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<19/20>
共720条结果
  • 1.

    【2hr】Forgotten but Not Gone! Syphilis Induced Tenosynovitis

    包量

    机译 被遗忘但没有消失！梅毒诱发的腱鞘炎
    摘要：Objective. Tenosynovitis, inflammation of a tendon and its synovial sheath, is a rare manifestation of secondary syphilis and if diagnosed early is reversible. Background. A 52-year-old male with past medical history of untreated syphilis presented with gradual onset of swelling and pain of the right fourth metacarpophalangeal joint (MCP). He reported a history of painless penile lesions after having sexual intercourse with a new partner approximately five months ago which was treated with sulfamethoxazole/trimethoprim. An RPR done at that time came back positive with a high titer; however, patient was lost to follow-up. On examination, patient had an edematous, nonerythematous right fourth proximal interphalangeal (PIP) joint. Urgent irrigation, debridement, and exploration of the right hand into the tendon sheath were performed. With his history of syphillis, an RPR was done, which was reactive with a titer of 1 : 64. A confirmatory FTA-ABS test was completed, rendering a positive result. Based on his history of untreated syphilis, dormancy followed by clinical scenario of swelling of the right fourth finger, and a high RPR titer, he was diagnosed with secondary syphilis manifesting as tenosynovitis.
  • 2.

    【2hr】The Liver as Another Possible Target Organ for Bacillus cereus Infection

    包量

    机译 肝是蜡状芽孢杆菌感染的另一种可能的靶器官
    摘要：A case of liver abscess due to Bacillus cereus infection in an immunocompetent 59-year-old man is reported. Percutaneous drainage and antimicrobial therapy, with vancomycin and levofloxacin afterwards, have been demonstrated to be an appropriate treatment, leading to clinical and radiological cure.
  • 3.

    【2hr】Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

    包量

    机译 免疫能力强的儿童中的爱泼斯坦-巴尔病毒性脑炎：爱泼斯坦-巴尔病毒性脑炎的病例报告和治疗
    摘要：Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.
  • 4.

    【2hr】Leprosy with Atypical Skin Lesions Masquerading as Relapsing Polychondritis

    包量

    机译 麻风病与非典型皮肤病变伪装为复发性软骨炎
    摘要：Leprosy can present with a variety of clinical manifestations depending on the immune status of the individual. After dermatological and neurological involvement, rheumatic features specially various forms of arthritis are the third most common manifestation of the disease. We describe a unique case of a 22-year-old patient presenting with external ear involvement mimicking relapsing polychondritis along with inflammatory joint symptoms and skin lesions. Ear involvement in relapsing polychondritis characteristically is painful and spares the noncartilaginous ear lobules, in contrast to painless ear involvement in leprosy affecting the lobules as well. Histopathology confirmed the diagnosis, although the ear and skin lesions were not classical of leprosy. Such a presentation of leprosy closely mimicking relapsing polychondritis has not been described previously. Tissue diagnosis should always be attempted whenever possible in patients presenting with autoimmune features, so that inappropriate therapy with immunosuppressants is avoided.
  • 5.

    【2hr】Nigerian Female with Skin Lesions in the Leg and Face: Herpetic Sycosis Folliculitis

    包量

    机译 尼日利亚女性的腿和面部皮肤病变：疱疹性囊肿性毛囊炎
    摘要：Nongenital HSV 1 presents outside the mucus membrane. Our patient had unusual presentation that caused diagnostic dilemma. 30-year-old native Nigerian female coming with fiancée to the United States presented to our service one day after arrival through ER with a lesion on her right ankle. She was diagnosed with cellulitis, started on antibiotics, and admitted to hospital. She had fever of 39.1°C. Head and neck exam showed multiple sized lesions over tongue and palate and inner aspect of lower lip. Abdomen and genital exam was normal. Skin exam showed lesions over the face and lesions over the lateral aspect of the right leg. There was ulcerated lesion over the right lateral malleolus with surrounding erythema and edema. Her tests showed elevated ESR of 98; HIV test was negative; CT scan of the ankle showed no abscess or osteomyelitis. TB quantiferon was indeterminate; AFB stain and culture were negative; HSV IgM was elevated at 1 : 16; RPR was negative; ANA was negative; malaria screen was negative, and blood cultures were negative for bacteria, fungus, and virus. Debrided wound had no growth of bacteria or fungus or virus. This case illustrates the unusual presentation of the HSV1 outside the mucus membrane and how it can be confused with other conditions that required extensive tests. Therapeutic trail with antiviral medications resolved lesions over the leg and face.
  • 6.

    【2hr】Rapidly Progressive Spontaneous Spinal Epidural Abscess

    包量

    机译 快速进展性自发性硬膜外脓肿
    摘要：Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.
  • 7.

    【2hr】Two Case Reports on Thalamic and Basal Ganglia Involvement in Children with Dengue Fever

    包量

    机译 登革热患儿丘脑和基底神经节受累两例报道
    摘要：There have been increasing numbers of case reports of dengue infection with unusual manifestations. Such unusual manifestations including acute liver failure and encephalopathy could be manifested even in the absence of significant plasma leakage. Further, severe organ involvement including nervous system involvement indicates severe dengue infection. However, neurological manifestations of dengue fever are rare. This is the first case report of dengue infection with thalamic and basal ganglia involvement in Sri Lanka.
  • 8.

    【2hr】First Pediatric Case of Tularemia after a Coyote Bite

    包量

    机译 土狼咬伤后第一例Tularemia小儿病
    摘要：Bite-transmitted tularemia is a rare event in humans and most of the cases have been associated with cat bites. We report the first pediatric case of tularemia caused by a coyote (Canis latrans) bite. Coyotes can be healthy carriers of Francisella tularensis and transmit this infectious agent through a bite. Pediatricians should be aware of this risk after a carnivore bite and implement appropriate antibiotic therapy, as amoxicillin/clavulanate potassium (Augmentin) may have prolonged the typical two to three days' incubation period commonly observed for tularemia after an animal bite and was not effective in preventing clinical signs in this child. Finally, it emphasizes again the importance of early and late serum samples for appropriate serodiagnostic.
  • 9.

    【2hr】Multifocal Aeromonas Osteomyelitis in a Child with Leukemia

    包量

    机译 儿童白血病多灶性气单胞菌骨髓炎
    摘要：Aeromonas hydrophila is a Gram negative organism causing both intestinal and extraintestinal disease. The case of a 14-year-old girl with underlying immunodeficiency and leukemia who developed systemic A. hydrophila infection is described in this report. While in deep bone marrow aplasia she developed fever, severe pain in the lower extremities, and swelling of the left femur. Blood culture showed Escherichia coli and A. hydrophila whereas pus culture from the soft tissue swelling showed the presence of A. hydrophila. Imaging studies showed diffuse osteolytic lesions. Patient received 5 months of intravenous and oral antibiotics and she improved clinically whereas the radiology findings persisted.
  • 10.

    【2hr】Risk Factors and Epidemiology of Coccidioidomycosis Demonstrated by a Case of Spontaneous Pulmonary Rupture of Cavitary Coccidioidomycosis

    包量

    机译 球囊球虫病自发性肺破裂一例显示球​​虫病的危险因素和流行病学
    • 作者：Amy A. Yau
    • 刊名：Case Reports in Infectious Diseases
    • 2016年第期
    摘要：A 31-year-old Hispanic male with no medical history was admitted for fevers, pleurisy, and cough after recent oral surgery and completing demolition and construction work in Juarez, Mexico. Imaging showed a 4.4 cm cavitary lesion and bilateral tree-in-bud opacities. Initial suspicion of bacterial infection confirmed with clinical improvement on culture specific antibiotics, but after discharge he returned with progression of symptoms and new dyspnea. Radiograph showed a pyopneumothorax. Chest computed tomography after thoracostomy showed worsening infiltrates and another cavitary lesion. Symptoms persisted despite addition of broad spectrum antibiotics. Surgical repair for persistent air leak was required. Weeks after discharge, cultures and serologies returned positive for Coccidioidomycosis immitis. Coccidioides species cause up to 30% of community-acquired pneumonia and incidental cavitary lesions in endemic regions. Symptoms are nonspecific yet usually involve fatigue, cough, and pleurisy. Most hosts have spontaneous resolution; however, certain demographics such as Hispanics and diabetics, later diagnosed in our patient, have higher morbidity. As seen with our patient, cavitary rupture and bronchopleural fistulas are rare occurring in 2.6% of cavitary lesions. High suspicion based on symptoms and host demographics is important to assist in early diagnosis and treatment to avoid and treat this common pathogen's presentations.
  • 11.

    【2hr】A Rare Manifestation of Tuberculosis Presenting in the United States

    包量

    机译 在美国出现的罕见结核病表现
    摘要：A 64-year-old Bangladeshi female presented to her primary care physician with a tender right breast lump that had been present for 4-5 days along with subjective fevers and malaise. Initial biopsy revealed granulomas, but Ziehl-Neelsen and Gram stain were negative for TB so antibiotics were prescribed for abscess until culture came positive for tuberculosis. She was started on triple therapy for extrapulmonary tuberculosis, an exceedingly rare presentation that requires high clinical suspicion in the Western world.
  • 12.

    【2hr】Cryptococcus gattii in an Immunocompetent Patient in the Southeastern United States

    包量

    机译 美国东南部一名有免疫能力的病人的隐球菌
    摘要：Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C. gattii. The patient underwent 12 lumbar punctures and a ventriculoperitoneal shunt and required 83 days of inpatient therapy with 5-flucytosine and amphotericin B. The patient was found to have multiple intracranial lesions and a large intramedullary spinal cryptococcoma within his conus. Following an almost 3-month hospitalization the patient required treatment with oral voriconazole for one year. In the United States meningitis caused by C. gattii infection is not isolated to the Northwestern region.
  • 13.

    【2hr】Spondylodiscitis Caused by Enterobacter agglomerans

    包量

    机译 团聚肠杆菌引起的脊椎盘炎
    摘要：All over the globe, the incidence of vertebral infection is rising. Nowadays, compared to tuberculous variety, pyogenic spondylodiscitis incidence is high. The increase in the susceptible population and improved diagnostics summatively contributed to this. In clinical grounds, differentiation of pyogenic and tuberculous spondylodiscitis is well defined. Enterobacter agglomerans is a hospital contaminant and associated with infections in immunocompromised individuals and intravenous lines. It causes a wide array of infections. Enterobacter agglomerans spondylodiscitis is unusual and there are, around the globe, only less than 31 suspected cases that have been previously reported. Enterobacter agglomerans histology mimics tuberculous rather than pyogenic spondylodiscitis. A 65-year-old farming lady, while being in hospital, developed sudden onset spastic paraparesis with hyperreflexia. Later blood culture revealed Enterobacter agglomerans with 41-hour incubation in 99.9% probability from Ramel identification system. Her initial ESR was 120 mm/first hour. Isolate was susceptible to ciprofloxacin and intravenous followed with oral therapy shows a drastic ESR fall and improved clinical response. Differentiation of tuberculous and pyogenic spondylodiscitis is very much important in management point of view. Therefore, blood culture has a role in diagnosis of spondylodiscitis. ESR can be used as important inflammatory marker in monitoring the response to treatment. Retrospectively, ESR would aid in reaching a definitive diagnosis.
  • 14.

    【2hr】Symptomatic Acute Hepatitis C Infection Following a Single Episode of Unprotected Sexual Intercourse

    包量

    机译 一次无保护的性交后有症状的急性丙型肝炎感染
    摘要：A previously healthy 23-year-old MSM presented with jaundice, systemic upset, and rash 2 months after a single episode of unprotected sexual intercourse. Liver biochemistry was grossly deranged, with markedly elevated transaminases and hyperbilirubinaemia. Serology was positive for genotype 1a hepatitis C virus (HCV) and in the absence of other causes, acute HCV infection was suspected. He was subsequently successfully treated with pegylated interferon and ribavirin for 24 weeks and made a full clinical and biochemical recovery.
  • 15.

    【2hr】Coccidioides immitis Cervical Lymphadenitis Complicated by Esophageal Fistula

    包量

    机译 球虫球菌性炎伴颈淋巴结炎并发食管瘘
    摘要：Coccidioidomycosis (valley fever) is caused by the dimorphic fungi Coccidioides immitis or Coccidioides posadasii. Most infections are asymptomatic or result in self-limited pneumonia; extrapulmonary dissemination via either hematogenous or lymphatic spread is rare. Here, we present a case of cervical C. immitis lymphadenitis that resulted in fistula formation to the esophagus via mediastinal extension. This case highlights a very unusual extrapulmonary manifestation of coccidioidomycosis, the difficulty in diagnosing coccidioidal infection when it is not suspected, and the importance of obtaining a thorough exposure history to assist with diagnosis.
  • 16.

    【2hr】Posttraumatic Skin and Soft-Tissue Infection due to Pseudomonas fulva

    包量

    机译 假单胞菌引起的创伤后皮肤和软组织感染
    摘要：We report a case of posttraumatic skin and soft-tissue infection in a patient with a left thigh wound after a traffic accident. Pseudomonas fulva was isolated from a wound aspirate and was identified to the species level by Maldi-tof. The patient responded to drainage, debridement of wound, and two weeks of intravenous antibiotic therapy. Follow-up after 3 weeks was satisfactory with healthy cover of the injured area.
  • 17.

    【2hr】Place of Colistin-Rifampicin Association in the Treatment of Multidrug-Resistant Acinetobacter Baumannii Meningitis: A Case Study

    包量

    机译 Colistin-Rifampicin协会在耐多药鲍曼不动杆菌脑膜炎的治疗中的应用：案例研究
    摘要：Treatment of Acinetobacter baumannii meningitis is an important challenge due to the accumulation of resistance of this bacteria and low meningeal diffusion of several antimicrobial requiring use of an antimicrobial effective combination to eradicate these species. We report a case of Acinetobacter baumannii multidrug-resistant nosocomial meningitis which was successfully treated with intravenous and intrathecal colistin associated with rifampicin.
  • 18.

    【2hr】Rituximab-Associated Inflammatory Progressive Multifocal Leukoencephalopathy

    包量

    机译 利妥昔单抗相关的炎性进行性多灶性白质脑病
    摘要：Progressive multifocal leukoencephalopathy (PML) is a rare disease of the immunosuppression that results from neurotropic invasion of the JC virus which leads to demyelination of oligodendrocytes. Immune reconstitution inflammatory syndrome (IRIS), on the other hand, is a condition of inflammation that develops as the immune system reconstitutes. This case report describes a case of a 35-year-old HIV-negative male who presented with three weeks of right lower extremity paresthesias as well as right upper extremity apraxia. He was diagnosed with PML complicated by IRIS secondary to Rituximab, which he had completed four months prior to presentation. Despite the condition's poor prognosis, the patient recovered with only minor deficits.
  • 19.

    【2hr】Identification of Dietzia spp. from Cardiac Tissue by 16S rRNA PCR in a Patient with Culture-Negative Device-Associated Endocarditis: A Case Report and Review of the Literature

    包量

    机译 Dietzia spp的鉴定。 16S rRNA PCR在与培养阴性设备相关的心内膜炎患者的心脏组织中的应用：病例报告和文献复习
    摘要：The genus Dietzia was recently distinguished from other actinomycetes such as Rhodococcus. While these organisms are known to be distributed widely in the environment, over the past decade several novel species have been described and isolated from human clinical specimens. Here we describe the identification of Dietzia natronolimnaea/D. cercidiphylli by PCR amplification and sequencing of the 16S rRNA encoding gene from cardiac tissue in a patient with culture-negative device-associated endocarditis.
  • 20.

    【2hr】PBP-2 Negative Methicillin Resistant Staphylococcus schleiferi Bacteremia from a Prostate Abscess: An Unusual Occurrence

    包量

    机译 前列腺脓肿对PBP-2阴性的耐甲氧西林的葡萄球菌细菌血症：罕见的发生
    摘要：Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative Staphylococcus which has been described as a pathogen responsible for various nosocomial infections including bacteremia, brain abscess, and infection of intravenous pacemakers. Recently, such bacteria have been described to be found typically on skin and mucosal surfaces. It is also believed to be a part of the preaxillary human flora and more frequently found in men. It is very similar in its pathogenicity with Staphylococcus aureus group and expresses a fibronectin binding protein. Literature on this pathogen reveals that it commonly causes otitis among dogs because of its location in the auditory meatus of canines. Also, it has strong association with pyoderma in dogs. The prime concern with this organism is the antibiotic resistance and relapse even after appropriate treatment. Very rarely, if any, cases have been reported about prostatic abscess (PA) with this microbe. Our patient had a history of recurrent UTIs and subsequent PA resulting in S. schleiferi bacteremia in contrast to gram negative bacteremia commonly associated with UTI. This organism was found to be resistant to methicillin, in spite of being negative for PBP2, which is a rare phenomenon and needs further studies.
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