Gustatory Change after Sympathetic Ganglion Block in Complex Regional Pain Syndrome Type I Patient: A case report

Some reports provide conclusive evidence of close interactive regulation between the taste receptor and sympathetic nervous system. We report a middle-aged male patient with gustatory change after cervical sympathetic ganglion block (CSGB) who had been suffering from hypersensitivity to sour taste since developing complex regional pain syndrome (CRPS) type 1, diagnosed according to the revised CRPS criteria. Despite receiving two high doses of prednisolone therapy, he experienced the recurrence of CRPS symptoms. We attempted other therapy treatments, including pamidronate intravenous infusion, non-steroidal anti-inflammatory drugs, opioids, tricyclic antidepressants, and CSGB. Following each CSGB administration, the patient reported decreased hypersensitivity to sour-tasting foods, such as kimchi and oranges, with decreased pain and reduction of dysautonomic symptoms. This case demonstrates that overactivation of the sympathetic nervous system may influence sensitivity and regulation of gustatory receptors; therefore, a patient demonstrating CRPS symptoms, including taste alterations, may respond positively to CSGB therapy.

Acute Renal Failure (ARF) Associated with Yersinia Pseudotuberculosis Infection Diagnosed by Polymerase Chain Reaction

The clinical significance of Yersinia pseudotuberculosis (Y. pseudotuberculosis) has recently recognized in various part of the world because it can cause a wide range of clinical problems such as mesenteric lymphadenitis, septicemia, reactive arthritis, terminal ileitis, erythema nodosum and acute renal failure. we experienced a case of acute renal failure associated with Y. pseudotuberculosis infection. We applied a nested polymerase chain reaction method for rapid diagnosis of Y. pseudotuberculosis infection. DNA was extracted from standard strains of Y. pseudotuberculosis, Y. enterocolitica, serial blood samples, urine, and mountain water by phenol-chloroform method. Using specific primers, we amplified inv and ail gene from extracted DNA samples by PCR method. The patient' serotype was Y. pseudotuberculosis 2a and it's titer was 1:40 initially, after 2 weeks the titer increased to 1:160. Stool culture was negative. Inv gene amplification was positive in patient's urine, febrile stage blood, and mountain water. The nested polymerase chain reaction method can be used clinically for rapid diagnosis of Y. pseudotuberculosis infection. So we report here the clinical findings and PCR method of this case with brief review of the literatures.