Cases reported "Fever"

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1/14. ehrlichiosis infection in a 5-year-old boy with neutropenia, anemia, thrombocytopenia, and hepatosplenomegaly.

    ehrlichiosis should be considered in the differential diagnosis of any patient with recent fever, pancytopenia, hepatosplenomegaly, and history of tick exposure. We present a previously healthy 5-year-old boy who was referred to the hematology-Oncology Clinic to consider a bone marrow etiologic process after his pediatrician discovered progressive neutropenia, anemia, thrombocytopenia, and hepatosplenomegaly accompanied by 2 days of fever. bone marrow aspirate and biopsy were nonrevealing. Because of the history of a recent tick bite, a diagnosis of ehrlichiosis infection was considered and ultimately confirmed by IgG-specific serum testing. The patient's fever was treated symptomatically with acetaminophen, and symptoms resolved on their own without intervention. ehrlichiosis is a tick-borne infection that occurs throughout the spring and summer, often causing findings that mimic a malignancy or serious hematologic disorder. The diagnosis should be considered in any person living in tick-infested areas and can be confirmed by polymerase chain reaction or serum antibody titers. Treatment with doxycycline can lead to rapid clinical improvement if the diagnosis is made early.
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2/14. Fever and rash in a 3-year-old girl: rocky mountain spotted fever.

    Initial symptoms of rocky mountain spotted fever (RMSF), a tick-borne illness caused by rickettsia rickettsii, are nonspecific and include headache, gastrointestinal disturbances, malaise, and myalgias, followed by fever and rash. The classic triad of fever, rash, and history of tick exposure is uncommon at presentation. Clinical manifestations of RMSF range from virtually asymptomatic to severe. Because of the potentially fatal outcome of RMSF, presumptive clinical diagnosis and empiric antimicrobial therapy can be critical. We present the case of a 3-year-old girl from new york State who presented with fever and rash.
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3/14. Mild rhabdomyolysis in a child with fever and "hematuria".

    rhabdomyolysis represents a life-threatening condition, which results in release of cellular contents (myoglobin, enzymes, and electrolytes) into the plasma. We report a pediatric patient with mild rhabdomyolysis who had a favorable outcome. A 3-year-old girl had been ill for 2 days with high fever, anorexia, pain in both thighs, and passage of dark-red urine. myoglobinuria was demonstrated by a "blood"-positive dipstick in the absence of red blood cells in the urinary sediment. diagnosis was confirmed by the presence of a high serum creatine kinase activity. The child was treated on an outpatient basis and has shown full clinical and biochemical recovery. There has been no recurrence of myoglobinuria during the 2-year follow-up.
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4/14. Sticky eyelid syndrome.

    PURPOSE: To report on patients seen with an unusual condition affecting the eyelids. The syndrome manifests as a temporary adhesion which forms between the upper and lower eyelid associated with laxity of the lower lid retractors. This results in a peculiar closure of the lids. DESIGN: Retrospective case reports. methods: charts of affected patients were reviewed for their clinical histories, examination findings, external photographs, and the results of treatment. RESULTS: Ten consecutive patients with the associated findings were reviewed. All cases were unilateral. Seven patients were Asian and three were Caucasian. Nine patients were symptomatic; of these, all were treated conservatively except for one who requested surgery. Two cases are described and photographs are shown. CONCLUSION: Lower eyelid retractor laxity combined with a temporary adhesion between the upper and lower lid results in the clinical findings of Sticky Eyelid syndrome.
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5/14. African tick bite fever: a not-so-uncommon illness in international travelers.

    BACKGROUND: African tick bite fever is a rickettsial illness that has recently emerged as a significant disease among international travelers. The vector is the Amblyomma tick, which is endemic to sub-Saharan africa and parts of the eastern Caribbean. OBSERVATIONS: We describe a middle-aged woman who returned from a mission trip to zimbabwe with an influenzalike illness and inoculation eschar; she also had a history of travel to a game farm. biopsy revealed a histopathologic pattern consistent with an infectious pathogenesis. Immunohistochemical staining confirmed the presence of rickettsial organisms. In light of the patient's history, the clinical constellation of signs and symptoms, and the results of ancillary laboratory testing, a diagnosis of African tick bite fever was made. The patient was treated with doxycycline hydrochloride and had an uncomplicated course. CONCLUSIONS: This report further highlights the epidemiological and clinical features of African tick bite fever. With the increase in international travel, it is important to recognize the illness in those who have been to endemic countries and to counsel patients regarding preventive measures for planned travel.
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6/14. A typhus-like illness caused by acute hiv seroconversion.

    A patient is described in whom an acute human immunodeficiency virus seroconversion illness occurred following a trip to southern africa. The presentation was strikingly similar to that of African tick typhus and could only be distinguished by serological testing.
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7/14. ehrlichiosis in children.

    Tick-borne rickettsiae of the genus ehrlichia have recently been recognized as a cause of human illness in the united states. In the years 1986-1988, 10 cases of ehrlichiosis were diagnosed in children in oklahoma. Fever and headache were universal: myalgias, nausea, vomiting, and anorexia were also common. Rash was observed in six patients but was a prominent finding in only one. leukopenia, lymphopenia, and thrombocytopenia were common laboratory abnormalities. Six patients were treated with tetracycline, three with chloramphenicol, and one was not treated with antibiotics: all recovered. The onset of illness in spring and early summer for most cases paralleled the time when Amblyomma americanum and dermacentor variabilis are most active, suggesting that one or both ticks may be vectors of human ehrlichiosis in oklahoma.
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8/14. colorado tick fever: clinical, epidemiologic, and laboratory aspects of 228 cases in Colorado in 1973-1974.

    During 1973 and 1974, we looked for cases of colorado tick fever throughout Colorado; 228 cases were identified. Although 90% of the patients reported exposure to ticks before illness, only 52% were aware of an actual tick bite. Typical symptoms of fever, myalgia, and headache were common, but gastrointestinal symptoms were also prominent in 20% of the patients. Twenty percent were hospitalized; no deaths or permanent sequelae were noted. Persistent viremia (greater than or equal to 4 weeks) was found in about half of the cases; this finding was not associated with the occurrence of prolonged symptoms (greater than or equal to 3 weeks), which were also reported in half of the cases. One patient became reinfected with the virus. Increasing tourism in endemic areas and the frequent occurrence of prolonged or biphasic illnesses provide the potential for patients with colorado tick fever to seek medical care anywhere in the united states.
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9/14. The spectrum of relapsing fever in the Rocky Mountains.

    Between 1940 and 1976, two cases of tick-borne relapsing fever were reported in Colorado, but since 1977, 23 confirmed cases have occurred. All patients had fever, with a mean of 2.8 febrile episodes (range, one to six). Complications included thrombocytopenia, endophthalmitis, meningitis, abortion, in utero infection, and erythema multiforme. All treated patients were eventually cured with antibiotics, although two pregnant patients failed to be cured by their initial courses of antibiotics. Seven of 21 treated patients had Jarisch-Herxheimer reactions, three of whom required intensive care. Five of nine patients who received tetracycline at an initial dose of 5 mg/kg or more had reactions v none of four patients treated with lower doses. Possible causes of the recent increased incidence include increased physician awareness and reporting, improved diagnostic techniques, and an actual increase due to a larger population at risk. Because summertime visits to the Rocky Mountains are becoming increasingly popular, physicians elsewhere should know how to recognize and treat this condition.
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keywords = tick
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10/14. Blisters, pruritus, and fever after bites by the Arabian tick ornithodoros (Alectorobius) muesebecki.

    A biologist was bitten by ornithodoros (Alectorobius) muesebecki Hoogstraal, an endemic tick parasite of nesting and resting marine birds on islands in eastern arabia. Irritating bullae developed and for four months he experienced intermittent inflammation and irritation. Two years earlier, after being bitten by the same tick species on a different island, he had experienced only irritation lasting no more than a fortnight. petroleum-industry labourers on another island were admitted to hospital for about two weeks with bullae at numerous bite sites, intense pruritus, headache, and fever. Zirqu virus (bunyaviridae, nairovirus) has been isolated from O. (A.) muesebecki samples from Abu Dhabi. The role of Zirqa virus and/or of salivary toxins in producing irritation and illness, as well as individual sensitivity to the tick and the seasonal dynamics of toxicity or infectivity, should be investigated.
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