China
Africa
Explore chapters and articles related to this topic
Vasculitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Ivy M. Obonyo, Virginia A. Jones, Kayla A. Clark, Maria M. Tsoukas
Laboratory studies: Tender subcutaneous nodules and livedo reticularis with central ulceration, with or without extracutaneous symptoms, should prompt a skin biopsy to confirm CPAN. A deep incisional biopsy alongside a normal skin sample is recommended when ulcerations are found. The following should be obtained to differentiate between CPAN systemic polyarteritis nodosa and other vasculitides: complete blood count, ESR, liver and renal studies, cryoglobulins, ANA, rheumatoid factor, ANCA, and complement levels. Antistreptolysin-O titer may also be obtained if suspicious of a streptococcal infection.
Psoriasis and lichen planus
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
This type of psoriasis is seen in children and young adults usually after acute streptococcal infections of throat. It presents with small lesions of 2 mm–1 cm distributed uniformly throughout the body, but mainly on the trunk, arms, and legs (Figure 9.7). Palms and sole involvement is rare. An elevated antistreptolysin O, streptozyme or anti-DNase B titer is found in nearly half of the patients, indicating a recent streptococcal infection. Resolution occurs within 2–3 months.
Post-viral syndromes
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Anusha K. Yeshokumar, Eliza Gordon-Lipkin, Brenda Banwell
Sydenham’s chorea is most frequently seen in children ages 8 to 9 years and is rarely seen in adults. Symptoms develop weeks to months after group-A streptococcal pharyngitis. In a study of 50 patients with rheumatic fever, chorea began unilaterally but spread to both sides in 80% of cases [58]. Diagnosis is by clinical Jones criteria (Table 25.4) and exclusion of other etiologies such as stroke, intoxication or infectious encephalitis. Antistreptolysin O or DNAse antibody titers may support evidence of streptococcal infection. Neuroimaging may be normal or transient T2 hyperintensities in the basal ganglia may be seen [59,60]. In one study of 24 children with recent onset of Sydenham’s chorea, while only two showed T2 hyperintensities on MRI in the basal ganglia, quantitative analysis revealed increased size of the basal ganglia relative to age-matched controls [61]. Other studies have demonstrated increased metabolism in the basal ganglia in two patients by PET [61] and six of ten of patients by SPECT imaging [62].
Acute rheumatic fever and erythema marginatum in an adult patient
Published in Baylor University Medical Center Proceedings, 2022
Sonali Batta, Hannah Pederson, Karen B. Brust, Katherine H. Fiala
A 41-year-old woman presented for evaluation of a pruritic eruption with an abrupt onset, starting on her flanks and then spreading to her arms and legs. She had 2 weeks of fever, chills, malaise, joint pain, nausea, and mental confusion. Despite being evaluated in the emergency department, she had only been tested for illicit drug use, which was negative. Edematous papules and annular plaques with surrounding blanching were noted on the thighs, bilateral flanks, and forearms characteristic of erythema marginatum (Figure 1). A punch biopsy was positive for antistreptolysin O (ASO) titer at 200 IU/mL. Her past medical history included anxiety, gastritis, seasonal allergies, and vaginitis. Drug allergies included cephalexin, penicillin, aspirin, doxycycline, naproxen, and prednisone.
Case report of post streptococcal multifocal choroiditis in a young pregnant female: A success story
Published in Ocular Immunology and Inflammation, 2022
Lyudmila Kishikova, Alastair Coulson, Divya Jacob, Ahmed Saad
The patient was extensively investigated for inflammatory and infectious etiologies by a multidisciplinary team, including rheumatology as well as obstetrics and gynecology. She had a normal full blood count, ESR was raised (which was an expected feature of pregnancy) and all other inflammatory markers were normal. She had normal renal function, a normal electrolytes and coagulation profile and normal serum angiotensin enzyme; serology for syphilis, toxoplasmosis, borreliosis, brucellosis, Epstein-Barr virus, and herpes simplex virus were negative. Antistreptolysin (ASO) was moderately raised. She was IgG positive for Varicella zoster virus, with no evidence of recent infection. Mantoux and gamma-interferon tests for tuberculosis were both negative. Autoantibody testing was negative for antinuclear antibodies, anti-double-stranded DNA, rheumatoid factor and anticardiolipin. The initial differential diagnosis included post-streptococcal uveitis, Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE), Multifocal Chorioretinopathy, Atypical Punctate Inner Choroidopathy (PIC) and immune reaction to occult infection.
From interned refugee to neuropathologist and psychiatrist
Published in Journal of the History of the Neurosciences, 2019
Anzo Nguyen, Frank W. Stahnisch
Such experiences had gradually dampened Igersheimer’s interest in neuropathology, and from 1945 to 1947, he held multiple residencies in pediatrics at the Floating Hospital for Children in Boston and the Jewish Hospital in Brooklyn. During this time, he published at least two neurological articles, a case report of progressive lipodystrophy (Igersheimer, 1948a) and a titer test for the presence of antistreptolysin O (ASO) in cerebrospinal fluid. The results of this study suggested that levels of antistreptolysin O in the cerebrospinal fluid of children of various ailments (e.g., concussion, epilepsy, and respiratory tract infections), but with no streptococcic infection, were lower than 50 arbitrary units, whereas 100 units was considered “normal.” Even in patients with high antistreptolysin O levels in serum, due to various infections, he found that levels in the cerebrospinal fluid remained under 50 units, thus indicating that some kind of confining mechanism existed between the blood–brain barrier and cerebrospinal fluid maintaining a low level of antistreptolysin O (Igersheimer, 1948b).