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1.
Pesqui. vet. bras ; 41: e06912, 2021. tab, graf, ilus
Article in English | ID: biblio-1346689

ABSTRACT

Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.(AU)


A leucoencefalomalácia (LEM) é uma enfermidade que acomete equídeos causada pela ingestão de milho e seus derivados e feno contaminados pela micotoxina fumonisina, um metabólito do fungo Fusarium verticillioides (sinônimo para F. moniliforme). Os sinais clínicos apresentam início agudo e evolução rápida e são decorrentes de lesões encefálicas. O objetivo deste estudo é descrever os achados clínicos de 11 equídeos diagnosticados com LEM, incluindo a análise do líquido cefalorraquidiano (LCR). 91% dos animais afetados eram equinos e somente 9% (1/11) era asinino. A localização clínica das lesões era 64% (7/10) cerebrais, manifestadas por alterações no estado mental e comportamento e 36% (4/10) no tronco encefálico, manifestadas por incoordenação, desvio lateral de cabeça, nistagmo, hipoalgesia da face e dificuldade de apreensão, mastigação e deglutição de alimentos. Comparativamente, os achados post mortem revelaram que 82% (9/11) das lesões eram no cérebro e 18% (2/11) no tronco encefálico. Alterações no LCR, tais como xantocromia (43%, 3/7), hiperproteinorraquia (50%, 3/6) e pleocitose (43%, 3/7), foram observadas. Os animais afetados apresentaram sinais clínicos compatíveis com lesões encefálicas e/ou de tronco cerebral. O LCR de animais com LEM pode apresentar xantocromia, hiperproteinorraquia, e pleocitose, reforçando que esta doença deve ser incluída como diagnóstico diferencial de encefalomielites.(AU)


Subject(s)
Animals , Brain Injuries , Cerebrospinal Fluid , Leukoencephalopathies/microbiology , Fusarium , Horses , Leukocytosis , Mycotoxins , Eating
2.
Pesqui. vet. bras ; 41: e06801, 2021. tab, graf
Article in English | ID: biblio-1346694

ABSTRACT

A reticular diaphragmatic hernia is a congenital or acquired alteration resulting from protrusion of the reticulum into the thoracic cavity. In ruminants, lesions to the diaphragmatic muscle, due to penetration of sharp metallic objects, is the most common cause of this disease. Therefore, given the low number of reports on this disease in the bovine species, the current study aims to describe the clinical, laboratory, and anatomopathological findings, with special emphasis on the ultrasound diagnosis of five cattle with reticular diaphragmatic hernia. The laboratory data were analyzed using mean and standard deviation, and clinical, ultrasound, and pathological findings were evaluated using descriptive statistics. Clinically the animals exhibited varying degrees of dehydration, abdominal distension, tympany, and alterations in ruminal motility, in addition to cardiorespiratory alterations such as murmur, dyspnea, and muffling of lung sounds. The laboratory examination showed neutrophilic leukocytosis and hyperfibrinogenemia. The ultrasonographic images demonstrated reticulum inside the thoracic cavity adjacent to the lung and heart, although no reticular motility was observed. The pathological lesions confirmed the findings of the ultrasound exams. Thus, the current study demonstrated that ultrasonography was efficient in diagnosing reticular diaphragmatic hernia in the bovine species.(AU)


A hérnia reticular diafragmática é uma alteração congênita ou adquirida resultante da protrusão do retículo para o interior da cavidade torácica. Em ruminantes, lesões no músculo diafragmático devido a penetração de objetos metálico pontiagudos constitui a causa mais comum dessa enfermidade. Portanto, diante dos poucos relatos a cerca dessa enfermidade nos animais da espécie bovina, este estudo tem como objetivo descrever os achados clínicos, laboratoriais, anatomopatológicos e dar ênfase especial no diagnóstico ultrassonográfico de cinco bovinos acometidos com hérnia reticular diafragmática. Os dados laboratoriais foram analisados utilizando-se media e desvio padrão e os achados dos exames clínico, ultrassonográfico e anatomopatológicos foram avaliados através de estatística descritiva. Clinicamente os animais exibiam desidratação em variados graus, distensão abdominal, timpania e alterações na motilidade ruminal. Além de alterações cardiorrespiratórias como sopro, dispneia e abafamento dos sons pulmonares. O exame laboratorial revelou leucocitose por neutrofilia e hiperfibrinogenemia. As imagens ultrassonográficas revelaram retículo no interior da cavidade torácica adjacente ao pulmão e coração, porém nenhuma motilidade reticular foi observada. As lesões anatomopatológicas confirmaram os achados dos exames ultrassonográficos. Dessa maneira, este trabalho demonstrou que a ultrassonografia foi eficiente no diagnóstico da hérnia reticular diafragmática nos animais da espécie bovina.(AU)


Subject(s)
Animals , Cattle , Hernia, Diaphragmatic/diagnostic imaging , Leukocytosis , Cattle/injuries , Ultrasonography
3.
Iatreia ; 33(3): 222-228, jul.-set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1143073

ABSTRACT

RESUMEN Introducción: las leucemias constituyen un grupo complejo de hemopatías que, por su etiología, patogenia y mortalidad, son consideradas un problema de salud pública. Su detección temprana permite la remisión oportuna para la confirmación del diagnóstico y el inicio del tratamiento. Objetivo: describir la celularidad sanguínea de pacientes con presencia de blastos en sangre periférica, provenientes de cinco ciudades de Colombia durante el año 2017. Métodos: estudio tipo descriptivo de serie de casos. A partir de hemogramas y sus respectivos extendidos de sangre periférica, se analizó cualitativa y cuantitativamente las células sanguíneas de los pacientes con blastos que cumplieron con los criterios de inclusión. Resultados: fueron incluidos 39 pacientes con presencia de blastos de novo en sangre periférica procedentes de Cúcuta 48,7 %, Valledupar 33,3 %, Tunja 10,3 %, Socorro 5,1 % y Villavicencio 2,6 %. El 100 % eran afiliados al sistema general de seguridad social en salud en donde predominó el sexo femenino con el 54 %, la edad promedio para las mujeres fue de 32,5 años y para los hombres fue de 44,2 años. El 76 % de los pacientes presentó leucocitosis de moderada a grave y 69,2 % neutropenia. El 95 % presentó anemia, 51 % hipocromía y 38 % microcitos. El 74 % presentó trombocitopenia y 15 % macroplaquetas. Conclusiones: los hallazgos concuerdan con lo reportado por la literatura en relación con el predominio de la enfermedad de acuerdo con la edad y el sexo. La anemia, trombocitopenia y neutropenia, se mantienen como característica constante en los pacientes con leucemia.


SUMMARY Introduction: Leukemia constitutes a complex group of haemopathies, which due to their etiology, pathogenesis and mortality, can be considered a public health problem. Its early detection allows for timely remission for confirmation of the diagnosis and early start of treatment. Objective: To describe the sanguineous cellularity in a population with presence of blasts in peripheral blood coming from different regions of Colombia du-ring the year 2017. Methods: A descriptive study, type case series. Hemograms and peripheral blood smears from patients with blast presence or a presumptive diagnosis of leukemia were analyzed in five cities of Colombia, all of whom met the inclusion criteria. Results: 39 patients with presence of de novo blasts from Cúcuta 48.7%, Valledupar 33.3%, Tunja 10.3%, Socorro 5.1% and Villavicencio 2.6% were found. All the individuals were affiliated to the Colombian health-care system. Fifty four percent of the subjects were female, with an average age of 44.2 years for men and 32.5 for women. Seventy six percent of the patients presented moderate to severe leukocytosis and 69.2% neutropenia. Ninety-five percent had anemia, 51% hypochromia and 38% microcytes, 74% presented thrombocytopenia and 15% macroplates. Conclusions: These findings are a match to those found in the literature, as for the predominance of the disease by age and sex. Anemia, thrombocytopenia and neutropenia are a set of characteristics that remain constant in patients with leukemia.


Subject(s)
Humans , Thrombocytopenia , Leukemia , Leukocytosis
5.
Rev. bras. anal. clin ; 51(3): 191-195, 20190930. tab
Article in Portuguese | LILACS | ID: biblio-1047605

ABSTRACT

Os enteroparasitos causam aos seus portadores, entre outros agravos, desnutrição seguida por perda de peso, diarreias, vômitos, desidratação, anemia e enterites. Todos esses sintomas podem desencadear distúrbios dos índices hematológicos como contagem de hemácias, hematócrito, hemoglobina, leucócitos totais e eosinófilos. Este estudo teve como objetivo avaliar e analisar as alterações hematológicas em indivíduos com diagnóstico parasitológico positivo para enteroparasitos. Foi realizado um estudo com base nos dados laboratoriais, em que se analisou o hemograma de 412 indivíduos positivos para enteroparasitoses. Os dados demonstraram que existem relações entre as alterações hematológicas, principalmente a anemia, leucocitose e a eosinofilia, com as infecções parasitárias intestinais. Verificou-se também a frequência de poliparasitismo e suas alterações mais frequentes. O estudo apresentou uma possível contribuição para futuros trabalhos que relatem a importância da prevenção e tratamento das doenças parasitárias em humanos.


The enteroparasites cause to their carriers, among other damages, malnutrition followed by weight loss, diarrhea, vomiting, dehydration, anemia and enteritis. All these symptoms can trigger hematological indices disorders such as red blood cell count, hematocrit, hemoglobin, total leukocytes and eosinophils. This study aimed to evaluate and analyze the hematological alterations in individuals with positive parasitological diagnosis for enteroparasites. A study was carried out based on the laboratory data, in which the hemogram of 412 positive individuals for enteroparasitoses was analyzed. The data demonstrated that there are relationships between hematological changes, mainly anemia, leukocytosis and eosinophilia, with intestinal parasitic infections. The frequency of polyparasitism and its most frequent alterations were also verified. The study presented a possible contribution to future studies that report the importance of the prevention and treatment of parasitic diseases in humans


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Parasitic Diseases , Eosinophilia , Anemia , Leukocytosis
6.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(2): 252-256, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1013282

ABSTRACT

ABSTRACT Objective: To highlight the importance of the new classification criteria for the macrophage activation syndrome (MAS) in systemic juvenile idiopathic arthritis in order to reduce morbidity and mortality outcome related to this disease. Case description: A 12-year-old female patient with diagnosis of systemic juvenile idiopathic arthritis under immunosuppression therapy for two years developed cough, acute precordial chest pain, tachypnea, tachycardia and hypoxemia for two days. Chest tomography showed bilateral laminar pleural effusion with bibasilar consolidation. The electrocardiogram was consistent with acute pericarditis and the echocardiogram showed no abnormalities. Laboratory exams revealed anemia, leukocytosis and increased erythrocyte sedimentation rate, as well as C-reactive protein rate and serum biomarkers indicative of myocardial injury. Systemic infection and/or active systemic juvenile idiopathic arthritis were considered. She was treated with antibiotics and glucocorticoids. However, 10 days later she developed active systemic disease (fever, evanescent rash and myopericarditis with signs of heart failure) associated with macrophage activation syndrome, according to the 2016 Classification Criteria for Macrophage Activation Syndrome in Systemic Juvenile Idiopathic Arthritis. She was treated for five days with pulse therapy, using glucocorticoids, immunoglobulin and cyclosporine A, with improvement of all clinical signs and laboratory tests. Comments: Myopericarditis with signs of heart failure associated with MAS is a rare clinical presentation of systemic juvenile idiopathic arthritis. Macrophage activation syndrome occurs mainly during periods of active systemic juvenile idiopathic arthritis and may be triggered by infection. Knowledge about this syndrome is crucial to reduce morbidity and mortality.


RESUMO Objetivo: Destacar a importância do conhecimento sobre os novos critérios de classificação para síndrome de ativação macrofágica (SAM) na artrite idiopática juvenil sistêmica para reduzir a morbidade e mortalidade desse desfecho. Descrição do caso: Adolescente do sexo feminino de 12 anos de idade, em terapia imunossupressora por diagnóstico de artrite idiopática juvenil sistêmica há 2 anos, com quadro de tosse, dor precordial aguda, taquipneia, taquicardia e hipoxemia há 2 dias. A tomografia de tórax evidenciou efusão pleural laminar bilateral com consolidação bibasal. O eletrocardiograma foi compatível com pericardite aguda, e o ecocardiograma foi normal. Os exames laboratoriais revelaram anemia, leucocitose e aumento da velocidade de hemossedimentação, proteína C-reativa e marcadores séricos de lesão miocárdica. Infecção sistêmica e/ou doença sistêmica em atividade foram consideradas. A paciente foi tratada com antibióticos e glicocorticoide. Entretanto, dez dias depois, evoluiu com doença sistêmica em atividade (febre, exantema e miopericardite com insuficiência cardíaca) associada à SAM, de acordo com o 2016 Classification Criteria for Macrophage Activation Syndrome in Systemic Juvenile Idiopathic Arthritis, e necessitou de cinco dias de pulsoterapia com glicocorticoide, imunoglobulina e ciclosporina A, com melhora de todos os parâmetros clínicos e laboratoriais. Comentários: A miopericardite com sinais de insuficiência cardíaca associada à SAM é uma apresentação clínica rara da artrite idiopática juvenil sistêmica, que ocorre principalmente em períodos de atividade sistêmica da doença e pode ser deflagrada por infecções. O conhecimento sobre essa síndrome é fundamental para reduzir morbidade e mortalidade desse grave desfecho.


Subject(s)
Humans , Female , Child , Cyclosporine/administration & dosage , Glucocorticoids/administration & dosage , Arthritis, Juvenile/complications , Arthritis, Juvenile/diagnosis , Arthritis, Juvenile/physiopathology , Arthritis, Juvenile/immunology , Chest Pain/diagnosis , Chest Pain/etiology , Tomography, X-Ray Computed/methods , Treatment Outcome , Immunoglobulins, Intravenous/administration & dosage , Pulse Therapy, Drug/methods , Electrocardiography/methods , Macrophage Activation Syndrome/etiology , Macrophage Activation Syndrome/physiopathology , Macrophage Activation Syndrome/blood , Macrophage Activation Syndrome/therapy , Immunosuppressive Agents/administration & dosage , Leukocytosis/diagnosis , Leukocytosis/etiology
7.
Article in English | WPRIM | ID: wpr-773422

ABSTRACT

OBJECTIVE@#This study was designed to evaluate hematological disorders and the orchestrating roles of hepcidin and IL-6 in rat models of thioacetamide (TAA) and carbon tetrachloride (CCl4) hepatotoxicity.@*METHODS@#Rats were intraperitoneally injected with TAA (10 mg/100 g rat weight dissolved in isosaline) or CCl4 (100 μL/100 g rat weight diluted as 1:4 in corn oil) twice weekly for eight consecutive weeks to induce subchronic liver fibrosis. Blood and tissue samples were collected and analyzed.@*RESULTS@#CCl4 but not TAA significantly decreased the RBCs, Hb, PCV, and MCV values with minimal alterations in other erythrocytic indices. Both hepatotoxins showed leukocytosis, granulocytosis, and thrombocytopenia. By the end of the experiment, the erythropoietin level increased in the CCl4 model. The serum iron, UIBC, TIBC, transferrin saturation%, and serum transferrin concentration values significantly decreased, whereas that of ferritin increased in the CCl4 model. TAA increased the iron parameters toward iron overload. RT-PCR analysis revealed increased expression of hepatic hepcidin and IL-6 mRNAs in the CCl4 model and suppressed hepcidin expression without significant effect on IL-6 in the TAA model.@*CONCLUSION@#These data suggest differences driven by hepcidin and IL-6 expression between CCl4 and TAA liver fibrosis models and are of clinical importance for diagnosis and therapeutics of liver diseases.


Subject(s)
Animals , Blood Chemical Analysis , Carbon Tetrachloride , Toxicity , Hepcidins , Pharmacology , Injections, Intraperitoneal , Interleukin-6 , Pharmacology , Iron , Blood , Metabolism , Leukocytosis , Therapeutics , Liver Cirrhosis , Therapeutics , Male , Rats , Thioacetamide , Toxicity , Thrombocytopenia , Therapeutics , Transferrin , Metabolism
8.
Article in English | WPRIM | ID: wpr-765918

ABSTRACT

BACKGROUND: Spinal cord involvement of primary central nervous system lymphoma (PCNSL) is rare in a young immunocompetent patient and can be misdiagnosed as an inflammatory demyelinating disease (IDD) of the central nervous system.


Subject(s)
Biopsy , Brain , Central Nervous System , Cerebrospinal Fluid , Cervical Cord , Demyelinating Diseases , Drug Therapy , Electrons , Hand , Humans , Leukocytosis , Lymphoma , Magnetic Resonance Imaging , Medulla Oblongata , Methotrexate , Middle Aged , Multiple Sclerosis , Neuromyelitis Optica , Spinal Cord
9.
Article in English | WPRIM | ID: wpr-761757

ABSTRACT

To analyze the clinical and endoscopic features of colonic anisakiasis. A retrospective chart review of 20 patients with colonic anisakiasis, who were diagnosed by colonoscopy at 8 hospitals between January 2002 and December 2011, was performed. Patients’ mean age was 53.6±10.74 years. Seventy percent patients were men. Acute abdominal pain was a common symptom that mostly developed within 48 hr after the ingestion of raw fish, and which lasted for 1–28 days. Sixty percent patients had ingested raw fish before the diagnosis of colonic anisakiasis and 40% patients were incidentally found to have colonic anisakiasis during the screening colonoscopies. Leukocytosis and eosinophilia were each found in 20% of the patients. In all patients who underwent colonoscopy, the worms were removed with biopsy forceps, except in 1 case, and a definite diagnosis of anisakiasis was made. In some cases of colonic anisakiasis, colonoscopy may be helpful in the diagnosis and treatment to avoid surgical intervention.


Subject(s)
Abdominal Pain , Anisakiasis , Biopsy , Colon , Colonoscopy , Diagnosis , Eating , Eosinophilia , Humans , Korea , Leukocytosis , Male , Mass Screening , Retrospective Studies , Surgical Instruments
10.
Article in English | WPRIM | ID: wpr-719625

ABSTRACT

PURPOSE: Though prompt diagnosis to minimize symptom duration (SD) is highly associated with organ salvage in cases of testicular torsion (TT), SD is subjective and hard to determine. We thus investigated the clinical implications of systemic inflammatory responses (SIRs) as potential surrogates of SD to improve testis survival. MATERIALS AND METHODS: Sixty men with TT that underwent immediate operation among orchiectomy and orchiopexy following a visit to a single emergency department were retrospectively enrolled. Mandatory laboratory tests conducted included neutrophil, lymphocyte, and platelet counts. RESULTS: Mean age and SD was 15.7±3.7 years and 8.27±4.98 hours, respectively. Thirty-eight (63.3%) underwent orchiectomy and the remaining 22 underwent orchiopexy. Leukocytosis (p=0.001) and neutrophil-lymphocyte ratio (NLR, p < 0.001) were significantly lower in the orchiopexy group as was SD (3.27±1.88 vs. 11.16±3.80, p < 0.001). Although multivariate model showed that the only single variable associated with receipt of orchiopexy was SD (odds ratio [OR]=0.259, p < 0.001), it also revealed NLR as a sole SIR associated with SD (B=0.894, p < 0.001). While 93.3% with a SD of within 3 hours underwent orchiopexy, only 26.6% of affected testes were preserved between 3 to 12 hours (n=30). When multivariable analysis was applied to those with window period, NLR alone predicted orchiopexy rather than orchiectomy (p=0.034, OR=0.635, p=0.013). The area under curve between SD (0.882) and NLR (0.756) was similar (p=0.14). CONCLUSIONS: This study showed NLR independently predicted testis survival by proper surgical correction particularly for patients with marginally delayed diagnosis, which suggest the clinical usefulness for identifying candidates for orchiopexy in emergency setting.


Subject(s)
Area Under Curve , Delayed Diagnosis , Diagnosis , Emergencies , Emergency Service, Hospital , Humans , Inflammation , Leukocytosis , Lymphocytes , Male , Neutrophils , Orchiectomy , Orchiopexy , Platelet Count , Retrospective Studies , Spermatic Cord Torsion , Symptom Assessment , Testis
11.
Article in English | WPRIM | ID: wpr-764981

ABSTRACT

BACKGROUND: Acute necrotizing encephalopathy (ANE) is a rare, but potentially life threatening neurological condition in children. This study aimed to investigate its clinical spectrum, diagnostic and therapeutic dilemma, and prognosis. METHODS: Twelve children with ANE were included in the study. The diagnosis was made by clinical and radiological characteristics from January 1999 to December 2017 and their clinical data were retrospectively analyzed. RESULTS: A total of 12 children aged 6 to 93 months at onset (5 male: 7 female) were evaluated. The etiology was found in 4 of them (influenza A, H1N1; coxsackie A 16; herpes simplex virus; and RANBP2 gene/mycoplasma). The most common initial presentations were seizures (67%) and altered mental status (58%). The majority of the subjects showed elevation of aspartate aminotransferase/alanine aminotransferase with normal ammonia and increased cerebrospinal fluid protein without pleocytosis. Magnetic resonance imaging revealed increased T2 signal density in bilateral thalami in all patients, but the majority of the subjects (67%) also had lesions in other areas including tegmentum and white matter. Despite the aggressive immunomodulatory treatments, the long-term outcome was variable. One child and two sisters with genetic predisposition passed away. CONCLUSION: ANE is a distinctive type of acute encephalopathy with diverse clinical spectrum. Even though the diagnostic criteria are available, they might not be watertight. In addition, treatment options are still limited. Further studies for better outcome are needed.


Subject(s)
Ammonia , Aspartic Acid , Brain Diseases , Cerebrospinal Fluid , Child , Diagnosis , Genetic Predisposition to Disease , Humans , Leukocytosis , Magnetic Resonance Imaging , Male , Prognosis , Retrospective Studies , Seizures , Siblings , Simplexvirus , White Matter
12.
Article in Korean | WPRIM | ID: wpr-758439

ABSTRACT

OBJECTIVE: This study was conducted to identify the characteristics of early infants with urinary tract infection (UTI) who visited the pediatric emergency department (PED) and to investigate the characteristics of patients with cerebrospinal fluid (CSF) pleocytosis and incidence of bacterial meningitis. METHODS: We retrospectively reviewed the records of UTI infants aged 31 to 90 days presenting at PED whom had lumbar puncture. From September 1, 2014 to August 31, 2017, a total of 225 infants were enrolled. RESULTS: Twenty three patients had CSF pleocytosis. Of these, two patients were positive for CSF enteroviral polymerase chain reaction, while none were positive for bacterial culture. We compared the characteristics of infants with CSF pleocystosis. There were not diffences in sex, vaccination before fever, general condition, peak body temperature, peripheral white blood cell, C-reactive protein, and procalcitonin between two groups. However, in patients with prematurity history, incidence of CSF pleocytosis was high. Four infants hot bacteremia, and organism of these patients was all Escherichia coli. All of them had negative CSF culture and normal CSF findings. CONCLUSION: No febrile early infants with UTI had bacterial meningitis. As a result, we must not do conventional test of CSF in patients with UTI.


Subject(s)
Bacteremia , Body Temperature , C-Reactive Protein , Cerebrospinal Fluid , Emergencies , Emergency Service, Hospital , Escherichia coli , Fever , Humans , Incidence , Infant , Leukocytes , Leukocytosis , Meningitis , Meningitis, Bacterial , Polymerase Chain Reaction , Retrospective Studies , Spinal Puncture , Urinary Tract Infections , Urinary Tract , Vaccination
13.
Article in English | WPRIM | ID: wpr-741867

ABSTRACT

Mycoplasma pneumoniae (MP) is the most common causative agent of community-acquired pneumonia in school-aged children. An 8-year-old boy who had been diagnosed with autism looked severely ill when he presented to our hospital due to dyspnea and lethargy. He had fever and cough 7 days prior to hospitalization. He had signs and symptoms of severe respiratory distress. The percutaneous oxygen saturation was 88% at high oxygen supply. Chest radiography showed diffusely increased opacity with moderate pleural effusion. He was intubated immediately and admitted to the intensive care unit. Under the clinical impression of mycoplasmal pneumonia, intravenous clarithromycin was started. Laboratory findings showed leukocytosis, hepatitis, decreased renal function, and presence of serum MP immunoglobulin (Ig) M (+) IgG (+) and sputum MP polymerase chain reaction (+). On hospital day 2, the patient developed multiple organ failure with acute respiratory distress syndrome (ARDS). Veno-venous extracorporeal membrane oxygenation (ECMO) was performed with continuous renal replacement therapy (CRRT) and was weaned successfully. This is the first reported case of an ARDS due to MP infection complicated by multiple organ failure that was successfully treated with ECMO and CRRT in South Korea.


Subject(s)
Autistic Disorder , Child , Clarithromycin , Cough , Dyspnea , Extracorporeal Membrane Oxygenation , Fever , Hepatitis , Hospitalization , Humans , Immunoglobulin G , Immunoglobulins , Intensive Care Units , Korea , Lethargy , Leukocytosis , Male , Multiple Organ Failure , Mycoplasma pneumoniae , Mycoplasma , Oxygen , Pleural Effusion , Pneumonia , Pneumonia, Mycoplasma , Polymerase Chain Reaction , Radiography , Renal Replacement Therapy , Respiratory Distress Syndrome , Sputum , Thorax
14.
Article in English | WPRIM | ID: wpr-741749

ABSTRACT

Ovarian vein thrombosis (OVT) is a rare disease with complications that can be life-threatening. An ovarian vein thrombus in a gestational trophoblastic neoplasia (GTN) is an extremely rare condition that has not been previously reported in the literature. We report the case of a 23-year-old woman who presented with symptoms of amenorrhea for 15 weeks and 6 days along with intermittent lower abdominal pain. She was diagnosed with a hydatidiform mole, and a metastatic workup was scheduled. Abdominal computed tomography showed a right ovarian vein thrombus. She received methotrexate chemotherapy combined with oral anticoagulants. Complete radiological remission was obtained. During the 12-month follow-up period, no disease progression or recurrence was noted. Early recognition and detection of the condition are of the utmost importance. The differential diagnosis of OVT must be considered when there is unexplained abdominal pain, fever, and leukocytosis during the diagnosis and treatment of GTN. A high level of suspicion is required for prompt diagnosis of OVT.


Subject(s)
Abdominal Pain , Amenorrhea , Anticoagulants , Diagnosis , Diagnosis, Differential , Disease Progression , Drug Therapy , Female , Fever , Follow-Up Studies , Gestational Trophoblastic Disease , Humans , Hydatidiform Mole , Leukocytosis , Methotrexate , Pregnancy , Rare Diseases , Recurrence , Thrombosis , Veins , Venous Thrombosis , Young Adult
15.
Laboratory Medicine Online ; : 177-180, 2019.
Article in Korean | WPRIM | ID: wpr-760497

ABSTRACT

Catabacter hongkongensis is an anaerobic gram-positive coccobacillus that was first isolated in Hong Kong. It is infectious and causes high mortality in patients with rare but underlying diseases. Alistipes indistinctus is an anaerobic gram-negative coccobacillus. This bacterium is a common member of the human intestinal microbiota. We report a case of C. hongkongensis and A. indistinctus isolated from blood cultures of a patient with acute appendicitis. A 35-year-old female patient with no specific medical history was admitted to the hospital due to abdominal pain, vomiting, nausea, and diarrhea experienced on the day before admission. On admission, laboratory tests revealed leukocytosis, neutropenia, and elevated C–reactive protein and procalcitonin levels. Following an abdominal computed tomography showing acute appendicitis with suspected perforation, emergency surgery was performed. Growth was observed in two anaerobic blood culture bottles after four days. After further culturing of the bacteria on Brucella Blood Agar, two types of bacteria were obtained. The two bacterial isolates, one gram-positive and one gram-negative, were unable to be identified using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Thus, 16S rRNA gene sequence analysis was performed, resulting in identification of the bacteria as C. hongkongensis and A. indistinctus. The patient was administered antibiotics and discharged two days after surgery. Although MALDI-TOF MS enables fast and accurate identification of bacteria, C. hongkongensis and A. indistinctus were not listed in the spectral library, and 16S rRNA gene sequence analysis was useful for identifying the two bacteria.


Subject(s)
Abdominal Pain , Adult , Agar , Anti-Bacterial Agents , Appendicitis , Bacteria , Brucella , Diarrhea , Emergencies , Female , Gastrointestinal Microbiome , Genes, rRNA , Hong Kong , Humans , Leukocytosis , Mass Spectrometry , Mortality , Nausea , Neutropenia , Sequence Analysis , Vomiting
16.
Article in Korean | WPRIM | ID: wpr-786525

ABSTRACT

Hyperleukocytosis (HL), defined by a peripheral white blood cell (WBC) count exceeding 100,000/mm³, is occasionally observed in childhood acute leukemia. The increased viscosity in the micro-circulation by HL and the interaction between the leukemic blasts and endometrium of blood vessels sometimes result in leukostasis. Leukostasis can incur life-threatening manifestations, such as respiratory distress, brain infarction and hemorrhage, and renal failure, needing an emergency care. Although early stage of leukostasis is difficult to detect due to nonspecific manifestations, an emergency care is mandatory because leukostasis can proceed to a fatal course. Initial management includes an aggressive fluid therapy that can reduce WBC count, and prevent other metabolic complications implicated by HL. Packed red blood cells should be judiciously transfused because it increases blood viscosity. Conversely, transfusion of platelet concentrates or fresh frozen plasma, which does not affect blood viscosity, is recommended for prevention of hemorrhage. To reduce tumor burden, leukapheresis or exchange transfusion is commonly performed. However, the efficacy is still controversial, and technical problems are present. Leukapheresis or exchange transfusion is recommended if WBC count is 200,000–300,000/mm³ or more, especially in acute myelocytic leukemia, or manifestations of leukostasis are present. In addition, early chemotherapy is the definite treatment of leukostasis.


Subject(s)
Blood Platelets , Blood Vessels , Blood Viscosity , Brain Infarction , Disease Management , Drug Therapy , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Endometrium , Erythrocytes , Female , Fluid Therapy , Hemorrhage , Leukapheresis , Leukemia , Leukemia, Myeloid, Acute , Leukocyte Disorders , Leukocytes , Leukocytosis , Leukostasis , Plasma , Renal Insufficiency , Tumor Burden , Viscosity
17.
São Paulo; HSPM; 2019.
Non-conventional in Portuguese | LILACS, ColecionaSUS, SMS-SP, HSPM-Producao, SMS-SP | ID: biblio-1247948

ABSTRACT

RESUMO A doença celíaca (DC) é uma forma crônica de enteropatia de mecanismo imunológico que afeta o intestino delgado de crianças e adultos geneticamente predispostos, precipitada pela ingestão de alimentos contendo glúten. Também é conhecida como espru celíaco, enteropatia sensível ao glúten ou espru não tropical. A doença pode se manifestar na forma Clássica, Não Classica e assintomática. Para o diagnostico é imprescindível a realização de endoscopia digestiva alta com biópsia de intestino delgado, considerado o padrão-ouro. Os marcadores sorológicos são úteis para identificar os indivíduos que deverão ser submetidos à biópsia de intestino delgado e também são úteis para acompanhamento do paciente celíaco. Os principais testes sorológicos para a detecção da intolerância ao glúten são o anticorpo antigliadina, o anticorpo antiendomísio e o anticorpo antitransglutaminase (TTG). O tratamento da DC consiste na introdução de dieta isenta de glúten de forma permanente, devendo-se, portanto, excluir da dieta os seguintes cereais e seus derivados: trigo, centeio, cevada, malte, aveia. Neste trabalho relatamos o caso de um paciente com diagnóstico tardio de DC, que iniciou o quadro com enteropatia perdedora de proteína, com quadro infeccioso vigente, PCR aumentado, leucocitose, plaquetose e hipoalbuminemia. Realizada EDA com biópsia que juntamente com anti endomisio IgA positivo resultaram no diagnóstico de DC. Paciente manteve-se com leucocitose e plaquetose. O objetivo deste relato é apresentar uma paciente com diagnóstico de DC e revisar aspectos clínicos e terapêuticos atuais da doença. Palavras-chave: Doença Celíaca; Enteropatia Perdedora de Proteína ; Plaquetose; Leucocitose.


Subject(s)
Humans , Male , Female , Protein-Losing Enteropathies , Thrombocytosis , Celiac Disease , Leukocytosis
18.
Pesqui. vet. bras ; 38(8): 1649-1655, Aug. 2018. tab, graf
Article in Portuguese | ID: biblio-976471

ABSTRACT

Foi realizado um estudo retrospectivo do líquido cérebro-espinhal de cães (LCE), atendidos pelo Serviço de Neurologia do Hospital Veterinário da Instituição, de 2004 a 2015, com o objetivo de analisar os resultados de cães com sinais neurológicos, comparar as alterações encontradas em dois locais de colheita no mesmo paciente e verificar se esse exame auxiliou o clínico em reforçar a suspeita clínica das principais doenças do sistema nervoso central. A pleocitose linfocítica esteve presente em 78,3% (29/37) das amostras de cães com cinomose e em 23,2% (10/43) de cães com DDIV. Houve dissociação albuminocitológica (DAC) em 73% (19/26) das amostras de cães com tumores IC e em 64,3% (9/14) de cães com tumores envolvendo a ME. Em cães com DDIV, houve significância estatística (p<0,05) entre o grau de disfunção neurológica e o total de células nucleadas (TCN) e total de proteínas (TP). Em 29 cães, houve a colheita do LCE da cisterna magna e da cisterna lombar e em 12 (41,4%) os resultados foram diferentes entre as duas amostras colhidas do mesmo cão, onde dois (6,9%) apresentaram alteração na amostra colhida cranial à lesão. Pode-se concluir que a pleocitose linfocítica foi a principal alteração encontrada no LCE de cães com cinomose e DDIV e DAC nas neoplasias, IC e ME, cães acometidos pela DDIV apresentaram sinais neurológicos mais severos conforme o TCN e o TP aumentaram e o LCE sofreu alteração, mesmo colhido cranial ao local da lesão e auxiliou o clínico em reforçar a suspeita clínica, mas não confirmou, as principais doenças neurológicas em cães.(AU)


A retrospective study including the analysis of the cerebrospinal fluid (CSF) of dogs neurologically affected was conducted by the Neurology Service of the Veterinary Hospital at the Institution, between 2004 and 2015. The aim of this study was to analyze the results of the CSF of dogs with neurological signs, and compare the changes in the CSF in two sampling sites in the same patient and see if this test helped the clinician to strengthen clinical suspicion of the major diseases of the central nervous system. Lymphocytic pleocytosis was present in 78.3% (29/37) of samples from dogs with distemper and in 23.2% (10/43) of samples from dogs with IVDD. The albumin cytologic dissociation (ACD) was found in 73% (19/26) of samples from dogs with IC tumors and in 64.3% (9/14) from dogs with tumors involving the SC. For dogs with IVDD, there was statistical significance (p<0.05) between the degree of neurological dysfunction and the total nucleated cells (TNC) and total protein (TP). In 29 dogs, CSF was collected from the cistern magna and the lumbar and in 12 (41.4%) the results were different between the samples of the same dog, where two cases (6,9%) showed alterations in the sample collected cranial to the injury. It can be concluded that the lymphocytic pleocytosis was the main alteration found in the CSF of dogs with distemper and IVDD and ACD in tumors. Dogs affected by IVDD had more severe neurological signs as TNC and TP increased and the CSF was altered even collected cranial to the lesion site and helped the clinician to strengthen the clinical suspicion, but not confirm, the major neurological diseases in dogs.(AU)


Subject(s)
Animals , Dogs , Dogs/abnormalities , Nervous System Diseases/veterinary , Cerebrospinal Fluid , Leukocytosis
19.
Acta méd. colomb ; 43(1): 49-49, ene.-mar. 2018. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-949536

ABSTRACT

Mujer de 58 años, ingresa a urgencias por presentar dolor pleurítico en hemitórax izquierdo de fuerte intensidad, irradiada a dorso, asociado a tos seca y disnea progresiva. No tiene antecedentes de importancia. Al ingreso con tensión arterial: 80/46 mmHg, frecuencia cardiaca 112 por minuto, fre-cuencia respiratoria: 22 por minuto y temperatura: 39°C. Al examen físico: disminución del murmullo vesicular basal izquierdo con estertores y llenado capilar prolongado. Se toman laboratorios que muestran leucocitosis, neu-trofilia y elevación de azoados. Se solicita radiografía de tórax que muestra consolidación basal izquierda y enfisema subcutáneo en cuello.


Subject(s)
Humans , Female , Middle Aged , Subcutaneous Emphysema , Physical Examination , Women , Emergencies , Heart Rate , Leukocytosis
20.
Rev. cuba. hematol. inmunol. hemoter ; 34(1): 83-88, ene.-mar. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-978413

ABSTRACT

La fase leucémica como presentación de un linfoma folicular es rara y debe ser considerada factor de mal pronóstico. Por otra parte, la asociación entre linfoma folicular y síndrome mielodisplásico no se ha descrito. Se presenta el caso de una paciente en la que se detectó marcada leucocitosis y a la que se diagnosticó un linfoma folicular. Recibió quimioterapia con R-CHOP y FCR cuando recayó. Meses después, se realizó un aspirado medular en el cual se observaron cambios compatibles con mielodisplasia, únicamente recibió terapia de soporte y finalmente evolucionó a leucemia mieloide aguda. Aunque se conoce que la mielodisplasia puede ser secundaria al uso de quimioterapia, la paciente presentó además trisomía del cromosoma 11, descrita previamente en mielodisplasia y linfoma tipo Burkitt, la cual pudiera estar en relación con la evolución a leucemia mieloide aguda(AU)


Follicular lymphoma rarely presents with a leukemic phase and this should be considered a negative prognostic factor. Also, follicular lymphoma and myelodysplastic syndrome association has not been previously reported. Herein we present a patient who debuted with marked hyperleukocytosis and was diagnosed with follicular lymphoma, receiving CHOP-R and FCR after she relapsed. Several months later, secondary myelodysplastic changes were observed in her bone marrow. She received supportive therapy and finally progressed into acute myeloid leukemia. Although secondary myelodysplasia is known to be produced by chemotherapy, this patient additionally had trisomy 11, previously described in myelodysplasia and Burkitt's lymphoma, which could be linked to progression to acute myeloid leukemia(AU)


Subject(s)
Humans , Female , Adult , Trisomy , Leukemia/mortality , Lymphoma, Follicular/complications , Leukocytosis/complications , Lymphoma, Follicular/drug therapy
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