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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

About 5 weeks after the beginning of the outbreak of Ebola virus fever in Yambuku, Zaire, several acute cases of the disease were observed. All of those affected had the following common signs and symptoms: sudden onset of high fever, with chills, headache, myalgia, anorexia, nausea, abdominal pain, sore throat, expressionless face, and profound prostration. In some cases, on around the fifth day of the acute phase, the appearance of an exanthematous rash on the trunk announced the hemorrhagic manifestations: hemorrhagic conjunctivitis, bleeding ulcerations in the mouth and on the lips, gingival bleeding, hematemesis, and melena; epistaxis, ear bleeding, hematuria, and postpartum hemorrhages were also reported. All these hemorrhagic cases had a fatal outcome within about a week. The hemorrhagic manifestations were less severe in the cases that occurred by the end of the outbreak than in the first reported cases. Hemorrhagic manifestations were less frequent and less severe, or even absent, in the nonfatal cases (convalescents, serologically confirmed). No biologic investigation of the hemostatic impairment could be performed under the emergency conditions of this field study.
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PMID:Firsthand clinical observations of hemorrhagic manifestations in Ebola hemorrhagic fever in Zaire. 274 10

Diverticulitis represents a spectrum of clinical entities ranging from minimal pericolitis in the adjacent mesentery to uncontrolled intra-abdominal sepsis and septic shock. The presentation most often described is left lower quadrant abdominal pain, fever, chills, and left lower quadrant tenderness associated with a mass. Unusual presentations occur when infection tracts to distant locations. Diverticulitis is a common cause of intra-abdominal sepsis associated with high morbidity and mortality. The pathogenesis of intra-abdominal sepsis is not well understood, but likely involves circulating host inflammatory mediators. The role of computed tomography in the early diagnosis of diverticulitis is increasing and supersedes barium enema in the assessment of the extracolonic extent of disease. Also, computed tomographic-directed percutaneous drainage of intra-abdominal abscesses is, in most cases, as effective as surgical drainage. Predictably, the micro-organisms involved are representatives from the commensal flora of the lower gastrointestinal tract. These bacteria are usually sensitive to a wide range of antimicrobial agents that are effective against facultative and obligate anaerobic gram-negative bacilli. Surgical intervention is reserved for those individuals who do not respond to therapy, or for generalized peritonitis, uncontrolled sepsis, free viscus perforation, and fistulas.
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PMID:Diverticulitis. 304 50

In an attempt to define a clinical index for the timing of blood cultures in febrile patients with acute leukemia, subjective symptoms at onset of bacteremia were investigated in a total of 109 consecutive episodes. General malaise, chills, and nausea and vomiting were most frequently observed (66%, 59%, and 50%, respectively). The gastrointestinal (GI) symptoms including nausea and vomiting, abdominal discomfort and fullness, abdominal pain, and diarrhea were encountered in 72% of all the episodes, forming the second largest group next to those closely associated with high fever. These GI symptoms were usually mild and of brief durations, and their occurrence had no relation to sites of infections or etiology of bacteremia. In some cases, nausea and vomiting were aggravated by intensive antileukemic chemotherapy or massive GI bleeding. It was thus suggested that GI symptoms, particularly nausea and vomiting, concomitant with a remarkable, sometimes abrupt rise in temperature during granulocytopenia may serve as a useful index for the timing for blood collection for culture to improve the probability of detection of bacteremia.
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PMID:A clinical index for the timing of blood cultures in febrile patients with acute leukemia. 320 53

A 69-year-old man developed abdominal pain, fever, shaking chills and acute hemiplegia. Computed tomography (CT) scanning demonstrated a hematoma within a thalamic space-occupying lesion having the radiological characteristics of a malignant glioma. Low-grade fever and leukocytosis persisted and follow-up CT scanning showed ring enhancement of the thalamic lesion and ependymitis suggesting a cerebral abscess. Stereotactic aspiration achieved drainage of the abscess and relief of mass effect and provided pus from which a causative organism was identified and treated with appropriate antibiotics. Contrast-enhanced CT scan should be obtained in cases of hemorrhage within mass lesions and tissue diagnosis should be achieved even in deep brain regions, as this can be accomplished safely using stereotactic techniques.
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PMID:Thalamic abscess: a stereotactically treatable lesion. 332 41

The records of 47 patients with a perinephric abscess diagnosed from 1975 to 1986 at 8 San Francisco Bay Area hospitals were reviewed. The mean age was 51 years. Fifty-five percent were females and 45%, males. The left kidney was affected in 47% of cases, the right kidney in 40%, both in 4%, and a transplanted pelvic kidney in 9%. Fever (55%), chills or diaphoresis (47%), flank pain (40%), abdominal pain (40%), and nausea or vomiting (32%) were the most common presenting symptoms. About half the patients had symptoms for 1 week or less and 12% had no symptoms. Fever was documented before diagnosis in 88% of patients. Abdominal mass (13%) or tenderness (49%), and flank mass (9%) or tenderness (42%) were seen less frequently, and 11% of patients did not have fever, flank, or abdominal findings. The most frequent underlying conditions included previous urologic surgery (45%), previous urinary tract infection (38%), diabetes mellitus (36%), and urinary tract stones (36%). Cultures of perinephric abscesses yielded gram-negative aerobes in 52% of patients, primarily Escherichia coli. Staphylococcus aureus was isolated in 26% of patients and anaerobes in 17%. A single pathogen was isolated in 71% and multiple isolates in 29%. Of interest and great potential therapeutic importance was culture of anaerobes, primarily Bacteroides spp. in 17%, Enterococcus spp. in 7%, and Candida albicans in 7%. Positive blood and urine cultures identified perinephric abscess organisms exactly in 58% and 37% of cases, respectively. Routine laboratory tests such as the white blood cell count and urinalysis were insensitive and non-specific for perinephric abscess. Leukocytosis and anemia at admission were seen in slightly more than half of the patients. For radiologic diagnosis, computerized tomographic scanning was most helpful. Ultrasound and intravenous pyelography were falsely negative in about one-third of cases. Mortality (13%) was low in this series when compared with earlier studies, and probably reflects modern medical care. Six patients (13%) died during hospitalization, 2 of whom had diagnosis of PNA established only at autopsy. Drainage of the perinephric abscess was carried out by open surgical drainage in 64% of patients, percutaneous drainage in 19%, and both in 13%. The initial procedure, whether open surgical drainage or percutaneous catheter drainage, was usually successful. Late complications included nephrocutaneous fistulas in 3 patients and disseminated candidiasis in 1 patient.
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PMID:Perinephric abscess. Modern diagnosis and treatment in 47 cases. 335 13

Chlamydia trachomatis was isolated from liver biopsy specimens on two separate occasions in a young, sexually inactive patient with a 10 month history of recurrent episodes of fever, chills, and abdominal pain. Liver function tests showed a five fold increase in alkaline phosphatase, and a 20 fold increase in 5'-nucleotidase. Liver histology changes consisted of mild inflammatory infiltrates in the portal tracts. Treatment with doxycycline was followed by complete recovery. We are not aware of any previous report describing isolation of this organism from the liver parenchyma, or of C trachomatis infection presenting as fever of obscure origin.
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PMID:Isolation of Chlamydia trachomatis from the liver of a patient with prolonged fever. 342 79

We have reported a case of diarrhea caused by Blastocystis hominis, an intestinal protozoan parasite of man. The organism is present in small numbers in up to one fifth of stool samples in hospitalized patients, but is associated with diarrhea in only heavily infested patients. Typical symptoms include diarrhea, crampy abdominal pain, nausea, vomiting, low-grade fever, gas, malaise, and chills. Fecal leukocytes are occasionally seen. The pathophysiologic mechanism of the diarrhea is not clear. Not all patients having large parasite burdens are symptomatic. Metronidazole, 1 to 2 gm/day orally in divided doses, is the treatment of choice.
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PMID:Diarrhea due to Blastocystis hominis: an old organism revisited. 360 19

Eighteen of the 71 cases of plague reported in New Mexico from 1980 to 1984 were septicemic. We reviewed these cases to better describe the clinical presentation of this disorder and to identify risk factors for developing septicemic plague. The symptoms (fever, chills, malaise, headache, and gastrointestinal symptoms) and signs (tachycardia, tachypnea, and hypotension) of septicemic plague are similar to those of other forms of gram-negative septicemia. Abdominal pain was reported in nearly half of the cases, and differential white blood cell counts revealed a marked shift to the left. The risk of developing septicemic plague was higher for persons greater than 40 years of age. Because of empirical antibiotic treatment of older persons, deaths from septicemic plague occurred primarily among persons less than 30 years old. Deaths from septicemic plague could be reduced by aggressive antibiotic therapy for patients with a clinical presentation suggesting gram-negative septicemia, especially patients less than 30 years old.
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PMID:Septicemic plague in New Mexico. 379 95

We report the cases of 3 patients in whom ajmaline-induced acute hepatitis was followed by anicteric cholestasis persisting for more than 1 year after cessation of administration of the drug. Ajmaline was given for 8-16 days before the onset of acute hepatitis. Jaundice was preceded by fever, chills and abdominal pain, and was associated with hypereosinophilia. The initial lesions included centrilobular cholestasis and portal inflammatory infiltration. Jaundice lasted for 3 weeks to 11 months. In these 3 patients liver tests were still abnormal 17-26 months after ajmaline withdrawal; histological examination, performed 9-26 months after the onset of jaundice, showed a decreased number of interlobular bile ducts, ductular proliferation, and mild portal fibrosis; circulating immune complexes were demonstrated. These observations demonstrate that prolonged cholestasis can follow ajmaline-induced acute hepatitis. Persistence of cholestasis long after the withdrawal of ajmaline suggests some form of autoimmunity.
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PMID:Prolonged cholestasis after ajmaline-induced acute hepatitis. 395 Mar 63

Side effects and their relationship with the material used were analyzed in 748 plasma exchanges (PE) performed in 75 patients. The total incidence of acute and mild adverse effects (chills and/or fever, paraesthesias, allergic reactions, acute anaemia, vasovagal reactions, abdominal pain and hypotension) was 18.04%. Two patients developed an episode of left cardiac insufficiency. One patient in whom all PE were performed with fresh frozen plasma (FFP) developed metabolic alkalosis. Three patients developed sepsis during treatment with repeated PE and immunosuppressive drugs; in these three patients a permanent vascular inlet was used (shunt or catheter). All patients in whom only FFP was used as replacement solution developed non-A, non-B hepatitis. Neither haemorrhagic nor thrombotic episodes were observed in these patients. It is of the greatest importance to choose the most suitable material for each patient and to develop a careful technique in order to avoid these complications during treatment with PE.
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PMID:Adverse effects secondary to the treatment with plasma exchange. 403 Jan 33


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