共查询到20条相似文献,搜索用时 15 毫秒
1.
Hlibczuk V 《The Journal of emergency medicine》2007,32(4):365-369
Internal jugular vein thrombosis occurs as an uncommon complication of oropharyngitis. The following case report describes a previously healthy adult woman who presented with sore throat, left ear pain, and fever. She was initially diagnosed with pharyngitis and inadvertently had blood cultures sent as part of her workup. She was then called back to the Emergency Department the following day for positive growth of the blood culture, and found to have thrombophlebitis of the internal jugular vein on computed tomography scan of the neck. Further workup revealed factor XII deficiency. The clinical course was further complicated by septic pulmonary emboli and disseminated intravascular coagulation. The patient was treated with broad-spectrum antibiotics and anticoagulation and made a full recovery. 相似文献
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OBJECTIVE: To describe a serum sickness-like reaction associated with griseofulvin in a child being treated for tinea capitis. CASE SUMMARY: A previously healthy 5-year-old boy presented with tactile fever, rash on his legs and back, swelling of his toes and fingers, and leg pain. He was being treated at the time with griseofulvin for tinea capitis. Laboratory evaluation including immunologic workup revealed no abnormalities. Replacement of griseofulvin with itraconazole, along with an antihistamine and a nonsteroidal antiinflammatory drug, led to complete resolution of the patient's symptoms. An objective causality assessment revealed that the adverse reaction was probable. DISCUSSION: Serum sickness-like reactions may occur 7-21 days following exposure to an offending agent. Clinical manifestations are similar to those of serum sickness, with fever, malaise, and cutaneous eruption. However, on laboratory workup, complement levels are normal. Management of serum sickness-like reaction includes replacing the offending agent and providing symptomatic relief. CONCLUSIONS: Clinicians should be aware of the possibility of serum sickness-like reaction associated with griseofulvin therapy and consider the possibility when choosing between griseofulvin and newer, more expensive drugs. 相似文献
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We describe the case of a 33-year-old African-American male who presented with multiple deep venous thromboses of the upper and lower extremities. Hypercoagulable workup was unrevealing. A chest x-ray showed bilateral hilar lymph node enlargement. Mediastinoscopy with hilar lymph node biopsy was performed. Lymph node histopathologic examination showed noncaseating granulomas. Lymph node tissue culture and special stains were negative for mycobacterial or fungal infection. This is an unusual case of multiple deep venous thromboses and sarcoidosis. The subject of sarcoidosis and venous thrombosis is discussed. 相似文献
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Seokho Yoon Kyeong Hwa Ryu Hye Jin Baek Hyo Jung An Yeon-Hee Joo 《World Journal of Clinical Cases》2021,9(7):1654-1660
BACKGROUNDPrimary non-Hodgkin’s lymphoma of the frontal sinus is extremely rare. In addition, Epstein-Barr virus (EBV) has been reported to play a role in the development of human immunodeficiency virus (HIV)-related malignant lymphomas. To the best of our knowledge, there is no report for the HIV-associated, EBV-positive primary diffuse large B-cell lymphoma (DLBCL) in the frontal sinus.CASE SUMMARYWe present a unique case of HIV-associated, EBV-positive DLBCL in the frontal sinus in a 46-year-old man. Computed tomography of paranasal sinuses revealed dense opacification of the right frontal sinus with combined soft tissue swelling. Based on the clinical and radiological findings, the initial diagnosis was complicated frontal sinusitis, presenting Pott’s puffy tumor. Unexpectedly, HIV testing was positive on preoperative laboratory test, and the frontal sinus lesion was confirmed as EBV-positive DLBCL on biopsy.CONCLUSIONThrough this article, we suggest that EBV-positive DLBCL should be considered as possible diagnosis for patients with nonspecific space-occupying lesion of the paranasal sinuses. We also highlight an importance of clinical suspicion in diagnosing HIV infection because HIV serology is not routinely tested in patients with paranasal sinus problem. 相似文献
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The case presented emphasizes the need for evaluation of the oral cavity in the diagnostic workup of fever of unknown origin. Hurley stated, "Protracted fever of obscure cause remains one of the more daunting clinical challenges facing the physician. It calls for mobilization of all the physician's own skills and the expertise of colleagues as well as maintenance of an open mind to the patient's complaints and observations. Dogged determination and a systematic approach are the keys to solving the problem." When the possibility of dental disease is overlooked, the resulting search is sometimes long, tedious, and expensive. Early examination of the oral cavity by qualified personnel should be done even though pain is not present. 相似文献
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Kunyu Wang Yan Miao Haoyong Ning Feng Guo Yang Bian Qingqing Wang Chenjing Sun Xiaokun Qi Feng Qiu 《The Journal of international medical research》2021,49(2)
Paraneoplastic cerebellar degeneration (PCD) is a neurological syndrome that is likely caused by tumor-induced autoimmunity against the cerebellum. Neuroendocrine carcinoma (NEC) is a type of neoplasm with high-grade malignant histology and biological behavior. The prognosis for both PCD and NEC is typically poor. We report a case of PCD secondary to metastatic NEC in the lymph nodes, with an unknown primary origin. The case presented acute cerebellar manifestations with typical neuroimaging findings, but with atypical prognosis after lymph node dissection. Neurological symptoms can provide clues to potential tumors, and early antitumor treatment may have contributed to the positive prognosis of PCD secondary to NEC in the present case. 相似文献
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Sarcoidosis is a multisystemic disease that usually involves the lungs and lymph nodes, but almost any organ can be involved. Genitourinary involvement with sarcoidosis is extremely rare. We report the case of a 30-year-old African-American male who presented with a right-sided intrascrotal mass and diffuse lymphadenopathy. On further workup, he was found to have sarcoidosis. Two months of corticosteroid treatment resulted in the disappearance of his intrascrotal mass. 相似文献
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目的 探讨XIAP与Omi/HtrA2在弥漫大B细胞淋巴瘤(DLBCL)组织中的表达及与其预后的相关性。方法 收集59例DLBCL患者和30例淋巴结反应增生(RHL)患者的石蜡病理切片,应用免疫组化法对XIAP和Omi/HtrA2进行染色,分析两种蛋白的表达与DLBCL的临床参数和预后的关系。结果 XIAP与Omi/HtrA2在DLBCL中均呈高表达,在RHL中呈低表达甚至未见表达。XIAP在DLBCL的平均阳性率为61.02%,在RHL平均阳性率为36.67%(P<0.05)。Omi/HtrA2在DLBCL中平均阳性率为52.54%,RHL平均阳性率为30.00%(P<0.05)。二者的阳性表达与DLBCL的临床分期、病理类型、乳酸脱氢酶(LDH)水平、淋巴瘤国际预后指数(IPI)评分相关(P<0.05),与性别、年龄、症状分组、结外受累无关(P>0.05)。XIAP和Omi/HtrA2表达呈负相关(P<0.05)。Kaplan meier生存分析显示,XIAP的表达与DLBCL患者的预后相关(P<0.05)。Omi/HtrA2与DLBCL预后不相关(P>0.05)。结论 XIAP与Omi/HtrA2在DLBCL组织中均呈高表达,二者呈负相关,上调Omi/HtrA2抑制XIAP表达可为DLBCL靶向治疗提供依据,XIAP是DLBCL预后相关性因素,有望成为判断DLBCL预后的指标。 相似文献
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A 46-year-old man with a history of chronic alcohol use was found to have milk of calcium that had developed in a pancreatic pseudocyst. This was found incidentally on abdominal computed tomography during a workup for abnormal liver enzymes. Milk of calcium in the pancreas has been described only twice in the literature using plain abdominal radiographs and computed tomography. To our knowledge, this case report is the first to describe magnetic resonance findings of this entity. 相似文献
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Dan Xie Wen Xu Ying Xian Xiaofeng Yuan Zhenchao Huang Jingya You Xiaogang Bi 《Journal of clinical laboratory analysis》2021,35(2)
BackgroundSeoul virus (SEOV) is a Hantavirus and the causative pathogen of Hemorrhagic Fever with Renal Syndrome (HFRS). Diagnosing SEOV infection is difficult because the clinical presentations are often undistinguishable from other viral or bacterial infections. In addition, diagnostic tools including serological and molecular assays are not readily available in the clinical settings.Case ReportA 57‐year‐old male presented with fever and a sudden loss of consciousness in November 2019. Computed tomography (CT) scan showed subdural hematoma, subfalcine herniation, and brain infarction. He developed thrombocytopenia and elevated transaminases, but no rashes or obvious kidney damage. He reported having a rat bite. HFRS was suspected. The Hantavirus IgG was positive, and the metagenomic next‐generation sequencing (mNGS) detected SEOV sequences directly in the blood.ConclusionThis report highlights the importance of suspecting SEOV infection in febrile patients with thrombocytopenia and elevated liver enzymes despite the absence of hemorrhagic manifestations of skin and renal syndromes. Next‐generation sequencing is a powerful tool for pathogen detection. Intracranial hemorrhage and brain infarction as extrarenal manifestations of HFRS are rare but possible as demonstrated in this case. 相似文献
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Ankang Wang Hao Chen Zhiwei Huang Hong Tang Hao Shi Jian Wen Qiu Li Yu Jiang Wenguang Fu 《The Journal of international medical research》2020,48(12)
Spontaneous internal hemorrhage from a hepatic hemangioma is rare. This case describes a 59-year-old woman who was hospitalized with recurrent cough and fever for 6 months. The doctor thought that she had pneumonia, but other infectious diseases could not be ruled out. Therefore, related tests were performed and strong antibiotics were used, but the symptom of fever was persistent and recurred. Enhanced computed tomography (CT) findings showed a right hepatic giant hemangioma with hemorrhage, while tuberculosis, liver abscess, and immune disease were excluded by the physician. Because the patient’s fever was associated with a large hepatic hemangioma, the patient was transferred to surgery. During treatment, the amount of bleeding increased, so she underwent a right hepatic hemangioma resection in the emergency department. Her postoperative fever symptoms subsequently resolved. Pathological examination confirmed hemorrhagic necrosis with infection in hepatic hemangioma. Follow-up showed that the patient was afebrile. 相似文献
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Marco Milone Miguel Emilio Sosa Fernandez Piero Venetucci Paola Maietta Loredana Maria Sosa Fernandez Caterina Taffuri Francesco Milone 《World Journal of Clinical Cases》2013,1(2):82-83
Although well recognized for tubo-ovarian abscesses, we report, in our best knowledge, the first case of a vaginal drain of a pelvic abscess due to colonic diverticulitis. A 78-year-old patient presented with abdominal and pelvic pain, fever (39.3 °C) and an elevated white blood cell count (18500/mL). After abdominopelvic computed tomography the patient was presumed to have a pelvic abscess, which developed as a complication of the sigmoid diverticulitis. Due to the numerous intervening structures that create obstacles to safe percutaneous access, we planned a trans-vaginal drain. A rapid recovery was obtained within 2 d from the procedure and, at present, the follow-up was uneventful after 18 mo. We believe that transvaginal drain of pelvic abscess could be a useful alternative, when percutaneous approach is not feasible. 相似文献
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精神运动迟滞(PMR)是抑郁症最重要症状之一,表现为显著的言语、思维及行动受限或迟缓。目前多数抑郁量表都只有少量的问题来评估PMR,但PMR的临床表现包括很多方面,如持续疲劳感、精力减退、注意力不集中等。PMR可能涉及特有的神经病理机制或可用于指导治疗干预方案。因此,本文综述了目前国内外常用的PMR临床评估方法及评定量表,PMR的生物学机制研究现状,并重点综述了寻找PMR客观生物学标记的实验研究,旨在为PMR的后续研究提供规范的评估方法,并为PMR生物学机制的进一步挖掘提供参考。 相似文献
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Hu XR Hu YX Fu HR Sheng LX Huang WJ Hu K Huang H Xie WZ 《The Journal of international medical research》2011,39(5):2051-2058
The simultaneous occurrence of diffuse large B-cell lymphoma (DLBCL) and gastric carcinoma is rare. The present case report describes a 61-year-old man with DLBCL at the ileocaecal junction with several metastatic lymph nodes and concurrent gastric intramucosal adenocarcinoma. Both tumours, together with the enlarged lymph nodes, were successfully removed by surgery. At 1 month postoperatively, the patient received chemotherapy consisting of rituximab, cyclophosphamide, vindesine, epirubicin hydrochloride and dexamethasone; he responded well to treatment. Reports published in the literature between January 2006 and March 2011 of other cases of DLBCL combined with concurrent non-haematological malignancies in immunocompetent patients were reviewed. The identification of common factors is important for clarification of the mechanisms of lymphomagenesis and carcinogenesis, as well as the creation of preventive and therapeutic strategies. Such cases highlight the need routinely to perform preoperative imaging studies to exclude other synchronous tumours and, if possible, to biopsy any such masses in order to offer timely and appropriate therapy. 相似文献
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Chronic and recurrent abdominal pains are common complaints in children and adolescents, but the evaluation in the emergency department (ED) can be challenging. We present a rare yet serious case of a 17-year-old white female who presented to the ED with a 2-day history of diffuse abdominal pain, nausea, and intractable vomiting. Abdominal examination and imaging, including computed tomography (CT), were negative during an episode 6 weeks previously. This was her fifth similar episode in a 2-month period, and she had been seen at three different hospitals and admitted on each occasion. Three days prior to presentation to our ED, she was seen at a gastroenterology clinic and diagnosed with irritable bowel syndrome and an ovarian cyst. Symptomatic therapy during the current presentation, with intravenous fluids, antiemetics, and parenteral narcotics, failed to alleviate her abdominal pain and vomiting. Emergent CT evaluation revealed a high-grade colonic obstruction with focal circumferential narrowing in the transverse colon and a lower gastrointestinal follow-through radiograph with Gastrografin enema showed a classic "apple-core" lesion. Colonic adenocarcinoma with positive regional lymph nodes was found during emergent exploratory laparotomy. Pediatric patients with recurrent, episodic abdominal pain should undergo systematic evaluation and symptomatic treatment. A previous negative workup should not dissuade emergency physicians from proceeding with a systematic and thorough evaluation of the pediatric patient presenting with abdominal pain and vomiting. 相似文献
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Aleksandra Gładyś Sylwia Kozak Kamil Wdowiak Mateusz Winder Jerzy Chudek 《World Journal of Clinical Cases》2021,9(3):748-757
BACKGROUNDPost-transplant lymphoproliferative disease (PTLD) is a heterogeneous group of diseases that develop after solid organ and hematopoietic stem cells transplantation related to intensive immunosuppression regimen, T-cell depletion and Epstein-Barr virus infection. Despite the improvement in the management of PTLD, the prognosis remains poor. Here we report the management of two transplanted patients with PTLD and infections during immunochemotherapy (ICTH).CASE SUMMARYOf 65-year-old woman 11 years after kidney transplantation (first case) presented with diffuse large B-cell lymphoma (DLBCL) CS III and started ICHT according to R-CHOP protocol. Despite the secondary prevention of neutropenic fever, the patient developed grade 4 neutropenia with urinary and pulmonary tract infections after the fifth cycle. ICTH was continued in reduced doses up to 7 cycles followed by involved-field radiation therapy of the residual disease. The second case presents a 49-year-old man, 8 years after liver transplantation due to cirrhosis in the course of chronic hepatitis B, who started ICTH for DLBCL Burkitt-like CS IV. The patient received four cycles of ICTH according to R-CODOX/R-IVAC protocol, with reduced doses. In both cases initially undertaken reduction of immunosuppression was ineffective to prevent infectious complications. Despite one incomplete ICHT treatment due to recurrent infections, both our patients remain in complete remission.CONCLUSIONReduction of immunosuppression and the doses of chemotherapeutics may be insufficient to prevent infectious complications during ICTH in PTLD patients. 相似文献
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Zheng JS Wang M Wan S Zhou YQ Yan M Chen QF Zhan RY 《The Journal of international medical research》2010,38(4):1553-1560
A case of isolated primary non-Hodgkin's lymphoma of the spine is presented along with a review of previous cases reported in the literature. An 80-year old immunocompetent man was admitted with progressive numbness and weakness of both lower extremities of 2 weeks' duration. Magnetic resonance imaging (MRI) of the cervicothoracic spine revealed an extradural spinal mass at the T1 - T3 level, with invasion into the T3 vertebral body. The lesion was at first thought to be a metastatic tumour. Because of the manifestations of compression, the patient underwent laminectomy and posterior decompression. Histopathological examination revealed diffuse large B-cell non-Hodgkin's lymphoma. All other investigations (including computed tomography of the chest and abdomen, bone scan, peripheral blood examination and tumour marker examination) were negative for occult disease. This case demonstrates that neurosurgeons should be aware of the occurrence of isolated primary spinal lymphoma, which should be included in the differential diagnosis of metastatic tumours. 相似文献