1/4. The question of PANDAS in adults.BACKGROUND: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a well-defined cause of obsessive-compulsive disorder in children. However, they have not been described or fully investigated in adults newly diagnosed with obsessive-compulsive disorder. methods: We describe an adult with onset of obsessive-compulsive disorder at 25 years of age after a severe antibiotic-responsive pharyngitis. He was evaluated with multiple psychiatric rating scales for obsessive-compulsive disorder and Tourette's syndrome, as well as with serologic assays and radiologic studies. RESULTS: In all respects except age our patient fulfilled established criteria for PANDAS. Assays for antibodies to group A beta-hematolytic streptococci, serum D8,17 lymphocytes, antistriatal (neuronal) antibodies, and anticytoskeletal antibodies all supported the hypothesis that a poststreptococcal process was active. magnetic resonance imaging was abnormal and is described. CONCLUSIONS: The findings suggest that this patient's illness is similar to PANDAS in presentation and that poststreptococcal disease may result in adult-onset obsessive-compulsive disorder.- - - - - - - - - - ranking = 1keywords = adult-onset (Clic here for more details about this article) |
2/4. hypereosinophilic syndrome in a child presenting as eosinophilic pharyngitis.A 3-year-old child with idiopathic hypereosinophilic syndrome (IHES) presented with sore throat and pharyngeal exudate. Recurrent throat cultures were negative and microscopic section of the exudate revealed an extensive eosinophilic infiltration. Fourteen months later, the child still has marked hypereosinophilia and pharyngeal involvement without other organ involvement. Eosinophilic pharyngitis may be a target organ in IHES. The benign clinical course and the laboratory characteristics are described.- - - - - - - - - - ranking = 1.7435795810158keywords = still (Clic here for more details about this article) |
3/4. adult-onset acute rheumatic fever: possible resurgence in southern taiwan.BACKGROUND: By the late 1980s, acute rheumatic fever (ARF) had become a rare disease in taiwan. The low prevalence rate in this area is attributed to a better economic status, which has led to improved public health and adequate medical services. OBJECTIVES: The increasing number of patients with adult-onset ARF in the united states described in the literature prompted us to evaluate the cases diagnosed in our medical center. methods: A retrospective chart review was performed for patients with arthritis from July 1988 to October 2004. To be included, patients had to meet revised Jones criteria. RESULTS: Three adult patients with ARF have been diagnosed since June 2001, with no childhood ARF being diagnosed. All cases presented with migratory polyarthritis, whereas 1 had erythema marginatum and transient carditis. These patients responded well to treatment with antibiotics and nonsteroidal antiinflammatory drugs. CONCLUSIONS: Clinicians must provide careful assessment and treatment to patients presenting with acute pharyngitis. A possible resurgence of ARF can be eradicated by primary prevention of streptococcal pharyngitis.- - - - - - - - - - ranking = 1keywords = adult-onset (Clic here for more details about this article) |
4/4. diphtheria presenting in the accident and emergency department.A case of diphtheria encountered in the accident and emergency department is described. In addition, 38 cases of diphtheria have been analysed, and demonstrate that, although now rare in this country, the disease still exists and its clinical features remain unchanged. It presents almost as often in the accident and emergency department as it does to the general practitioner and remains overwhelmingly a disease of children. diphtheria is still a notifiable disease. The diagnosis must be made clinically and appropriate action taken before the bacteriological confirmation is received. This prevents unnecessary delay in treatment and makes contact tracing less arduous.- - - - - - - - - - ranking = 3.4871591620316keywords = still (Clic here for more details about this article) |