ABSTRACT
Streptococcus bovis/Streptococcus equinus complex includes the subspecies Streptococcus alactolyticus. The prevalence of systemic infection in humans with S alactolyticus is scarce. We present a case of infective endocarditis complicated with hemorrhagic and ischemic stroke in a healthy 31-year-old woman.
ABSTRACT
Rocky Mountain spotted fever (RMSF) is a tick-borne illness that can cause extreme sickness, even death, in otherwise healthy individuals. Sometimes, it is difficult to confirm the diagnosis as the rash often lags behind other symptoms of the illness and may not occur at all. Other symptoms of RMSF are nonspecific, such as fever, headache, and malaise. Besides the confirmatory serology test, antibody titers remain negative in the early phase of the illness. Here, we reported a case of a 21-year-old male who presented with fever, mild headache, body aches, joint pain, dry cough, and characteristic maculopapular rash after visiting a tick-prone area. Doxycycline was started because symptoms and laboratory values heightened our suspicion for the diagnosis of RMSF. His condition improved gradually, and his labs became normal. Our study supports the empirical use of doxycycline in suspected RMSF cases.
ABSTRACT
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by inflammation and eosinophilic accumulation of the esophagus, resulting in dysphagia and food impaction. While the exact etiology of EoE remains unclear, it is believed to be triggered by food allergens and dynamic environmental factors, resulting in various clinical manifestations, from inflammation to fibrosis. Although clinical presentation varies with age, the number of eosinophils in esophagogastroduodenal endoscopy remains the diagnostic gold standard. While diet elimination, proton pump inhibitors (PPIs), topical corticosteroids, and biological therapy are promising treatment options for EoE, there are insufficient data to determine the optimal therapeutic treatment approach. Combination therapies - the use of dietary therapies in conjunction with other treatment modalities, such as PPIs, topical corticosteroids, or biologic agents - have also emerged as a potential management strategy for EoE. In this systematic review, we attempt to highlight the recent advances in EoE therapies and provide updated guidance to their management. From 2017 to 2022, we conducted a comprehensive electronic search of PubMed (MEDLINE) using specific keywords related to our objective and eventually included a total of 44 articles.
