Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A previously healthy 7-year-old white boy presented to St. Louis Children's Hospital with a 1-day history of headache, malaise, temperature of 38.7 degrees C, and a progressively erythematous, tender calf with central dusky purpura. On the morning of admission, his mother noticed a 2-mm crust on the patient's right calf with a 3-cm x 3-cm area of surrounding erythema. No history of recent trauma or bite was obtained. He had suffered two episodes of nonbloody, nonbilious emesis during the last day. In addition, over the previous 12 h, he presented brown urine without dysuria. His mother and brother had suffered from gastroenteritis over the previous week without bloody diarrhea. On initial physical examination, there was a 6-cm x 11-cm macular tender purpuric plaque with a central punctum on the right inner calf, which was warm and tender to the touch, with erythematous streaking towards the popliteal fossa (Fig. 1). The inguinal area was also erythematous with tender lymphadenopathy and induration, but without fluctuance. Laboratory studies included an elevated white blood cell count of 20, 800/microL with 6% bands, 86% segs, and 7% lymphocytes, hemoglobin of 12.5 g/dL, hematocrit of 35.1%, and platelets of 282,000/microL. The prothrombin time/activated partial tissue thromboplastin was 10. 4/28.0 s (normal PT, 9.3-12.3 s; normal PTT, 21.3-33.7 s) and fibrinogen was 558 mg/dL (normal, 192-379 mg/dL). Urinalysis showed 1+ protein, 8-10 white blood cells, too numerous to count red blood cells, and no hemoglobinuria. His electrolytes, blood urea nitrogen (BUN), and creatine were normal. The urine culture was negative. Blood culture after 24 h showed one out of two bottles of coagulase negative Staphylococcus epidermidis. The patient's physical examination was highly suggestive of a brown recluse spider bite with surrounding purpura. Over the next 2 days, the surrounding rim of erythema expanded. The skin within the plaque cleared and peeled at the periphery. The coagulase negative staphylococci in the blood culture were considered to be a contaminant. Cefotaxime and oxacillin were given intravenously. His leg was elevated and cooled with ice packs. The patient's fever resolved within 24 h. The lesion became less erythematous and nontender with decreased warmth and lymphadenopathy. The child was discharged on Duricef for 10 days. Because the patient experienced hematuria rather than hemoglobinuria, nephritis was suggested. In this case, poststreptococcal glomerulonephritis was the most likely cause. His anti-streptolysin-O titer was elevated at 400 U (normal, <200 U) and C3 was 21.4 mg/dL (normal, 83-177 mg/dL). His urine lightened to yellow-brown in color. His blood pressure was normal. Renal ultrasound showed severe left hydronephrosis with cortical atrophy, probably secondary to chronic/congenital ureteropelvic junction obstruction. His right kidney was normal.
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PMID:A child with spider bite and glomerulonephritis: a diagnostic challenge. 1080 79

A 33-year-old man presented with new-onset, asymmetric, migratory oligoarthritis in the setting of several weeks of nausea and vomiting, diarrhoea, fevers and dysuria. He was initially treated in the inpatient setting with broad-spectrum antibiotics due to concern for an evolving sepsis presentation. Arthrocentesis of a large right knee effusion revealed inflammatory synovial fluid without findings suggestive of septic arthritis. Human leucocyte antigen B27 was positive and, taken together with the antecedent history of gastroenteritis, dysuria and inflammatory oligoarthritis, the clinical diagnosis was most consistent with reactive arthritis. Antibiotics were discontinued. His treatment course proved refractory to non-steroidal anti-inflammatory drugs and intra-articular and systemic glucocorticoid therapy with concurrent use of sulfasalazine and ultimately necessitated treatment with a tumour necrosis factor alpha inhibitor.
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PMID:A rare cause of oligoarthritis with septic presentation. 2966 92

A 43-year-old male, known to be deaf, mute, and blind, presented to the ED accompanied by his daughter. She said that he had multiple episodes of diarrhea and vomiting for two days. At first, it gave the impression of gastroenteritis because the patient also had upper abdomen pain, but later a series of investigations were carried out, including blood tests, electrocardiogram (ECG), chest X-ray, ultrasound abdomen (USG), and CT of the kidney and the urinary bladder (CT KUB), to reach a diagnosis. It was confirmed on CT KUB that the patient had a stone in his ureter, which was causing dysuria and increased urinary frequency leading to multiple bathroom visits and vomiting due to severe pain. The patient was given analgesia, and the stone was removed via ureteroscopy. It was challenging to make a diagnosis due to a lack of communication, and it was an emotionally distressing case for the clinical team.
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PMID:Emotional and Clinical Challenges While Dealing With a Blind-Deaf-Mute Patient. 3283 3

Salmonellosis is characterized by gastroenteritis and enteric fever in humans and affects various organs, particularly in endemic regions and in immunocompromised patients. Here, we report on a 45-year-old male patient with multifocal osteomyelitis, pneumonia and colonic ulcers caused by Salmonella typhi infection. The patient was admitted to our outpatient department with dysuria, fever and hip pain and had been treated with prednisolone and methotrexate for pemphigus vulgaris for two months. After Salmonella typhi was isolated in the urine culture, the patient was hospitalized and treated according to the antibiogram. However, despite antibiotherapy, the patient's ongoing complaints suggested an existing resistance problem or a rare or atypical involvement of Salmonella spp. As immunosuppressive agents were not used in high doses or for prolonged periods, this disease course and severity were not expected. For an infectious process with an atypical course or multiorgan involvement, particularly in endemic regions and immunocompromised patients, salmonellosis should be considered in the differential diagnosis.
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PMID:A rare case of salmonellosis with multifocal osteomyelitis and pulmonary involvement. 3305 Nov 59