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Infectious Disease: Endemics
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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...
Source: Journal of Investigative Medicine - March 21, 2016 Category: Research Authors: Nguyen, L. Tags: Pulmonary/Critical Care Source Type: research
Current Concepts in the Epidemiology, Diagnosis, and Management of Histoplasmosis Syndromes
Semin Respir Crit Care Med 2020; 41: 013-030 DOI: 10.1055/s-0039-1698429Histoplasmosis is a global disease endemic to regions of all six inhabited continents. The areas of highest endemicity lie within the Mississippi and Ohio River Valleys of North America and parts of Central and South America. As a result of climate change and anthropogenic land utilization, the conditions suitable for Histoplasma capsulatum are changing, leading to a corresponding change in epidemiology. The clinical manifestations of histoplasmosis are protean, variably resembling other common conditions such as community-acquired pneumonia, tuberculo...
Source: Seminars in Respiratory and Critical Care Medicine - January 29, 2020 Category: Respiratory Medicine Authors: Azar, Marwan M. Loyd, James L. Relich, Ryan F. Wheat, L. Joseph Hage, Chadi A. Tags: Review Article Source Type: research
New Insights on Pulmonary Paracoccidioidomycosis
Semin Respir Crit Care Med 2020; 41: 053-068 DOI: 10.1055/s-0039-3400544Paracoccidioidomycosis (PCM) is one of the most relevant systemic endemic mycoses in Latin American countries, especially in South American countries, with endemic and hyperendemic areas. The real burden of PCM may be underestimated because of a lack of compulsory case notification. Recent phylogenetic data revealed that Paracoccidioides brasiliensis comprises several cryptic species including P. brasiliensis and P. lutzii. However, the genetic biodiversity of Paracoccidioides does not affect the clinical manifestations or therapeutic response to thera...
Source: Seminars in Respiratory and Critical Care Medicine - January 29, 2020 Category: Respiratory Medicine Authors: Queiroz-Telles, Fl á vio de Pe çanha Pietrobom, Paula Massaroni Rosa J únior, Marcos Baptista, Rodrigo de Melo Pe çanha, Paulo Mendes Tags: Review Article Source Type: research
Endemic Fungi Presenting as Community-Acquired Pneumonia: A Review
Semin Respir Crit Care Med 2020; 41: 522-537 DOI: 10.1055/s-0040-1702194In endemic areas, dimorphic fungal infections due to Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides posadasii/immitis account for up to 30% of cases of community-acquired pneumonia. Because respiratory manifestations are often indistinguishable from common bacterial causes of pneumonia, the diagnosis of pulmonary histoplasmosis, blastomycosis, and coccidioidomycosis is often delayed and associated with antibiotics overuse. In addition to being highly endemic to certain regions of North America, dimorphic fungi have global significan...
Source: Seminars in Respiratory and Critical Care Medicine - July 5, 2020 Category: Respiratory Medicine Authors: Azar, Marwan M. Malo, Joshua Hage, Chadi A. Tags: Review Article Source Type: research
Pediatric Bilateral Facial Paralysis: An Unusual Presentation of Lyme Disease
Pediatric bilateral facial nerve paralysis (FNP) is a rare condition, representing less than 2% of all cases of FNP. The differential diagnosis of FNP is extensive (ranging from infectious, traumatic, neurologic, to idiopathic) and often can present as a diagnostic challenge. In contrast to unilateral presentation, bilateral FNP presents as a manifestation of serious systemic conditions, including meningitis (infectious and neoplastic), brain stem encephalitis, Guillain-Barre syndrome, sarcoidosis, Lyme disease, human immunodeficiency virus infection, leukemia, and vasculitis. In the evaluation of a child who presents with...
Source: Pediatric Emergency Care - October 31, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Two Cases Illustrating the Diagnostic Challenge of Pediatric Blastomycosis Presenting as Osteomyelitis
Blastomyces dermatitidis is a dimorphic fungus endemic to the United States and Canada. Although both Histoplasma and Blastomyces are found in similar geographic regions, Blastomyces is many times more likely to cause dissemination in the immunocompetent host, frequently involving the bone. However, given the indolent nature of this fungal infection and more prevalent bacterial etiologies of osteomyelitis, diagnosis and treatment are often significantly delayed. We review 2 pediatric cases that initially presented with isolated orthopedic symptoms without documented fever or pulmonary complaints, although both had signs of...
Source: Pediatric Emergency Care - October 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Chagas Disease Cardiomyopathy
This article provides an overview of the clinical course, management, and treatment options of Chagas cardiomyopathy.PMID:37219474 | DOI:10.1097/DCC.0000000000000590
Source: Dimensions in Critical Care Nursing - May 23, 2023 Category: Nursing Authors: Ariana Jimenez Elizabeth J Winokur Source Type: research
