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Unexplained Fever Associated with Diseases of the Gastrointestinal Tract
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Stool(a) Gram stain and microscopy in search for Staphylococcus and Candida albicans (overgrowth)(b) Repeat culture and search for ova or parasites(c) Sudan stain for excess fat(d) Toxin identification, especially Clostridium difficile and enterotoxigenic E. coli (when required and available)
Gastrointestinal Complications of Diabetes Mellitus
Published in Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu, Medical Management of Diabetes Mellitus, 2000
Bernard Coulie, Michael Camilleri
The presence of anemia, macrocytosis, hypoalbumincmia, or excess stool fat suggest intestinal malabsorption, and specific tests are indicated to diagnose small-intestinal bacterial overgrowth, celiac disease, or pancreatic exocrine insufficiency. These are relatively infrequent causes of diarrhea in diabetes. Quantitation of stool fat over 48 or 72 h is the ideal way to assess steatorrhea, although a quantitative measurement (Sudan stain) is a good screening test. However, moderately increased fecal fat excretions (^ 14 g/day) may also result from altered small-bowel motor or secretory function. Hence, fecal fat outputs within the range of 7-14 g/day may not distinguish nutrient malabsorption from an intestinal motor or secretory disorder.
Acute lung injury secondary to e-cigarettes or vaping
Published in Baylor University Medical Center Proceedings, 2020
Sarah Freathy, Nitin Kondapalli, Srikant Patlolla, Adan Mora, Clayton Trimmer
According to the recent Centers for Disease Control and Prevention report, EVALI remains a diagnosis of exclusion, with emphasis placed on first excluding entities such as influenza or bacterial pneumonia. Patients often present with respiratory symptoms including cough, dyspnea, and chest pain.4 The initial imaging workup should include a chest radiograph, which will often show bilateral infiltrates. On chest CT, findings consistent with acute eosinophilic pneumonia, hypersensitivity pneumonitis, diffuse alveolar damage, diffuse alveolar hemorrhage, organizing pneumonia, and lipoid pneumonia have been identified. Most patterns display diffuse ground-glass opacities and consolidation, predominantly in the basilar lobes, with subpleural sparing. Exceptions include hypersensitivity pneumonitis, which presents with a pattern of upper- and mid-lung–predominant ground-glass opacities and organizing pneumonia, which is typically more peripheral.5 Bronchial alveolar lavage can be performed on a case-by-case basis, along with staining for lipid-laden macrophages with Oil Red O or Sudan stain. Treatment typically includes broad-spectrum antibiotics until infection is ruled out and corticosteroids.4