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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of panarteritis nodosa with positive Australia antigen is presented. Panarteritis appeared following serum hepatitis and caused arthromyalgia, abdominal pain, prolonged fever of unknown origin, peripheral polyneuropathy, blood hypertension, and renal insufficiency. A muscular biopsy showed atrophy due to denervation and necrotizing arteritis in various stages causing serious damage to the arteries. Abdominal arteriography clearly demonstrated the existence of aneurismal dilations in the liver, pancreas, and kidneys. The angiographic findings in panarteritis nodose are discussed with special reference to the aneurysms localized in several organs. Their situation is described in detail; it is usually abdominal and more specifically intrarenal. The fact that they occur in a high percentage of cases is helpful when establishing the diagnosis. Lastly, the role of Australia antigen in the development of panarteritis nodose is discussed. It stimulates an immune response and the production of circulating immunocomplexes which are depostied on the vascular walls with complement fixation and damage to the blood vessels. The possibility that other viral agents may be present in the various types of necrotizing vasculitis in humans is commented on.
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PMID:[Panarteritis nodosa with positive Australia antigen (author's transl)]. 3 58

We reported an autopsy case of thrombotic occlusion of the superior cerebral vein with hemorrhagic laminar necrosis of the right parietal cortex. A 68-year-old woman was admitted to our hospital because of a severe headache and left hemiplegia of acute onset. There was a past history of hypertension, fever of unknown origin, leukocytopenia and nasal dermatitis. Magnetic resonance images (MRI) disclosed thrombosis of the superior sagittal sinus and of the right parietal cortical vein as well as right parieto-occipital cerebral infarction. Although she improved with mild sequelae, the subsequent MRI showed a recurrent thrombosis of the superior sagittal sinus. Ten months after the onset she died suddenly, presumably due to acute myocardial infarction. Pathologically, thrombotic occlusion of the right parietal cortical vein, recurrent thrombosis of the superior sagittal sinus and old hemorrhagic cortical laminar necrosis of the right parietal region were revealed. Moreover, intracranial arteritis and phlebitis were observed, as well as arteriolitis in the peripheral nerves. In our case, MRI was useful for the diagnosis and following the course of cerebral venous thrombosis. Cerebral noninfective vasculitis may well have caused the venous thrombosis.
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PMID:[Thrombosis of the superior cerebral vein with hemorrhagic cerebral infarction--serial MRI and pathological study of a case]. 225 22

The clinical picture of the panarteritis nodosa is characterized by vague early symptoms, manifestations in various organs and a changing prognosis. In seven patients with histologically proven panarteritis nodosa the clinical course was followed up over a long period. The commonest early symptoms were fever of unknown origin and a considerable loss of weight. Three out of seven patients showed in the initial phase a hypertension, in two other patients the blood pressure rose as the disease progressed. Those patients, whose renal function was impaired when the diagnosis was established, had a poor prognosis in spite of immunosuppressive therapy and dialysis. The life expectancy of these patients was between two and 16 months (in average 6,4 months). On the other side the clinical course in two patients without renal failure was more favourable; they are alive eight months and 15 years respectively after the diagnosis was confirmed.
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PMID:[The clinical picture of panateritis nodosa]. 611 Jan 63

A rare case of a paraganglioma (extraadrenal pheochromocytoma) that complicated both pregnancy and the puerperium is described. The patient presented a confusing clinical picture simulating pregnancy-induced hypertension, which, after delivery, masqueraded as intractable fever of unknown origin. Computed tomography precisely identified the presence and location of the mass, which had eluded detection despite exhaustive testing. Pheochromocytoma should be considered in the differential diagnosis of postpartum fever of unknown origin, especially if associated with paroxysmal hypertension.
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PMID:Paraganglioma complicating pregnancy and the puerperium. 708 20

A 74-year-old male was referred for the sudden onset of bilateral sudden deafness. The patient had no history of any disease or trauma to the head. Pure tone audiometry revealed bilateral moderate, to severe, sensorineural hearing loss. Auditory brain stem responses (ABRs) showed normal peak and interpeak latencies. These audiological findings suggested that his hearing loss could be attributed to inner ear lesions. However, we felt an alternative explanation for this sudden deafness was likely to exist because the patient also had a month-long fever of unknown origin (FUO) and weight loss of 5 kg/month. Using the criteria of The American College of Rheumatology, we made the diagnosis of polyarteritis nodosa (PAN). Serum MPO-ANCA was positive (x 661). For treatment, the patient was begun on prednisolone and cyclophosphamide. Nine months later, fever, hypertension, nephritis, pneumonitis, and arthritis had completely resolved, the MPO-ANCA became negative (MPO-ANCA < x 10). Furthermore, his hearing improved.
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PMID:Sensorineural hearing loss as the initial manifestation of polyarteritis nodosa. 1127 37

A 21-year-old woman with a 6-year history of ulcerative colitis admitted to our hospital with chest pain, cough and fever of unknown origin in August 1998. On admission, laboratory data showed positive inflammatory signs. A chest radiograph and chest computed tomogram (CT) revealed nodular shadows in the right upper lung field. Fifty days after admission, hypertension developed and a bruit was audible in the neck and the upper abdomen. Digital subtraction angiography showed stenosis in carotid, renal and right upper pulmonary arteries. On the basis of these results, a diagnosis of aortitis syndrome was made. Moreover, these findings indicated pulmonary infarction in the right upper lobe due to aortitis syndrome. Aortitis syndrome preceded by pulmonary infarction involvement is very rare. Autoimmune disorders may have been involved in this case because of the association with ulcerative colitis.
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PMID:[Aortitis syndrome associated with ulcerative colitis, preceded by pulmonary infarction involvement]. 1148 30

Two patients with Takayasu arteritis are reported who presented with fever of unknown origin. Takayasu arteritis was diagnosed at the prepulseless period after stenotic lesions of the aorta, and its branches were seen with imaging methods. In the first month of steroid treatment, hypertension developed in both patients that was related to fibrosis in stenotic lesions in renal arteries. Both patients were treated with percutaneous transfemoral renal angioplasty. Takayasu arteritis should be considered in the differential diagnosis of fever of unknown origin, especially in young women. Absence of the physical findings related to vasculitic lesions will not rule out the disease, which can be seen in the prepulseless period.
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PMID:Takayasu arteritis presenting with Fever of unknown origin: two case reports. 1704 55

57-year-old woman with a history of ischaemic heart disease, arterial hypertension and after myocardial infarction was admitted to the university hospital because of progressive hearing loss and fever of unknown origin. Shortly before hospitalization she developed cough, hemoptysis and conjunctivitis. On the basis of clinical presentation Wegener's granulomatosis was suspected. To confirm the diagnosis, CT scans of the chest, sinuses and ears were performed and revealed massive lesions especially in tht tympanic cavity, mastoid antrum and cells. Infiltrations were also observed in sinuses, especially maxillary, and typical granulomas were found in the lungs. Moreover, the biopsy taken from the mucous membrane of the nose showed abnormalities typical of Wegener's granulomatosis. Antineutrophil cytoplasmatic antibodies (ANCA) were also examined. It is of interest that c-ANCA (cytoplasmatic) were negative and p-ANCA (perinuclear) were positive which is rare in this disease. The patient was treated with immunosuppressive drugs (intravenous methylprednisolone, oral prednisolone and cyclophosphamide). Following therapy fever, hemoptysis and conjunctivitis subsided, while inflammatory parameters normalized. This case report presents on unusual clinical manifestation of Wegener's granulomatosis with the leading sign of hearing loss.
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PMID:[Progressive hearing loss as the leading sign of Wegener's granulomatosis]. 1803 Aug 78

Septic arthritis may represent a direct invasion of joint space by various microorganisms, including bacteria, viruses and fungi. Although any infectious agent may cause bacterial arthritis, bacterial pathogens are the most significant because of their rapidly destructive nature. We present a case of septic arthritis in a 56-year old male patient due to Streptococcus viridans which is member of the viridans group streptococci. Patient was admitted to Our Hospital presented as fever of unknown origin, losing more than 30 kg of body weight during couple of months, and anemia of chronic disease as paraneoplastic process. He had long history of arterial hypertension and stroke. There was swelling and pain of the right sternoclavicular joint and precordial systolic murmur in physical status. A large diagnostic panel has been made, computerized tomography (CT) of right sternoclavicular joint showed widening of periarticular soft tissue and loss of clavicular corticalis. Cytologic analysis of synovial fluid showed more than 90% of polymorphonuclear leukocytes. There were no crystals on microscopic examination and Gram stain of fluid was negative. Blood cultures were positive for S. sanguis and there was a consideration about possible periodontal disease. Stomatologic examination verified periapical ostitis and extraction of potential cause of infection has been done. Therapy with benzilpenicilline was followed by the gradual improvement of clinical and laboratory parameters. Although viridans group streptococci and Streptococcus sanguis in particular are rare causes of septic arthritis in native joints, they should be considered in the differential diagnosis of periodontal disease.
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PMID:Septic arthritis due to Streptococcus sanguis. 2069 49

A 73-year-old man was admitted to our hospital because of a decrease in spontaneity. His medical history included two stroke episodes, probably related to hypertension. Brain MRI on admission demonstrated acute infarction in the right caudate nucleus and left putamen. Intravenous infusion of a low molecular-weight heparin added to oral antiplatelets was started. Following admission, he developed a low grade fever and severe inflammatory reaction. The focus of infection was not evident, and none of the antibiotics tried were effective. Ten days after admission, he developed right hemiparesis, and an additional brain MRI showed new multiple infarctions. We also determined the presence of a high MPO-ANCA titer (57 EU), and we diagnosed the patient's condition to be ANCA-associated vasculitis (AAV). Steroid therapy improved his inflammatory reaction and stroke recurrence was not observed. We suggest that vasculitis should be considered as a potential risk factor for repeated small infarctions with fever of unknown origin, especially those of perforating artery territories.
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PMID:[Case of CNS-limited ANCA-associated vasculitis presenting as recurrent ischemic stroke]. 2494 81


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