Cases reported "Acute Disease"

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1/24. Serologic examinations in acute appendicitis.

    Authors studied the formation of endotoxic antibody level in healthy adults and in patients with appendicitis with a technique (indirect haemagglutination) not used till now. They found the antibody level against endotoxin to be increased in 91% of their patients in the postoperative period. Decrease in the antibody level against endotoxin was observed in two patients with gangrenous appendicitis and two patients with perforated appendicitis. Summarizing their results, authors consider mixed (aerobic, anaerobic) infection to be of decisive importance in the development of acute appendicitis, contributing to the weakened immune response of the host.
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2/24. brucella endocarditis complicated by acute glomerulonephritis--early surgical intervention.

    brucellosis, a zoonotic disease, occurs most frequently in areas of the middle east and Mediterranean-bordering countries. endocarditis, which occurs in less than 2% of all cases of brucellosis, accounts for most brucellosis-related deaths.The patient described here had brucella endocarditis in a bicuspid aortic valve complicated by acute glomerulonephritis, which was successfully treated with urgent aortic valve replacement and intensive medical therapy. The diagnosis was made initially by a high agglutination titer and later confirmed with positive blood culture.
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3/24. A 7-year-old boy with mycoplasmal infection requiring extracorporeal membrane oxygenation.

    A 7-year-old boy with down syndrome developed severe acute respiratory distress syndrome after a respiratory infection with mycoplasma pneumoniae with an unusually high agglutination titre (1:10240). Initially, mechanical ventilation and nitric oxide inhalation were used, but these did not improve the alveolar-arterial oxygen gradient. extracorporeal membrane oxygenation for 152 h improved the lung condition. CONCLUSION: our case suggests that mycoplasma pneumoniae should be considered as an aetiological agent in acute respiratory distress syndrome. extracorporeal membrane oxygenation might have a valuable role in the management.
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4/24. Acute epiglottitis caused by haemophilus influenzae type b: a case report.

    Acute epiglottitis is an inflammatory, edematous disease of the epiglottis and adjacent structures, usually caused by haemophilus influenzae type b. It is a life-threatening condition, occurring mainly in childhood. There have never been any reports of this condition in taiwan. We report a case of 4-year-old boy who presented with characteristics of systemic illness combined with respiratory distress on arrival at the emergency room. His mouth was open and his neck was hyperextended. The diagnosis of epiglottitis was established on the basis of physical examination, lateral neck x-ray, and the finding of an enlarged, swollen, erythematous epiglottis on flexible fiberoptic laryngoscopy. urine latex agglutination test for H. influenzae type b was positive and a blood culture grew H. influenzae type b. He was treated with cefotaxime and did not require intubation.
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5/24. Benign acute myositis associated with rotavirus gastroenteritis.

    Acute myositis developed concomitantly with gastroenteritis in a 2-year-old girl. She had temporary pain and swelling of the calf muscles and transient marked elevation of serum creatine kinase values. rotavirus antigen was detected in stool by latex agglutination, and there was seroconversion of complement-fixation antibody to rotavirus.
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6/24. Two cases of acquired syphilis with acute central chorioretinitis as initial manifestation.

    Acquired syphilis has become an overlooked cause of posterior uveitis including chorioretinitis. Two male cases of bilateral acute acquired syphilitic chorioretinitis were observed, one of whom demonstrated an early delay of choroidal circulation during fluorescein angiography, possibly indicating the choroidal or subretinal neovascular proliferation which occurred later. Although both patients had been treated with oral prednisone for approximately one month before their initial visit to our clinic, good visual recovery had not been achieved. Diagnosis was first confirmed by the positive results of serologic treponema pallidum hemagglutination and Venereal disease research Laboratory tests. The patients were successfully treated with orally administered bacampicillin, which resulted in the complete recovery of visual acuity and normal fundus appearance except for slight pigmentary changes of the retina in the macular area.
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7/24. Acute Chagas' disease (trypanosomiasis americana) in acquired immunodeficiency syndrome: report of two cases.

    Two heterosexual men, aged 31 and 40 years, with the acquired immunodeficiency syndrome and presenting with the acute form of Chagas' disease are reported. The first patient, a carrier of hemophilia a, was treated for 20 years with Chilean and Brazilian cryoprecipitates. This patient acquired both diseases through this medium. The second patient, an inhabitant of northern chile (fourth region), was allegedly bitten by triatoma infestans and was an intravenous drug addict. The hemophilic patient presented with a neurologic syndrome; a brain biopsy showed a necrotizing encephalitis with an obliterative angiitis and abundant macrophages. The second patient developed intractable congestive heart failure; necropsy showed a dilated myocarditis with rupture of myofibers and an inflammatory infiltrate rich in plasma cells, lymphocytes, and macrophages. Using light and electron microscopy, abundant amastigotes of trypanosoma cruzi were seen in brain tissue, especially in the cytoplasm of macrophages, as well as in some myocardial fibers. In both cases, determination of anti-T cruzi antibodies (indirect hemagglutination technique) and xenodiagnosis were positive.
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8/24. Transfusion-related acute lung injury caused by an NB2 granulocyte-specific antibody in a patient with thrombotic thrombocytopenic purpura.

    HLA and granulocyte-specific antibodies have been implicated in the production of transfusion-related acute lung injury (TRALI). Reported here is a case that suggests that the patient's preexisting condition may play an important role in determining whether TRALI develops upon transfusion of blood products containing anti-white cell (WBC) antibodies. A 29-year-old woman with thrombotic thrombocytopenic purpura (TTP) underwent an uneventful 1.5-volume plasma exchange, which was followed by the transfusion of 2 red cell (RBC) units. At the end of the second RBC transfusion, the patient developed clinical signs and symptoms of noncardiogenic pulmonary edema. Serologic studies demonstrated that the serum from the second RBC donor had no HLA antibodies but did have a granulocyte-specific antibody (anti-NB2) that caused the agglutination of the recipient's granulocytes, which were NB2 positive. serum from the donor of the first RBC unit and serum from the donors of units used in the exchange had no HLA or granulocyte-specific antibodies that reacted with the recipient's WBCs. Because the donor implicated in this reaction had a history of 21 blood donations, none of which had been associated with a transfusion reaction, we suggest that the patient's preexisting condition played a significant role in this episode of TRALI, owing to the granulocyte-specific antibody.
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9/24. Japanese encephalitis after a two-week holiday in Bali.

    Japanese encephalitis is described in a 10-year-old girl after a short holiday in Bali. Four days after returning to australia the patient presented with a high fever, stupor and rapidly-developing focal neurological signs. Recovery occurred gradually over a period of three months and she has returned to school. Japanese encephalitis viral infection was confirmed by a marked rise in specific haemagglutination-inhibition antibodies and the presence of immunoglobulin m antibodies to the flavivirus group. It is important to be aware of the possibility of arboviral infection in patients with encephalitis. In view of the recent outbreaks of Japanese encephalitis in asia, travellers to the region should be warned to protect themselves from mosquito-bites.
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10/24. Acute interstitial nephritis associated with yersinia pseudotuberculosis infection.

    We report two cases of acute interstitial nephritis associated with yersinia pseudotuberculosis infection. The patients had fever, abdominal pain, vomiting and acute renal failure coinciding with elevated agglutination antibody titer for Y. pseudotuberculosis. Renal biopsy revealed interstitial nephritis in both patients. Although it is well known that yersiniosis sometimes affects glomeruli, this is the first report to demonstrate acute interstitial nephritis in patients with Y. pseudotuberculosis infection.
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