The Case Files: Culling through Diagnoses to Get to Rat Bite Fever

By Dyer, Alexandra; Berg, Kenneth MD; King, Andrew MD Rat bite fever (RBF) is a fairly rare illness caused by Streptobacillus moniliformis or Spirillum minus. It can be a devastating and even fatal illness if left undiagnosed or untreated. Despite its name, RBF is not only transmitted by rat bites but also by contact with rat feces, ingestion of rat-contaminated food and water, or simply through direct contact with rats. (Clin Microbiol Rev 2007;20[1]:13; Vet Microbiol 2009;133[3]:211; BMJ Case Rep 2009; Epub Dec 17.) The first documented outbreak in Haverhill, MA, in 1926 was believed to be caused by a pathogen named Haverhillia multiformis. It was later determined to be identical to S. moniliformis. Other outbreaks with matching symptoms have also been documented and frequently misdiagnosed. (Clin Microbiol Rev 2007;20[1]:13.) RBF is difficult to diagnose. Its sequelae are often nebulous — chills, rigors, and polyarthralgias — and the causative pathogens are difficult to isolate in cultures. RBF is also likely to respond to empiric therapy and it is not a reportable disease, so definitive diagnosis may never be established even if treated appropriately. (Clin Microbiol Rev 2007;20[1]:13; Vet Microbiol 2009;133[3]:211.) Consequently, this condition is often erroneously omitted from the differential when evaluating fevers in the ED unless the history is highly suggestive of a rat bite. Rats are more than pests in today's society. Humans are coming increasingly...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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Conclusions: The present findings suggest that self-monitoring confusions may be linked to trait-risk for psychosis in adolescence. Future studies can prospectively assess whether the association between negative schizotypal traits and self-monitoring represents a distal marker of psychosis vulnerability. PMID: 32100624 [PubMed - as supplied by publisher]
Source: Cognitive Neuropsychiatry - Category: Psychiatry Tags: Cogn Neuropsychiatry Source Type: research
Authors: Berenbaum F, Walker C Abstract Globally, osteoarthritis (OA) is the most prevalent arthritic condition in those aged over 60 years. OA has a high impact on patient disability and is associated with a significant economic burden. Pain is the most common first sign of disease and the leading cause of disability. Data demonstrating the increasing global prevalence of OA, together with a greater understanding of the burden of the disease, have led to a reassessment of the seriousness of OA and calls for the designation of OA as a serious disease in line with the diseases impact on comorbidity, disability,...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
[New Zimbabwe] A Typhoid outbreak is suspected to have hit Gweru with two people confirmed dead due to diarrhoea infections.
Source: AllAfrica News: Health and Medicine - Category: African Health Source Type: news
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Source: AIChE Journal - Category: Science Authors: Tags: SOFT MATTER: SYNTHESIS, PROCESSING AND PRODUCTS Source Type: research
Authors: Rossi DM, Resende RA, Hotta GH, da Fonseca ST, de Oliveira AS Abstract Altered scapular movement in subacromial pain syndrome has been demonstrated using discrete data reduction approach. However, this approach does not consider the data collinearity and variability, and scapular translations are poorly investigated in symptomatic individuals. The purpose of this study was to investigate the scapular rotation and translation of asymptomatic individuals and those with subacromial pain syndrome during arm motions using principal component analysis. Scapulothoracic kinematics were evaluated in 47 participants...
Source: Journal of Applied Biomechanics - Category: Sports Medicine Tags: J Appl Biomech Source Type: research
Bonds designed to provide fast funding for poor countries branded ‘obscene’ because of complex payout criteriaA flagship $500m World Bank scheme to help the poorest countries deal with a health emergency is “too little too late” for the coronavirus outbreak, say health experts.The first pandemic emergency financing (PEF) bonds were launched in 2017 by Jim Yong Kim, the bank ’s president at the time, after the Ebola outbreak in west Africa. Designed to potentially “save millions of lives and entire economies” by speedily funnelling money to nations facing pandemics.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Global health Coronavirus outbreak Global development Infectious diseases World Bank Microbiology Science Business World news Source Type: news
[Zimbabwe Independent] IN the wake of the coronavirus (Covid-19) outbreak, which has triggered a wave of deaths in China, while sparking panic across the globe, Zimbabwe Independent (ZI) senior reporters Tinashe Kairiza and Bridget Mananavire last week spoke to the deputy secretary-general of the International Department of the Central Committee of the Communist Party of China (IDCPC), Dong Weihua (DW), who said the global economic powerhouse has spent over US$12,8 billion (90 billion yuan) to contain the disease. Dong said deve
Source: AllAfrica News: Health and Medicine - Category: African Health Source Type: news
Authors: Xu X, Lin S, Yang Y, Chen Y, Liu B, Li B, Wu Y, Meng F, Zhu Q, Li Y, Tang S, Yuan S, Shao L, Qi X Abstract Background: Terlipressin can effectively control acute gastrointestinal bleeding (GIB) in cirrhotic patients by acting on the V1 receptors, but may lead to the development of dilutional hyponatremia by acting on the V2 receptors.Research design and methods: This retrospective multicenter study enrolled 674 cirrhotic patients with acute GIB in whom serum sodium concentrations were tested before and during the use of terlipressin. ΔSodium reduction ≥5 mmol/L, hyponatremia (sodium
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
Authors: Huang YW, Tsai TF Abstract Introduction: Risankizumab is a fully human monoclonal antibody that selectively targets interleukin (IL)-23A, interfering with the IL-23/17 axis that plays a crucial role in keratinocyte proliferation. In 2019, risankizumab was approved globally for the treatment of moderate-to-severe psoriasis.Areas covered: The safety profile of risankizumab for the treatment of psoriasis is assessed in this review. A literature search was performed on 18 October 2019, and additional data from pooled safety analyses were evaluated.Expert opinion:Drugs blocking the IL-23 pathway are the most re...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
One of the challenges faced when treating a child with genitourinary rhabdomyosarcoma is what to do when a residual mass remains after organ sparring treatment. The authors present an interesting case which exemplifies the dilemma. The answer to this question is simplified for when the residual mass is associated with pain, is growing or impairs organ function, providing a rational for excision. When this is not the case concern centers around residual disease and recurrence. Today the post-treatment finding of mature rhabdomyoblasts is not a reason for exenterative surgery, however some point bear mentioning.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
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