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)

Catatonia is an infrequent but severe condition in young people. Organic diseases may be associated and need to be investigated though no specific recommendations and guidelines are available. We extensively reviewed the literature of all the cases of organic catatonia in children and adolescents from January 1969 to June 2007. We screened socio-demographic characteristics, organic diagnosis, clinical characteristics and treatment. We found 38 cases of children and adolescents with catatonia due to an organic condition. The catatonic syndrome occurred in 21 (57%) females and 16 (43%) males. The mean age of patients was 14.5 years (+/-3.39) [range=7-18 years], and three died from their condition. The organic conditions included infectious diseases (N=10), neurological conditions (N=10), toxic induced states (N=12) and genetic conditions including inborn errors of metabolism (N=6). The onset was dominantly acute, and the clinical presentation most frequently stuporous. Although benzodiazepines were recommended as primary symptomatic treatment, they were rarely prescribed. In several cases, therapeutic approach was related to organic cause (e.g., plasma exchange in lupus erythematosus; copper chelators in Wilson's disease). Based on this review and on our own experience of catatonia in youth, we proposed a consensual and multidisciplinary diagnostic strategy to help practitioners to identify underlying organic diseases.
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PMID:Multidisciplinary approach of organic catatonia in children and adolescents may improve treatment decision making. 1841 62

Infection with the parasitic dinoflagellate Hematodinium sp. can be devastating to blue crab Callinectes sapidus populations. Morbidity and mortality appear to depend on the burden of parasitic organisms. Heavily infected crabs become lethargic and, if not preyed upon, succumb to overwhelming infection. We report on the transmission of Hematodinium sp. into blue crabs that were fed pieces of infected tissues and examined for evidence of infection at time periods from 1 to 48 h and for the general state of their health after 4 d. During the first 16 h after feeding, Hematodinium sp. was found in the gut, followed by large increases in hemolymph hemocytes and the appearance of hemocytic nodules in tissues. By 16 h, the hemocytic nodules appeared poorly circumscribed and disorganized. No nodules were seen in a heavily infected crab after 24 h. By the end of the 48 h after feeding, 73% (11 of 15) of the crabs had shown evidence of infection with Hematodinium sp. Those crabs with infection intensities (Hematodinium sp. as percent of cells in hemolymph) higher than 20% were dead within 4 d.
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PMID:Transmission of the parasitic dinoflagellate Hematodinium sp. infection in blue crabs Callinectes sapidus by cannibalism. 1975 Aug 7

Infection with the nematode Angiostrongylus vasorum is an emerging cause of canine disease in Europe and part of North America, yet published data on its epidemiology in endemic areas are lacking. This study tested faecal samples from 897 dogs attending veterinary practices in the southern part of Great Britain, a long standing endemic focus. Among 790 dogs presenting with respiratory or other signs broadly suggestive of angiostrongylosis, 16% tested positive on a single Baermann's examination, compared with 2% of healthy dogs in the same catchment areas. Risk factors for positive tests included age (higher risk in younger dogs), season (more cases earlier in the calendar year), and worming history (lower risk if given milbemycin oxime in the past 12 weeks). Sex, neutering status and breed were not significant in terms of risk of testing positive. The most common clinical signs in infected dogs were respiratory, along with non-specific signs such as lethargy and exercise intolerance, while bleeding, neurological and gastrointestinal signs were also recorded. Around half the dogs sampled that showed signs of extra-pulmonary disease also had respiratory signs. Direct faecal smears and Baermann's tests read after one hour detected 56% and 83% of diagnosed cases respectively. The data confirm that A. vasorum is commonly associated with disease in endemic areas, which manifests with a broad range of signs at primary care level. Information on risk factors is useful in diagnosis and control, and forms a basis for further epidemiological investigation.
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PMID:Angiostrongylus vasorum infection in dogs: Presentation and risk factors. 2069 67

Amblyomma americanum was confirmed as a competent vector in the transmission of Cytauxzoon felis to domestic cats. Infection with C. felis was produced and replicated in four domestic felines by the bite of A. americanum adults that were acquisition fed as nymphs on a domestic cat that survived cytauxzoonosis. Numerous attempts to transmit C. felis with Dermacentor variabilis at the same time were not successful. All cats upon which infected A. americanum were transmission fed exhibited disease typical of cytauxzoonosis, and the eitiologic agent's presence was confirmed. Clinical signs including fever, inappetence, depression, and lethargy were observed beginning 13 d postinfestation. Pale mucus membranes, splenomegaly, icterus, and dyspnea were also observed during the course of the disease. Rectal temperatures of the C. felis-infected principal cats fluctuated from high to subnormal before returning to the normal range. Clinical signs of cytauxzoonsis improved by 24 d postinfestation in all but one cat, with survivors remaining parasitemic and subclinically infected with C. felis. Unengorged A. americanum and D. variabilis were collected from wild habitats to determine the minimum infection rate of C. felis in ticks from an enzootic area. Infection of C. felis was found only in wild-collected A. americanum. The minimum infection rate of C. felis in A. americanum was 0.5% (one of 178) in males, 0.8% (three of 393) in nymphs, and 1.5% (three of 197) in females. We found no wild-collected D. variabilis infected with C. felis. Our results confirm that A. americanum is a primary vector of C. felis.
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PMID:Confirmation of Amblyomma americanum (Acari: Ixodidae) as a vector for Cytauxzoon felis (Piroplasmorida: Theileriidae) to domestic cats. 2093 86

Methylergonovine (MEV) is a semi-synthetic ergot alkaloid used in the prevention and control of postpartum hemorrhage. This report describes 12 newborns born on the same day in a local country hospital in Turkey and developed sepsis-like symptoms and encephalopathy within the first 6 h of life due to accidental administration of MEV instead of vitamin K in the delivery room. The major features of MEV poisoning were lethargy (41.7%), seizure (75.0%), feeding intolerance (66.6%), hypoventilation (58.3%), irritability (25%), and peripheral circulatory abnormalities (58.3%). As a conclusion, clinical findings of ergot toxicity in newborns cannot be distinguished from infectious disease or neonatal encephalopathy.
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PMID:An unusual mimicker of a sepsis outbreak: ergot intoxication. 2097 85

Ticks are hematophagous parasites of people and animals and are a public health hazard in several countries. They are vectors of infectious diseases; in addition, the bite of some ticks, mainly from the Ornithodoros genus, may lead to local lesions and systemic illness, referred to as tick toxicosis. In this report, we describe a dog bitten by Ornithodoros brasiliensis, popularly known as the mouro tick. The main clinical findings were disseminated skin rash, pruritus, mucosal hyperemia, lethargy, and fever. Laboratory abnormalities 48 hours after the bites occurred included mild nonregenerative anemia, eosinophilia, basophilia, increased serum creatine kinase activity, increased serum C-reactive protein concentration, and prolonged coagulation times. Tick-borne pathogens were not detected by PCR analysis or serologic testing, supporting the diagnosis of a noninfectious syndrome due to tick bite, compatible with tick toxicosis.
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PMID:Tick toxicosis in a dog bitten by Ornithodoros brasiliensis. 2182 17

A 4 yr old male castrated Labrador retriever was evaluated for a short history of inappetance, lethargy, small-bowel diarrhea, polyuria, and polydipsia. Clinicopathologic abnormalities were consistent with protein-losing nephropathy and renal azotemia. Expansive infectious disease testing implicated Babesia gibsoni via whole blood polymerase chain reaction. Renal histopathology results were consistent with membranoproliferative glomerulonephritis and immune complex deposition. The dog was treated with azithromycin, atovaquone, and one dose of corticosteroids/cyclophosphamide. Three months after therapy was completed, the dog was clinically healthy, and all clinicopathologic abnormalities (including Babesia species polymerase chain reaction) had resolved. Atypical presentations of Babesia gibsoni should be considered with proteinuric nephropathy.
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PMID:Resolution of a proteinuric nephropathy associated with Babesia gibsoni infection in a dog. 2205 61

Chryseobacterium (formerly Flavobacterium) indologenes, is a non-fermentative gram-negative bacillus which is widely found in the nature, primarily soil and water. Since it can survive in chlorine-treated municipal water supplies, and can colonize the sink basins and tap waters of the hospitals, this bacterium may be a potential infectious agent. Contamination of the medical devices containing water (respirators, intubation tubes, humidifiers, incubators for newborns, etc.) in hospital settings may lead to serious infections especially in patients with predisposing diseases, newborns and immunocompromized patients. In this report, a case of fatal C.indologenes septicemia developed in a newborn with hydrocephalus has been presented. A two-months old male infant was admitted to our hospital with the complaints of failure to suck and lethargy for five days and head enlargement. He was diagnosed as meningitis based on the clinical and laboratory findings of cerebrospinal fluid (CSF) (protein: 572 mg/dl, glucose 9.5 mg/dl, chlorine: 111 mg/dl, and presence of abundant polymorphonuclear leukocytes), and empirical antibiotic treatment (ampicillin/sulbactam and cefotaxime) had been started. Since the computerized tomography of the brain pointed out hydrocephalus, an external shunt was placed for CSF drainage on the second day of hospitalization. A total of five CSF and two blood cultures collected during the hospitalization period were inoculated into pediatric aerobic CSF and blood culture bottles (BacT/ALERT, BioMerieux, France) and incubated for 24-48 hours. The isolated bacteria from all of the cultures were identified as C.indologenes by conventional methods and BD Phoenix (Becton Dickinson, USA) system. Antibiotic susceptibility tests were performed with microdilution method according to CLSI guidelines. The isolate was found susceptible to ciprofloxacin, levofloxacin and trimethoprim/sulfamethoxazole, while it was resistant to amikacin, gentamicin, tobramycin, piperacillin, cefotaxime, ceftazidime, aztreonam, meropenem, imipenem, tetracycline, and chloramphenicol. The treatment continued with ampicillin/sulbactam and levofloxacin without removing the shunt. However, C.indologenes growth persisted in CSF and blood cultures of the patient. The general condition of the patient deteriorated on the 65. day of the hospitalization and the patient was lost due to cardiopulmonary arrest. Case reports related to isolation of C.indologenes from blood cultures are present in the literature, however, isolation of C.indologenes from central nervous system was reported previously in a single case. In conclusion, C.indologenes should be considered as opportunistic infectious agents especially in the infectious diseases that develop in immunocompromised patients with underlying disease and with foreign device implementation.
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PMID:[Sepsis caused by Chryseobacterium indologenes in a patient with hydrocephalus]. 2209 Mar 5

Acute encephalopathy with bilateral striatal necrosis (EBSN) is a rare reversible neurological disease characterized by an abrupt onset following an acute infectious disease and by severe extra-pyramidal signs associated with striatal lesions. Brainstem involvement is rarely observed in this disease. We report a 10-year-old boy who had EBSN associated with Mycoplasma pneumoniae. He became lethargic after acute bronchitis. A few days later, he showed extra-pyramidal signs, pyramidal signs and overactive urinary bladder symptoms. Cranial T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) demonstrated high-signal intensity in the bilateral striatum and substantia nigra. These symptoms improved soon after the administration of L-dopa in the acute phase. The effects of corticosteroids were not apparent in the acute phase. The serum particle agglutination titers against Mycoplasma pneumoniae determined on admission, the 12th hospital day and 2 months later were 1:2,560, 1:2,560 and 1:320, respectively. Two years later, a mild tic was observed. A mild atrophy was noted in the bilateral basal ganglia, but not in the substantia nigra on cranial MRI. This case is the first reported one with EBSN with the presence of an overactive urinary bladder, which could possibly caused by loss of dopaminergic inhibition.
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PMID:[Case of acute brainstem and striatal encephalopathy associated with Mycoplasma pneumoniae infection]. 2218 Sep 63

Erlotinib (Tarceva) is a selective small-molecule inhibitor of HER1/EGFR tyrosine kinases that is especially effective for treating non-small cell lung cancer (NSCLC) harboring a constitutively active EGFR mutation. Erlotinib treatment frequently induces adverse effects such as skin rashes and diarrhea, but severe toxicity is rare. Whereas interstitial pneumonia induced by erlotinib is sometimes observed, toxicity in the central nerve system (CNS) is rarely reported. Here, we report a 75-year-old female NSCLC patient who developed subacute encephalopathy during erlotinib treatment. She showed increased irritability, loss of consciousness, convulsions, confusion, lethargy, and urinary incontinence. A brain MRI and an analysis of her CSF and blood serum detected no other causes of encephalopathy such as brain metastasis, leptomeningeal carcinomatosis, metabolic disturbances, liver damage, or infectious disease. Her subacute encephalopathy was considered to have been induced by erlotinib because her symptoms improved rapidly and spontaneously after the cessation of erlotinib treatment.
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PMID:Subacute transient encephalopathy induced by erlotinib. 2232 99


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