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1.
Cureus ; 14(8): e28233, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36158374

ABSTRACT

Scrub typhus is an endemic disease caused by the bites of infected chiggers (larval mites) harboring causative bacteria Orientia tsutsugamushi. Acute pancreatitis is a rare but occasionally fatal complication of scrub typhus infection caused by vascular and perivascular inflammation of the pancreas.A 34-year-old female presented with severe epigastric pain and multiple episodes of vomiting. Extensive evaluation of the patient revealed acute pancreatitis secondary to scrub typhus. The patient also had septic shock and multiple organ dysfunction syndrome. The patient was mechanically ventilated and treated with doxycycline, and pancreatitis was managed conservatively.

2.
JNMA J Nepal Med Assoc ; 60(253): 811-814, 2022 Sep 01.
Article in English | MEDLINE | ID: mdl-36705131

ABSTRACT

Toxic epidermal necrolysis is a potentially life-threatening dermatological condition whose pathogenesis and exact treatment are not yet known. Drugs like anticonvulsants, allopurinol and non-steroidal anti-inflammatory drugs like etoricoxib, a selective cyclo-oxygenase-2 inhibitor prescribed for pain management are associated with a high risk of toxic epidermal necrolysis. It is also associated with immunodeficiency and dysregulated immune reactions like systemic lupus erythematosus, an autoimmune disease in which organs and cells undergo damage initially mediated by tissue binding auto-antibodies and immune complexes. Here, a 34 year old lady was presented in emergency with multiple maculopapular rashes over the neck and trunk region after treatment with etoricoxib for osteoarthritis of the left foot.


Subject(s)
Etoricoxib , Exanthema , Lupus Erythematosus, Systemic , Stevens-Johnson Syndrome , Adult , Female , Humans , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Etoricoxib/adverse effects , Exanthema/complications , Exanthema/drug therapy , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapy , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/etiology , Stevens-Johnson Syndrome/drug therapy
3.
JNMA J Nepal Med Assoc ; 60(254): 898-901, 2022 Oct 01.
Article in English | MEDLINE | ID: mdl-36705151

ABSTRACT

Rhabdomyolysis refers to skeletal muscle breakdown causing a release of different intracellular proteins including myoglobin and several electrolytes in the bloodstream. Elevations diagnose rhabdomyolysis in serum creatine kinase. Mass envenomation by multiple wasp stings can cause rhabdomyolysis followed by acute kidney injury, although it is scarce. A 24-year-old male presented to our tertiary centre in an anaphylaxis-like state after multiple wasps sting, rapidly developing rhabdomyolysis followed by acute kidney injury. Despite having an ectopic kidney with a pre-existing renal parenchymal disease, he recovered and was discharged, which in itself is a rare entity of low clinical incidence. Wasp stings can potentially result in serious clinical manifestations, which need to be watched over, assessed and promptly treated. Keywords: acute kidney injury; case reports; creatine kinase; hymenoptera; rhabdomyolysis.


Subject(s)
Acute Kidney Injury , Insect Bites and Stings , Rhabdomyolysis , Wasps , Animals , Humans , Male , Young Adult , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Creatine Kinase , Insect Bites and Stings/complications , Kidney , Rhabdomyolysis/etiology , Rhabdomyolysis/complications
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