1/17. The natural history of varicella embryopathy: a 25-year follow-up.A patient with clinically and immunologically proven varicella embryopathy achieved substantial recovery after initial severe developmental delay and manages well with her residual physical disabilities in adulthood.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/17. Case study: type-specific HSV serology and the correct diagnosis of first-episode genital herpes during pregnancy.It is now known that the physical presentation of genital herpes simplex (HSV) infection can be misleading in making the diagnosis of genital herpes. An incorrect diagnosis can be particularly damaging in pregnancy where it may result in extended exposure of the fetus to antiviral agents, an inappropriate route and timing of delivery and a significant increase in fetal exposure to HSV during labour and delivery. Case 1 describes a 32-year-old woman at 30 weeks in her first pregnancy who had the appearance and clinical course typically ascribed to primary genital HSV infection. In contrast, Case 2, a 24-year-old woman at 34 weeks' gestation, had the physical appearance of a recurrent episode. Type-specific serological testing revealed that what Case 1 was actually experiencing was the first symptomatic reactivation of genital herpes, whereas Case 2 had a true primary genital HSV-2 infection that was accompanied by minimal symptoms. Had serology testing not been available, Case 1 would probably have delivered unnecessarily by Caesarean section, and Case 2 would have been managed as a recurrent infection and allowed to deliver vaginally with potentially disastrous results. These cases illustrate the usefulness of a type-specific serology in diagnosing genital herpes in pregnant women.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
3/17. Intrauterine west nile virus: ocular and systemic findings.PURPOSE: To report the first documented case of intrauterine transmission of west nile virus (WNV) with resulting congenital chorioretinal scarring and central nervous system malformation in a newborn. DESIGN: Case report. methods: Ophthalmic findings and laboratory data in an otherwise presumed healthy 2-day-old female are presented. The infant's mother developed paraplegia due to WNV during the second trimester of her pregnancy. The newborn's external and general physical examination were unremarkable. RESULTS: Ophthalmic examination disclosed marked chorioretinal changes, and magnetic resonance imaging of the brain demonstrated severe abnormalities. serology for WNV was positive. Other causes of congenital chorioretinal changes were ruled out with the appropriate serology. CONCLUSIONS: Intrauterine transmission of WNV may result in significant ocular and neurologic morbidity. Titers for this important and emerging viral pathogen should be obtained when standard serologies are negative in an infant with congenital chorioretinal scarring.- - - - - - - - - - ranking = 7.0215870056295keywords = physical examination, physical (Clic here for more details about this article) |
4/17. life-threatening maternal and fetal macrocytic anemia from antiretroviral therapy.BACKGROUND: Antiretroviral therapy is recommended for human immunodeficiency virus (hiv)-infected patients during pregnancy to reduce the vertical transmission to the newborn. Complications from this therapy are uncommon. CASE: A 38-year-old hiv-positive pregnant woman was treated with lamivudine and zidovudine. At 28 weeks of gestation, her hemoglobin had fallen to 4.6 g/dL with an mean corpuscular volume (MCV) of 126 microm. At 36 weeks the fetal biophysical profile was abnormal. A pale hydropic infant was delivered via emergency cesarean, with a hemoglobin of 2.1 gm and MCV of 131 microm. The newborn hemoglobin normalized after withdrawal of the neonatal retroviral therapy. CONCLUSION: Maternal-fetal macrocytic anemia may complicate antiretroviral therapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/17. A rare cause of anemia and thrombocytopenia in a newborn: congenital malaria.A newborn with fever and jaundice was referred to our hospital with anemia and thrombocytopenia of unknown origin. The patient's mother suffered from malaria infection during the third trimester of her pregnancy, but she did not accept medical therapy. On physical examination the newborn showed mild splenomegaly and jaundice. Laboratory tests revealed marked anemia with a hemoglobin value of 7.7 g/L and thrombocytopenia with platelet numbers of 17,000/mm3. plasmodium vivax was detected in blood smear. Oral therapy with chloroquine and primaquine was started. This patient is the second case of congenital malaria reported from turkey, and shows that the diagnosis of congenital malaria should be considered in infants with suspected congenital infection who are born to mothers with a history of malarial disease. We emphasize the importance of adequate antenatal medical therapy during pregnancy.- - - - - - - - - - ranking = 7.0215870056295keywords = physical examination, physical (Clic here for more details about this article) |
6/17. Congenital rubella infection from reinfection of previously immunised mothers.Two children developed congenital rubella infection when their mothers had been proven to be satisfactorily immunised against rubella before the affected pregnancy. One child was severely affected with heart lesions, brain damage, severe deafness, physical retardation, cataracts and rubella retinopathy. The other child had moderately severe sensorineural deafness and a mild reduction in visual acuity due to rubella retinopathy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/17. Pyogenic infection of the sacroiliac joint. case reports and review of the literature.Three cases of pyogenic sacroiliitis are described, and the English literature from 1878 to 1990 reviewed, for a total of 166 cases. In 1 patient the source of infection was identified at the site of an intravenous line; 1 patient had 2 risk factors for developing the disease (pregnancy and intravenous drug use); and a third patient had no source of infection and no associated risk factors. The diagnosis of pyogenic sacroiliitis was made in each patient by history, physical examination, and positive skeletal scintigraphy or computed tomography of the sacroiliac joint. The infectious agent causing septic arthritis was identified by fine-needle aspiration of the sacroiliac joint under fluoroscopic guidance. Two of the 3 patients also had an open biopsy of the sacroiliac joint--one to confirm the organism causing septic arthritis, and the other for surgical drainage of the infected sacroiliac joint. Cultures from all 3 patients grew organisms uncommon for this disease, and all were treated for 6 weeks with intravenous antibiotics. In all patients pain diminished after treatment. Pyogenic sacroiliitis is a relatively rare condition (1-2 cases reported/year) that may be clinically difficult to diagnose unless the clinician is familiar with the disease. A prompt diagnosis can prevent significant morbidity and reduce serious complication. Major predisposing factors include intravenous drug use, trauma, or an identifiable focus of infection elsewhere, but 44% of patients have no predisposing or associated factors identified. Most patients present with an acute febrile illness with pain in the buttocks and pain on movement that stresses the affected sacroiliac joint. There is no specific blood test which points to the diagnosis of pyogenic sacroiliitis, although the erythrocyte sedimentation rate may be greater than 100 mm/hr. The diagnostic procedure of choice is bone scan with attention to the early perfusion phase, which usually localizes the affected sacroiliac joint. Unilateral involvement is the rule. In patients whose blood cultures fail to reveal a causative organism, fluoroscopic guided fine-needle aspiration of the sacroiliac joint under general anesthesia may help to identify the organism. If all cultures are negative, open biopsy of the sacroiliac joint may be required. Open biopsy should also be done if sequestration or an abscess is formed, or if the patient fails to respond to antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/17. The asymptomatic patient with a positive VDRL test.Although VDRL and RPR tests are excellent screens for syphilis, false-positive reactions do occur. A positive VDRL or RPR test must be confirmed with an FTA-ABS test. patients with positive serologic tests should have a thorough physical examination to determine the stage of syphilis. A patient with a low-titer VDRL or RPR may have active disease and may require lumbar puncture to rule out neurosyphilis.- - - - - - - - - - ranking = 7.0215870056295keywords = physical examination, physical (Clic here for more details about this article) |
9/17. Routine radiographic screening of the chest in pregnant women: is it indicated?Experience with routine antepartum chest radiographic screening from July 1, 1976, through June 30, 1977, in a city-county hospital which serves a predominantly black indigent population was reviewed. The 5422 routine screening chest radiographs produced an extremely low yield of pathology (11 cases), and only 3 of the 11 cases were not suspected from the history or physical examination. Only 2 cases of active pulmonary tuberculosis were discovered, and both patients were recent immigrants from countries with a much higher incidence of tuberculosis. This low case finding probably reflects the general decline in incidence of pulmonary tuberculosis in the united states and suggests that routine screening chest radiographs (done primarily to exclude tuberculosis) are no longer indicated in our pregnant population.- - - - - - - - - - ranking = 7.0215870056295keywords = physical examination, physical (Clic here for more details about this article) |
10/17. Fetal immune response following maternal diphtheria during early pregnancy.A pregnant Sudanese woman contracted pharyngeal diphtheria during the first trimester of gestation. She had a severe diphtheritic toxaemia and paralysis of all four limbs but made a full recovery from these manifestations. pregnancy, apart from vaginal bleeding, was not interrupted. At term she was delivered of a female baby who was physically normal but had a very high level of IgA in cord blood. Diphtheria in adults is a rare disease and the occurrence of diphtheria in a pregnant woman has not, as yet, been reported. Accordingly it is not known how fetal growth and development progress in the presence of diphtheria toxin in the maternal circulation. Similarly the effects on fetal immune responses of an acute maternal infection like diphtheria occurring in early pregnancy are not known.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
| | Next -> |