1/94. clostridium difficile diarrhea and colitis: a clinical overview.Infection with toxin-producing strains of clostridium difficile is common and potentially life-threatening. It occurs mostly in patients in the hospital or nursing home who are taking or have recently taken antibiotics. Two toxins, A and B, damage the colonic mucosa, resulting in symptoms ranging from mild diarrhea to bloody diarrhea with fever and abdominal pain, colitis, or even pseudomembranous colitis. Severe cases may involve dehydration, toxic megacolon, or colonic perforation. This article reviews the microbiology, epidemiology, clinical manifestations, diagnosis, treatment, and prevention of this disease.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/94. typhlitis complicating autologous blood stem cell transplantation for breast cancer.Three cases of typhlitis occurring during autologous blood stem cell transplantation (ABSCT) for metastatic breast cancer are described. typhlitis is a rare complication of neutropenia and has uncommonly been reported in the autologous transplant setting. Although it has been most commonly described in children with leukemia, typhlitis has increasingly been reported in adult leukemias and in association with neutropenia secondary to chemotherapy for a number of solid tumors. Only five previous cases of typhlitis in the setting of ABSCT have been described. Whereas diarrhea and fever are common toxicities associated with high-dose chemotherapy, it is likely that many cases of typhlitis go unrecognized. bone marrow transplantation (2000) 25, 321-326.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/94. Intractable nausea, vomiting and diarrhea in a Mexican woman with No recent travel history.A 45-year-old Mexican woman with a history of noninsulin dependent diabetes mellitus (NIDDM), hypertension, and coronary artery disease presented to the hospital after 2 months of intractable nausea, vomiting and diarrhea-all made worse by eating and drinking. She reported fever, chills, anorexia and a documented 50-pound weight loss during this period. She denied the signs and symptoms of melena, hematochezia, steatorrhea or constipation. She also reported left leg pain and decreased sensation and strength of her left leg compared to the right leg. She had been hospitalized 2 weeks prior to admission with the same symptoms and a diagnosis of viral gastroenteritis. She was also treated for H. pylori, but subsequent biopsy results were negative by Steiner stain.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
4/94. Alternative medicine in gynecologic oncology: A case report.A patient with Stage IIB squamous cell cancer of the cervix presented 10 days into her primary radiation therapy with neutropenic fever and diarrhea requiring hospitalization and delay in treatment. The patient's history revealed extensive use of alternative therapies including potential toxic botanicals. This case raises the possibility that a patient's use of alternative therapies may have caused toxicity and delayed primary therapy. Gynecologic oncology patients may be using alternative therapies justifying the need for incorporating this classification into the historical exam.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
5/94. ceftriaxone-resistant salmonella infection acquired by a child from cattle.BACKGROUND: The emergence of resistance to antimicrobial agents within the salmonellae is a worldwide problem that has been associated with the use of antibiotics in livestock. Resistance to ceftriaxone and the fluoroquinolones, which are used to treat invasive salmonella infections, is rare in the united states. We analyzed the molecular characteristics of a ceftriaxone-resistant strain of salmonella enterica serotype typhimurium isolated from a 12-year-old boy with fever, abdominal pain, and diarrhea. methods: We used pulsed-field gel electrophoresis and analysis of plasmids and beta-lactamases to compare the ceftriaxone-resistant S. enterica serotype typhimurium from the child with four isolates of this strain obtained from cattle during a local outbreak of salmonellosis. RESULTS: The ceftriaxone-resistant isolate from the child was indistinguishable from one of the isolates from cattle, which was also resistant to ceftriaxone. Both ceftriaxone-resistant isolates were resistant to 13 antimicrobial agents; all but one of the resistance determinants were on a conjugative plasmid of 160 kb that encoded the functional group 1 beta-lactamase CMY-2. Both ceftriaxone-resistant isolates were closely related to the three other salmonella isolates obtained from cattle, all of which were susceptible to ceftriaxone. CONCLUSIONS: This study provides additional evidence that antibiotic-resistant strains of salmonella in the united states evolve primarily in livestock. Resistance to ceftriaxone, the drug of choice for invasive salmonella disease, is a public health concern, especially with respect to children, since fluoroquinolones, which can also be used to treat this disease, are not approved for use in children.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
6/94. Clinical onset of the Crohn's disease after eradication therapy of helicobacter pylori infection. Does helicobacter pylori infection interact with natural history of inflammatory bowel diseases?BACKGROUND: There are conflicting reports concerning the prevalence of helicobacter pylori infection in patients with inflammatory bowel diseases: some studies connected Sulphasalazine therapy and lower incidence of helicobacter pylori infection, but others showed lower prevalence of helicobacter pylori infection in inflammatory bowel diseases despite the choice of therapy. CASE REPORT: A 28-year-old male patient presented in January 1996 with the symptoms of ulcer like dyspepsia. There was no significant abnormality on physical examination, laboratory testing and abdominal ultrasound. histology examination of the biopsy specimen taken during the upper endoscopy revealed helicobacter pylori associated active gastritis only in the corporal part of the stomach. After two weeks eradication therapy (omeprazole, amoxicillin) he was well. Three months later, at the control endoscopy, granulomatous gastritis of the corporal localization was detected, without helicobacter pylori present. Antral mucosa appeared normal, both, on endoscopy and histology examination. In July 1996 he started with cramping abdominal pain, mild periodical fever and episodes of watery diarrhea. In laboratory results we found nonspecific signs of inflammation. We repeated upper endoscopy, colonoscopy and enteroclysis--with evidence of segmental stenotic lesions of the upper part of ileum and jejunum. Again, we confirmed granulomatous gastritis and small granuloma in the proximal jejunum. After starting the 5-ASA therapy in combination with Metronidazol, patient was better clinical condition, and laboratory results were normal. We suggested mesalamine maintenance therapy 1 gr. every day, and three years later he is well, in clinical remission of Crohn's disease. CONCLUSION: The clinical course of the Crohn's disease maybe "sui generis" connected with helicobacter pylori infection- but the exact mechanisms remain to be discovered.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
7/94. Thrombotic stroke in a child with diarrhea-associated hemolytic-uremic syndrome with a good recovery.A boy aged 3.5 years with post-diarrheal hemolytic-uremic syndrome (HUS) was referred to our hospital because of convulsion and stupor. He had been admitted to a regional hospital with a 3-day history of bloody diarrhea, colic abdominal pain and fever. Two days later, he had complained of generalized seizures and oliguria. On admission, he developed anuria, and serum blood nitrogen and creatinine increased to 56 mg/100 ml and 2.8 mg/100 ml, respectively. Platelets decreased to 42,000/microl. Under the diagnosis of HUS, a continuous hemodiafiltration treatment had to be instituted. Computed tomography of his head at hospital day 5 revealed abnormal low density area of infarction with edema in both the basal ganglia involving with the posterior limb of internal capsule. serum titer of IgM antibody to escherichia coli o157 showed positive value. Although his anuria and stupor persisted over 10 days, he recovered without serious complications. These clinical observations may indicate that patients with similar lesions do not necessarily have serious morbidity.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
8/94. Amatoxin poisoning from ingestion of Japanese Galerina mushrooms.BACKGROUND: Although some Japanese Galerina species poisonings manifest as gastrointestinal symptoms followed by late-onset hepatorenal failure (phalloides syndrome), the toxin responsible for this has not been determined. CASE REPORT: We report a 6-year-old boy who developed characteristic cholera-like diarrhea and late-onset severe hepatic deterioration after eating mushrooms, later identified as a Galerina species, most likely Galerina fasciculata. A residual mushroom revealed alpha-amanitin. This account is the first known reported case of poisoning by Japanese Galerina species where an amatoxin was demonstrated to be responsible for the toxicity.- - - - - - - - - - ranking = 451.83353777788keywords = cholera (Clic here for more details about this article) |
9/94. Three cases of bacteremia caused by vibrio cholerae o1 in Blantyre, malawi.We report three fatal cases of bacteremia (two adults, one neonate) caused by vibrio cholerae o1 (Ogawa), which occurred in the context of a community outbreak of cholera diarrhea in Blantyre, malawi. Only four cases of invasive disease caused by V. cholerae O1 have previously been reported. We describe the clinical features associated with these rare cases and discuss their significance.- - - - - - - - - - ranking = 3162.8347644452keywords = cholera (Clic here for more details about this article) |
10/94. Shigella septicaemia in adults: report of two cases and mini-review.INTRODUCTION: We report 2 cases of Shigella septicaemia in adult patients. CLINICAL PICTURE: Two 57-year-old women presented with non-bloody diarrhoea and fever. The first patient was an inmate of a long-term care facility who was schizophrenic and the second patient was a diabetic who recently travelled to Medan, indonesia. Both patients were febrile, hypotensive and dehydrated. The first patient was neutropenic, thrombocytopenic and had acute renal failure. blood cultures yielded shigella flexneri and stool cultures gave negative results for both patients. TREATMENT: Rehydration and intravenous ceftriaxone were instituted. OUTCOME: The patients' symptoms and hypotension resolved. CONCLUSION: Appropriate antibiotics can decrease the severity and duration of Shigella septicaemia.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
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