1/25. Emphysematous pyelonephritis related to specific gas-forming Escherichia coli without diabetes mellitus.A 60-year-old-man without a history of diabetes mellitus, or invasive manipulation or obstruction of the urinary tract was admitted for septic shock. Type I emphysematous pyelonephritis was clear in this case: gas within the renal parenchyma extending into the subcapsular region and the perirenal space was present on spiral computerised tomography (CT). Surgical nephrectomy was performed because biochemistry, urography and CT identified a damaged non-functioning left kidney. The outcome was favourable. All urine, blood and nephrectomy specimen cultures were positive for a specific Escherichia coli which produced a high level of gas compared to a reference E. coli strain in the same standard medium, despite the absence of diabetes mellitus. Certain strains of bacteria are able to produce high levels of nitrogen, carbon dioxide and hydrogen and such fermentation in the absence of a high glucose serum level might explain the acute gas-producing bacterial renal infection.- - - - - - - - - - ranking = 1keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
2/25. Transient diabetes insipidus following Escherichia coli meningitis complicated by ventriculoperitoneal shunt.Although disorders of ADH secretion associated with meningitis are usually consistent with the syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH), central diabetes insipidus (DI) is an exceptional complication of meningitis. Transient DI as a complication of Escherichia coli (E. coli) meningitis due to ventriculoperitoneal shunt in an 18-month-old boy is presented. Blood and spinal fluid cultures yielded E. coli, sensitive to cefotaxime. The DI arose on the day 3 after admission and continued to the day 20. Treatment comprised cefotaxime, dexamethasone, fluid adjustment and vasopressin. The course of our case supports that in cases of bacterial meningitis, initial fluid restriction may occasionally result in dangerous conditions. Therefore, all children with bacterial meningitis should be followed closely not only in terms of SIADH but also DI. To our knowledge this is the first transient DI associated with E. coli-caused meningitis case reported.- - - - - - - - - - ranking = 0.13578588592987keywords = diabetes (Clic here for more details about this article) |
3/25. Fatal emphysematous pyelonephritis with gas in the spinal extradural space in a patient with diabetes.BACKGROUND: Emphysematous pyelonephritis (EP) is a rare but life-threatening condition of the upper urinary tract, characterized by the presence of gas in the renal parenchyma and perirenal space. The vast majority of patients with EP (90%) are known to have diabetes, with Escherichia coli being the most common causative pathogen. CASE REPORT: We present a case of fatal bilateral EP in a patient with diabetes, with an unusual radiological finding of gas around the spinal cord and in the psoas muscle, with renal parenchymal sparing. Our case serves as an important reminder of this life threatening entity in diabetic patients, which is not well recognized by clinicians because of its rarity.- - - - - - - - - - ranking = 0.16294306311584keywords = diabetes (Clic here for more details about this article) |
4/25. Diabetes and infarcted papillary thyroid cancer.A young black Jordanian lady who has type one diabetes, chronic diabetic complication and ischemic heart disease, presented with a picture of diabetic keto-acidosis, precipitated by an acute neck swelling. This was suggestive of acute suppurative thyroiditis with abscess formation causing compressive symptoms. This unfortunate patient had an eventful course despite aggressive treatment by antibiotics and surgery and then succumbed of an acute cardiac event. The operative tissue biopsy revealed an abscess in an infarcted papillary thyroid cancer. We believe this is a rare presentation of such an association with a fatal outcome.- - - - - - - - - - ranking = 0.027157177185974keywords = diabetes (Clic here for more details about this article) |
5/25. Emphysematous cystitis.An elderly woman with poorly controlled diabetes entered the casualty department suffering from abdominal pain. Clinical and radiological examinations revealed intramural and intraluminal gas in the urinary bladder, suggesting the diagnosis as emphysematous cystitis, a rare disorder usually caused by aerobic and not anaerobic microbes. The causal agent is often, as in this case, Escherichia coli.- - - - - - - - - - ranking = 0.027157177185974keywords = diabetes (Clic here for more details about this article) |
6/25. troponin i levels in a hemolytic uremic syndrome patient with severe cardiac failure.Troponins are highly sensitive and specific biochemical markers of myocardial injury that are released into the circulation during myocardial ischemia. We describe changes in cardiac troponin i (cTnI) prior to and following clinical evidence of severe myocardial dysfunction in a child with hemolytic uremic syndrome (HUS). A previously healthy, 22-month-old girl presented with typical HUS and stool cultures positive for escherichia coli o157:H7. She required dialysis, blood and platelet transfusions, and insulin for HUS-related diabetes mellitus. On the 6th hospital day she had sudden circulatory collapse with a blood pressure of 70/40 mmHg and an oxygen saturation of 88%. She responded rapidly to emergency resuscitation but had diminished left ventricular function (ejection fraction 18%). Four days after the acute event an echocardiogram showed normal ventricular size and contractility. She underwent hemodialysis for 22 days, and renal function was normal after 33 days. cTnI levels were measured with a microparticle enzyme immunoassay. cTnI was normal (>0.4 microg/l) 32 h prior to cardiac collapse, mildly increased (2.1 microg/l) 8 h before the cardiac collapse, severely elevated shortly after the cardiac event (43.1 microg/l), and peaked (140.6 microg/l) at 24 h. It then fell gradually and was normal at discharge. These results suggest that measurement of cTnI may be a useful predictor of cardiac involvement in severely affected children with HUS.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
7/25. Clinics in diagnostic imaging (99). Left emphysematous pyelonephritis.A 57-year-old woman, known to have diabetes mellitus, presented with a one-week history of fever, dysuria, and left flank pain. Computed tomography showed extensive left renal parenchymal destruction and a large gas collection. urine culture revealed growth of Escherichia coli. The diagnosis of emphysematous pyelonephritis was confirmed at left nephrectomy. The clinical manifestations of emphysematous pyelonephritis, types of gas-forming renal infection, and their radiological findings are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
8/25. Xanthogranulomatous funiculitis and orchiepididymitis: report of 2 cases with immunohistochemical study and literature review.Two patients with xanthogranulomatous inflammation are described, one with involvement of the spermatic cord and the other with 1 testicle and epididymis affected. To our knowledge, only 12 cases of xanthogranulomatous orchiepididymitis have been reported previously, one of which also presented a xanthogranulomatous funiculitis. Clinically, our patients presented with spermatic cord enlargement (case 1) and chronic orchitis that did not respond to treatment with antibiotics (case 2). Histopathologically, both cases showed extensive xanthogranulomatous inflammation with numerous foamy macrophages that were associated with colonies of microorganisms suggestive of actinomyces in case 1. Additionally, Escherichia coli was cultured from the surgical specimen of case 2. The possible underlying pathology may be diabetes in case 1 and phlebitis associated with chronic orchitis in case 2. Differential diagnoses with other lesions that are rich in macrophages, such as malakoplakia, and those testicular neoplasms without serologic tumor markers are discussed.- - - - - - - - - - ranking = 0.027157177185974keywords = diabetes (Clic here for more details about this article) |
9/25. Atypical presentations of emphysematous cystitis.Emphysematous cystitis is an uncommon infection of the bladder with the formation of carbon dioxide either within the bladder or within its wall. It is commonly seen in women and those with poorly controlled diabetes mellitus, in association with some form of urinary stasis and obstruction. The clinical features are very varied and the outcome is often unpredictable. radiography may reveal a radiolucent line around the bladder wall or gas within the bladder. Occasionally, computed tomography scans are required to help in the diagnosis due to their atypical presentation with acute abdominal pain. Herein, we report three patients with such a condition who were treated with favourable outcomes. Of the three patients, two had to undergo exploratory laparotomy due to their initial presentations with acute abdomens.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
10/25. Successful medical management of recurrent emphysematous pyelonephritis.Emphysematous pyelonephritis is characterized by infection and gas formation in the renal parenchyma. This rare disorder tends to occur more frequently in patients with diabetes mellitus and urinary tract obstruction. In this case report, we describe a nondiabetic patient with Hinman syndrome who developed recurrent emphysematous pyelonephritis that was successfully treated with antibiotics on both occasions.- - - - - - - - - - ranking = 0.16666666666667keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
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