What Is This International Traveler's Diagnosis?

​BY GREGORY TAYLOR, DO; DAWN ZELENKA-JOSHOWITZ, DO; &ANDREW TAECKER, DOA 34-year-old man presented with intermittent fever and body aches for 10 days. He had been visiting family in India, and the symptoms began when he returned home. His fever had been as high as 104°F, and he was experiencing nausea, two episodes of bilious emesis, body aches, nonspecific abdominal pain, and multiple episodes of watery, nonbloody diarrhea.He said he knew of no tuberculosis exposure or ill contacts, and he was current on his routine influenza and hepatitis A vaccines. His temperature was 101.4°F (he had taken acetaminophen three hours earlier), blood pressure was 98/52 mm Hg, heart rate was 125 bpm, respiratory rate was 21 bpm, and oxygen saturation was 100% on room air. The patient appeared pale and ill but in no acute distress. His oral mucosa were dry, and he was tachycardic.His lungs were clear, and his abdomen was soft and nonperitoneal with tenderness to palpation in the epigastric region and right upper quadrant. Evidence for meningeal signs was negative, and we suspected sepsis given his clinical presentation. Fluid resuscitation was initiated with 30 cc/kg, and blood cultures, a malaria screen, a peripheral smear, parasites, and stool culture were performed. He was empirically started on 2 gm ceftriaxone IV daily for suspected typhoid, deferring malaria treatment until confirmed.The patient had a leukopenia of 2.6, RBC count of 3.71, hemoglobin of 12.7 d/dL, a mean cor...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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ConclusionsBleeding requiring transfusion is an under-reported complication of hemorrhoids. Increased recognition could lead to expeditious surgical treatment and less costly diagnostic workup.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Authors: Yalcin S, Kaya E, Ebiloglu T, Akay S, Zor M, Sarıkaya S, Yilmaz S, Bedir S Abstract OBJECTIVES: In this research, we designed a cognitive fusion(CF) prostate biopsy(PB) (CFPB) technique by examining the multiparametric MRI of prostate (MP_MRI-P) images in a smart-phone near the trans-rectal ultrasound (TRUS) device, and examined the results. METHODS: Between January 2011 and January 2017, a total of 344 men who had PB enrolled in this study. Group 1 had a minimum of a 12-core standard TRUS PB (TRUSPB). Group 2 had CFPB while examining the MP_ MRI-P images in a smartphone near the TRUS device. A minimu...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
Authors: Park MG, Cho MC, Cho SY, Lee JW Abstract OBJECTIVES: To compare the antibiotic susceptibility of Escherichia coli (E. coli) between community- acquired acute bacterial prostatitis (CA-ABP) and ABP following transrectal ultrasound-guided prostate biopsy (Bx-ABP). METHODS: A total of 4,383 patients underwent prostate biopsy from January 2005 to June 2014. Among these patients, 34 had Bx-ABP; of which 22 patients had E. coli identified in their urine or blood culture. E. coli was also identified in 91 out of 209 patients with CA-ABP in urine or blood culture. We investigated patient and microbiological ch...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
In this study, 48 PCV2 strains were isolated in China between 2016 and 2018 and the genetic diversity of these PCV2 isolates was determined. Results showed that these PCV2 isolates were classified into genotypes PCV2a (4 of 48), PCV2b (13 of 48) and PCV2d (31 of 48). Among them, 54.5% isolated in 2016, 65.2% isolated in 2017 and 71.4% isolated in 2018 belonged to PCV2d. It indicated that the prevalence of PCV2d genotype increased. All strains shared 93.4%-100% nucleotide sequence identity for the whole genome. Results of the analysis using RDP 4.0 molecular recombination software showed there were no recombinant events amo...
Source: Acta Virologica - Category: Infectious Diseases Authors: Tags: Acta Virol Source Type: research
Abstract Rabies virus is an enveloped negative-stranded RNA virus belonging to the family Rhabdoviridae. It can be successfully controlled by vaccination however, there are still tens of thousands of deaths each year caused by rabies virus due to its mutations and complexity. A better understanding of the interaction between the rabies virus and the host might help solve this problem. Therefore, in this study, we used two-dimensional electrophoresis to investigate the protein expression of rabies virus-infected mice. This can help us to understand the impact of rabies virus on host protein expression during infect...
Source: Acta Virologica - Category: Infectious Diseases Authors: Tags: Acta Virol Source Type: research
Abstract The use of live attenuated vaccine (LAV) is the main method for controlling infectious bronchitis (IB). It is advisable to develop a LAV using a dominant serotype in the region in the case of vaccine failure. Since 793/B serotype is one of the most predominant circulating IB viruses in Iran, attenuation of three Iranian 793/B isolates (IR/773/2001, IR/794/2002 and IR/520/2002) was done by serial passaging in specific pathogen free (SPF) embryonated chicken eggs up to 90 passages to assess the degree of their attenuation to achieve a native LAV in the future. Virulence and pathogenicity of passage levels 1...
Source: Acta Virologica - Category: Infectious Diseases Authors: Tags: Acta Virol Source Type: research
In conclusion, different strains of MDV are circulating for up to 120 days in layers in Antioquia-Colombia and could be of major impact in poultry health. Keywords: Marek's disease virus (MDV); Antioquia-Colombia; qPCR; PCR; Meq gene phylogeny. PMID: 31802681 [PubMed - in process]
Source: Acta Virologica - Category: Infectious Diseases Authors: Tags: Acta Virol Source Type: research
rečková E Abstract Influenza A viruses (IAVs) cause yearly repeating infections in humans. The current vaccination approach is based on the production of virus-neutralizing antibodies. Virus-neutralizing antibodies, however, are closely strain-specific due to the IAV variability. Therefore, antibodies produced during the previous influenza season do not provide sufficient protection against new infection, and, hence, annual revaccination is needed. The utilization of the influenza conserved stem domain of hemagglutinin (HA), the HA2 gp, led to a new vaccine design based on cross-reactive cellular and ...
Source: Acta Virologica - Category: Infectious Diseases Authors: Tags: Acta Virol Source Type: research
Authors: Dávila XA, Olivera EYG, Vásquez BNZ, Romaní F PMID: 31800952 [PubMed - in process]
Source: Revista Peruana de Medicina de Experimental y Salud Publica - Category: International Medicine & Public Health Tags: Rev Peru Med Exp Salud Publica Source Type: research
We report the case of a male patient with cutaneous metastasis of prostate adenocarcinoma located in the cervical and upper thoracic area. The patient also had a history of pulmonary tuberculosis. A CT scan revealed the presence of bone metastasis, pleural effusion, and infiltration of the soft tissues of the neck. The histopathological study confirmed the presence of cutaneous metastasis of primary prostate neoplasia. We present this case due to its unusualness and its importance in the differential diagnosis of this pathology. PMID: 31800950 [PubMed - in process]
Source: Revista Peruana de Medicina de Experimental y Salud Publica - Category: International Medicine & Public Health Tags: Rev Peru Med Exp Salud Publica Source Type: research
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