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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study was undertaken to determine the role of typhoid in febrile illness. It was found that in 1992, Salmonella typhi, the causative agent of typhoid, played a 2.3% role in 25404 diagnostic specimens sent to Mulago Hospital, Kampala, the largest hospital in Uganda. The rates of isolation fell gradually from 2.3% in 1992 to 0.3% by 1995. Instead malaria was found to play a major role in febrile illnesses. Out of 355 patients attending a private clinic in Kampala, whose blood was examined for both malaria and typhoid, 97% were positive for malaria parasites compared to 0.84% with significant O and H Salmonella typhi antibody titres of > 1:80. Also malaria parasites were found in 60% (out of 105) of patients who had had persistent fevers and in whom doctors had also requested for HIV antibodies. Those who had HIV antibodies alone were six per cent and the ones with both were 28%, a finding which showed relatively low association of malaria and HIV. Where multiple tests were requested on one patient having general malaise or body joint pains and/or constant headaches, malaria was found to play a major role (73%) compared to syphilis (4.3%) and brucellosis (13.3%). Malaria parasites were seen in normal sizes and in somehow young or stunted forms. The latter were found more often in patients who had experienced one or a combination of the following: intermittent fevers, backache, headache, tiredness, joint and/or neck pains, and who had already received treatment for malaria.
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PMID:Selected laboratory tests in febrile patients in Kampala, Uganda. 964 Aug 25

Brucellosis is an infection due to Brucella species and is characterized by acute febrile illness, chilly sensations, sweats, weakness, generalized malaise, body aches and headache. The involvement of the nervous system is rare. A few cases have been reported with symptoms and sign of optic neuritis, meningoencephalitis, meningomyelitis and cranial nerve palsy. We report a case with culture proven neurobrucellosis who presented with diabetes insipidus along with systemic signs. Neuroimaging revealed multiple lesions in brain parenchyma, including the suprasellar region. Both diabetes and suprasellar lesions improved markedly with specific antibiotic therapy.
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PMID:Diabetes insipidus in neurobrucellosis. 1099 15

Brucellosis is hyperendemic in Saudi Arabia. We report infection in a breast implant as an unusual complication of laboratory-acquired brucellosis. A 48-year-old female developed fever, rigors, headache, arthralgia and weight loss. A blood culture for Brucella was positive. A 6-week course of antibiotics effected a clinical and bacteriological cure but the resolution was short-lived. Six weeks later a relapse of her febrile symptoms occurred together with the appearance of a breast abscess. Cultures of the abscess and blood yielded brucella. A second course of antibiotics together with surgical drainage and subsequent reconstruction resulted in a cure.
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PMID:Unusual complication of breast implants: Brucella infection. 1168 12

The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headache and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals; this might be the reason of the acquired infection. With appropriate antibiotic therapy (aminoglycoside, doxicyclin, rifampicin), symptomatic therapy and rehabilitation the disease had favourable outcome; there was no recidive. The authors point out the importance of specific microbiological examinations of patients with fever of unknown origin, especially if the patient has the symptoms that are compatible with brucellosis. In our case it was sacroileitis, as a characteristic complication. As brucellosis is endemic in some parts of our country, there is always a possibility of brucellosis in general medical practice.
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PMID:[Brucellosis--diagnostic dilemmas--case report]. 1215 22

Brucellosis is an infectious disease with multisystem involvement caused by the genus Brucella. Neurological complications including meningitis, meningoencephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess, and meningovascular syndromes are rarely encountered. We present here a patient with sixth cranial nerve palsy that occurred during treatment for brucellosis, a form of presentation rarely been reported in English-language literature. We conclude that neurobrucellosis, pseudotumor cerebri, and side effects of tetracyclines which are frequently used in brucellosis should be kept in mind when considering intractable headaches and cranial nerve palsies in patients with brucellosis.
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PMID:Abducent nerve palsy during treatment of brucellosis. 1286 May 18

Brucellosis is a common zoonotic disease transmittable to humans from infected animal reservoirs. Malta, Rock, Gibraltar, Cyprus or Mediterranean fever, Bang's disease, intermittent typhoid or typho-malarial fever, undulant fever, etc. are just various synonyms for brucellosis. Patients suffering from this disease show unspecific symptoms, e.g. fever, chills, malaise, arthralgia, headache, tiredness and weakness. Human brucellosis may be caused by four of totally six genetically and phenotypically closely related Brucella species, i.e. B. melitensis, B. abortus, B. suis and B. canis. Although many organ systems may be involved, brucellosis is rarely fatal. Therapeutic failure and relapses, chronic courses and severe complications like bone and joint involvement, neurobrucellosis and endocarditis are characteristic for the disease. A definite diagnosis requires the isolation of Brucellae from blood, bone marrow or other tissues. However, cultural examinations are time-consuming, hazardous and not sensitive. Thus, clinicians often rely on the indirect proof of infection. The detection of high or rising titers of specific antibodies in the serum allows a tentative diagnosis. A variety of serological tests has been applied, but at least two serological tests have to be combined to avoid false negative results. Usually, the serum agglutination test is used for a first screening and complement fixation or Coombs' test will confirm its results. As Brucella ELISAs are more sensitive and specific than other serological tests, they may replace them step by step. This review will summarize advantages and disadvantages of the serological techniques used in clinical laboratories for indirect verification of human brucellosis.
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PMID:Laboratory-based diagnosis of brucellosis--a review of the literature. Part II: serological tests for brucellosis. 1465 29

Human brucellosis has become a rare disease in Germany since the eradication of bovine and ovine/caprine brucellosis in this country. Therefore, most physicians are unfamiliar with the illnesses clinical presentation, diagnostic tools, and therapeutic strategies. This retrospective study was carried out to evaluate the epidemiological, clinical, and laboratory features of human brucellosis in Germany in the years 2002 and 2003. Thirty-one bacterial isolates from 30 patients sent to the German national reference laboratory were characterized using the genus-specific bcsp31 real-time PCR, the species-specific AMOS-PCR, and standard microbiological methods for the detection and identification of Brucella spp. The medical records of all patients with bacteriologically confirmed brucellosis were evaluated. All 31 isolates proved to be Brucella (30 Brucella melitensis and 1 Brucella suis). Most of the brucellosis patients were infected in endemic countries while visiting friends and relatives during their summer holidays. One case of laboratory-acquired infection was identified. Brucellosis was transmitted mainly by the consumption of contaminated unpasteurized milk or cheese from goats and sheep. The patients presented primarily with flu-like symptoms, i.e. fever, chills, sweating, headaches, arthralgia, and myalgia. In most cases, however, symptoms and signs of focal complications, e.g. spondylitis, endocarditis, and meningoencephalitis, predominated. The rate of complications was much higher than that in endemic countries, presumably as a result of diagnostic delay due to a low index of suspicion. In summary, physicians in nonendemic countries such as Germany must be aware of brucellosis being a possible cause of fever of unknown origin in immigrants and tourists travelling from endemic countries.
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PMID:Human brucellosis in a nonendemic country: a report from Germany, 2002 and 2003. 1595 15

Brucellosis is an infectious disease of humans and animals caused by Brucella species. We report on a 34-year-old housewife who presented with recurrent headache, fever, and malaise. Blood cultures yielded slow-growing gram-negative coccobacilli that were later identified as Brucella melitensis. The patient recalled handling goat placenta in China. She was prescribed a 6-week course of doxycycline and rifampicin. Laboratory staff who had been exposed to the isolate remained asymptomatic. The epidemiology, diagnosis, and treatment of brucellosis are discussed.
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PMID:A case of human brucellosis in Hong Kong. 1621 62

Brucellosis is a significant health problem in countries where control of zoonoses is inadequate. During 1993-98, we analysed sera and cultures from 792 suspected brucellosis patients who presented with histories of fever, chills, night sweating, weakness, malaise and headache to the referral hospital in Yazd. Cases were investigated by tube agglutination test (TAT) and 2-mercaptoethanol test (2-MET) and a questionnaire was completed for each.TAT titre was > or = 1:1 60 for 745 patients (94.1%) and 2-MET was positive for 42 (5.3%). Of 745 confirmed cases, 460 were from 1996-1997. Prevalence was highest in summer (39.5%) and more common males than among females. Prevalence was highest among those aged 10-19 years (27.7%). Most patients had a history of infected cheese, milk and milk product consumption (98%).
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PMID:Selected epidemiological features of human brucellosis in Yazd, Islamic Republic of Iran: 1993-1998. 1645 May 37

A new controlled-release isosorbide-5-mononitrate (CR-ISMN) preparation has been developed to meet the requirement for a low nitrate concentration interval in order to avoid nitrate tolerance. We conducted a randomized, double-blind, placebo-controlled study in 31 Japanese patients with stable effort angina pectoris to investigate the efficacy and safety of CR-ISMN. Patients were randomly assigned to either CR-ISMN (40 mg once daily) or placebo groups for 2 weeks after two consecutive symptom-limited treadmill exercise tests using the Bruce protocol to ascertain the reproducibility of exercise tolerance during the placebo run-in period. Exercise tests were repeated at 5, 12, and 24 hours after administration on the final day. No significant difference in exercise time to moderate angina was identified between the CR-ISMN and placebo groups at 5, 12, or 24 hours after administration. However, the changes in exercise were prolonged at 5 hours but not shortened at 24 hours in the CR-ISMN group. The results of subgroup analysis suggested that the concomitant use of insulin might lead to confounding results. Although headache was the most frequent adverse effect in the CR-ISMN group, all symptoms were mild and at self-limiting levels. The plasma concentrations of CR-ISMN maintained therapeutic levels at 5 and 12 hours, and gradually decreased to less than the minimum therapeutic concentration (100 ng/mL) at 24 hours after administration. This study demonstrates that CR-ISMN improves exercise tolerance during the daytime and is well-tolerated in Japanese patients with stable effort angina pectoris without increasing the number of serious adverse effects.
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PMID:Efficacy and safety of controlled-release isosorbide-5-mononitrate in Japanese patients with stable effort angina pectoris. 1710 40


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