Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infectious Mononucleosis is a common viral illness mainly of adolescent-young adult age group. Spontaneous splenic rupture is a rare but potentially fatal complication of Infectious Mononucleosis occurring in less than 0.5 % of the cases. A high index of suspicion especially if abdominal pain develops during Infectious Mononucleosis is very crucial to early diagnosis and intervention in the case of rupture. Here we discuss the case of a 24 year old male with no previous comorbidities and stable vitals who presented with febrile illness of one week duration associated with abdominal discomfort. Even though initial evaluation did not point towards any etiological clues, a CT imaging of the abdomen was opted due to his persistent abdominal symptoms which showed features suggestive of a contained rupture of spleen. The lack of a specific trauma history prompted further workup for an infective etiology and patient was subsequently found to be positive for Epstein Barr Virus antigen and was diagnosed to have Infectious Mononucleosis. Rupture being of lower grades, non-operative management was opted for and patient improved with conservative management over 4-8 weeks with no further complications. We also discuss the internationally accepted grading of splenic injury and the general consensus regarding management of the same. A general search of the available literature showed very few cases of spontaneous splenic rupture in Infectious Mononucleosis being reported especially from India and hence the importance of this case.
 ...
PMID:Spontaneous Splenic Rupture in a Case of Infectious Mononucleosis. 3155 84

Infectious mononucleosis (IM) is a disease common among adolescents in the United States. Frequently, symptoms include sore throat, malaise, fevers, lymphadenopathy, and abdominal pain. Severe complications have been reported such as splenic rupture, acute upper airway obstruction, hepatitis, acute renal failure, and hematological and neurological complications. The mainstay of treatment is supportive care. Steroids are recommended for impending airway obstruction and hematological complications. However, steroids are commonly used in uncomplicated cases of IM, with insufficient evidence on the efficacy of steroids for symptom control. Furthermore, there is a lack of research on the adverse effects and long-term complications of steroid use for IM. We present a case of an adolescent boy who presented to his primary care physician with symptoms consistent with uncomplicated IM that was treated with a prolonged course of steroids. Subsequently, he developed worsening symptoms, including fevers, headache, vomiting, and left-sided facial swelling. He presented to a pediatric emergency department in decompensated septic shock as a result of polymicrobial bacteremia. During his hospital course, he developed pulmonary septic emboli, a sinus thrombus, an empyema, and orbital cellulitis complicated by Pott puffy tumor. In this case report, we summarize the current literature on steroid treatment of uncomplicated IM and highlight how our case addresses the use and possible complications of prolonged steroid use in uncomplicated IM.
 ...
PMID:Severe Complications From Infectious Mononucleosis After Prolonged Steroid Therapy. 3185 Oct 74

Infectious mononucleosis, a syndrome characterized by the triad of pharyngitis, fever, and lymphadenopathy, is caused in the majority of cases by Epstein-Barr virus and usually presents in adolescents and young adults. The disease is for the most part self-limited with full recovery; however, life-threatening complications can occur. Manifestations of Epstein-Barr virus associated infectious mononucleosis can be variable and at times atypical, leading to a delay in diagnosis and consequently unnecessary tests and treatment. We present a case of infectious mononucleosis from Epstein-Barr virus in a female college student who was admitted to the hospital with the initial diagnosis of pyelonephritis. This diagnosis was made based on an abnormal urinalysis, including the presence of white blood cells, red blood cells, and protein, in the setting of high fevers, cough, abdominal pain, left costovertebral tenderness, and an unexplained left neck mass. A monospot was negative two days prior. Renal involvement in Epstein-Barr virus infection is not common and bridges the spectrum from asymptomatic urinary abnormalities to acute renal failure, with acute interstitial nephritis being the most frequent pathological finding. Our patient received corticosteroids and albuterol for a worsening cough, in addition to supportive care. Despite steroid therapy, she developed a debilitating, protracted urticarial rash, also thought to be caused by the Epstein-Barr virus infection. Our case highlights the varied and complex constellation of findings sometimes seen in Epstein-Barr virus infectious mononucleosis. Like in our patient, pharyngitis, a part of the hallmark triad of symptoms characterizing infectious mononucleosis, is not always present, and the monospot may be negative. A high degree of suspicion, as well as recognition that multiple organ systems may be involved in Epstein-Barr virus associated infectious mononucleosis, is required to make the proper diagnosis.
 ...
PMID:An Atypical Presentation of Epstein-Barr Virus Associated Infectious Mononucleosis Mistaken for Pyelonephritis. 3239 17

We discuss a 23-year-old active duty male who presented to the emergency department with left shoulder pain after deadlifting heavy weights the day prior. His physical examination revealed a nontender and otherwise unremarkable left shoulder with full range of motion and mild tenderness to palpation in the left upper quadrant of the abdomen. A bedside focused assessment with sonography for trauma (FAST) examination showed free fluid in the abdomen and a computed tomography scan showed a splenic laceration and splenomegaly. He later tested positive for infectious mononucleosis. This is the first case report of atraumatic splenic laceration after heavy weight lifting. This case illustrates the importance of a broad differential and high index of suspicion in the patient with undifferentiated abdominal pain in order to diagnose a potentially fatal disease.
 ...
PMID:Atraumatic Splenic Rupture After Weight Lifting in a Patient Presenting With Left Shoulder Pain. 3290 4


<< Previous 1 2 3 4 5 6