Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of fulminant acute Q fever presenting as fever of unknown origin with rapidly progressive hepatic failure in a patient with alcoholism. A 51-year-old electrician, who was a habitual drinker, presented with a 2-week history of intermittent high fever, acute hepatomegaly and rapidly progressive jaundice after being accidentally exposed to dust from bird nests when he was repairing electrical equipment and circuitry at an abandoned factory in Taipei County. Ascites and prolonged prothrombin time were noted at admission. Transjugular liver biopsy and bone marrow biopsy found multiple small fibrinoid-ring granulomas in liver parenchyma and bone marrow. Doxycycline therapy was empirically started. The fever gradually subsided over a 2-week period, along with the recovery of liver function. The diagnosis of acute Q fever was confirmed by high titers of antibodies against Coxiella burnetii (phase I IgM 1:160 and IgG 1:2560, phase II IgM > 1:320 and IgG 1:5120) and a four-fold elevation of phase II IgG titer in the paired serum. The experience of this case shows that the possibility of Q fever should not be overlooked in patients who have an unexplained febrile illness and severe liver function impairment following exposure to a contaminated environment in Taiwan.
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PMID:Acute Q fever presenting as fever of unknown origin with rapidly progressive hepatic failure in a patient with alcoholism. 1897 Nov 60

Scrub typhus, once endemic in India, has virtually disappeared from our country. Recently, there have been many case reports of scrub typhus. Haematuria in scrub typhus is a rare presentation, but it has been reported earlier. Here one such case of a 55-year-old man is reported who presented with fever and arthralgia. There was an erythematous maculopapular rash on his body. One enlarged lymph node in the right axilla and hepatomegaly were elicited. Weil-Felix reaction Ox-K was positive with 1:360 dilution. Doxycycline was advised for 7 days. Two months after follow-up, he had no symptoms.
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PMID:A case of scrub typhus with haematuria. 2302 29