Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three Chinese infants with methylmalonic acidaemia were described. They presented in the neonatal period with recurrent episodes of poor feeding, lethargy, apnoea and severe acidosis. The diagnosis was established by increased methylmalonic acid concentration in the plasma and/or urine. Pancytopenia was a prominent feature in all three patients. Only patient three had assessment of lymphocyte subsets and it showed diminished population of B-lymphocytes and a reversed CD4/CD8 ratio. All three patients were unresponsive to vitamin B12. They experienced severe infections including Gram-negative septicaemia, candidiasis and Pneumocystis carinii pneumonia which caused their deaths. Patients with this disease should be regarded as having severe immunodeficiency, and in addition to optimal metabolic control, they should be treated aggressively for any suspected infective episodes.
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PMID:Immunodeficiency in methylmalonic acidaemia. 156 72

Nosocomial disseminated candidiasis was diagnosed in 6 out of 200 (3%) children receiving pediatric intensive care over a period of 9 months. The ages of patients ranged between 20 days to 3 years; 4 were < 2 months. Therapy with broad spectrum antibiotics (in all), indwelling cannula (in all), peritoneal dialysis (in 3), low birth weight (in 3) and invasive hemodynamic monitoring were recognizable predisposing factors. The diagnosis was suspected on an average after 14 days, PICU stay (range 8-20 days). All the patients showed a secondary worsening after evidence of improvement from the primary illness. It was characterized by lethargy, fever (in 3), weight loss (in 3), loose stools (in 2) and respiratory distress (in 3), and was indistinguishable from any bacterial sepsis. Presumptive diagnosis was made on basis of KOH wet mount and Gram stained smear findings of mycelia, and was confirmed later on isolation of candida species from one or more body sites and blood culture. All the patients showed disappearance of symptoms and mycological cure within 6-14 days of oral itraconazole therapy, (10 mg/ kg/day in 2 divided doses). The therapy was continued for upto 14 days after sterile fungal blood culture, and was well tolerated. Fungal superinfection especially with candida must be looked for in hospitalized patients suspected of nosocomial infection. Early oral itraconazole is effective in disseminated candidiasis and well tolerated by children.
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PMID:Disseminated nosocomial candidiasis in a pediatric intensive care unit. 877 63

An adult female Greek tortoise (Testudo graeca) presented with dyspnea, lethargy, and anorexia. Severe unilateral pulmonary candidiasis was diagnosed and confirmed by histologic and microbiologic evaluations. Initial treatment with ketoconazole resulted in plasma elevations of aspartate aminotransferase, lactate dehydrogenase, and bile acids consistent with imidazole-induced hepatotoxicity. Plasma chemistry abnormalities resolved upon withdrawal of the drug. Temporary osteotomy permitted access to the diseased lung and facilitated intrapulmonary catheterization. Intrapulmonary amphotericin B therapy at 0.1 mg/kg s.i.d. for 34 days proved to be both safe and effective in this case.
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PMID:Pulmonary candidiasis caused by Candida albicans in a Greek tortoise (Testudo graeca) and treatment with intrapulmonary amphotericin B. 1278 85

An adult male sun conure (Aratinga solstitialis) was evaluated because of lethargy, ruffled feathers, and decreased appetite. Physical examination revealed hypothermia, dehydration, dyspnea, and crop distention. Results of a complete blood cell count revealed a marked inflammatory leukogram, and cytologic examination of a crop swab sample identified gram-negative bacilli and occasional yeast organisms. Radiographs demonstrated an opaque, ill-defined, soft tissue structure in the caudal coelom just cranial to the renogonadal silhouette, loss of serosal detail, and splenomegaly. Endoscopic examination revealed a pale, granuloma-like structure within the caudal aspect of the left lung, splenomegaly, and an enlarged proventriculus. Intraoperative cytologic examination of a biopsy sample of the lesion demonstrated yeast organisms, and a subsequent culture of the biopsy sample revealed Candida albicans . The bird was treated intraoperatively with intralesional amphotericin B. Postoperative treatment consisted of meloxicam, trimethoprim sulfa, amphotericin B by nebulization, and systemic itraconazole and fluconazole. The bird made a complete recovery, was discontinued from all medications, and has remained asymptomatic for 6 months. Although rare, pulmonary candidiasis should be on the list of differential diagnoses for any respiratory infection in birds. Endoscopic biopsy, cytology, and fungal culture were valuable in making the diagnosis.
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PMID:Antemortem Diagnosis and Successful Treatment of Pulmonary Candidiasis in a Sun Conure (Aratinga solstitialis). 2584 70