1/10. Quinolone drug rash in a patient with infectious mononucleosis.infectious mononucleosis and the associated ampicillin rash are well documented. The case of a patient with infectious mononucleosis who was treated with levofloxacin and developed a rash similar to the ampicillin rash is reviewed. The exact mechanism is not understood. With closer observation, physicians may be able to recognize more cases with similar phenomena.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/10. Simultaneous vocal fold and tongue paresis secondary to Epstein-Barr virus infection.dysphonia is a common presenting symptom in cases referred for otolaryngologic evaluation. Similarly, primary care physicians frequently see adolescents or young adults with symptomatic Epstein-Barr virus infection. Some of the patients with active Epstein-Barr virus infection who have severe clinical manifestations of infectious mononucleosis will be referred for otolaryngologic evaluation. voice abnormalities in these patients, though, are usually limited to altered resonance due to pharyngeal crowding by hyperplastic lymphoid tissue. We describe a patient with infectious mononucleosis who was referred for evaluation of dysphonia and was diagnosed with unilateral tongue and vocal fold paresis. We also discuss the patient's clinical course and review the related literature. Although uncommon, cranial nerve palsies must be considered in the patient with Epstein-Barr virus infection who presents with voice or speech disturbance. Arch Otolaryngol head neck Surg. 2000;126:1491-1494- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/10. infectious mononucleosis presenting as postpartum fever.infectious mononucleosis and pregnancy are common conditions seen by obstetricians and family physicians. However, infectious mononucleosis in the postpartum period has not been reported in the literature. A 20 year-old woman presented with a four-day history of fever of 40 degrees C, and chills at her six-week postpartum visit, which prompted an evaluation of the cause of the fever. The atypical presentation of mononucleosis in this patient delayed the eventual diagnosis. Although infectious mononucleosis has not been mentioned in the literature as a cause of postpartum fever, it is likely more common than realized. For that reason the evaluation of infectious mononucleosis and postpartum fever are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/10. Nonoperative management of spontaneous splenic rupture in infectious mononucleosis: the role for emerging diagnostic and treatment modalities.infectious mononucleosis (IM) is a self-limiting lymphoproliferative disorder affecting teenagers and young adults. splenomegaly is a common manifestation of IM and results in a compromised organ that may rarely rupture spontaneously, with significant morbidity and mortality. The IM spleen should be protected from even minor trauma. Although traditional management of spontaneous splenic rupture in IM has been splenectomy, the role of nonoperative management is evolving. The advent of endovascular interventional modalities has augmented the physician's armamentarium in managing these patients nonoperatively. We report a case of spontaneous splenic rupture in a patient with IM managed conservatively with the aid of splenic angiography. The option of arteriography, with or without embolization, should be considered in the management of all patients with spontaneous splenic rupture in the setting of IM.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/10. cytomegalovirus mononucleosis in a healthy adult: association with hepatitis, secondary Epstein-Barr Virus antibody response and immunosuppression.A 35 year old previously healthy physician had clinical manifestations of a mononucleosis illness complicated by arthralgia, vesicular pharyngitis and hepatitis. Initially, the patient had cytomegalovirus (CMV) viremia (predominantly in polymorphonuclear leukocytes) followed by the presence of CMV in the urine, throat and semen. He also had an antibody response to the Epstein-Barr virus which appeared to be a secondary type. During the acute phase of illness, only 7 per cent of the patient's lymphocytes formed spontaneous T cell rosettes as compared to a normal value of 65 to 70 per cent. Concurrently, evidence of abnormal delayed hypersensitivity was manifested by the loss of reactivity to mumps skin test antigen. All clinical and laboratory abnormalities except for the persistence of CMV in the pharynx, urine and semen returned to normal after resolution of the clinical illness.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/10. Nasopharyngeal obstruction in infectious mononucleosis.Obstruction of the upper respiratory tract is an alarming and serious manifestation of infectious mononucleosis. The physician must distinguish this disease from other causes of upper airway obstruction. The presence of nasal obstruction by viscous secretions can aid in establishing the diagnosis of infectious mononucleosis. Steroid therapy should be initiated as soon as respiratory obstruction is apparent and infectious mononucleosis is suspected.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/10. Acute psychosis in a 45-year-old man with bipolar disorder and primary Epstein-Barr virus infection: a case report.A 45-year-old physician with bipolar disorder presented with an acute organic psychosis, fever, and hematologic and serologic findings of a primary Epstein-Barr virus infection. Pathogenesis was complicated by the history of discontinued lithium therapy prior to the psychosis. The patient recovered completely. literature concerning psychosis and infectious mononucleosis is reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/10. Recovery from infectious mononucleosis after altitude training in an elite middle distance runner.OBJECTIVES: This investigation was designed to monitor altitude acclimatisation in an elite cohort of distance runners and follow the subsequent recovery from infectious mononucleosis which developed in one of these athletes. methods: Twenty six national standard distance runners performed treadmill tests 24 days before they travelled to an altitude camp (1500 to 2000 m). One of these athletes was diagnosed as suffering from infectious mononucleosis 14 days after return to sea level. A physician prescribed an individualised training programme which was designed to maximise recovery from the condition, which was monitored on days 16 and 147 after altitude training. RESULTS AND CONCLUSIONS: The data suggest that the athlete was in a state of over-reaching during the altitude sojourn. After return to sea level, the early stages of infectious mononucleosis resulted in a marked impairment in physiological response to endurance exercise, which improved over time. Longitudinal physiological monitoring in conjunction with a carefully prescribed training programme made recovery from this condition possible.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/10. An adolescent girl with abnormal liver profile.A 17-year-old previously healthy high school student who lived in a dormitory was referred to our office by her private physician for evaluation of abnormal liver function tests. She was sexually active with one partner but denied any current or past substance abuse. The patient was not taking any medications or nutritional supplements. family history was unremarkable. physical examination revealed scleral icterus and minimal hepatomegaly. spleen was not palpable. The liver function tests are shown in table 1. Total leucocyte count was 6.3 x 10(9)/1 with 53% lymphocytes. The platelet count was normal. Anti-Hbc IgM antibody was negative, so were anti-HAV IgM and anti-HCV antibodies. HBsAg was negative and anti-HBs antibody was positive. Erythrocyte sedimentation rate was 16 mm in the first hour. An abdominal sonogram was done to evaluate a persistent elevation in alkaline phosphatase and it showed only hepatomegaly.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/10. diagnosis of spontaneous splenic rupture with emergency ultrasonography.Rapid evaluation of the hypotensive patient in the emergency department is essential. The availability of ultrasonography in the ED, performed by emergency physicians and surgeons, has made it easier to evaluate the hypotensive trauma patient. We describe a 44-year-old man transferred to our institution from a community hospital for evaluation of syncope and hypotension with no obvious cause. On arrival the patient began to complain of slight lower abdominal pain. The patient's physical examination revealed minimal abdominal tenderness. A rapid ultrasound examination performed at bedside revealed the presence of intraperitoneal fluid. Examination of the spleen suggested likely rupture. The patient was promptly taken to surgery for splenectomy and discharged home in 4 days.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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