Cases reported "Recurrence"

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11/94. leishmaniasis recidivans recurrence after 43 years: a clinical and immunologic report after successful treatment.

    We describe a patient with very late recurring leishmaniasis recidivans from whom lesional biopsy samples were obtained during and after topical steroid treatment that demonstrated the ability of the host to contain the parasite in the absence of therapy. Combination therapy with intralesional sodium stibogluconate and oral itraconazole was successful and immunologic data suggest that both CD4( ) and CD8( ) T cell subsets had roles in this disease process.
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ranking = 1
keywords = leishmaniasis
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12/94. meningitis in a girl with recurrent otitis media caused by streptococcus pyogenes--otitis media has to be treated appropriately.

    streptococcus pyogenes rarely causes meningitis. A recent increase in the incidence and severity of diseases due to S. pyogenes has been observed worldwide, without an apparent increase in the incidence of S. pyogenes meningitis. However, more recently severe and fulminant cases of S. pyogenes meningitis have been reported in the literature. This case report emphasizes the fact that S. pyogenes can cause meningitis with severe clinical sequelae such as hygromas and right-sided third cranial nerve palsy. Most importantly, it is concluded that recurrent otitis media has to be treated carefully following appropriate identification of the causing organism in order to prevent severe clinical courses of streptococcal infections.
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ranking = 0.0005929793911016
keywords = world
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13/94. ginkgo biloba precipitating epileptic seizures.

    BACKGROUND: The herbal remedy ginkgo biloba is promoted as a treatment for a variety of ailments including memory loss and dementia, poor concentration and mood, glaucoma, 'cerebral insufficiency' and 'peripheral circulatory disturbances'. It is gaining worldwide popularity, particularly as a potential treatment for dementia. case reports: Two patients with well-controlled epilepsy presented with recurrent seizures within 2 weeks of commencing extract of Ginkgo biloba. The herbal remedy was discontinued and both patients are seizure-free several months later. DISCUSSION: ginkgo biloba may have precipitated seizures in these two patients. This and other potential adverse effects should be highlighted on the packaging of the drug.
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ranking = 0.0005929793911016
keywords = world
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14/94. Successful treatment of ocular leishmaniasis.

    PURPOSE: To report successful treatment of a case of ocular leishmaniasis with combined stibogluconate and allupurinol. METHOD: A 32-year-old physician developed a non-tender reddish chalazion like lesion in his right lower lid, associated with conjunctivitis and nodular episcleritis. biopsy of the lesion in his eyelid and conjunctiva disclosed a dense inflammatory response including histiocytes containing typical leishmania organisms. RESULT: Therapy with stibogluconate, both intralesional and intramuscular, was initiated with some improvement. However recurrence of the lesion occurred. Systemic retreatment with combined stibogluconate and allupurinol led to complete healing of the lesion. CONCLUSION: Ocular leishmaniasis is a rare and potentially blinding disorder. Combined stibogluconate and allupurinol may be an effective therapy in such cases.
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ranking = 6
keywords = leishmaniasis
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15/94. optic nerve cysticercosis.

    cysticercosis of the optic nerve is an extremely rare entity and only seven cases have been reported in the world literature. A case of optic nerve cysticercosis in a 25-year-old woman is reported, along with a review of literature. The patient presented with two episodes of pain, diminution of vision and proptosis. Computed tomography and ultrasonography revealed an intraneural cyst with scolex in the retrobulbar portion of the optic nerve. A positive enzyme-linked immunosorbent assay test for cysticercosis further confirmed the diagnosis. Medical therapy in the form of oral albendazole and steroids resulted in complete resolution of the cyst, with few visual sequelae.
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keywords = world
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16/94. North American paragonimiasis: case report of a severe clinical infection.

    paragonimiasis is an important cause of pulmonary disease worldwide. It results from an infection with paragonimus, a parasite that reproduces through a complex life cycle involving snails, crustaceans, and mammals. humans acquire the disease by ingesting uncooked freshwater crab or crayfish. paragonimus species are distributed globally, and the disease is well known in endemic regions of asia where culturally based methods of food preparation foster human transmission. paragonimus also exists in regions of the united states but has been a rare cause of pulmonary disease. We report a case of a previously healthy young man who developed a dense empyema from paragonimus kellicotti that ultimately required thoracotomy and praziquantel to eradicate his infection.
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keywords = world
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17/94. Relationship of contact lenses, pregnancy, and herpes simplex virus.

    herpes simplex virus (HSV) is one of the most common causes of corneal infections in the world, affecting more than 500,000 people in the united states alone. HSV keratitis recurrences can occur with systemic immunosuppression. pregnancy can resemble a modified state of immunosuppression resulting in an increased risk for HSV keratitis. This type of immunosuppression combined with contact lens wear may have an additive effect and increase the possibility of HSV recurrence. Despite the obvious correlation, there are no reported cases in the literature. A case of bilateral HSV keratitis in a pregnant contact lens wearer is presented with an explanation of the causes and possible treatment methods.
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keywords = world
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18/94. erythema multiforme due to contact with weeds: a recurrence after patch testing.

    erythema multiforme (EM) as a complication of patch testing (PT) is rare. A 52-year-old woman with a 13-year history of episodes of EM, after contact with weeds during home gardening, had had no recent history of herpes simplex, other infection, drug ingestion or vaccination. On examination, EM lesions were distributed on the exposed skin. 5 weeks after complete resolution, PT and photopatch testing (PPT) were done with fresh plants she brought in. She was PT with a standard series and the Hermal-Trolab plants, woods, tars, balsams and flavors series. Intradermal testing, with a 3 reaction to mixed weed pollens, was done 3 weeks later. Specific IgE to weed pollens class 1 (CAP-Pharmacia) was detected. Eczematous PT reactions were obtained with fresh leaves: common chickweed (stellaria media caryophyllaceae), dandelion (taraxacum officinale Compositae), field-milk thistle (sonchus arvensis Compositae) and white clover (trifolium repens Leguminosae). Photoaggravation was seen to common chickweed and dandelion. Positive PT was also seen with alantolactone. By the 4-day reading, a typical EM had commenced, coming up to quite the same extent as seen on admission. There was no photosensitivity (UV skin tester, K. Waldmann). In the essential oil obtained from common chickweed, thin layer chromatography (TLC) revealed the well-known contact allergens borneol, menthol, linalool, 1,8-cineole, and other terpenes such as epoxy-dehydro-caryophyllene, monoterpene alcohol-ester and caryophyllene. Up to now, no data on essential oil in stellaria media (common chickweed) have been reported. It can be concluded that EM developed due to contact with weeds, and recurred after patch testing. Neither blistering nor eczematous lesions have been seen on her skin, making this case very unusual. As far as the world literature is concerned, this is only the 4th report of EM developing in association with patch testing.
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keywords = world
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19/94. Recurrent allograft HCV presenting as acute cellular rejection: successful management with interferon and ribavirin alone.

    hepatitis c virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 post-operative years because of accelerated graft injury and cirrhosis. Traditional induction immunosuppressive regimens and intensive immunosuppression used to treat episodes of acute cellular rejection (ACR) are associated with enhanced viral replication and higher likelihood and severity of recurrent HCV. At our institution, therefore, we have used low-dose steroid therapy in an effort to limit HCV replication. However, this practice has been associated with frequent early presentations consistent with ACR. Here, we present three cases consistent with histologic ACR treated with conventional antirejection therapy that improved transiently, but evolved rapidly to progressive HCV. A fourth patient with a similar presentation experienced dramatic improvement in aminotransferases when treated solely with interferon and ribavirin. We propose that histologic characteristics traditionally associated with ACR may, in fact, represent early recurrent HCV as both processes share common immunopathogenetic mechanisms, or alternatively, that both ACR and recurrent HCV may be present simultaneously. We conclude that in cases suggestive of ACR, careful consideration should be given to treatment for recurrent HCV in lieu of or in concert with intensive immunosuppression.
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ranking = 0.0005929793911016
keywords = world
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20/94. Topical treatment of persistent cutaneous leishmaniasis with ethanolic lipid amphotericin b.

    A 1.5-year-old infant was referred because of spreading skin lesions diagnosed earlier as cutaneous leishmaniasis that did not respond to repeated courses with paromomycin-containing ointment. After consideration of the alternative therapeutic options, the infant was treated with a topical colloidal solution of amphotericin b for 3 weeks, This mode of therapy resulted in resolution of the skin lesions. No local or systemic side effects were observed. There were no signs of recurrence 3 months after cessation of the treatment.
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ranking = 5
keywords = leishmaniasis
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