1/680. Acute rheumatic fever with three major criteria: polyarthritis, carditis and chorea. A case report.An eight-year-old girl is presented with three major criteria of acute rheumatic fever: polyarthritis, carditis and chorea. The diagnosis was confirmed with a history of pharyngitis 15 days prior to admission and with the findings of positive acute phase reactants such as elevated erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP), elevated anti-streptolysin-O (ASO) titration, and clinical findings of polyarthritis, carditis and chorea. Patient responded well to salicylate and phenobarbital treatment. The rare association of these three major criteria in acute rheumatic fever is emphasized.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/680. central nervous system T-cell lymphoproliferative disorder in a patient with chronic active Epstein-Barr virus infection.PURPOSE: central nervous system (CNS)-T cell lymphoproliferative disorder (T-LPD) developing during the course of chronic active Epstein-Barr virus (CAEBV) infection is reported. patients AND methods: CAEBV was diagnosed in a 14-month-old boy with fever, cytopenia, hepatosplenomegaly, and abnormal high titers of anti-Epstein-Barr virus (EBV) antibodies. At 8 years of age, he had a splenectomy because of progressive disease. RESULTS: After 27 months of clinical remission, muscle weakness and paresthesia developed. magnetic resonance imaging of his brain showed spotty T2 prolongation in left parietal, bilateral frontal, and temporal white matter with meningeal enhancement. brain biopsy revealed the cerebral infiltration of CD3 , CD4 , CD8-, CD45RO , CD56-, and EBV-encoded RNA 1 cells. CONCLUSIONS: The CNS involvement of EBV-associated T-LPD is a rare but serious complication in CAEBV without known underlying immunodeficiency.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
3/680. Systemic candidiasis with candida vasculitis due to candida kruzei in a patient with acute myeloid leukaemia.candida kruzei-related systemic infections are increasing in frequency, particularly in patients receiving prophylaxis with antifungal triazoles. A Caucasian male with newly diagnosed acute myeloid leukaemia (AML M1) developed severe and persistent fever associated with a micropustular eruption scattered over the trunk and limbs during induction chemotherapy. blood cultures grew candida kruzei, and biopsies of the skin lesions revealed a candida vasculitis. He responded to high doses of liposomal amphotericin b and was discharged well from hospital.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
4/680. Distinguishing immunosilent AIDS from the acute retroviral syndrome in a frequent blood donor.BACKGROUND: There are seven reports of "immunosilent AIDS" in which there was a lack of development of anti-hiv for more than 6 months. Thus, when a frequent blood donor presented with clinical findings highly suggestive of overt AIDS, there was concern that he may have had a prolonged immunosilent infection. CASE REPORT: A 24-year-old man who had donated blood six times in the previous year was diagnosed as having AIDS; he presented with fever, nausea, vomiting, diarrhea, weight loss, and oral candidiasis. The anti-hiv enzyme immunoassay was positive, the Western blot was indeterminate (gp160 only), the CD4 count was 174 per mL, the hiv polymerase chain reaction was positive (2.8 x 10(6) copies/mL), and the hiv p24 antigen assay was positive. Twelve components from previous donations had been transfused, and 2 units of fresh-frozen plasma were still in inventory. Repeat donor testing 57 days after donation indicated seroconversion with a positive anti-hiv enzyme immunoassay, a positive Western blot, a negative hiv p24 antigen assay, and a positive test for hiv by polymerase chain reaction (89,000 copies/mL). Both units of fresh-frozen plasma tested negative for hiv by polymerase chain reaction. Four transfusion recipients had died, and the remaining eight are anti-hiv negative with >6 months' follow-up. CONCLUSION: The donor had an unusually severe acute retroviral syndrome and presented with findings that were difficult to distinguish from overt AIDS.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
5/680. Acute necrotizing otitis media in an infant: a case report.Acute necrotizing otitis media (ANOM), an uncommon but severe form of bacterial otitis media, frequently causes distressing sequelae if not properly diagnosed and treated. A four-month-old female infant initially became ill with intermittent fever, followed by left facial nerve paralysis and left otorrhea four days later. Microscopic examination of the left ear revealed congestion and swelling of the external ear canal, perforation of the eardrum and erosions on the malleus. culture of pus from the otic lesion grew pseudomonas aeruginosa. The patient's condition did not improve despite systemic administration of antibiotics; thus, surgical intervention was arranged. During the operation, near-total perforation of the eardrum, a dislodged incus, cholesteatoma-like matrix around the stapes, and granulation tissue occupying the middle ear and mastoid cavities were noted. Radical mastoidectomy was conducted and pathologic examination of the surgical specimen disclosed necrotic changes in both soft and bony tissues. The patient recovered soon after surgery. Her fever subsided one day after surgery and the patient was discharged in a stable condition 12 days later. However, she still had left facial nerve paralysis six months later.- - - - - - - - - - ranking = 0.33333333333333keywords = fever (Clic here for more details about this article) |
6/680. Acute generalized varicella zoster in the setting of preexisting generalized erythema.We report a 5-year-old girl who initially had generalized erythema from scarlet fever. Four days later she developed sheets of monomorphous vesicles in the areas of erythema. A Tzanck smear of a vesicle base showed multinucleated giant cells, and viral culture grew varicella zoster virus, confirming a clinical diagnosis of varicella. This case illustrates that, with a background of preexisting erythema, varicella may present in an atypical manner.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
7/680. Acute respiratory distress syndrome in a welder exposed to metal fumes.A 43-year-old man began having malaise, chills, and fever 12 hours after cutting a galvanized steel grating with an acetylene torch at work. Over the next 72 hours, his symptoms persisted and became worse with progressive shortness of breath. He was admitted to the hospital and begun on antibiotics and steroids. The next day his condition had deteriorated to the point that he had to be intubated. Chest x-ray film and computed tomography showed patchy and interstitial infiltration bilaterally, consistent with acute respiratory distress syndrome. Open lung biopsy showed focal mild interstitial pneumonia. Multiple laboratory studies were negative for an infectious or an immune process. The patient remained on mechanical ventilation for 10 days and was discharged from the hospital 2 days after extubation. He continued to improve, with minimal symptoms and a return to normal activity levels several months after the incident with no continued treatment. Re-creation of his exposure was done under controlled circumstances, with air sampling revealing elevated air levels for cadmium and zinc and borderline levels of arsenic, manganese, lead, and iron.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
8/680. Fatal virus-associated hemophagocytic syndrome associated with coexistent chronic active hepatitis b and acute hepatitis c virus infection.A 28-year-old man was admitted to our department with intermittent fever, hepatosplenomegaly and pancytopenia. liver parameters and serum ferritin were markedly elevated. bone marrow biopsy showed hypocellularity, histiocytic hyperplasia, and hemophagocytosis consistent with a virus-associated hemophagocytic syndrome (VAHS). There was serological evidence of chronic active hepatitis b and acute hepatitis c virus infection. The patient died despite aggressive immunosuppressive and supportive treatment. autopsy revealed signs of acute viral hepatitis with cholestasis. histiocytes engaged in hemophagocytosis were observed in bone marrow and spleen. The condition was interpreted as VAHS associated with chronic active hepatitis b and acute hepatitis c virus infection. To our knowledge this is the first report of a hemophagocytic syndrome in that setting.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
9/680. Clinical and laboratory findings in immunocompetent patients with persistent parvovirus B19 dna in bone marrow.The clinical relevance of parvovirus B19 dna persistence in bone marrow was examined in 10 immunocompetent individuals undergoing examinations for unexplained fever, arthralgia or chronic leukopenia. Common causes of these symptoms had been ruled out and bone marrow aspiration was indicated at this stage of investigation. In addition to morphological analysis of the bone marrow, a test for B19 dna was performed with 2 nested PCRs. Five of these 10 selected patients had detectable B19 dna in their bone marrow, whereas no viraemia was observed. Additional bone marrow samples were collected at least 6 months after the first sample from the B19 dna-positive patients, of whom 3 were found to be still positive. Indeed, 2 of the patients have been positive for more than 5 y of follow-up. Sera from all patients with persistent B19 dna in bone marrow could neutralize the virus. One patient responded to treatment with immunoglobulin but later relapsed. No other cause of the symptoms was found, despite extensive investigations, and at least some of the prolonged disease manifestations may be due to parvovirus B19.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
10/680. Acute hypernatremia and neuroleptic malignant syndrome in parkinson disease.neuroleptic malignant syndrome is a clinical syndrome characterized by fever, muscle rigidity, and mutism. Some patients with neuroleptic syndrome may have elevated creatine phosphokinase values and abnormal liver aminotransferase values. precipitating factors are important clues for prompt diagnosis. Typical precipitating factors include antipsychotic agents and major tranquilizers. In parkinson disease, drug withdrawal, menstruation, and hyponatremia are precipitating factors. We report a case of neuroleptic malignant syndrome in a patient with parkinson disease and hypernatremia. In addition, we hypothesized that sudden change of sodium concentrations in the central nervous system could trigger neuroleptic malignant syndrome in patients with parkinson disease. According to our experience, neuroleptic malignant syndrome is a clinical diagnosis and prompt diagnosis avoids unnecessary, expensive work-ups.- - - - - - - - - - ranking = 0.16666666666667keywords = fever (Clic here for more details about this article) |
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