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

Reported is the case of a 32 years old man, who developed a severe condition with recurrent fever episodes, lymphadenopathy, liver and spleen enlargement, and severe headaches 6 weeks after having been bitten by a rat. The headaches even increased during the further course. Psychological tests indicated an increased instability and irritability. The brain scan revealed diffuse cerebral ischemias (on the basis of an increased cerebrovascular resistance). Following the treatment with penicillin, the symptoms cleared almost completely. Although the pathogenic organism could not be identified, the findings and the clinical course of the disease indicate the presence of sodoku with meningoencephalopathic involvement.
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PMID:[Rat bite disease with meningoencephalitic involvement]. 731 23

Twenty-two cases of rickettsiosis imported to Germany (13 men, nine women, average age 42 years) in a 5-year period were analyzed retrospectively regarding the travel histories, symptoms and clinical findings, laboratory features and course of the disease. The two primary rickettsial diseases were boutonneuse fever (18 patients) and scrub typhus (three patients). One patient had murine typhus. The main symptom was fever in 91% followed by headache (64%), myalgia (40%), arthralgia (50%) and diarrhea (36%). The most frequent clinical finding was lymphadenopathy in 65%. Eschar was detectable in 55% of patients with Rickettsia conori infection and in one patient with Rickettsia tsutsugamushi infection. All patients with R. tsutsugamushi infection as well as 33% of the patients with R. conori infection had a macular exanthema. One patient with scrub typhus had pleural and pericardial effusions. Seventy-three percent had an increased ESR. Three patients had leucocytosis, three increased transaminases and two normochromic anemia. The incubation period for R. conori infection was 5 to 28 days (average 14 days), for R. tsutsugamushi infection 7 to 21 days (average 16 days). Twenty-one patients were treated with tetracycline or doxycycline, one with erythromycin. All patients were cured. One patient had a relapse. Due to the fact that the symptoms are often not characteristic and that the routine laboratory findings are of only marginal help, the diagnosis of rickettsial diseases is often not easy. A detailed travel history sometimes gives an important hint for diagnosis.
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PMID:Imported rickettsioses in German travelers. 762 71

A formalin-inactivated aluminium hydroxide adsorbed hepatitis A vaccine was evaluated in a dose-response study on 195 healthy male adults (age range: 18-31 years) in two French hospitals (Lyon, Rouen). Four doses (20, 40, 80, 160 RIA antigen units) were administered intramuscularly (i.m.) in two injections over a 6-month period. At the time of the first vaccine injection, 32 subjects (16.4%) were found positive (> 20 mIU ml-1) for HAV antibody (total Ig RIA HAVAB assay, Abbott Laboratories) and were excluded from the analysis of immunogenicity criteria. Fourteen days after the first vaccine injection, 78.1% (95% confidence interval (CI): 62-90) of seronegative subjects who received the 160 RIA antigen unit dose seroconverted with a geometric mean titre (GMT) of 43 mIU ml-1 (95% CI: 33-56). Seroconversion was 100% (95% CI: 91-100) at 1 month with a GMT of 95 mIU ml-1 (95% CI: 79-112). Statistical analysis revealed a significant dose-related effect (p < 0.0001) on GMT by multivariate regression analysis of the results after the first injection. Biological safety was evaluated and alanine aminotransferase and aspartate aminotransferase levels were similar prior to and 14 days after the first injection in the four groups. Reactions after injection were similar in the four dosage groups: 6.2% of subjects reported immediate reactions after first vaccination (feeling sick, spontaneous pain, headache), 8.9% reported local reactions at the site of injection (spontaneous pain, haematoma, local adenopathy) and 13.5% reported general reactions ('flu-like' syndrome, gastrointestinal tract disorders, fatigue, headache).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Good immunogenicity of GBM strain inactivated hepatitis A vaccine in healthy male adults. 762 20

Two young soldiers presented with acute abdomens, then received surgical procedures under initial impression of acute cholecystitis and acute appendicitis respectively. Operative findings did not confirm the initial diagnosis, and the clinical condition did not improve after operation. Scrub typhus was suggested later by clinical manifestations of fever, chills, headache, lymphadenopathy, skin rash and presence of eschar formation; this diagnosis was finally confirmed by positive serologic results of high Weil-Felix OXK agglutination and/or Rickettsia tsutsugammushi immunoflorescence titers in paired sera. Both patients rapidly became afebrile after administration of tetracycline. This unusual presentation with acute abdomen in scrub typhus is emphasized, with caution that the possibility of scrub typhus should be taken considered, especially in patients coming from hyperendemic areas.
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PMID:Unusual presentation of acute abdomen in scrub typhus: a report of two cases. 764 Nov 27

Ten new cases of nasopharyngeal carcinoma were diagnosed at our unit during a recent twelve month period. An evaluation of these cases is presented. This stimulated an examination of the national data for the years 1981-1990 and it was discovered that 69 cases were diagnosed in that period. A chart review was performed of the patients with nasopharyngeal carcinoma that were treated at St. Lukes Hospital 10 years previously and compared to the 10 recently diagnosed patients. This data highlights: the young age at which this tumour can occur; that there has been no improvement in the early detection of these neoplasms and the importance of an ENT assessment for patients presenting with cervical lymphadenopathy, persisting middle ear effusion or atypical headaches.
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PMID:Nasopharyngeal carcinoma--the Irish experience. 773 36

Human brucellosis, a multisystem disease which may mimic other conditions, has a low incidence in childhood and the diagnosis may easily be missed. Over a 7-month period 9 children with brucellosis presented to the Department of Paediatrics and Child Health, Tygerberg Hospital. Six of the children had consumed unpasteurized milk. The main presenting symptoms were fever, fatigue, headache, myalgia and haematuria. Clinical signs included lymphadenopathy (3), nasopharyngitis (2), features of lower respiratory tract infection (2), splenomegaly (2) and pyrexia (1). The diagnosis was made on the basis of a positive serological titre (> 1:160) for Brucella abortus. The prozone phenomenon was encountered in 6 cases; however, the Coombs test confirmed the diagnosis in these cases. Children under 7 years were treated with co-trimoxazole and rifampicin and those over 7 years with tetracycline and rifampicin, for at least 6 weeks. No relapses were detected on follow-up.
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PMID:Brucellosis in childhood in the Western Cape. 777 72

Twenty-eight SLE patients (Arabs and Asians) in the UAE were studied in this report. The F:M ratio was markedly high; 27:1 in the group as a whole and 21:1 among Arabs. Local patients (Emirians) developed the disease at an earlier age compared to their expatriate Arab compatriots. Arthropathy occurred in 86% and nephropathy in 43% of cases. Next in frequency were leucopenia, mucocutaneous manifestations and serositis. Apart from lupus headache, the other neuro-psychiatric LE were uncommon or not encountered. Anti-cardiolipin syndrome, Sneddon's syndrome, shrunken lung syndrome, sicca complex, thyrotoxicosis and myasthenia gravis were also present in this small group of patients. Their presence reflects the marked heterogeneity displayed by the disease irrespective of the number of cases involved. An unusually high prevalence of anti ds (DNA) antibodies (92.5%) as compared to ANF (82.5%) was detected (P = NS). Anti-Sm antibody occurred in 30% of cases particularly in those patients with lymphadenopathy and fever. There was a relative paucity in the prevalence of anti RNP, Ro and La antibodies in this group. Differences with and similarities to previous reports concerning other populations are also presented.
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PMID:Characterization of systemic lupus erythematosus in patients in U.A.E. 778 58

We report an unusual clinical presentation of toxoplasmosis. Fever and headache were the only complaints of a 48-year-old immunocompetent man who was found to have a rash, hepatitis and a pericardial effusion. Lymphadenopathy was not present. Evolving atypical lymphocytosis was the clue to the diagnosis of toxoplasmosis. Undercooked meat was the probable source of infection.
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PMID:Unusual presentation of acquired toxoplasmosis in an immunocompetent adult. 780 80

Lyme disease is an important consideration in the differential diagnosis of patients seen by the otolaryngologist. Facial paralysis is the most common sign. The otolaryngologist may also see patients with temporal mandibular joint pain, cervical lymphadenopathy, facial pain, headache, tinnitis, vertigo, decreased hearing, otalgia and sore throat. The incidence is increasing and known to be endemic to certain areas of the United States and abroad. This paper reviews the various ways Lyme disease appears to the otolaryngologist. Three cases along with a discussion including epidemiology, vector, animal host relationship, clinical manifestations and pathophysiology are included. The literature is reviewed and the treatment discussed.
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PMID:Lyme disease: a review for the otolaryngologist. 782 75

A spotted fever group (SFG) rickettsia was isolated in Zimbabwe from a patient with tick-bite, fever, headache and regional lymphadenopathy. A further six isolates were obtained from Amblyomma hebraeum ticks collected in Zimbabwe. These human and tick isolates were indistinguishable from each other, and from an Ethiopian SFG rickettsia, by microimmunofluorescence (MIF), sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), Western blotting and polymerase chain reaction followed by restriction fragment length polymorphism analysis (PCR-RFLP). They were, however, distinguishable from other SFG ricketsiae by MIF serotyping and in the case of the most closely related serotypes, Rickettsia conorii and the Israeli SFG rickettsia, by SDS-PAGE and Western blot. PCR-RFLP failed to distinguish between the Zimbabwean and Israeli SFG rickettsia, though each of these gave different digestion products from R. conorii. The Zimbabwean human and tick isolates and the Ethiopian SFG rickettsiae therefore represent a previously undescribed rickettsial serotype which apparently is pathogenic in human beings. It is proposed that the new serotype be named the agent of African tick-bite fever in order to distinguish it from R. conorii, which until now has been recognized as the only SFG rickettsia to infect man in Africa.
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PMID:A new pathogenic spotted fever group rickettsia from Africa. 791 46


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