Cases reported "Fever"

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1/49. Impressive remission in a patient with locally advanced malignant pleural mesothelioma treated with gemcitabine.

    The results of treatment of malignant pleural mesothelioma are quite unsatisfactory regardless of the substance or schedule employed. Although some activity is proved for anthracyclines, platinum compounds and alkylating substances, no chemotherapeutic regimen has emerged as a standard of care. Response rates documented in literature are between 10 and 20% for all these regimens. We report about a patient with locally advanced, unresectable pleural mesothelioma treated with the nucleoside analog gemcitabine (2,2-difluorodeoxycytidine). A 54-year-old male patient with unresectable pleural mesothelioma confirmed by thoracoscopic biopsy was treated with seven cycles of gemcitabine (1000 mg/m2 on day 1, 8 and 15) over a period of 36 weeks. Restaging by thoracic computed tomography (CT) scan was performed after 8, 20 and 36 weeks. At week 36 after beginning of treatment, the CT scan exhibited a substantial partial remission with a reduction of tumor volume of over 50%. The adverse effects of the therapy were very moderate with a hematotoxicity not exceeding WHO grade I and a mild 'flu-like syndrome' during the first three cycles which responded quite well to steroids. The compliance of the patient was excellent and his general condition improved significantly under therapy. Gemcitabine seems to be an active drug for the treatment of pleural mesothelioma. Compared to other active regimens it is normally very well tolerated by the patients. Because of these characteristics gemcitabine seems a suitable antineoplastic substance, especially in palliative settings. It would be worthwhile to test its activity in pleural mesotheliomas in controlled trials.
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2/49. A dentoalveolar abscess in a pediatric patient with ketoacidosis caused by occult diabetes mellitus: a case report.

    oral health professionals are frequently asked to evaluate patients with routine odontogenic infections. These patients can sometimes present with systemic signs and symptoms, including fever, malaise, tachycardia, and dehydration. It is important for the astute clinician to understand the possible associated systemic diseases that may be contributing to odontogenic infections. We present here an interesting case of a pediatric patient with a routine canine space infection who exhibited classic clinical signs and symptoms of diabetic ketoacidosis.
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3/49. Favourable effect of chemotherapy on clinical symptoms and human herpesvirus-8 dna load in a patient with Kaposi's sarcoma presenting with fever and anemia.

    The case of a patient infected with human immunodeficiency virus type 1 (hiv-1) with Kaposi's sarcoma who presented with fever of unknown origin, severe anemia, thrombocytopenia and hypoalbuminemia but only limited involvement of the skin is presented. Chemotherapy directed at Kaposi's sarcoma resulted in resolution of these clinical signs and symptoms and was associated with a significant reduction in human herpesvirus-8 dna load in serum, despite continued hiv-1 replication. Such a decreasing human herpesvirus-8 load following Kaposi's sarcoma-directed chemotherapy has not been reported previously. These findings suggest that Kaposi's sarcoma was indeed responsible for the clinical syndrome and that this neoplasm is a source of human herpesvirus-8 virus particle production, which can be inhibited by chemotherapy-induced reduction in tumor burden.
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4/49. Human herpesvirus-6 (HHV-6)-associated hemophagocytic syndrome.

    Virus-associated hemophagocytic syndrome (VAHS) is characterized by histiocytic proliferation and phagocytosis triggered by virus infections. viruses in the herpes group, especially the Epstein-Barr virus (EBV), are well known to cause VAHS; however, the relationship between this syndrome and human herpesvirus-6 (HHV-6) infection has rarely been reported. In this study, we describe a 23-month-old girl who exhibited typical manifestations of VAHS associated with HHV-6 infection. To the best of our knowledge, this case is the fifth reported case in the English literature.
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5/49. A case of intoxication after a bite by Latrodectus tredecimguttatus.

    A case of intoxication in Southern bulgaria after a bite from the venomous spider Latrodectus tredecimguttatus is reported. The development of both local (acute pain, itching erythema, paraesthesiae in the area of the bite) and general (weakness, headache, dizziness, fever, vomiting, myalgia, muscle cramps) symptoms, which passed relatively easily, is described. The clinical picture and treatment are briefly commented on.
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6/49. 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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ranking = 113.07075425089
keywords = tick bite, tick, bite
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7/49. Tula virus infection associated with fever and exanthema after a wild rodent bite.

    Reported here is the first case of human acute infection with Tula virus, which occurred in a 12-year-old boy in switzerland. This hantavirus had been considered apathogenic to humans, and in switzerland only TULV-genome sequences have been demonstrated in wild rodents to date. In this case, paronychia, fever and exanthema occurred after the patient was bitten by a wild rodent, indicating an unusual route of hantavirus transmission. Thus, Tula virus infection should be taken into account in patients with appropriate clinical symptoms and contact with rodents.
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8/49. 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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ranking = 16.160768735066
keywords = tick
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9/49. Pseudobacteraemia in a patient with neutropenic fever caused by a novel paenibacillus species: paenibacillus hongkongensis sp. nov.

    AIMS: To characterise a strain of Gram negative aerobic straight or slightly curved rods (HKU3) isolated from the blood culture of a 9 year old Chinese boy with neutropenic fever and pseudobacteraemia. methods: The isolate was phenotypically investigated by standard biochemical methods using conventional biochemical tests, scanning electron microscopy, and transmission electron microscopy. Genotypically, the 16S rRNA gene of the bacterium was amplified by the polymerase chain reaction (PCR) and sequenced. The sequence of the PCR product was compared with known 16S rRNA gene sequences in the Genbank by multiple sequence alignment. The G C content was determined by thermal denaturation. A phylogenetic tree was constructed by the PileUp method. RESULTS: The cells of the bacterial strain were aerobic, sporulating, Gram negative straight or slight curved rods. The bacterium grew on horse blood agar as non-haemolytic, grey colonies of 1 mm in diameter after 24 hours of incubation at 37 degrees C in ambient air. No enhancement of growth was seen in 5% CO(2). It grew at 50 degrees C as pinpoint colonies after 72 hours of incubation, but did not grow at 65 degrees C or on MacConkey agar. It was non-motile. It produced catalase (weakly positive) and cytochrome oxidase. It reduced nitrate, produced beta galactosidase, hydrolysed esculin, and utilised sodium acetate. A scanning electron micrograph of the bacterium showed straight or slightly curved rods. A transmission electron micrograph of the cell wall of the bacterium revealed multiple electron dense layers, including the outer membrane, middle murein layer, and inner cytoplasmic membrane, compatible with its Gram smear appearance. 16S rRNA gene sequencing showed that there were 7.7%, 8.0%, 8.2%, and 8.6% differences between the 16S rRNA gene sequence of the bacterium and those of paenibacillus macerans, paenibacillus borealis, Bacillus ehimensis, and paenibacillus amylolyticus, respectively. The mean (SD) G C content of the bacterium was 47.6 (2.1) mol%. Phylogenetically, it belongs to the genus paenibacillus (previously called group 3 bacillus). CONCLUSIONS: A bacterium that exhibited phenotypic and genotypic characteristics that are very different from closely related members of paenibacillus was the cause of pseudobacteraemia in a patient with neutropenic fever. A new species, paenibacillus hongkongensis sp. nov. is proposed, for which HKU3 is the type strain.
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10/49. 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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ranking = 8.0803843675328
keywords = tick
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