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At least 1,135 records · Page 63Linked to original sources
PubMed2006

Pneumocystis carinii and Trichosporon beigelii pneumonia following allogeneic haemopoeitic stem cell transplantation.

Pneumocystis Carinii and Trichosporon beigelii are opportunistic infections in immunocompromised patients. We report a case of a young lady who underwent haemopoeitic stem cell transplantation for relapsed acute lymphoblastic leukemia. This 25 years old female developed fever, dry cough and rapidly progressive dyspnoea during post transplant neutropenia and was found to be suffering from Pneumocystis carinii pneumonia. She was successfully treated with Co-trimoxazole. The patient again presented with similar symptoms on day 55 post transplant. This time Trichosporon beigelii was isolated from bronchoalveolar lavage and she responded to prompt antifungal therapy. Other complications encountered during the subsequent course were extensive subcutaneous emphysema and spontaneous pneumothorax that required chest intubation and brief hospitalization. The patient is presently nine months post transplant and is asymptomatic.

Adult↗
PubMed1991

Malaria and Widal reaction.

Widal reaction was studied in 52 patients having malaria parasites in the peripheral blood smear. Twenty had Plasmodium vivax, 26 had Plasmodium falciparum and the rest had mixed (both vivax and falciparum) infections. Widal test for both O and H antigens of Salmonella typhi was positive in high titres in 3 falciparum, 3 vivax and 2 cases of mixed infection. Of these 8 cases, one had been treated for typhoid fever 3 months back and again one month back for relapse. Blood culture for Salmonella typhi was negative in all. All were cured after antimalarial therapy. The positive Widal reaction may be false.

Adolescent↗
PubMed1990

Unilateral cutaneous emboli of Aspergillus.

A 40-year-old white woman with acute nonlymphocytic leukemia, which relapsed despite bone marrow transplantation and various chemotherapeutic regimens, developed fever and neutropenia. Her fever was unresponsive to broad-spectrum antibiotics, and on hospital day 53 she developed purpuric macules with necrotic centers on her left hand and forearm. Frozen sections of lesional skin were stained with Grocott's methenamine-silver and showed hyphae consistent with a species of Aspergillus; culture of the skin biopsy specimen yielded a pure culture of Aspergillus flavus. Localization of the emboli to the left upper extremity was subsequently explained by magnetic resonance imaging scan of the chest demonstrating invasion of the left subclavian artery by a pulmonary aspergilloma.

Adult↗
PubMed1982

Doxorubicin, mitomycin, and 5-FU (DMF) in the treatment of hormone-resistant stage D prostate cancer: a preliminary report.

Fifteen patients with advanced stage D hormone-resistant prostate cancer were treated with the combination of doxorubicin, mitomycin, and 5-FU. Nine patients (60%) had objective responses, with a mean duration of 27.9 weeks. No responding patient had relapsed. Although three patients developed a culture-negative leukopenic fever, no deaths from chemotherapy occurred. Preliminary results with doxorubicin, mitomycin, and 5-FU indicate that this is a very effective chemotherapy regimen, resulting in a high objective response rate in metastatic prostate cancer.

Adenocarcinoma↗
PubMed1993

Interleukin-6, gamma interferon, and tumor necrosis factor receptors in typhoid fever related to outcome of antimicrobial therapy.

To study mechanisms of antibiotic effects in typhoid fever, levels of interleukin-6 (IL-6), gamma interferon (IFN-gamma), and cytokine receptors (tumor necrosis factor receptor [TNF-R] p55 and TNF-R p75) were measured in the plasma of 29 adult Nepalese with culture-positive typhoid fever before therapy and on days 4 and 15 after start of therapy with either ceftriaxone at 2 g/day for 3 days or chloramphenicol at 50 mg/kg of body weight per day for 14 days. Bacteriologic cure was defined as blood cultures testing negative on days 4 and 15 after start of therapy; clinical cure was defined as symptomatic improvement within 5 days after start of therapy and absence of relapse. Clinical and bacteriologic cures occurred in 24 patients. There were two clinical failures, two patients who failed to complete therapy because of leukopenia, and one relapse. Mean levels before therapy were elevated compared with those in healthy controls (IL-6, 11.4 pg/ml; IFN-gamma, 1.3 ng/ml; TNF-R p55, 3.8 ng/ml; and TNF-R p75, 6.1 ng/ml) and fell progressively during and after therapy. For six patients (three in each treatment group) who showed prolonged fever (> 5 days) or relapse, mean levels of IL-6 and TNF-R p55 before therapy (29.5 pg/ml and 6.1 ng/ml, respectively) and on day 4 (17.7 pg/ml and 4.0 ng/ml) were significantly greater than corresponding means for 23 patients who showed early defervescence (on admission, 6.7 pg/ml and 3.3 ng/ml, and on day 4, 1.8 pg/ml and 2.7 ng/ml, P < .05). These results indicate that the concentrations of plasma cytokines and their receptors are elevated in typhoid fever and that these concentrations can be useful in predicting outcome.

Adolescent↗
PubMed1994

Analysis of factors influencing the outcome and development of septic metastasis or relapse in Salmonella bacteremia.

One-hundred seventy-two consecutive adult patients with salmonella bacteremia documented by at least one positive blood culture were prospectively evaluated over a 10-year period. Salmonella enteritidis was isolated in 121 cases (70.3%), Salmonella typhimurium in 29 (16.9%), and other Salmonella species in 22 (12.8%). Twenty-seven patients (15.7%) developed septic metastasis; 21 patients (12.2%) died of bacteremia, and 24 (16.7%) of the 144 patients who survived had at least one relapse. A logistic regression analysis selected three variables as independently influencing outcome: septic shock (P = .005), coma (P = .029), and immunosuppression (P = .04). By means of the same statistical analysis, leukopenia (a white blood cell count of < 4 x 10(9)/L) was identified as an independent risk factor for relapse (P < .0001). The possibility of salmonella bacteremia must be considered when immunosuppressed patients have fever and no obvious source of infection. Treatment with a drug active against Salmonella species is essential in this population. Patients with leukopenia should be considered as recipients of prophylaxis for relapse.

Adolescent↗
PubMedDate not supplied

[Electrolytic changes in febrile convulsions].

The authors valued some metabolic parameters (sodium, potassium, calcium, blood levels of glucose, proteins, nitrogen, creatinine) in 159 children with febrile convulsions and compared the results with those of a group of children with fever (50 subjects) and of a group of health, fever free children (50 subjects). In the patients with febrile convulsions serum levels of sodium, calcium and osmolarity resulted significantly lower than those obtained in both control groups. The electrolytic modification (overall hyponatremia, probably due to a SIADH) may have a role in short-term relapses of febrile convulsions. Hyponatremia is present also in some children with high fever, without seizures; it may be that hyponatremia, in predisposed subjects, lower the threshold of neuromuscular excitability.

Calcium↗
PubMed1998

[Marked airway constriction due to relapsing polychondritis].

A 40-year-old woman was admitted to our hospital presenting with dry cough, sore throat, and fever. Her right auricle was markedly swollen and her ocular conjunctiva were reddened, suggesting scleritis. A chest computed tomogram showed narrowing of the trachea due to enlarged mediastinal soft tissues. These clinical findings suggested the patient had relapsing polychondritis. A cartilage biopsy from her right auricle was taken to confirm the diagnosis. Pathological findings revealed loosening and dissolution of cartilage and infiltration of lymphocytes, which were consistent with relapsing polychondritis. Although prednisolone was given to the patient, her symptoms were not alleviated. Methylprednisolone pulse therapy and oral diaminodiphenylsulfone were added to the patient's treatment regimen. With this combination, her symptoms gradually subsided. Constriction of the airway has been cited as one of the prognostic factors in relapsing polychondritis. In view of the danger of sudden death caused by airway obstruction, close observation of the patient in this case was considered necessary.

Adult↗
PubMed2001

Anti-lymphoma effect of naproxen and indomethacin in a patient with relapsed diffuse large B-cell lymphoma.

A 77-year-old man with relapsed non-Hodgkin's lymphoma, diffuse large B-cell type, was treated with naproxen, a nonsteroidal anti-inflammatory drug (NSAID), for paraneoplastic fever. A dramatic disappearance of not only the fever but also generalized lymphadenopathy was observed. Naproxen was continued, and he maintained remission for 10 months. When relapse of lymphoma occurred in spite of continuous naproxen administration, indomethacin, another type of NSAID, was tried. Surprisingly, rapid regression of lymphoma occurred again and was maintained for almost 1 year. These results indicate that NSAIDs are effective in some patients with non-Hodgkin's lymphoma.

Aged↗
PubMedDate not supplied

[Clinical characteristics and care of the rheumatic child in Cuba].

The incidence, prevalence, evolution, prognosis and prophylaxis of rheumatic fever in Cuba are explained. Some results relative to prophylaxis and relapses in two different periods are compared. In both periods, carditis became evident in almost one half of the patients, although its severeness has decreaed in recent years due to the lesser number of cases with congestive heart insufficiency at the initial break. In the last part of the paper, a report is made of the organization established for the management and control of rheumatic patients, according to the new model for medical care in the polyclinics of the community.

Adolescent↗
PubMed1992

Relapsing acute disseminated encephalomyelitis associated with chronic Epstein-Barr virus infection: MRI findings.

A 25-year-old women had a fever, left cervical lymphadenopathy, neurological symptoms and signs, CSF pleocytosis and persistent high serum antibodies to the Epstein-Barr virus (EBV); she had a recurrence 1 year later. She was thought to have relapsing acute disseminated encephalomyelitis associated with chronic EBV infection. MRI revealed abnormalities, mainly in the right basal ganglia and left midbrain. At the time of the recurrence, further abnormalities appeared in the opposite basal ganglia and right cerebral white matter.

Adult↗
PubMed1998

Bone marrow necrosis in bone marrow transplantation: the role of MR imaging.

We describe an ALL patient who developed extensive bone marrow necrosis at the time of relapse 2 months after allogeneic bone marrow transplantation from an HLA-identical sibling. The excruciating and diffuse bone pain, fever and precipitous drop in peripheral blood counts were characteristic. This case illustrates the importance of repeat bone marrow biopsies for the diagnosis of disease relapse and the potential application of MR imaging in the assessment of patients with bone marrow necrosis.

Adult↗
PubMed1992

Atypical clinical manifestations of hepatitis A.

Viral A hepatitis is a self-limited infection occurring predominantly among children usually as an anicteric often subclinical illness. Adults afflicted with this virus are more likely to develop icteric hepatitis. This is exemplified in developed countries when a common source outbreak occurs among non-immune adults. Fulminant hepatitis is uncommon in the USA and hepatitis A has never been documented to evolve into chronic hepatitis. However, prolonged cholestasis and relapsing hepatitis are well described. The usual features of cholestatic viral hepatitis A are pruritus, fever, diarrhoea, and weight loss. Serum bilirubin levels are > 10 mg/dl and the clinical course lasts at least 12 weeks. Cholestasis will spontaneously resolve, although corticosteroids will hasten the resolution but may predispose the patient to develop a relapse of the hepatitis. A biphasic or relapsing form of viral hepatitis A occurs in 6 to 10% of cases. The initial episode lasts 3 to 5 weeks and is followed by a period of remission characterized by normal liver chemistries lasting 4 to 5 weeks. Relapse may mimic the initial episode of the acute hepatitis. The full duration of the illness ranges from 16 to 40 weeks from the onset and immunoglobulin M antibody to hepatitis A virus persists throughout the clinical course. Hepatitis A virus has been recovered from stools during the relapse. Extrahepatic manifestations of hepatitis A include evanescent skin rash and transient arthralgias. Documented cases of arthritis and cutaneous vasculitis have been associated with cryoglobulinaemia and are rare.

Adult↗
PubMed2004

[Clinical manifestations and late complications of the hepatic hydatid cyst: report of 4 cases].

INTRODUCTION: Hepatic hydatid cyst (HHC) may appear and remain free of symptoms for a long time, require treatment of its syptoms or relapse after an adequate treatment. The HHC relapse after a medical and surgical treatment is considered a complication of the disease as well as the infection, breakup or other complications. OBJECTIVES: Describe four patients with HHC whose complication or relapse symptoms appeared between 13 and 26 years after the disease was known or adequately treated. CASE REPORT: Four patients with previously diagnosed HHC and symptoms associated to its relapse or infection were retrospectively studied. Patient 1: woman, 48 years old, with diagnosis of HHC during a cholecistectomy in 1977, who showed a touchable mass in 1998. Patient 2: woman, 45 years old, with HHC surgery in 1973, who referred pain and HHC relapse in 1996. Patient 3: woman, 43 years old, with HHC diagnosed in 1980, who referred abdominal pain with increase of HHC volume in 1996. Patient 4: man, 60 years old, with HHC diagnosed in 1981, who referred fever in 1996 related to an abscess of the HHC. The four patients presented HHC relapse and symptoms due to its complications. Medical and surgical treatment was needed in all the cases. CONCLUSIONS: We observed that HHC disease may present complications many years after its surgical treatment with late symptomatic relapses and that the non-treated disease may also develop complications many years after remaining asymptomatic.

Adult↗
PubMed1992

[Q fever and endocarditis. Apropos a new case].

Endocarditis is the first manifestation of Q fever in its chronic form, generally affecting prosthetic cardiac valves or previously injured valves. Its clinical presentation is an endocarditis with negative culture and there is not agreement with regard to the most adequate antimicrobial treatment and its duration. Frequently, the valve has to be replaced. We present a case of a patient with double aortic lesion, in whom endocarditis by Q fever was diagnosed and treated with doxycycline, initially with success. However, she relapsed one year later, being then resistant to the medical treatment (doxycycline, ciprofloxacine plus rifampicine). It was not possible to replace the valve and the patient died two months later due to cardiac failure.

Aged↗
PubMed2005

[Placement of an ultraflex nitinol stent for severe tracheobronchial obstruction in a case of relapsing polychondritis].

A 59-year-old man, who had been treated for bronchial asthma since 2000, was hospitalized with high fever and productive cough in November 2003. Chest radiography on admission showed consolidations in both lower lung fields, and computed tomography demonstrated anteroposterior narrowing of both main bronchi. A physical examination revealed deformity of auricular cartilage and saddle nose, and we diagnosed him relapsing polychondritis (RP). When he was readmitted 4 months later because of severe tracheobronchial stenosis and respiratory failure he required mechanical ventilation, but it was difficult to wean him from the ventilator. Self-expandable metallic stents were placed in the left main bronchus and the trachea. After the procedure, he was successfully weared from mechanical ventilation. Since airway complications of RP can be fatal, stent implantation should be considered in the management of RP with airway manifestations.

Alloys↗