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Progress in Antimalarial Drug Discovery and Development
Published in Venkatesan Jayaprakash, Daniele Castagnolo, Yusuf Özkay, Medicinal Chemistry of Neglected and Tropical Diseases, 2019
Anna C.C. Aguiar, Wilian A. Cortopassi, Antoniana U. Krettli
Malaria is usually classified as asymptomatic, uncomplicated or severe. The typical initial symptoms are nonspecific and include intermittent fever every two or three days, moderate-to-severe shaking chills, profuse sweating, headache, nausea, vomiting, diarrhea and anemia. The symptoms may appear suddenly (paroxysms), after hemolysis of the infected red blood cells (RBC), and then progress to drenching sweats, high fever and exhaustion. Severe malaria is often fatal and may be related to severe anemia and manifestations of multi-organ damage, including cerebral malaria. Severe disease is usually caused by infection with P. falciparum, and less frequently by P. vivax or P. knowlesi (Barber et al. 2013, Elizalde- Torrent et al. 2018, Saharan et al. 2009). The severity of P. falciparum is linked to sequestration of infected RBC (iRBC) within the microvasculature of various organs including the brain (Wassmer et al. 2017).
Viral myositis
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
A 5-year-old girl is brought to the emergency department with a complaint of bilateral lower leg pain for the past 2 days. There is a history of intermittent fever 1 week ago for 4 days, maximum temperature to 38.9°C. She had rhinorrhea, cough, and vomiting for 4 days at the start of her illness but these symptoms have resolved. The leg pain has increased in severity. Last night she refused to walk without assistance, prompting the visit to the emergency department.
The Small Intestine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
CD more commonly presents with features of chronicity. Small bowel CD is often characterised by abdominal colicky pain, which may be postprandial, and mild diarrhoea extending over many months occurring in bouts. A tender mass may be palpable in the right iliac fossa. Intermittent fevers, secondary anaemia and weight loss are common. After months of repeated attacks characterised by acute inflammation, the affected area of intestine begins to narrow with fibrosis, causing more chronic obstructive symptoms. Children developing the illness before puberty may have retarded growth and sexual development. With progression of the disease, adhesions and transmural fissuring, intra-abdominal abscesses and fistu- lae may develop.
Clinical presentation of a neuropsychiatric lupus patient with symmetrical basal ganglia lesions containing cytotoxic oedema cores surrounded by vasogenic oedema
Published in Modern Rheumatology Case Reports, 2020
Syoko Tsubouchi, Haeru Hayashi, Koichiro Tahara, Kayo Ishii, Takuya Yasuda, Yusuke Yamamoto, Takahiro Mizuuchi, Hiroaki Mori, Mayu Tago, Eri Kato, Tetsuji Sawada
A 28-year-old Japanese woman with a one-month history of intermittent fever occasionally reaching over 38 °C, was admitted to a hospital following complaints of headache accompanied by high fever up to 40 °C, nausea and vomiting. Although she was alert and conscious, there was nuchal rigidity and lumbar puncture revealed elevation of white blood cells (WBCs) (48 cells/ μL with 67% mononuclear cells). She was diagnosed with viral or bacterial meningitis and was intravenously administered acyclovir and meropenem. Brain MRI, which was performed 3 days after admission, showed no abnormalities (Figure 1(A)). However, fever and nuchal rigidity persisted despite treatment, and the second brain MRI, performed 4 days after the first, revealed the presence of multiple high intensity lesions on T2W images and fluid attenuated inversion recovery (FLAIR) images (Figures 1(B) and 2) showed lesions in the basal ganglia (head of caudate and lenticular nuclei). Each T2W/FLAIR high intensity region in the basal ganglia could be divided into two parts: (1) small round region located at the centre of basal ganglia that was hyperintense on DWI and hypointense on ADC; (2) surrounding region that ranged from isointense to slightly hyperintense on DWI and hyperintense on ADC. The disseminated deep grey-matter lesions led to a tentative diagnosis of acute disseminated encephalomyelitis (ADEM), and she was transferred to our hospital.
Hemophagocytic lymphohistiocytosis in pregnancy: a case report and review of the literature
Published in Journal of Obstetrics and Gynaecology, 2020
Jie Cheng, Jiaxin Niu, You Wang, Chuan Wang, Qiong Zhou, Yunyan Chen, Yu Zhang, Jianhua Lin, Wen Di
However, most of the time, lasting or intermittent fever would be the initial and main symptom at first admission. The lab results can also be atypical. So it is necessary to differentiate HLH from other diseases like infections, adult’s Still disease, HELLP (haemolysis, elevated liver enzymes and low platelet), TTP (thrombotic thrombocytopenic purpura), AA (Aplastic anaemia) and so on. The best diagnostic procedure is bone marrow aspiration. Several cases in Table 3 alert that sometimes a second time of bone marrow aspiration is needed. From cases in Table 3 and our case, we alert that just one-time bone marrow biopsy often has the missed diagnosis. A second-time bone marrow biopsy is necessary sometimes.
A Case of Postoperative Endophthalmitis Caused by Streptococcus Bovis
Published in Ocular Immunology and Inflammation, 2023
Guangsen Liu, Yue Li, Lei Gao, Na Li, Jing Su
Vitreous cultures remained positive for S. bovis. Vancomycin, cefotaxime, linezolid, chloramphenicol, meropenem, cefepime, and ceftriaxone exhibited sensitivity to this organism. However, the second vitreous cultures were negative. Taking into account the patient’s low fever, he was started on intravenous Ceftriaxone 250 mg drip every 12 hours. The intermittent fever lasted for about 2 weeks. According to our literature search, the patient underwent chest x-ray, color Doppler echocardiography, and colonoscopy with no abnormal findings.