Histoplasmosis and inflammatory bowel disease:A case report

BACKGROUND Infection with Histoplasma capsulatum can lead to a disseminated disease involving the gastrointestinal tract presenting as diffuse abdominal pain and inflammatory diarrhea which may mimic inflammatory bowel disease(IBD).CASE SUMMARY In the current report, we discuss the case of a 41-year old male who presented to the emergency department with complaints of high-grade intermittent fevers and severe abdominal pain with associated diarrhea and hematochezia. Laboratory results demonstrated transaminitis and elevated erythrocyte sedimentation rate, C-reactive protein and ferritin levels. The patient's presentation was thought to be an exacerbation of his underlying IBD, but further investigations revealed a positive Histoplasma antigen in the urine. The patient was offered a colonoscopy and biopsy to confirm the diagnosis; however, he refused. He was treated with itraconazole and showed significant improvement of his symptoms, thereby confirming the diagnosis of gastrointestinal histoplasmosis.CONCLUSION Here within, we provide a review of IBD, evaluation of chronic diarrhea, and gastrointestinal histoplasmosis.     

炎症性肠病合并严重低磷血症病例讨论并文献复习

目的:提高对炎症性肠病(IBD)合并低磷血症的营养治疗的认识。方法:回顾性分析1例炎症性肠病合并严重低磷血症患者的临床资料,并复习相关文献。结果:此例患者存在严重营养不良,在出现严重神经肌肉症状后发现严重低磷血症。予以营养支持治疗后其临床症状、营养状态及低磷血症均得到显著改善。结论:在炎症性肠病的临床治疗中,应关注营养不良问题,同时注意补充电解质和维生素,对于营养不良患者血清磷应作为常规监测项目,以便及时发现及时干预。     

Infectious colitis endoscopically simulating inflammatory bowel disease: a prospective evaluation

This prospective evaluation of patients presenting with mucoid bloody diarrhea and suspected idiopathic inflammatory bowel disease demonstrated a 38% incidence of infectious colitides. The infectious agents detected were Campylobacter, Salmonella, Shigella, Amoeba, and Clostridium difficile. An increased awareness and the utilization of selective culture media should allow the clinician to definitively diagnose patients who present with signs and symptoms suggestive of idiopathic inflammatory bowel disease.     

Cerebral sinus thrombosis in patients with inflammatory bowel disease： A case report

Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of the gastrointestinal tract. The pathophysiology of IBD is probably the result of the complex interaction of genetic susceptibility and environmental influences. There is a well-known risk of thrombosis in patients with IBD. We present the case of a 53-year-old man with ulcerative colitis, who spontaneously developed intracranial sinus thrombosis that was treated with low molecular weight heparin. Literature was searched to assess the frequency and characteristics of cerebral sinus thrombosis in IBD and the role of certain etiopathological factors in such thrombotic patients.     

Turner's syndrome and inflammatory bowel disease: a case report with immunologic studies

A patient with Turner's syndrome who developed ulcerative colitis (UC) is reported, and reports from the literature of 16 cases of Turner's syndrome with inflammatory bowel disease (IBD) are reviewed. Most of the patients previously described had severe disease. Half of the patients had ulcerative colitis and half had Crohn's disease (CD). Of those with Crohn's, most had colonic involvement. Of note, also, half of the patients had an isochromosome for the long arm of X which usually is found in only 17% of all patients with Turner's syndrome. A high incidence of autoimmune diseases is associated with this syndrome. We demonstrate the presence of specific anticolonic antibodies in this patient and propose some possible explanations for the association of this particular chromosomal disorder with autoimmune diseases.     

Mantle zone lymphoma of the colon simulating diffuse inflammatory bowel disease

We describe the first reported case of mantle zone lymphoma of the colon presenting as diffuse ileocolitis simulating severe inflammatory bowel disease. This case serves to illustrate the importance of immunohistochemistry in establishing the diagnosis of lymphoma in extranodal sites.     

A case of cryopyrin-associated periodic fever syndrome during canakinumab administration complicated by inflammatory bowel disease

Clinical Rheumatology - Cryopyrin-associated periodic fever syndrome (CAPS) is a highly debilitating disorder, which is characterized by unregulated interleukin-1β production driven by...     

Pericardial actinomycosis: case report and review

Pericardial actinomycosis is rare and frequently goes unrecognized during life, a circumstance due in part to a paucity of clinical manifestations and to a low rate of positivity in cultures. We present a case report of pericardial actinomycosis and a review of 18 other cases reported in the literature since 1950. Possible risk factors include aspiration pneumonia, alcohol abuse, and periodontal disease. Actinomyces may cause purulent pericarditis that evolves into cardiac tamponade or constrictive pericarditis. Clues to the identity of the causative organism (e.g., draining sinus tracts and the presence of sulfur granules) are frequently absent, and cultures often fail to yield the organism. Histologic examination of material obtained by biopsy is often necessary to make the diagnosis. Most cases originate from a thoracopulmonary site of actinomycosis and spread directly to the pericardium. Widespread dissemination to extrathoracic organs is uncommon. Treatment consists of high-dose, long-term antimicrobial therapy as well as drainage of the pericardial space.     

烟雾病合并特发性甲状旁腺功能减退症1例

烟雾病又称脑底异常血管网病,是颈内动脉虹吸部及大脑前动脉和大脑中动脉起始部进行性狭窄或闭塞,软脑膜动脉、穿支动脉等小血管代偿增生形成脑底异常血管网为特征的异常脑血管疾病。烟雾病于1955年由日本学者最早报告,存在显著的种族和地区差异,以日本和韩国等东亚国家发病率最高。截至2003年,日本的烟雾病发病率约为0.54/10万,而欧美国家仅为日本的1/10［1］。烟雾病的病因和发病机制至今不清,可能与免疫炎症、基因遗传性因素、细胞因子分泌异常有关［2］。烟雾病主要有2个发病高峰,分别是5岁和40岁左右。儿童患者以缺血性卒中或短暂性脑缺血发作为主,而成年患者多表现为出血性卒中。     

新型冠状病毒肺炎合并糖尿病酮症酸中毒一例报道

本文报道1例中年女性患者,发热,伴呼吸道和消化道症状,存在意识障碍和休克,诊断为新型冠状病毒肺炎(COVID-19)合并DKA,经救治康复出院。重症COVID-19和DKA临床表现相似,及时识别和尽早干预有利于患者预后。     

Pulmonary actinomycosis simulating a bronchial neoplasm

We report a case of pulmonary actinomycosis, stimulating a bronchial neoplasm, in which serological tests for actinomycosis were positive.