Id: 62: hemophagocytic lymphohistiocytosis caused by infection by ehrlichia chaffeensis: a case report.

We present a case of HLH triggered by severe infection with Ehrlichia chaffeensis in a patient taking methotrexate for seronegative spondyloarthropathy. A 45-year-old man with a history of ankylosing spondylitis taking methotrexate presented to a community hospital with acute onset of nausea, vomiting and diarrhea. Physical examination revealed a febrile patient with diffuse abdominal tenderness with splenomegaly and diffuse maculopapular rash involving the trunk and all extremities. Labs showed leukopenia and thrombocytopenia. Clinical course was complicated by development of acute renal failure, altered mental status and hypoxic respiratory failure requiring endotracheal intubation and mechanical ventilation. Plasmapheresis was initiated due to concern for thrombotic thrombocytopenic purpura with no response. A bone marrow biopsy was performed which revealed a tri-lineage hematopoiesis with increased number of histiocytes, including hemophagocytic forms. Further lab abnormalities included a hypofibrinogenemia, hyperferritinemia, low complement protein C3 and C4, and hypertriglyceridemia. Patient met diagnostic criteria for HLH and was transferred to our tertiary care hospital for further management. Given concern for tick borne disease, patient was started on doxycycline in addition to previously initiated broad spectrum antibiotics. Serum antibody testing was sent for Lyme disease, Rocky Mountain spotted fever and human Ehrlichiosis. Soluble interleukin-2-receptor alpha wa...
Source: Journal of Investigative Medicine - Category: Research Authors: Tags: Pulmonary/Critical Care Source Type: research

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Authors: Hammerschlag MR, Sharma R Abstract INTRODUCTION: Azithromycin was recommended as the first-line therapeutic regimen for treatment of genital infections in men and women by the Centers for Disease Control in 1998. A series of studies of azithromycin for treatment of rectal chlamydial infection in men who have sex with men (MSM) found that azithromycin was significantly less effective than doxycycline. AREAS COVERED: Literature on treatment of rectal C. trachomatis from 2000 through May 2020 was searched using PubMed. Retrospective and observational studies were identified documenting the frequency and t...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
AbstractPurposeEnhanced management of the pre-term patient has resulted in improved survival rates in increasingly premature patients. Although prematurity predisposes to congenital airway pathology, there is also increased risk of endotracheal intubation, and therefore acquired subglottic pathology. We sought to evaluate airway pathology in children outside the neonatal period with a history of prematurity to explore the relationship between prematurity and upper airway pathologies.MethodsData for patients undergoing elective microlaryngobronchoscopy (MLB) at our centre were collected prospectively over a 5-year period. P...
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
ConclusionAS/AD is a mechanical disorder of the larynx that can be successfully treated if promptly diagnosed. Clinical trials and multi-centric studies are necessary to set management guidelines.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Authors: Kim MS, Moon JS, Kim MJ, Seong MW, Park SS, Ko JS Abstract Hereditary fructose intolerance (HFI) is an autosomal recessive disorder caused by a mutation in the aldolase B gene. HFI patients exhibit nausea, vomiting, abdominal pain, hypoglycemia, and elevated liver enzymes after dietary fructose exposure. Chronic exposure might lead to failure to thrive, liver failure, renal failure, and, eventually, death. HFI usually manifests in infants when they are being weaned off of breastmilk. Because HFI has an excellent prognosis when patients maintain a strict restrictive diet, some patients remain undiagnosed du...
Source: Gut and Liver - Category: Gastroenterology Tags: Gut Liver Source Type: research
Authors: Yamaya T, Baba T, Hagiwara E, Ikeda S, Niwa T, Kitayama T, Murohashi K, Higa K, Sato Y, Ogura T Abstract Coronavirus disease 2019 (COVID-19) has been recognized as a worldwide pandemic. However, the clinical course of COVID-19 remains poorly characterized. Although some cases of pneumothorax have been reported, they all had pulmonary complications or were managed with mechanical ventilation. We herein report a case of pneumothorax that developed even though the patient had no pulmonary underlying diseases and had never been managed with mechanical ventilation. In the present case, a lung bulla was found on...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Kobayashi T, Nakajima K, Oshima Y, Ikeda M, Kitaura S, Ikeuchi K, Okamoto K, Okada Y, Ohama Y, Higurashi Y, Okugawa S, Moriya K Abstract Staphylococcus condimenti is a Gram-positive coccus that was first isolated from soy sauce mash. Only four cases of human S. condimenti infections have been reported to date. We herein report the first case of spondylodiscitis caused by S. condimenti. A 72-year-old Japanese man complaining of lower back pain and numbness in his legs was diagnosed with spondylodiscitis. A computed tomography (CT)-guided biopsy was performed. A culture of the intravertebral disc aspirate yi...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Li H, Zhang J, Chen Y PMID: 33034436 [PubMed - as supplied by publisher]
Source: Giornale Italiano di Dermatologia e Venereologia - Category: Dermatology Tags: G Ital Dermatol Venereol Source Type: research
We report the rare case of a patient co-existing NS and DLBCL. DLBCL might be pathogenesis of NS; the findings are supported by the presence of MN, an underlying malignancy (DLBCL), and the lack of anti-PLA2R antibodies. Although further investigation is warranted, our case suggests that DLBCL is a possible cause of secondary MN. PMID: 33028760 [PubMed - in process]
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
In conclusion, our multidisciplinary approach to prevent de novo hepatitis B is considered useful. PMID: 33028756 [PubMed - in process]
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
This study aimed to evaluate in vitro and in vivo the wound healing effects of babassu oil. In vitro, babassu oil increased the migration of L929 fibroblasts, inhibited the production of nitric oxide by LPS-stimulated peritoneal macrophages, and increased the levels of INF-γ and IL-6 cytokines production. In vivo, babassu oil accelerated the healing process in a full-thickness splinted wound model, by an increase in the fibroblasts number, blood vessels, and collagen deposition in the wounds. The babassu oil also increased the recruitment of inflammatory cells into the wound site and showed an anti-inflammatory effec...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
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