Plesiomonas
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Plesiomonas-derived gastrointestinal diseases can be of three types: an acute secretory gastroenteritis, an aggressive colitis, or chronic infections lasting more than 2 weeks [56]. The secretory enteritis is the most commonly accepted plesiomonad gastroenteric complication, accounting for >50% of the reported clinical cases, although some studies suggest that the dysenteric colitis can be more common [57,58]. The main symptoms associated with this enteritis are abdominal pains and watery diarrhea, as well as nausea and low-grade fever. Second, about 20% of the reported infections attributed to P. shigelloides can also present a more aggressive and severe form of colitis including blood and mucus in the stools, with significant abdominal pain and vomiting. Other symptoms, such as chills and dehydration, can also be rarely present [35]. Although the dysenteric form is severe, most cases of P. shigelloides gastroenteritis are mild and self-limiting, resolving spontaneously in a few days: the watery diarrhea duration can vary from a few days if treated to 2 weeks if untreated [57,59], and found to be commonly associated to underlying conditions [59]. However, in a number of the cases (5% according to one study), the infection can extend in time and become persistent, lasting up to 2 months [59]. Finally, it is noteworthy to mention that few fatal outcomes following gastrointestinal plesiomonad infections have been reported [59–62].
Vomiting in Pregnancy
Tony Hollingworth in Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
The most important clues to diagnosis lie in the history of vomiting and its accompanying symptoms. Hyperemesis tends to recur in subsequent pregnancies, and hence an absence of its history in previous pregnancies makes the diagnosis less likely.9Vomiting only in the early morning occurs in pregnancy, hyperacidity, and uraemia.Vomiting after eating is more likely to point to peptic ulcer.Projectile vomiting without nausea occurs in raised intracranial tension. Silent regurgitation of food occurs in oesophageal diverticuli.Vomiting accompanied by tinnitus and/or giddiness is seen in middle ear disease.Vomiting with diarrhoea occurs in enteritis and food poisoning.Vomiting accompanied by lower abdominal pain could signify appendicitis.
Unexplained Fever Associated with Diseases of the Gastrointestinal Tract
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
The most difficult cases to diagnose are those presenting with fever, anemia, and weight loss, without abdominal pain and diarrhea. Lee and Davies55 reported two such cases. One patient presented with fever, joint pains, mild anemia, and an elevated ESR. Rheumatic fever was suspected and the patient was treated accordingly. After 3 months in which the patient failed to respond to therapy, he developed severe, colicky, lower abdominal pain. The patient underwent operation; histologic examination of the resected gut revealed Crohn’s disease. A second patient presented with fever, a systolic murmur, and splenomegaly. The presumptive diagnosis was bacterial endocarditis. Again there was no response to treatment. Subsequently a tender, mobile, sausage-shaped mass was palpated in the right iliac fossa. The diagnosis of regional enteritis was confirmed by histologic examination of resected intestine. Wolff et al.56 report several patients with recurrent, spiking fevers, sometimes without gastrointestinal symptoms, who were shown to have regional enteritis.
Beyond the commonest: right lower quadrant abdominal pain is not always appendicitis
Published in Alexandria Journal of Medicine, 2020
Mahmoud Agha, Maha Sallam, Mohamed Eid
Crohn’s disease or regional enteritis is an idiopathic chronic inflammatory bowel disease, which may affect any segment of the gastrointestinal tract, from the mouth to the anus. Crohn’s disease usually shows multiple asynchronous skip segmental gastrointestinal involvement with varying degrees of severity. Ileocecal region is the most commonly involved site, with relative long segmental affection of the terminal ileum and the proximal right colon. The revised history of our candidates documented 6 (0.6%) radiologically diagnosed and histopathologically proven Chron’s disease. Patients’ age ranged between the ages of 15 and 25 years, with near similar clinical and laboratory presentation of questionable acute appendicitis. The complaint was acute exacerbated right iliac fossa pain on top of chronic pain. [26]
Advances in genetic and molecular understanding of Omenn syndrome - implications for the future
Published in Expert Opinion on Orphan Drugs, 2018
Andrew R Gennery
Clinically, patients with Omenn syndrome have similar features to patients with SCID and materno-fetal GvHD, although the features are usually more severe. Classically, patients demonstrate a generalized thickened erythematous rash, often with scaling and with erythematous exfoliating, protein-losing erythroderma, which develops a ‘leathery’ consistency (Figure 2). Hair, often including eyebrows and eyelashes, is lost as the rash evolves – this severe alopecia is characteristic, and an important clinical indication of the diagnosis. The rash can be present at birth or shortly afterwards, or evolve over the first few weeks of life. There is an associated lymphadenopathy, particularly of the axillary and inguinal nodes. Hepatosplenomegaly is a frequent finding. An inflammatory enteritis, hepatitis or pneumonitis may be present, and there may be coexisting infection with conventional or opportunistic pathogens.
Ileostomy diarrhea: Pathophysiology and management
Published in Baylor University Medical Center Proceedings, 2020
Kyle M. Rowe, Lawrence R. Schiller
Development of small bowel inflammation after colonic resection for established Crohn’s disease is understandable as the natural history of Crohn’s disease; however, inflammatory enteritis after colectomy for ulcerative colitis represents a different challenge. This simply could represent misdiagnosis of colonic Crohn’s disease as ulcerative colitis and may occur in up to 10% of patients who had colectomy for ulcerative colitis. An alternative categorization was proposed by Corporaal et al in a case series of 42 patients presenting with inflammatory enteritis after colectomy for ulcerative colitis.48 These patients demonstrated a spectrum of clinical and pathologic changes consistent with autoimmune gastritis and enteritis and showed response to corticosteroids, calcineurin inhibitors, and immunomodulators. This postcolectomy enteritis is histologically and endoscopically distinct from Crohn’s disease and may represent a unique entity. While colectomy can control ulcerative colitis, it may not be curative in every case.
Related Knowledge Centers
- Inflammation
- Small Intestine
- Pathogen
- Serratia
- NONsteroidal Anti-Inflammatory Drug
- Radiation Therapy
- Autoimmune Disease
- Crohn's Disease
- Coeliac Disease
- Diarrhea