1/22. Induced hypothermia: electrocardiographic abnormalities.hypothermia was induced intermittently in a patient to combat hyperpyrexia. The electrocardiogram taken during the hypothermic phase displayed typical abnormalities and consisted of: pronounced sinus bradycardia, marked prolongation of the Q-T interval, muscle tremor artifact, and the characteristic "Osborn wave." Spontaneous rewarming resulted in disappearance of the electrocardiographic alterations, underscoring the functional and reversible nature of the abnormalities.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/22. Suppurative granulomatous eosinophilic panniculitis: case report.A case of 12 year-old Nigerian male is presented. He had an unusual variant of Weber-Christian disease and manifested massive subcutaneous indurations and nodules limited to the cheeks, lips, left pectoral, infraclavicular and supraclavicular areas. A wedge biopsy revealed suppurative granulomatous eosinophilic panniculitis. Despite exhaustive investigations, no obvious trigger of the panniculitis could be identified. Response to corticosteroids and to empirical trials with other drugs was poor, and the outcome was fatal. We believe this is the first report from nigeria of this rare variant of Weber-Christian panniculitis in the paediatric age, and draw attention to the life-threatening nature of this disorder.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/22. Characteristics of human sperm chromatin structure following an episode of influenza and high fever: a case study.semen samples from a fertile patient presenting with influenza and a 1-day fever of 39.9 degrees C were obtained and analyzed at 18-66 days postfever (dpf) for sperm nuclear proteins, dna stainability, free thiols (-SH), and susceptibility to dna denaturation in situ. At 18 dpf, 36% of sperm demonstrated denatured dna as measured by the sperm chromatin structure assay (SCSA), and decreased to 23% by 39 dpf. Samples at 33 and 39 dpf contained 49% and 30%, respectively, of cells with increased dna stainability (HIGRN). A unique sperm nuclear protein band migrating between histones and protamines on acid-urea gels appeared at 33 and 39 dpf and nearly disappeared by 52 dpf. Amino acid sequencing of the first 8 N-terminal residues identified this protein as the precursor to protamine 2. The protamine P1 and P2 ratio remained normal, whereas the histone to protamine ratio increased slightly at 33 to 39 dpf. Flow cytometric measurements of nuclear -SH groups revealed the greatest reduction in free nuclear thiols at 33 dpf, and returned to normal by 45 dpf. The time of appearance of the unprocessed protamine 2 precursor and the relative increase in histone suggest a fever-related disruption of the synthesis of mRNA that codes for a P2 processing enzyme or enzymes. Increased dna staining is likely due to the increased histone/protamine ratio. This case study demonstrates that fever/influenza can have latent effects on sperm chromatin structure and may result in transient release of abnormal sperm.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/22. Case of multiple myeloma mimicking an infectious disease with fever, intrahepatic cholestasis, renal failure, and pulmonary insufficiency.We describe a case of multiple myeloma (MM) presenting with high fever, inflammatory chemistry abnormalities, simultaneous acute renal failure, cholestatic hepatitis, and acute lung failure. The extremely aggressive course and pulmonary involvement in the form of pulmonary alveolar proteinosis (PAP) are discussed, stressing the unusual nature of the findings and the variable picture of MM.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/22. bacteremia due to comamonas species possibly associated with exposure to tropical fish.comamonas species are environmental gram-negative rods that grow forming pink-pigmented colonies. Despite their common occurrence in nature, they rarely cause human infection. We present a case of comamonas bacteremia that we think may have been related to tropical fish exposure. The patient was treated successfully with levofloxacin.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/22. Are children with Kawasaki disease and prolonged fever at risk for macrophage activation syndrome?Kawasaki disease (KD) patients are known to be at increased risk for coronary artery lesions. We present evidence of another possible complication associated with KD: macrophage activation syndrome (MAS). In this case, a patient with KD and prolonged fever developed MAS. This case is of particular interest because of the late age of onset and recurrent nature of KD as well as the complication of MAS. We also present a review of the literature that supports the inclusion of MAS as an infrequent complication of KD.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/22. Recurrent acute rheumatic fever: a forgotten diagnosis?The incidence of acute rheumatic fever has seen a dramatic decline over the last 15 to 20 years in most developed countries and treatment of this disease has changed little since. The ease of travel and immigration and the cosmopolitan nature of many cities mean that occasionally the disease will come to the attention of clinicians not familiar with its presentation, resulting in delayed diagnosis and treatment. We present a case of recurrent acute rheumatic fever in a patient who was initially thought to be suffering from acute bacterial endocarditis on her previously diseased rheumatic aortic valve. This culminated in her undergoing urgent aortic valve replacement during a phase of the illness that should have been treated with high dose anti-inflammatory medication. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patient with a previous history of rheumatic fever. We briefly discuss the diagnostic dilemma of patients suffering from this condition and in differentiating it from acute endocarditis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/22. Infected neonatal cephalohematomas caused by anaerobic bacteria.OBJECTIVE: To present the microbiological and clinical features of six children with infected cephalohematomas (IC) caused by anaerobic bacteria. DESIGN: Presentation of a case series. RESULTS: Polymicrobial infection was present in all instances, where the number of isolates varied from two to four. Two patients had anaerobes only and the other four had mixed flora of strict anaerobes and facultatives. There were 16 bacterial isolates (12 anaerobic, 4 aerobic). The anaerobic isolates were peptostreptococcus spp. (5 isolates), prevotella spp. (4), bacteroides fragilis group (2), and propionibacterium acnes (1). The aerobic isolates were E. coli (2), staphylococcus aureus (1) and group B streptococci (1). blood cultures were positive for three patients. The most common predisposing conditions were vacuum extraction and amnionitis (4 instances of each), instrumental delivery (3), electronic fetal monitoring (2), prolonged delivery (1), and premature rupture of membranes (1). All patients underwent drainage, and four also had surgical incision and drainage of the IC. osteomyelitis developed in one instance and scalp abscess developed in two patients, both of whom had electronic fetal monitoring. All patients eventually recovered from infection after receiving parenteral and subsequent oral antibiotic therapy for a total of 14-38 days. CONCLUSION: This study highlights the polymicrobial nature and potential importance of anaerobic bacteria in IC in newborns.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/22. Actinomycotic suppurative thyroiditis in a child.AIM: To present a rare case of actinomycotic suppurative thyroiditis in an infant with provision of the etiology, pathogenesis, clinical findings and treatment of this rare disease. DESIGN: A report of an 18-month-old female infant who presented with fever, erythema, induration and tenderness of the neck. The patient had the diagnosis of acute suppurative thyroiditis after a series of laboratory evaluation. RESULT: She was treated successfully with surgical debridement and intravenous penicillin g. CONCLUSION: Although rare, actinomyces spp. should be considered in the etiology of acute suppurative thyroiditis. Because of its fastidious nature the probability of positive culture is low, thus, the microbiology laboratory should be called in advance to make preparations before culture and transport.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/22. Fever and headache in an intravenous drug user.zygomycosis refers to diseases caused by filamentous fungi from the class Zygomycetes. These organisms are ubiquitous in nature and can be found in soil as well as in decaying organic matter such as fruit and bread. risk factors for zygomycosis include uncontrolled diabetes mellitus, hematologic malignancies, corticosteroid therapy, deferoxamine therapy, intravenous drug use, and malnutrition. Clinical manifestations include rhino-orbital-cerebral, pulmonary, cutaneous, disseminated, gastric, and isolated cerebral disease. Isolated involvement of the central nervous system is rare and is most often associated with intravenous drug use. This case report describes isolated cerebral zygomycosis in an intravenous drug user.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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