Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 71-year-old man who presented with toxoplasmic chorioretinitis and meningoencephalitis is reported. He had been healthy and immunologically normal. Initially, he complained of blurring of vision without headache, nor fever. Neurological examinations revealed papilledema, nuchal rigidity, and disorientation. Fluorescent angiography of the ocular fundi disclosed hyperfluorescent leaks suggesting chrioretinitis. His EEG had dysrhythmic slow alpha wave with some theta slowing. CSF studies showed pleocytosis up to 80/mm3; the cells were predominantly lymphocytes. The titers of toxoplasma antibody in the serum and CSF were prominently increased. Toxoplasmosis was highly suspected and he was treated with predinsolone, acetylspiramycin, and pyrimethamine. After the treatment, ophthalmologic and neurological symptoms improved, and the laboratory findings including the titers of toxoplasma antibody in the serum and CSF were also improved. Recently, toxoplasmosis associated with neurological complications as an opportunistic infection is a serious problem in the immunocompromised hosts, especially in AIDS, but this infection is rare in immunologically normal adults. Our case and some other reports may suggest a chance of developing toxoplasmic meningoencephalitis even in healthy individuals. We have to think of the possibility of toxoplasmosis in the immunocompetent hosts when they are presenting with chorioretinitis and meningoencephalitis.
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PMID:[A case of toxoplasmic chorioretinitis and meningoencephalitis in an immunocompetent adult]. 766 31

A patient with acquired immune deficiency and antecedents of pancreatitis presented with headaches, fever, dyspnea and bilateral decrease of vision. A diagnosis of disseminated cryptococcosis was made by lumbar puncture, alveolar washing and elevated cryptococcal antigen in blood, urine and stool. Bilateral chorioretinitis with ischaemic maculopathy was responsible of the low vision and attributed to cryptococcal infection after vitreous puncture and isolation of yeast from the vitreous. Systemic treatment with Amphotericin led to resolution of the chorioretinitis. A retinitis due to cytomegalovirus was associated short time before the patient died. Post-mortem anatomopathologic analysis revealed cryptococcus in high number in the choriocapillaris.
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PMID:[Cryptococcal chorioretinitis and acquired immunodeficiency syndrome: apropos of a case]. 795 65

A 29-year-old woman suffered from headaches, diarrhoea, and high grade fever followed by a unilateral retinal vasculitis, papillitis, and chorioretinitis. Abnormal electrocardiographic findings and antibody titre dynamics strongly suggested a coxsackievirus B3 infection. With respect to prior observations on coxsackievirus B group associated uveitis this viral infection may be considered in patients with well defined extraocular manifestations and uveitis.
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PMID:Coxsackievirus B3-associated panuveitis. 838 74

The authors present 17 cases of symptomatic acute toxoplasmosis acquired by the ingestion of raw mutton offered during a party in September 1993. The incubation period carried from 6 to 13 days (10.9 +/- 7.0). Sixteen (94.5%) patients presented fever, headache, myalgia, arthralgia, and adenopathy (cervical or cervical/axilar). Hepatomegaly was found in 6 patients, splenomegaly in 4 and rash in 2. One patient presented clinical picture of chorioretinitis confirmed by ophthalmological exam. All patients showed increased serum levels of specific antibodies (IgG and IgM) on indirect immunofuorescence assay evidencing acute phase of toxoplasmosis. The patients were treated with specific drugs for toxoplasmosis and presented satisfactory clinical and laboratory response.
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PMID:[Outbreak of acute toxoplasmosis transmitted thru the ingestion of ovine raw meat]. 902 28

Infection caused by Toxoplasma gondii, toxoplasmosis, is one of the most frequent zoonoses in the world; it normally affects both genders equally. Humans are one of several possible intermediate hosts, and the disease is oligosymptomatic in most cases. Vertical transmission is an important cause of fetal malformation and sequels in newborns. Approximately 10% of postnatal cases present multiple manifestations, ranging from low fever and mild lymphadenopathy to severe encephalitis. In moderate cases, lesions such as retinochoroiditis may emerge during acute infection or even years later. We analyzed 313 cases of toxoplasmosis from 1992 to 2004, including 261 acute cases. Most patients were women (68.1%), and 39% of these were pregnant. Among acute infection cases, 64.8% presented symptomatic disease; the most frequent manifestations were lymphadenomegaly (59.8%), fever (27.2%), headache (10.7%), asthenia (10%), weight loss (8.4%), myalgia (8%), retinochoroiditis (3.4%) and hepatosplenomegaly (1.5%). Although ocular lesions by T. gondii are well documented as a possible consequence of postnatal infection, two patients developed retinochoroiditis only two years after primary infection. This demonstrates the need for toxoplasmosis case surveillance, even long after acute manifestations.
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PMID:Postnatal acquired toxoplasmosis patients in an infectious diseases reference center. 1921 85

Most cases of acute acquired toxoplasmosis (AAT) are oligosymptomatic and self-limited. Therefore, these infections rarely indicate treatment. Prospective studies of AAT patients are rare in the medical literature. The frequency of systemic manifestations has not been sufficiently studied. In order to search for risks factors for systemic and ocular involvement, 37 patients were submitted to a diagnostic investigative protocol. The most frequent findings were lymph node enlargement (94.6%), asthenia (86.5%), headache (70.3%), fever (67.6%) and weight loss (62.2%). Hepatomegaly and/or splenomegaly were present in 21.6% of cases (8/37). Liver transaminases were elevated in 11 patients (29.7%) and lactic dehydrogenase in 17 patients (45.9%). Anaemia was found in four patients (10.8%), leucopoenia in six patients (16.2%), lymphocytosis in 14 patients (37.8%) and thrombocytopenia in one patient (2.7%). Fundoscopic examination revealed retinochoroiditis in four patients (10.8%). No statistical association was found between any one morbidity and retinochoroiditis. Nevertheless, a significant association was found between the presence of more than eight morbidity features at evaluation and long-lasting disease. An ideal diagnostic protocol for AAT would include evidence of systemic involvement. Such a protocol could be used when planning treatment.
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PMID:Acute acquired toxoplasmosis: clinical-laboratorial aspects and ophthalmologic evaluation in a cohort of immunocompetent patients. 1943 Jun 71

Dengue is a mosquito-borne infection caused by a flavivirus. I describe the ocular findings observed in two patients infected with dengue virus who presented with acute onset of loss of vision preceded by febrile illness, malaise, generalized fatigue headache, and maculopapular rash. Ophthalmologic evaluation in each patient revealed a normal anterior segment. Vitreous cells were noted in one patient. Ophthalmoscopy revealed multiple foci of retinochoroiditis, vasculitis, cotton-wool spots, and retinal hemorrhages. The healing of the lesion showed discrete atrophic and pigmented retinochoroiditic scars. Fluorescein angiography displayed early hypofluorescence and late hyperfluorescence suggestive of leakage. The healed scars showed late staining. The serologic testing showed elevated IgG antibodies, and one had high IgM antibodies to dengue virus. Ocular findings of dengue fever consist of multifocal areas of retinochoroiditis and may lead to loss of vision. In Saudi Arabia, dengue fever should be considered in the differential diagnosis of multifocal chorioretinal lesions and retinal vasculitis.
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PMID:Dengue retinochoroiditis. 2345 48

In late April 2012, an infectious disease physician contacted CDC regarding a patient with aseptic meningitis who worked at a rodent breeding facility in Indiana. Lymphocytic choriomeningitis virus (LCMV) infection was suspected, and LCMV-specific antibody was detected in blood and cerebrospinal fluid from the patient, confirming the diagnosis. LCMV is an arenavirus carried by the common house mouse. Persons become infected through close contact with infected rodents, through infected organ transplantation, or from mother to fetus. In immunocompetent adults, symptoms can range from mild febrile illness to meningeal symptoms (e.g., headache, stiff neck, or sensitivity to light). Congenitally infected infants can have a range of severe birth defects including hydrocephalus, chorioretinitis, blindness, and mental retardation (1). Infections in organ recipients, who are immunosuppressed, can have a case-fatality rate approaching 90% (2).
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PMID:Notes from the field: lymphocytic choriomeningitis virus infections in employees of a rodent breeding facility--Indiana, May-June 2012. 2289 87

A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye. The ophthalmological examination revealed hypertensive non-granulomatous panuveitis, retinal vasculitis with focus of retinochoroiditis with pigmented central area suggestive of ocular toxoplasmosis in the active phase. He started treatment with azithromycin, pyrimethamine, topical steroids and measures for control of intraocular pressure. Serology for Toxoplasma gondii was positive and for HIV, negative. For headache and vomiting, he was hospitalised in order to exclude cerebral toxoplasma. The cerebral CT scan, MRI and lumbar puncture were negative and treatment was changed to pyrimethamine, sulfadiazine and prednisolone. For persistence of vomiting he started clindamycin with clinical and ophthalmological improvement. The patient is currently under prophylaxis with co-trimoxazol for 1 year, and maintains clinical improvement. This case illustrates the rarity of presentation of ocular toxoplasmosis, without cerebral in an immunocompetent patient.
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PMID:Ocular toxoplasmosis: a very rare presentation in an immunocompetent patient. 2527 Jan 56

This report describes the case of a 21-year-old heroin user who presented with a 6-day history of decreased vision in her right eye, preceded by 1 week of headache and tender scalp nodules, neck stiffness, and photophobia. A broad infectious workup for acute vision loss was completed, and she was ultimately presumed to have acquired toxoplasmic chorioretinitis (ocular toxoplasmosis). We review the initial workup for chorioretinitis, and the epidemiology, diagnosis, and treatment of ocular toxoplasmosis. Intravenous drug users may be at increased risk of acquired ocular toxoplasmosis.
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PMID:Acute Central Vision Loss in an IV Drug User. 2675 60


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