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At least 73 records · Page 4Linked to original sources

Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta with fatal outcome.

Ulceronecrotic Mucha-Habermann disease is a severe, febrile form of pityriasis lichenoides et varioliformis acuta. The condition may sometimes have a fatal outcome, especially in elderly patients. In this paper, we are reporting on a 60-year-old male patient who suffered from the eruption of erythematous, haemorrhagic, ulceronecrotic papules accompanied by high temperature. Erosions and ulceronecrotic papules covered over 80% of his body. Three weeks after his admittance to our hospital, clinical signs resembling ileus together with the leucocytosis occurred. The patient was transferred to the department of internal medicine and later to the surgery department. The fulminant course of the disease could not be stopped, and the patient died of severe intestinal and colon gangrene caused by the massive thrombosis of superior mesenteric artery. Up to date, only 23 cases of this severe form of the disease have been reported, and even with the early recognition, fulminant course may lead to death.

Colonic Diseases↗

Complete genetic characterization of a Brazilian dengue virus type 3 strain isolated from a fatal outcome.

We have determined the complete nucleotide and the deduced amino acid sequences of Brazilian dengue virus type 3 (DENV-3) from a dengue case with fatal outcome, which occurred during an epidemic in the state of Rio de Janeiro, Brazil, in 2002. This constitutes the first complete genetic characterization of a Brazilian DENV-3 strain since its introduction into the country in 2001. DENV-3 was responsible for the most severe dengue epidemic in the state, based on the highest number of reported cases and on the severity of clinical manifestations and deaths reported.

Adult↗

Group B streptococcal infections in neonates and infants. Report of 16 cases, with referrence to the fatal outcome in late-onset leucopenic cases.

Sixteen cases of group B streptococcal (GBS) infections in neonates and infants aged up to 3 months were detected from November 1973 to January 1977. Three patients presented with pneumonia, 10 with meningitis and 3 with both pneumonia and meningitis. All diagnoses were confirmed by positive blood and/or cerebrospinal fluid cultures. The serotypes involved were type Ia (2 cases), type II (4 cases) and type III (10 cases). Ten patients died (62.5%). Early antibiotic treatment did not appear to affect the outcome, but low peripheral leucocyte count indicated a uniformly fatal outcome in 6 cases where leucopenia was documented, and this appeared to be associated with late-onset disease. The current status of GBS disease is presented, with particular reference to the control measures at present available and the possibility of immunotherapy and vaccination.

Diagnosis, Differential↗

Patients with abdominal trauma and fatal outcome: analysis of a 30-year series.

Patients with blunt abdominal trauma and fatal outcome during 30 years in a well-defined rural Swedish area have been analyzed. There were 127 patients. Several facts indicate that more severe trauma has been appearing more often during this period The mortality rate has, however, been stable, but the patients have become older. More patients die from pulmonary complications than from the trauma itself. One very important development is the significant decrease in mortality among children.

Abdominal Injuries↗

Headache angina with fatal outcome.

We report 2 fatal cases of angina pectoris in patients who complained primarily of headache during the ischemic attack. The first patient, who was hospitalized because of headache and chest pain, demonstrated repeated ST-segment elevation and fatal ventricular fibrillation on ambulatory ECG monitoring. The second patient had post-infarction angina preceded by headache and by ST-segment elevation in the precordial leads. She eventually died of reinfarction. The mechanism of the headache in relation to the angina pectoris is discussed.

Aged↗

Chlamydia pneumoniae infection associated with multi-organ failure and fatal outcome in a previously healthy patient.

Chlamydia pneumoniae has been associated with respiratory infections and with cardiovascular disease. We describe here a patient with multi-organ failure and fatal outcome in whom C. pneumoniae was implicated as a causative agent. Serological analysis for C. pneumoniae was done by immunofluorescence. Immunohistochemistry was carried out with avidin-biotin peroxidase staining. The patient had pneumonia I month prior to death. C. pneumoniae was detected in the heart and lungs by immunohistochemistry at autopsy. The patient had an antibody pattern suggestive of current or chronic C. pneumoniae infection. Serological analysis for Legionella sp., Mycoplasma pneumoniae, CMV, EBV, enteroviral agents and markers for autoimmune disease were negative. The findings suggest C. pneumoniae as the aetiological agent in this case of multi-organ failure.

Chlamydia Infections↗

[Analysis of a boxing match with fatal outcome resulting from unusually severe brain damage (author's transl)].

A boxing match with fatal outcome is described. The boxer received 21 punches in the nape of his neck, as well as many other blows. After a knock out in the 15th round he conceded the fight; some minutes later he suddenly collapsed. Deep unconsciousness, maximal dilated pupils and extensor-spasms were observed but respiration continued. Although it was possible to evacuate a subdural hematoma 30 to 45 min later, a high-grade cerebral oedema remained resistant to therapy. In addition hypoxemia caused disseminated necroses of heart-muscle fibres. Intensive hemorrhages were detected in the cervical muscles and in the dorsal parts of the intervertebral discs on the level of C 2/3 and C 3/4. Neuropathological investigation revealed the typical alterations brought about by craniotomy carried out for a subdural hematoma caused by the tearing off of Vv. cerebralis superiores, as well as extensive contusion hemorrhages. The high-grade cerebral oedema caused congestion and dislocation which led to massive hemorrhages, hypoxemia to unusually extensive hemorrhagical and white necroses of cortex and brain stem ganglions. Special attention is paid to the pathogenesis of these findings. A report on boxing--particularly professional boxing--issued by the Federal Institute of Sport Medicine in Cologne in 1977 is critically analysed.

Adult↗

Radiographic features of a case of severe acute respiratory syndrome with fatal outcome.

INTRODUCTION: Severe acute respiratory syndrome (SARS) is a new form of atypical pneumonia caused by a coronavirus. We present the clinical course and chest radiographic findings of a case of SARS with fatal outcome. CLINICAL PICTURE: A 39-year-old Chinese male presented with fever, sore throat and non-productive cough. During his illness, serial chest radiographs showed increasingly severe air-space shadowing in both lungs. TREATMENT AND OUTCOME: The patient was treated with supplemental oxygen, levofloxacin, oseltamivir, ribavirin and methylprednisolone. As his condition worsened, the required ventilatory and inotropic support. He later developed a myocardial infarct and coagulopathy, and succumbed to his illness. CONCLUSION: The reported case mortality of SARS is about 9% worldwide. In Singapore, the mortality is 15.5%. Acute respiratory distress syndrome (ARDS) is believed to be a contributory factor to our patient's demise. We report this case to show the radiographic changes of ARDS in a patient with SARS.

Adult↗

Rapunzel syndrome with a fatal outcome in a neglected child.

The "Rapunzel" syndrome (a trichobezoar with a long tail extending from the stomach to the small bowel) is an uncommon disease. It is related to severe complications but rarely associates to a fatal outcome. We report a case of a 5-year-old girl admitted at the emergency department in cardiorespiratory arrest whose autopsy disclosed an ileal perforation that is caused by a long bezoar extending from the stomach to the small bowel. The authors discuss a possible link between Rapunzel syndrome and child neglect.

Bezoars↗

[Severe preeclampsia. Analysis of a case with fatal outcome].

We report a case of preeclampsia presenting initially as a moderate hypertension, and complicated over a ten-day period by eclampsia, retinal hemorrhage, cerebral and hepatic subcapsular hematomas, HELLP syndrome, disseminated intravascular coagulation and renal failure. Fatal outcome was related to cerebral death and rupture of the liver hematoma. The case analysis points out inaccurate initial management: probable misdiagnosis of epigastric pain related to subcapsular hematoma, ineffective antihypertensive therapy, aspiration of the gastric content after benzodiazepine treatment of eclampsia, transfer of the patient without stabilisation of her clinical status.

Acute Kidney Injury↗

Primary Langerhans' cell histiocytosis of the central nervous system with fatal outcome. Case report.

An unusual case of primary parenchymal Langerhans' cell histiocytosis of the central nervous system is reported. The definitive diagnosis was obtained by ultrastructural detection of Birbeck granules and by immunohistochemical evidence of CD1a expression. Despite complete surgical resection, there was an early recurrence with multiple central nervous system metastases leading to a fatal outcome.

Adult↗

Delusions of parasitosis with fatal outcome.

The case of a 40-year-old man with delusions of parasitosis as the presentation of a monodelusional psychosis is reported. In spite of treatment with pimozide and depot neuroleptics the patient committed suicide. Since the introduction of pimozide, this drug has come to be regarded as the specific treatment for this disorder; this case is presented to emphasize the fact that not all cases respond, and that the disorder can have a fatal outcome.

Adult↗

Case report. Mixed systemic mycosis with fatal outcome in a patient with acute myeloblastic leukaemia.

Fungal infections represent an increasing problem in immunocompromised patients. The majority of cases are caused by one single fungal pathogen and infections with more than one fungus are very rare. Here we describe a case of combined infection with Aspergillus and a zygomycete species, involving the lungs, spleen and the brain and leading to fatal outcome in spite of early antimycotic therapy.

Aspergillosis↗

Changing epidemiology of melioidosis? A case of acute pulmonary melioidosis with fatal outcome imported from Brazil.

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is endemic in South East Asia and tropical regions of Northern Australia. Sporadic cases have been described elsewhere. In this article we present a case of acute pulmonary melioidosis with fatal outcome imported from Brazil. The most common pathogen causing severe community-acquired pneumonia in Brazil is Streptococcus pneumoniae. Other possible pathogens include Legionella spp., Mycoplasma pneumonia, Gram-negative rods and viruses. There are few reports of melioidosis in the Americas. This article represents the second known human case of melioidosis from Brazil. Recognition of melioidosis as a possible cause of severe pneumonia, even if a patient has not been travelling in a highly endemic area, is important because of the therapeutic consequences. The epidemiology of melioidosis will be reviewed.

Acute Disease↗

Fatal outcome in a patient with autoimmune hemolytic anemia associated with an IgM bithermic anti-ITP.

BACKGROUND: Several cold autoantibodies (usually IgG) with IT specificity have been reported previously, as have autoantibodies with joint I and P blood group specificities (IP1, ITP1, iP1, IP). A fatal outcome associated with an IgM cold autoantibody of ITP specificity is reported. CASE REPORT: A 54-year-old man suffered from progressively severe cold autoimmune hemolytic anemia for 9 months. Hemoglobin concentration ranged from 6 to 7 g per dL (60-70 g/L) and reticulocytes from 3 to 5 percent (0.030-0.050). The direct antiglobulin test was weakly positive for IgM and strongly positive for C3d. The serum contained a cold agglutinin that reacted strongest with cord i red cells (RBCs) > adult I RBCs > adult i RBCs, which is consistent with IT specificity. The Donath-Landsteiner test was positive; the reaction was neutralized by globoside. The serum reacted weakly or was negative with RBCs from five group p blood donors, which suggests anti-ITP specificity. Dithiothreitol treatment of the serum abolished the cold agglutinin reactivity, which suggests that the anti-IT was IgM. The patient received > 40 RBC transfusions and failed to respond to oral steroids, oral cytoxan, high-dose pulse intravenous steroids, and plasma exchange at room temperature and at 35 degrees C. He died of sepsis following an unsuccessful trial of chlorambucil. Autopsy revealed unsuspected disseminated non-Hodgkin's lymphoma. CONCLUSION: Serologic studies are consistent with our patient's having a single IgM cold autoantibody with IT and P specificities (anti-ITP) and requiring both specificities on the same RBC to permit maximal antibody expression.

Adsorption↗

Two cases of HELLP syndrome with fatal outcomes.

Severe preeclampsia and HELLP syndrome are still the leading causes of maternal and perinatal morbidity and mortality. We present two cases of pregnancies which were complicated by HELLP syndrome at 31 weeks of gestation and 25 weeks of gestation, the first one with maternal and the second with perinatal fatal outcomes. The aim of this report is to draw attention to the life-threatening complications that might occur in cases of preeclampisa and HELLP syndrome. The importance of early diagnosis with implications for management is also discussed.

Adult↗

Bilateral acute suppurative parotitis due to Staphylococcus aureus: an hospital acquired case with fatal outcome.

During recent decades, acute bacterial parotitis has progressively changed its etiological and clinical spectrum. New risk factors and causative agents are emerging, while the associated rates of complications and mortality may remain still significant. A rare case of concurrent bilateral suppurative parotitis caused by Staphylococcus aureus has been observed in a patient hospitalized for prior abdominal surgery and multiple underlying illnesses. The disease had a complicated and ultimately fatal outcome, despite a timely diagnosis being made and a specific treatment started. A literature review dealing with risk factors, microbiology, clinical picture, complications, differential diagnosis, treatment and outcome of suppurative parotitis is presented.

Acute Disease↗