1/7. Double prosthetic valve endocarditis caused by streptococcus pneumoniae.Infective endocarditis (IE) caused by streptococcus pneumoniae is a rare disease. Only eight cases of pneumococcal prosthetic valve endocarditis have been described in the literature. In this report we describe the first case of pneumococcal endocarditis involving two prosthetic heart valves. The patient had pneumonia as the probable portal of entry but no predisposing conditions for invasive pneumococcal disease. Our case also illustrates the importance of transesophageal echocardiography (TEE) for the early diagnosis of IE and a timely decision for cardiac surgery.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
2/7. sirolimus-induced pneumonitis: three cases and a review of the literature.Interstitial pneumonitis is a rare disease that is seen in the context of some infections (e.g. PCP and CMV pneumonia), as side-effects of drugs (e.g. beta-blockers, amiodarone) and rarely in the context of renal transplantation. It manifests itself usually as a pneumonic illness; with symptoms of dyspnea, cough, fatigue and sometimes fever. Characteristic radiological changes are bilateral lower zone haziness. Interstitial pneumonitis is now emerging in solid organ transplant patients secondary to sirolimus). We describe three cases of sirolimus-induced pneumonitis in two patients who started sirolimus to permit cyclosporin withdrawal and in one patient initially started on sirolimus. The presentations in these cases ranged from insidious to fulminant; there was a rapid response to sirolimus withdrawal. This is an important syndrome, with an unknown frequency.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
3/7. Pneumonic presentation of brucellosis.brucellosis is a rare disease in children. lung involvement is an uncommon presentation of brucellosis. The authors are presenting a child with brucellosis, who presented with predominant pulmonary involvement. It was an eight-year-old child who was referred to us a case of non-resolving pneumonia. brucella agglutination test was suggestive of brucellosis. He responded to the combination of doxycycline and rifampicin.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
4/7. Unresolved pneumonia due to endobronchial lipoma and actinomycosis.We report an unusual case of unresolved pneumonia in a 59 yr old woman due to endobronchial lipoma and actinomycosis, two rare diseases that have never been described before in the same person.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
5/7. A case of melioidosis originating in north america.A case of melioidosis is described in a patient from mexico. The cases that have been previously reported to originate in the western hemisphere are critically reviewed. The clinician must be aware of this rare disease because its treatment is quite different from that of other gram-negative infections.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
6/7. Q-fever in a patient with a ventriculo-peritoneal drain. Case report and short review of the literature.Although Q-fever is still a relatively rare disease in the netherlands, its incidence seems to be increasing. In this article we describe the case-history of a 65-year-old woman with a Pudenz-drain, who acquired Q-fever pneumonia while manuring her garden. The course of the disease was deviant, which most likely was caused by colonization of the ventriculo-peritoneal drain with coxiella burnetii. Q-fever usually presents as a self-limiting illness. In the case of chronic Q-fever, complications such as endocarditis, hepatitis or meningo-encephalitis can be fatal and require long-term treatment. patients with artificial drains or valves carry a greater risk of developing such complications. Therefore, especially in patients at risk, Q-fever should be included in the differential diagnosis when dealing with a patient with unexplained fever.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
7/7. Primary hyperparathyroidism in infancy: a case report.Primary hyperparathyroidism is a rare disease of childhood. The condition is even rarer in the neonatal and infant stages. The disease, with its main manifestation-hypercalcemia-often is fatal. The authors successfully treated a 2.5-month-old boy who had primary parathyroid hyperplasia. The patient had recurrent pneumonia and failure to thrive. blood test results showed an abnormally high level of calcium, which was resistant to medical therapy. Further investigations showed high levels of parathyroid hormone. The patient underwent neck exploration, which showed hyperplasia of the all four parathyroid glands. Total parathyroidectomy was performed, with one gland being autotransplanted to the deltoid muscle. The patient had an immediate hypocalcemic period, followed by normocalcemia. In light of the present case and others in the literature, the authors recommended total parathyroidectomy followed by autotransplantation of a gland to an accessible muscle.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |