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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coccidial parasites of the genus Isospora cause intestinal disease in several mammalian host species. These protozoal parasites have asexual and sexual stages within intestinal cells of their hosts and produce an environmentally resistant cyst stage, the oocyst. Infections are acquired by the ingestion of infective (sporulated) oocysts in contaminated food or water. Some species of mammalian Isospora have evolved the ability to use paratenic (transport) hosts. In these cases, infections can be acquired by ingestion of an infected paratenic host. Human intestinal isosporiasis is caused by Isospora belli. Symptoms of I. belli infection in immunocompetent patients include diarrhea, steatorrhea, headache, fever, malaise, abdominal pain, vomiting, dehydration, and weight loss, blood is not usually present in the feces. The disease is often chronic, with parasites present in the feces or biopsy specimens for several months to years. Recurrences are common, Symptoms are more severe in AIDS patients, with the diarrhea being more watery. Extraintestinal stages of I. belli have been observed in AIDS patients but not immunocompetent patients. Treatment of I. belli infection with trimethoprim-sulfamethoxazole usually results in a rapid clinical response. Maintenance treatment with trimethoprim-sulfamethoxazole is needed because relapses often occur once treatment is stopped.
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PMID:Biology of Isospora spp. from humans, nonhuman primates, and domestic animals. 899 57

Traveler's diarrhea occurs with considerable frequency in individuals traveling to underdeveloped countries. It is acquired through the ingestion of fecally contaminated food and water. Traveler's diarrhea is caused by a variety of bacterial, protozoal, viral, and parasitic organisms. Typically self-limiting, traveler's diarrhea is more of an inconvenience than a life-threatening process. Patient education is an important element in the management of traveler's diarrhea; the well-informed traveler can manage most cases empirically without sophisticated medical technology. The presence of fever, bloody stool, abdominal pain, or profound dehydration indicates a more severe infection requiring medical attention.
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PMID:Traveler's diarrhea. 905 75

A case of significant proteinuria occurred as a result of bilateral renal vein thrombosis secondary to dehydration, which resolved after treatment with urokinase. The patient developed nausea and vomiting from viral gastroenteritis with subsequent volume contraction. He later noted the onset of aching lower abdominal and flank pain. On admission, he was noted to have a serum creatinine of 1.7 mg/dL, and 4+ proteinuria on urinalysis. A 24-hour urine collection showed 2.34 g protein. A renal venogram showed bilateral renal vein thrombosis (RVT) without involvement of the inferior vena cava. Therapy was initiated with heparin at 1,000 U/hr, followed by intravenous (IV) urokinase, 4,400 U/kg bolus, followed by 4,400 U/kg/hr with continuous infusion for 12 hours. A repeat renal venogram done at this time showed partial resolution of thrombosis bilaterally. A second 12-hour infusion of urokinase at 5,000 U/kg/hr was performed; at this time, the patient reported resolution of his flank and abdominal pain. A repeat 24-hour urine collection showed 60 mg protein with a normal creatinine clearance. Levels of antithrombin III, protein C, and protein S were all normal. A renal biopsy was performed and showed normal histology on light, immunofluorescent, and electron microscopic evaluation. The patient has done well on no therapy and has had no recurrence of thrombosis or proteinuria after 2.5 years. This is a US government work. There are no restrictions on its use.
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PMID:Resolution of proteinuria secondary to bilateral renal vein thrombosis after treatment with systemic thrombolytic therapy. 910 53

A reproducible, reversible model of colitis induced in ponies by administering castor oil (2.5 ml/kg bodyweight [bwt] per os) was characterised by abdominal pain, fever, watery diarrhoea, dehydration, hypovolaemia, toxaemia, leucopenia, decreased serum Cl, Na and K levels and metabolic acidosis. The signs were most severe between 24 and 48 h post induction, stabilisation was frequently observed after 72 h, although diarrhoea could persist beyond 96 h. Morphological and in vitro transport studies (right ventral colon) were conducted on tissues from animals destroyed at 24, 48 and 72 h. In the caecum and colon, surface epithelial disruption and exfoliation from the basement membrane occurred between 24 and 48 h. Early signs of recovery were evident by replenishment of denuded areas with columnar epithelium at 72 h. The crypt epithelium was unaffected throughout the intestinal tract. In vitro transport studies were consistent with the morphological findings. Decreased Na-Cl absorption and normal Cl secretion indicated an impaired surface epithelium coincident with an undamaged cryptal epithelium. Increased mucosal permeability was demonstrated by high ionic conductance and large unidirectional isotopic fluxes. Tissue conductance improved during in vitro incubation suggesting epithelial repair after removal of castor oil. Changes in the population and proportion of bacteria in the faeces as diarrhoea ensued were confirmed at necropsy with a predominance of E. coli and Enterobacter/Klebsiella sp in the large bowel. The experimental induction of castor oil colitis showed many similarities to intestinal endotoxaemia and the secretory type diarrhoea encountered in naturally occurring acute colitis syndromes in horses. The model could prove applicable in studying the pathophysiological mechanisms precipitating such life-threatening disorders.
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PMID:Castor-oil induced diarrhoea in ponies: a model for acute colitis. 911 9

A 66-year-old man was hospitalized for abdominal pain and diarrhea of more than 10 times a day. He had been under regular medication with prednisolone for rheumatoid arthritis. On admission, laboratory data and clinical examination indicated inflammation, dehydration, acute renal failure with a high level of serum musculogenic enzyme (creatine kinase), and ileus. Salmonella enteritidis was isolated from his fecal and blood samples. The patient died within 24 hours after admission, and autopsy showed hemorrhagic necrotic enteritis localized to the ileum. Enterocolitis due to Salmonella enteritidis, which is usually an acute self-limited gastrointestinal illness, may occasionally be a serious and lethal disease.
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PMID:Fatality due to severe Salmonella enteritis associated with acute renal failure and septicemia. 937 24

The most common diagnoses of elderly patients in the emergency department (ED) were compared among three age subgroups: 65 to 74, 75 to 84, and 85 and older. The computerized billing records for patient visits to 10 northern New Jersey hospital EDs for the years 1985 to 1991 were retrospectively analyzed. The most frequently occurring ICD-9-CM codes for elderly patients were compared among the three age subgroups. Elderly persons comprised 174, 146 (14% of the total) patient visits. The 176,146 patient visits were assigned 259,440 ICD-9-CM codes. The most common ICD-9-CM codes for medical diagnoses included chest pain, cardiac dysrhythmias, congestive heart failure, syncope, abdominal pain, and dyspnea. Fractures, particularly of the lower limb and upper limb; contusions; open wounds, particularly of the head, neck, and trunk; and falls were among the most common trauma diagnoses. The proportions in the three age subgroups of each diagnosis were statistically significantly different, except for cardiac arrest and contusions of the trunk and of multiple sites. The diagnoses with clinically significant higher relative risks in older age subgroups were atrial fibrillation, congestive heart failure, syncope, hypovolemia/dehydration, gastrointestinal hemorrhage, dyspnea, pneumonia, pulmonary edema, cerebrovascular accident, septicemia, urinary tract infection, fractures, and open wounds of the head, neck, trunk, particularly the scalp, and falls. Clinically significant lower relative risks were found in older age subgroups for chest pain, acute myocardial infarction, hypertension, angina, chronic airway obstruction not elsewhere classified, epistaxis, contusions of the upper limb, and open wounds of the finger.
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PMID:Age-related differences in diagnoses within the elderly population. 945 12

Acute pancreatitis is probably commoner in children than was previously thought. In children it is most commonly associated with trauma or viral infection. The presentation may be subtler than in adults, requiring a high index of suspicion in the clinician. In three children, two boys aged 4 and 10 and a girl of 15 years, acute pancreatitis was suspected because of the findings at ultrasonography and endoscopic retrograde cholangiopancreatography performed when the disease recurred (the boy aged 4), apathy and immobility without dehydration or other obvious causes (the boy aged 10), and severe abdominal pain in combination with vomiting (the girl). All three patients had severely increased (urinary) amylase levels. Most often, acute pancreatitis in children tends to be a self-limiting disease which responds well to conservative treatment.
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PMID:[Acute pancreatitis in children]. 956 70

Sixteen cases of acute idiopathic toxaemic colitis developed in a veterinary hospital over a period of three years. Before the onset of colitis, 15 horses had received antibiotics, 11 had undergone general anaesthesia and various surgical procedures, and 10 had been treated with non-steroidal anti-inflammatory drugs. The horses had acute onset, profuse watery diarrhoea, profound depression, mild to moderate abdominal pain, reduced intestinal borborygmi, tachycardia, dehydration and endotoxic shock. Leucopenia, neutropenia and pyrexia were common early indicators of impending colitis. Metronidazole appeared to be an effective treatment; eight horses treated with metronidazole survived whereas five of seven horses that received other treatments, but no metronidazole, died or had to be euthanased. The aetiology of the colitis could not be determined, but the clinicopathological features resembled those of colitis attributed to an intestinal overgrowth of Clostridium perfringens type A. No Salmonella species were isolated from 52 samples of faeces, colonic contents and colonic mucosa which were collected from the horses antemortem and postmortem.
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PMID:Use of metronidazole in equine acute idiopathic toxaemic colitis. 967 Apr 51

Salmonella typhimurium phage type (PT) or definitive type (DT) 104 is a virulent pathogen for humans and animals, particularly cattle. It has been isolated increasingly from humans and animals in the United Kingdom and several other European countries and, more recently, in the United States and Canada. Humans may acquire the infection from foods of animal origin contaminated with the infective organism. Farm families are particularly at risk of acquiring the infection by contact with infected animals or by drinking unpasteurized milk. The symptoms in cattle are watery to bloody diarrhea, a drop in milk production, pyrexia, anorexia, dehydration and depression. Infection may result in septicemic salmonellosis and, upon necropsy, a fibrinonecrotic enterocolitis may be observed. The infection occurs more commonly in the calving season than at other times. Feedlot cattle and pigs may also be affected. Prolonged carriage and shedding of the pathogen may occur. Symptoms in humans consist of diarrhea, fever, headache, nausea, abdominal pain, vomiting, and, less frequently, blood in the stool. Salmonella typhimurium DT104 strains are commonly resistant to ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline.
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PMID:Salmonella typhimurium DT104: a virulent and drug-resistant pathogen. 975 92

Cryptosporidium was detected in 21 (3.8%) individual stool samples collected from 553 pediatric patients hospitalized in our center employing a Telemann concentration technique (formalin-ether-centrifugation) and stained with the modified Kinyoun method. The mean age of populations with Cryptosporidiosis (16 boys and 5 girls) was 11 months; 15 months for girls and 6.5 for boys. Ages of 81% of them were less than 19 months. Seventy-six per cent of patients lived on the outskirts of Buenos Aires and 71% lacked pretreated running water at home. In 62% of the cases parasitological diagnoses coincided with warm seasons. At diagnosis mucous (63%) or watery (36%) diarrhea was presented in 90% of the patients with a median of 5 (3-8) bowel movements per day. Fever was presented in 66% of patients while abdominal pain and vomits in 60% and 52%, respectively. The median time from hospitalization up to parasitologic diagnosis was 20 days. Concomitant diseases observed were malnutrition, acute leukemia, bronchiolitis, HIV infection, anemia, celiac disease, myelofibrosis, vitelline sac tumor, neutropenia, osteosarcoma and dehydration. Cryptosporidiosis in our environment seems to occur more frequently in children younger than 18 months of age; who present diarrhea; are immunodeficient; come from a low socioeconomical background; and who live in poor sanitary conditions with no potable running water.
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PMID:Cryptosporidiosis in pediatric patients. 983 Jul 36


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