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)

Chronic frontal sinusitis in 12 dairy cattle most often was associated with a history of dehorning, in which the sinus was entered (67%), or with respiratory tract disease (25%). The most common organisms isolated were Actinomyces pyogenes and Pasteurella multocida. Signs of infection did not develop for months in some cattle and were often intermittent. The most common clinical signs included anorexia, lethargy, fever, frontal bone distortion, exophthalmos, abnormal posture, nasal discharge, and neurologic abnormalities. Treatment consisted of trephination at 2 sites, drainage and lavage of the sinus cavity, and administration of antibiotics and analgesics. Eight cattle responded well to treatment and were discharged, but 4 others had signs of CNS involvement and died or were euthanatized. Trephination of the frontal sinus cavity at carefully chosen sites and antibiotic treatment are indicated when sinusitis is suspected. Drainage of the sinus cavity is imperative to avoid extension of the infection into the CNS.
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PMID:Chronic frontal sinusitis in dairy cattle: 12 cases (1978-1989). 150 Mar 35

At this point, it is customary for all hands to gather round the old decision tree and whittle on a few algorithms. Because I have been chastened by occasional painful falls from slippery decision branches, however, I must make do with a short reprise. Some nodal points in analyzing vertical diplopia include: (1) evidence of central nervous system involvement; (2) pupillary sparing; and (3) the presence of proptosis of orbital congestion. As endlessly stated, premature closure of the differential diagnosis should be avoided and the tendency to diagnose partial third nerve palsy staunchly resisted. However, all of this will probably be of little comfort to you when you face your next lethargic patient who has small angle diplopia and speaks one of the obscure rural dialects of Freedonia.
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PMID:Vertical diplopia. 333 19

Rhino-orbital-cerebral mucormycosis is a disease that is frequently fatal. A 39-year-old man with diabetic ketoacidosis was referred to the authors' ophthalmic service with fever, orbital apex syndrome in the right eye, lethargy, and a black eschar in the palate. He was treated with systemic and local (intraconal) amphotericin B and his ketoacidosis was controlled; exenteration was not performed. Biopsy of the palate proved mucormycosis. Eighteen months later the patient was still alive and had a blind, anatomically preserved right eye with ptosis and intact extraocular muscle function without proptosis or pain. The authors propose this alternative means of treatment to achieve higher doses of the drug at the site of infection and better cosmetic and psychological results.
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PMID:Intraconal amphotericin B for the treatment of rhino-orbital mucormycosis. 885 37

A 62-year-old immunocompetent woman presented with 11 days of headache, 2 days of right eye ache and 1 day of fever and lethargy. Neurological examination revealed nuchal stiffness, right proptosis, bilateral ptosis, and right abducens palsy. Cerebrospinal fluid (CSF) examination revealed elevated white cell count (164 /microl) and protein level (115 mg/dl). Cranial MRI showed sphenoid sinusitis, thromboses of the right superior ophthalmic vein, bilateral cavernous sinuses, left sphenoparietal sinus and left sigmoid sinus, and enhanced meninges. Purulent meningitis and multiple mycotic cerebral venous sinus thromboses were diagnosed. After empirical therapy with meropenem, fever persisted and CSF cell count further elevated (668/microl on day 3). Additional treatment with liposomal amphotericin B (L-AMB) and low-dose heparin from day 3 ameliorated her symptoms and lowered her CSF cell count. Laboratory test on admission later revealed elevated serum aspergillus antigen (index = 3.6) and positive blood culture for streptococcus viridans. L-AMB was replaced by voriconazole due to skin rash, and the latter was changed to itraconazole due to drug-induced hepatitis. She was discharged without complication and has been free of recurrence for 7 months. Aspergillus has a propensity to invade cerebral vessels and meninges, causing local thrombosis and meningitis with high mortality and morbidity. Direct penetration from adjacent sphenoid sinus can be a cause of cavernous sinus thrombosis, due to extreme thinness of the wall of sphenoid sinus. Cerebral venous sinuses lack valves, and this may facilitate the spread of mycotic thrombus to the other sinuses. Early preemptive treatment with antimycotic agents brought a favorable outcome to our patient.
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PMID:[Successful treatment of multiple sinus thromboses and meningitis due to aspergilli and alpha-streptococci with preemptive antimycotic therapy: a case report]. 2096 Sep 32

A microsporidian species with 98.3-98.4% nucleotide identity to Tetramicra brevifilum (Journal of Fish Diseases, 3, 1980, 495) was diagnosed in lumpfish (Cyclopterus lumpus, L.) broodstock held at a breeding and rearing facility in western Ireland. The fish were wild-caught from the west coast of Ireland, and the first case was diagnosed one year after capture. Clinical signs included severe bloating, lethargy, exophthalmos, anorexia, white patches on the cornea and externally visible parasitic cysts on skin and fins. Necropsy revealed severe ascites, white nodules and vacuoles in all the internal organs and partial liquefaction of the skeletal muscle. On histological examination, microsporidian xenomas were observed in all internal organs, the skin, skeletal muscle, gills and the eyes. The microsporidian species was identified by molecular analysis and transmission electron microscopy. This is the first record of T. brevifilum infecting lumpfish, and the disease is considered to be of potential significance to the rising aquaculture industry of this species.
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PMID:First record of Tetramicra brevifilum in lumpfish (Cyclopterus lumpus, L.). 2771 59

This report describes a new syndrome affecting farmed Atlantic salmon on the Canadian east coast that has resulted in increased morbidity and mortality in affected stocks. The major pathological findings are apparent only microscopically and include renal interstitial haemorrhage and acute tubular necrosis and tubular casting. As a result, the disease has become known as haemorrhagic kidney syndrome (HKS). Affected fish are lethargic and anorectic, and lack external lesions. Clinically, HKS fish are anaemic, hypoproteinaemic and hyperosmolalic, with increased serum concentrations of sodium and chloride. At necropsy, internal changes ranged from apparently normal to include one or several of the following: swelling and/or patchy reddening of the kidney, pale gills, exophthalmos, serosanguinous ascites, darkening of the posterior intestine and splenomegaly. Ultrastructurally, viral inclusions were found in the cytoplasm of erythrocytes of HKS fish, and there were unusual electron-dense inclusions within the tips of renal tubular microvilli of HKS fish. The significance and relevance of the ultrastructural findings to HKS are unknown. Virus isolation was attempted using CHSE, RTG-2, FH-10, BB and EPC cell lines; no virus was isolated. Bacteriological analysis failed to reveal significant pathogens. Analysis of tissues for heavy metals and pesticides was negative. Assays for clostridial toxins, lipopolysaccharide and verotoxins were negative. The aetiology of HKS remains unresolved.
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PMID:Haemorrhagic kidney syndrome of Atlantic salmon, Salmo salar L. 2973 42