) is a rare and idiopathic vasculitis associated with the presence of Antineutrophil Cytoplasmic Antibody (ANCA), that affects, preferentially, the small vessels. The clinical manifestations are diverse, occurring in over 90% of cases, symptoms in the respiratory tract. Kidney damage is a late and bad prognostic predictor. Morbidity in the medium and long term includes chronic renal failure. The probability of renal function maintenance success depends on serum creatinine concentration at the beginning of treatment that indicates the importance of early diagnosis and deployment of an appropriate therapy. Case Report: We present a case of a 61-year-old female patient, carrier of GW with advanced renal impairment presentation, not preceded by expected pulmonary symptoms. The immunosuppressive treatment associated with plasmapheresis allowed the improvement of the patient’s renal function, saving her from becoming dialysis-dependent Discussion: The patient developed the disease through asymptomatic renal failure, renal function with values that are compatible with the most advanced stage of chronic kidney disease, ultrasound of the kidneys without compatible changes and without the expected respiratory symptoms. According to the literature, the combination of immunosuppressive drugs and plasmapheresis is associated with renal recovery in three months with survival without dialysis for 12 months. In this case, a result was obtained in 22 days without the need for dialysis after one year. Conclusion: Due to the early diagnosis, appropriate treatment was quickly installed giving the patient increased life expectancy and quality, preventing dependence on renal replacement therapy.Keywords: Wegener’s granulomatosis, Plasmapheresis, Chronic renal failure.

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