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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A healthy 21-year-old man presented with a right neck palpable mass and calcifications diagnosed during a Panorex odontologic study. Computed tomography angiography imaging of the neck demonstrated a right common and internal carotid artery (ICA) pseudoaneurysm with irregular thrombus and calcifications causing severe right ICA stenosis (A, B). An elongated styloid process was identified adjacent to the pseudoaneurysm associated with ossification of the stylohyoid ligaments (C/Cover). A diagnosis of stylocarotid artery syndrome, a subtype of Eagle's syndrome, was considered and operative treatment recommended, given the ps...
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Vascular images Source Type: research
ConclusionCTPA was the primary modality for confirming PE in all trimesters of pregnancy, although its proportional use was higher in later stages of pregnancy.Key Points•Computed tomography pulmonary angiography (CTPA) was the primary modality of diagnosis in all trimesters of pregnancy among patients with confirmed pulmonary embolism, even in the first trimester.•From the first trimester of pregnancy to postpartum period, there was a linear increase in the proportion of patients with pulmonary embolism who were diagnosed based on CTPA.•In the postpartum period, use of CTPA as the modality to confirm pulmon...
Source: European Radiology - Category: Radiology Source Type: research
A Correction to this paper has been published:
Source: European Radiology - Category: Radiology Source Type: research
ConclusionMeasuring the CSMA at C3 obtained results equivalent to those obtained by calculating the SMMI at L3, suggesting that direct SMM assessment from C3 is a useful approach to evaluating PCF formation risk after TL.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
ConclusionsA tracheostomy performed in this way is now referred to as the Shield Tracheostomy. Further improvements to the surgical technique are expected in the future.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Conditions:   Kidney Failure, Chronic;   Hemodialysis Interventions:   Drug: Human Erythropoiesis Injection (CHO cell);   Drug: Recombinant Erythropoiesis Stimulating Protein Injection(CHO cell) Sponsor:   Shenyang Sunshine Pharmaceutical Co., LTD. Recruiting
Source: - Category: Research Source Type: clinical trials
Conditions:   Closed Head Injury;   Penetrating Head Injury Intervention:   Diagnostic Test: CT scan Sponsor:   Centre Hospitalier Universitaire de NÄ«mes Not yet recruiting
Source: - Category: Research Source Type: clinical trials
"It'll become endemic and we'll be stuck with it forever," he says."It's frustrating, but what can you do about it?"Associated Press
Source: Medscape Infectious Diseases Headlines - Category: Infectious Diseases Tags: Infectious Diseases News Source Type: news
Conclusions: In this cohort, patients with middle and distal third OTA/AO 32-C type fractures had the highest association with an ipsilateral OTA/AO 31 type fracture. OTA/AO 32-A2 and 32-A3 type fractures had the highest association with femoral neck fractures seen only on MRI. The data presented suggest continued usage of the rapid sequence pelvic MRI for all patients with high-energy femoral shaft fractures in whom a femoral neck fracture was not seen on an x-ray or a computed tomography scan. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
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