Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-six cases of miliary tuberculosis were studied in retrospect. The mean age of the patients was 62 years. Eighteen patients suffered from another underlying chronic disease. Nine had been treated with corticosteroids or cytotoxic agents. A limited manifestation of tuberculosis had been previously verified or suspected in ten cases. Fever was present in 85% of the patients, frequently combined with fatigue or abdominal pain. Serum alkaline phosphatase was elevated in 81% of the cases. Minor haematological abnormalities (anaemia, etc.) were found in 16 cases and pancytopenia, stimulated lymphocytes or chronic myeloid leucaemia in six. Miliary mottling was found in the chest radiographs of 13 patients. Other findings were pleural effusion, mediastinal node enlargement, opacities suggesting pneumonia or old, possibly tuberculous lesions. Antituberculosis therapy was initiated in 12 patients, two of whom died within a few days. There was a high frequency of liver or system involvements. It is concluded that laparoscopy or liver needle biopsy are valuable diagnostic procedures in patients with fever and elevated alkaline phosphatases of unknown aetiology. A therapeutic test with antituberculous drugs should be undertaken in suspected cases.
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PMID:Miliary tuberculosis. 39 82

A 74-year-old housewife was admitted to the hospital with complaints of high fever and general fatigue. The physical examinations on admission showed no particular findings except for mild hepatomegaly, but laboratory findings showed severe liver dysfunction, active inflammation and negative tuberculine test. On the 4th day, she suddenly complained of severe respiratory distress. A chest X-ray film demonstrated surprising changes in comparison with that taken on admission. On suspicion of adult respiratory distress syndrome (ARDS) associated with military tuberculosis (Miliary TB), administration of Methylpredonisolone (1000 mg a day for 3 days) in addition to antituberculous drugs was immediately started. With this therapy she was recovered from such ill condition, but the general exhaustion and slight fever continued. We suspected that her condition might be due to adrenocortical involvement of Miliary TB and hormonal examinations were performed. Unexpectedly, Cushing's syndrome was suspected on the basis of the following; high level of plasma cortisol without normal daily variation, normal ACTH level, an absent response to the Dexamethasone suppression test. Computed tomography revealed left side adrenal mass. During these examinations, renal dysfunction probably due to Miliary TB grew gradually worse and she died of renal failure on the 56th day. Necropsy revealed disseminated tuberculosis involving the lungs and the liver, but the adrenal glands were not examined.
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PMID:[A case of miliary tuberculosis (miliary TB) accompanied with adult respiratory distress syndrome (ARDS) in a patient with Cushing's syndrome]. 140 68

Ten unselected African patients infected with human immunodeficiency virus (HIV) and with slim disease were evaluated using physical examination, anthropometric measurements, Karnovsky performance score, and muscle biopsy. All had marked weight loss (36.8 +/- 10.8%) with extreme fatigue, marked diffuse wasting with significantly decreased circumferences of arms, thighs and calves (P < or = 0.002), and a low Karnovsky performance score (range 30-70). Mild to moderate motor deficit (in 9/10 patients) contrasted with the major amyotrophy. Chronic diarrhoea (in 7/10) and/or prolonged fever (in 7/10) were always associated with the amyotrophy. Atrophy of muscle fibers was the main finding of muscle biopsy. Only 5 patients met the CDC criteria for the 'HIV wasting syndrome'. We conclude that slim disease, which is highly suggestive of the acquired immune deficiency syndrome (AIDS) in Africa, is a condition associated with chronic diarrhoea and/or prolonged fever, that encompasses the 'HIV wasting syndrome' sensu stricto and probably other debilitating diseases associated with AIDS, such as tuberculosis.
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PMID:The slim disease in African patients with AIDS. 141 62

A total of 630 pulmonary tuberculosis patients newly registered with the health centres in the Republic of Korea were interviewed to determine their process of case-finding. One-quarter of the cases had a previous history of tuberculosis. About 70% of these retreatment cases had been treated for less than 1 year, indicating the importance of more thorough follow-through during treatment. Almost all of the cases had at least one standard symptom, with fatigue being most frequent, followed by cough and sputum. On developing the illness, about 40% of the cases were motivated to seek medical help after seeking advice from people other than family members such as friends or health workers. Half of the patients first went to the health centre, and one-third to a private clinic. The average time between the onset of symptoms and the initial medical consultation was 1.8 months (patient's delay). This delay is longer in the rural areas; besides location no other patient characteristics had any correlation with patient's delay. Nearly 80% of all cases were diagnosed as tuberculous within the first 2 weeks. Health centres diagnosed cases faster than private clinics and thus had a shorter doctor's delay. Mean total delay (patient's delay plus doctor's delay) was 2 months, with 80% of this being patient's delay.
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PMID:Analysis of case-finding process of tuberculosis in Korea. 147 90

We report a case of cerebral tuberculosis following miliary tuberculosis. A 54-year-old man was admitted to our hospital in October 1990 because of fever and general fatigue. Chest x-ray film on admission showed diffuse granular shadows in both lungs. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl Neelsen's staining, and anti-tuberculous therapy was quickly started. But a few days after admission, the disturbance of consciousness, neck stiffness, and headache appeared. The examination of cerebrospinal fluid disclosed that leucocytes was increased in number, and that ADA was elevated to 14.6 IU/l. Tubercle bacilli were detected from cerebrospinal fluid by culture. Although CT scan of the brain was normal at first week of admission, brain CT at eighth week of admission showed several nodulus enhanced with contrast medium. The findings were confirmed by T2 weighted magnetic resonance images (MRI) as high intense areas. Although T1 weighted MRI showed isointensity of the gray matter, T1 weighted MRI enhanced by Gd-DTPA revealed abnormal enhancement. At twenty-ninth week of admission CT showed no abnormality even by contrast enhancement, but enhanced T1 weighted MRI revealed a small lesion with enhancement which was not shown by CT. MRI enhanced by Gd-DTPA was more useful for evaluating cerebral tuberculosis than brain CT.
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PMID:[A follow-up study by MRI and enhanced-MRI in a case of cerebral tuberculosis]. 154 5

Tuberculosis of the spine or ribs is uncommon, occurring in less than 1% of patients with tuberculosis (TB). 2 women are presented who recently immigrated from Ethiopia and India, respectively. One, aged 55, presented with chest pain, fatigue and several masses under the skin of the scalp. Chest X-ray and CT scan suggested Pancoast tumor, and the lateral parts of the first 2 right ribs were absent. The origin of the patient, clinical findings and positive PPD suggested TB of the ribs and anti-TB therapy resulted in cure. The diagnosis was later confirmed by a positive culture. The other woman, aged 68, presented with fatigue, mild abdominal pain and axillary lymphadenopathy. The PPD was positive and X-ray showed widening of the mediastinum. A caseating granuloma with Langhans epithelioid cells was found in a lymph node. Flaccid paraparesis developed before therapy was started. CT scan showed a typical picture of TB affecting the T3-T6 vertebrae. Drainage of a cold abscess of the spine via the anterior approach was followed by anti-TB therapy. Culture of a biopsied lymph node and of pus obtained at operation confirmed the diagnosis of TB. The patient died 2 months later from gastrointestinal bleeding. Awareness of the unusual presentations of various forms of TB is mandatory in countries with immigration from countries in which TB is still common.
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PMID:[Tuberculosis of the spine and ribs]. 175 49

The percentage of the patients with PaCO2 more than 60 Torr and PaO2 more than 50 Torr were 13% in the patients with tuberculosis sequela (N = 502) and 4% in the patients with chronic obstructive lung disease (COLD, N = 727), who were treated with home oxygen therapy in the western region of Japan. Patients with chronic respiratory failure caused by tuberculosis sequela have higher PaCO2 than patients with COLD. Although the prognosis of patients with hypercapnia and moderate hypoxemia is not necessarily poor, some patients may need treatment for severe hypoventilation to prevent respiratory muscle fatigue and abnormal breathing during sleep. In this study, nine patients with hypercapnic chronic respiratory failure caused by tuberculosis sequela were ventilated by Chest Negative Pressure Ventilation (CNPV). The patients were monitored as in polysomnography by transcutaneous PCO2 (PtcCO2) electrode and Respiratory Inductance Plethysmography (RIP). Tidal volume induced by CNPV was larger during mouth breathing (504 +/- 128 ml, mean +/- s.d.) than during nose breathing (438 +/- 109 ml) calculated from RIP in awake state (N = 7). Oxygen saturation measured by ear oximeter and PtcCO2 were 94.4 +/- 2.9% and 57.8 +/- 12.2 Torr in awake state. Following CNPV SaO2 and PtcCO2 were 95.7 +/- 3.0%, 42.7 +/- 12.1 Torr in awake state (N = 9) and 93.0 +/- 4.4%, 57.0 +/- 15.7 Torr in Non-REM sleep (N = 5), respectively. CNPV is effective in these patients in awake state. During Non-REM sleep, CNPV maintains the PtcCO2 level only in awake state.
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PMID:[Tuberculosis sequelae: pathophysiological aspect (ventilation)]. 207 61

We reported a case of 64 year-old female patient of pulmonary tuberculosis associated with ARDS during corticosteroid treatment of Rheumatoid Arthritis. On admission her chief complaints were fever, fatigue and dyspnea. A chest roentgenogram showed diffuse alveolar infiltration consistent with pulmonary edema. Arterial blood gas studies showed severe hypoxemia. We clinically diagnosed so-called ARDS. Smears of sputum for acid fast bacilli were negative, but transbronchial lung brushing by bronchofiberscope revealed many acid fast bacilli. Intensive therapy with anti-tuberculosis drugs (INH, RFP, SM), high dose corticosteroid (methylprednisolone) therapy and mechanical ventilation was started. During the following 2 weeks, the PaO2 rose gradually and the alveolar infiltration on the chest roentgenogram disappeared. The experience of this case to emphasized the importance of suspecting this condition because pulmonary tuberculosis is a potentially curable cause of ARDS and it should also be emphasized that the good treatment effect could be expected with combined use of high dose corticosteroid and mechanical ventilation.
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PMID:[A case of pulmonary tuberculosis associated with adult respiratory distress syndrome during corticosteroid treatment of rheumatoid arthritis]. 221 15

Whilst the sequelae of extensive tuberculous infections generally manifest as an overall respiratory failure, characterised by a rise in the alveolar arterial gradient for oxygen and often CO2 retention, we report some observations on six patients with significant pleural and parenchymal tuberculosis; these patients presented with a restrictive syndrome associated with an apparently isolated alveolar hypoventilation. In four of these patients an effort test showed that there was adequate adaptation to alveolar ventilation on effort. In one patient measurement of PO.1 in a resting state and then during the course of a test of CO2 responsiveness revealed an absence of any response to CO2. On the basis of these results, we propose that in certain subjects suffering from significant sequelae of tuberculous disease the major functional abnormalities can be expressed as alveolar hypoventilation. This latter is not necessarily followed by a mechanical overload leading to an eventual fatigue of respiratory muscles but rather to a disorder of the regulation of ventilation. The basic mechanism of such an anomaly remains undetermined.
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PMID:[Isolated alveolar hypoventilation as a tubercular sequellae]. 232 Jul 85

We reported a case of 64 a year-old male patient of miliary tuberculosis associated with ARDS, DIC and pneumothorax, who had a history of gastric ulcer and pulmonary tuberculosis. On admission his chief complaints were fever, fatigue, palpitation, appetite loss and weight loss, and most noticeable abnormalities were bleeding from the gastric ulcer and miliary shadow on the chest x-ray film with hypoxemia. On the day after admission to the hospital he was diagnosed as ARDS as he showed severe hypoxemia due to extensive tuberculous infiltration in bilateral lung fields, and treatment with antituberculous drugs and steroids were started. On the third hospital day DIC appeared on laboratory data, Gabexate mesilate (FOY) for DIC and respirator for ARDS were introduced. Two weeks later pulmonary infiltration, PaO2 and general condition were somewhat improved. On the 15th day after admission pneumothorax occurred on the right side, and on the 20th day on the left. Tube drainage of both pleural cavities, and instillation of OK-432 and Fibrinogen HT into the right pleural cavity were done, but it showed no effect. Two months after admission pouring Fibrinogen HT and thrombin into the left B1+2 and right B1 with cannula washing pipe through the instrument channel of bronchoscope was carried out. A few days later air leakage stopped and collapsed lungs were completely expanded. This method is effective in the case of incurable pneumothorax with pulmonary hypofunction.
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PMID:[A case of miliary tuberculosis associated with ARDS, DIC and bilateral pneumothorax]. 259 62


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