1/66. Acute pancreatitis and parotitis induced by methimazole in a patient with Graves' disease.A wide variety of adverse effects of methimazole (MMI) have been reported. Here we report a new MMI-induced disorder, acute pancreatitis and parotitis. Three weeks after a woman started MMI treatment for Graves' disease, she developed a high fever, painful parotid swelling and dull pain in the upper abdomen with elevation of the serum levels of salivary and pancreatic enzymes. These abnormalities disappeared soon after the withdrawal of MMI. However, the same abnormalities were rapidly provoked when MMI was reintroduced. Marked increases in the leucocyte count and CRP were also observed during these episodes. The possible mechanisms of MMI-induced pancreatitis/parotitis are discussed.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/66. The pathology of human west nile virus infection.west nile virus (WNV) was identified by immunohistochemistry (IHC) and polymerase chain reaction (PCR) as the etiologic agent in 4 encephalitis fatalities in new york city in the late summer of 1999. The fatalities occurred in persons with a mean age of 81.5 years, each of whom had underlying medical problems. Cardinal clinical manifestations included fever and profound muscle weakness. autopsy disclosed encephalitis in 2 instances and meningoencephalitis in the remaining 2. The inflammation was mostly mononuclear and formed microglial nodules and perivascular clusters in the white and gray matter. The brainstem, particularly the medulla, was involved most extensively. In 2 brains, cranial nerve roots had endoneural mononuclear inflammation. In addition, 1 person had acute pancreatitis. Based on our experience, we offer recommendations for the autopsy evaluation of suspected WNV fatalities.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/66. Thrombotic thrombocytopenic purpura in acute pancreatitis.Thrombotic thrombocytopenic purpura (TTP) is a rare syndrome of unknown cause with an estimated incidence of one case per million. The disease is characterized by a pentad of symptoms: thrombocytopenia, microangiopathic hemolytic anemia, neurologic changes, renal dysfunction, and fever. It causes thrombosis in the microvasculature of several organs, producing diverse manifestations. Acute pancreatitis (AP) is a well-described consequence of TTP. We report a patient who developed TTP after presenting with AP, suggesting pancreatitis to be the cause, rather than a consequence, of TTP.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
4/66. A case of duodenal papillary carcinoma complicated by repeated acute pancreatitis.We present a patient with duodenal papillary carcinoma who repeatedly developed acute pancreatitis preoperatively. The patient was a 65-year-old male. In February 1997, the patient consulted a local hospital due to vomiting, high fever, and jaundice. With the diagnosis of obstructive jaundice, percutaneous transhepatic biliary drainage (PTBD) was performed, revealing a distal bile duct obstruction. Because duodenal papillary carcinoma was diagnosed based on endoscopic findings, the patient was admitted to Kurume University Hospital. Hypotonic duodenography (HDG) disclosed a protruding lesion with an irregular surface in the descending part of the duodenum, resulting in a diagnosis of positive duodenal invasion (du1). Because computed tomography (CT) demonstrated a protruding lesion on the medial side of the second portion of the duodenum, positive pancreatic invasion (panc2) was diagnosed. On March 18 and April 22, sudden abdominal pain, leukocytosis, and an increase in serum amylase were noted. CT revealed that the pancreas was diffusely enlarged, showing an ill-defined boundary between the pancreas and adipose tissue and fluid collection. On CT, the lesion was evaluated as Grade 3 and moderate. For treatment, pancreatic enzyme inhibitors and antibiotics were intravenously injected. Peritoneal perfusion was concomitantly performed during the second treatment. Because symptoms remitted thereafter, a pylorus preserving pancreatoduodenectomy (PpPD) was carried out. The postoperative histologic examination revealed negative pancreatic invasion. Concerning the etiology of acute pancreatitis, not pancreatic invasion, but impaction of the liberated tumor mass in the common canal was considered responsible for the repeated pancreatitis because the tumor showed a cauliflower-like shape.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
5/66. Recurrent pancreatitis secondary to type V hyperlipidemia: report of one case.With the exception of cystic fibrosis and hereditary pancreatitis, case reports about pancreatitis in children have rarely been mentioned. We report here an 11-year-old boy with type V hyperlipidemia, who suffered from two episodes of acute pancreatitis. Sudden onset of severe upper abdominal pain, fever, and hypertriglyceridemia were the common presentations. Initial treatments including analgesics, fasting, parenteral nutrition support and following diet control with medium-chain triglycerides seem to be successful in our case.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
6/66. Acute pancreatitis with Purtscher's retinopathy: case report and review of the literature.The case is described of a 32-year-old man suffering from alcoholism who came to the Emergency Unit with vomiting, fever and sharp epigastric pain irradiating to the chest and upper abdomen. A diagnosis of acute pancreatitis was made after high amylase and lipase levels were observed and the results of computed tomography scan revealed images typical of acute pancreatitis. Findings upon admission and after the initial 48 hours did not correlate with a severe or complicated course according to Ranson's criteria. On the third day after admission he suddenly developed decreased vision. A fluorescein angiogram showed arteriolar occlusion, retinal and choriocapillary ischaemia. Purtscher's retinopathy was suspected. After 4 weeks, the patient had recovered from acute pancreatitis, ophthalmoscopic examination showed normal results, and visual acuity had almost returned to normal. Activation of complement in acute pancreatitis could account for many haematologic acute disorders due to leucocyte emboli or other complement-mediated aggregates. Coagulation abnormalities may range from isolated intravascular thrombosis to severe disseminated intravascular coagulation. Purtscher's retinopathy, due to microembolizations in the choroidal and retinal arterioles, should be included among the various systemic effects of acute pancreatitis. This visual disorder is a rare systemic manifestation of acute pancreatitis which was not correlated to a severe or complicated clinical course. Treatment of these ocular complications remains to be established and outcome, therefore, depends upon resolution of the pancreatic disease.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
7/66. Unusual presentation of typhoid fever: cutaneous vasculitis, pancreatitis, and splenic abscess.We report a case of typhoid fever with an unusual presentation: prolonged fever with cutaneous vasculitis, pancreatitis, and splenic abscess. This is the first case of cutaneous leukocytoclastic vasculitis associated with salmonella typhi. The diagnosis was made upon isolation of S. typhi in blood cultures, and after ruling out other causes of leukocytoclastic vasculitis. The outcome was favourable with antibiotics alone without surgery.- - - - - - - - - - ranking = 6keywords = fever (Clic here for more details about this article) |
8/66. Groove pancreatitis: case report and literature review.Groove pancreatitis is a form of chronic pancreatitis affecting the groove between the head of the pancreas, the duodenum and the common bile duct. It was first described by Becker in 1973. Differentiation between groove pancreatitis and pancreatic head carcinoma is often difficult. Herein, we report a 24-year-old man with groove pancreatitis presenting with epigastralgia, jaundice, fever and vomiting. The diagnosis was confirmed by computed tomography of the abdomen, endoscopic retrograde cholangiopancreatography and surgical exploration. The operative procedures involved were pancreatic biopsy and choledochotomy with T-tube drainage. The patient had an uneventful postoperative course.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
9/66. Unusual complications following laparoscopic Nissen fundoplication.Laparoscopic Nissen fundoplication is commonly used to treat medically refractory gastroesophageal reflux disease. The most frequent severe complications following laparoscopic Nissen fundoplication are pneumothorax, gastroesophageal leak, and splenic injury. Prompt recognition and treatment of complications are important in reducing subsequent morbidity and mortality. This report describes two postoperative complications: (1) delayed diagnosis of a postoperative gastric perforation despite an unrevealing work-up for postoperative fever and abdominal pain; and (2) postoperative pancreatitis following revision of a fundoplication.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
10/66. pancreatitis in enteric fever.pancreatitis in enteric fever is rare. We report two patients with enteric fever, one due to salmonella typhi infection and other due to S. paratyphi, who on investigation were found to have pancreatitis. Both patients recovered uneventfully.- - - - - - - - - - ranking = 6keywords = fever (Clic here for more details about this article) |
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