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1.
Southeast Asian J Trop Med Public Health ; 2008 Sep; 39(5): 804-7
Article in English | IMSEAR | ID: sea-31737

ABSTRACT

A 16-year-old Thai male presented with sudden onset severe epigastric and right upper quadrant pain, fever (39 degrees C), chills and malaise. He gave no history of underlying disease, migratory swelling or urticarial skin rash. He had a history of frequently eating raw pork. Physical examination revealed a soft abdomen with markedly tender hepatomegaly. His blood count showed extreme leukocytosis with hypereosinophilia. After admission he developed a non-productive cough with left sided chest pain, a chest x-ray showed a left pleural effusion. Serological findings were positive for Gnathostoma larval antigen but not Fasciola antigen. The patient recovered completely after albendazole treatment. His clinical presentation is compatible with abdominopulmonary hypereosinophilic syndrome or visceral larva gnathostomiasis. The presented case is interesting not only for physicians who work in endemic areas of gnathostomiasis but also for clinicians who work in travel medicine clinics in developed countries, to consider abdominopulmonary gnathostomiasis when patients present with the signs and symptoms of visceral larva migrans.


Subject(s)
Abdomen/parasitology , Adult , Albendazole/therapeutic use , Animals , Anthelmintics/therapeutic use , Antigens, Helminth/blood , Eosinophilia/etiology , Gnathostoma/isolation & purification , Humans , Lung Diseases, Parasitic/complications , Male , Spirurida Infections/complications , Thailand
2.
Article in English | IMSEAR | ID: sea-39597

ABSTRACT

The authors reported a case of systemic lupus erythematosus (SLE) with an unusual presentation. The patient presented with acute febrile illness along with progressive pancytopenia related to increasing hemophagocytic activity of histiocytes in the bone marrow. Concomitant polyarthritis, myositis, nephritis, high titer of antinuclear factor (1:2,560) and positive test for anti-DNA antibody made him fit the diagnostic criteria of SLE. No definite evidence of associated infections was confirmed by bacteriologic, serologic and viral studies. He did not respond to empiric antibiotic therapy but dramatically responded to corticosteroid treatment. Therefore, diagnosis of acute lupus hemophagocytic syndrome was made. The clinical presentation, laboratory diagnosis, and management of the patient are discussed and the literature was reviewed and presented.


Subject(s)
Acute Disease , Adult , Anti-Inflammatory Agents/therapeutic use , Bone Marrow/pathology , Diagnosis, Differential , Humans , Lupus Erythematosus, Systemic/complications , Male , Pancytopenia/drug therapy , Phagocytosis/immunology , Prednisolone/therapeutic use
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