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)

Melioidosis is endemic in Southeast Asia and tropical Australia with varying clinical features from benign skin lesions to fatal septicaemia. Imaging plays an important role in evaluation of the melioid liver abscesses. A 45-year-old man with underlying diabetes presented with fever and lethargy for 2 weeks and abdominal pain for 2 days. His liver was enlarged on examination. Blood investigations revealed mild leucocytosis and raised liver enzymes. Ultrasound showed multiple multiloculated hypoechoic lesions throughout the liver and spleen. CT of abdomen confirmed that some liver lesions were made up of asymmetric locules of varying sizes (honeycomb sign), while others had hypodense centre with small symmetric peripheral locules in radial fashion (necklace sign). Blood culture was positive for Burkholderia pseudomallei He was subsequently treated with ceftazidime for a month followed by oral trimethoprim-sulfamethoxazole for 3 months. Follow-up CT of abdomen a month after diagnosis and treatment showed resolving hepatic and splenic lesions.
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PMID:Honeycomb and necklace signs in liver abscesses secondary to melioidosis. 2905 59

Melioidosis is an emerging infectious disease of humans and animals caused by the bacterium Burkholderia pseudomallei and endemic in tropical regions, principally Southeast Asia and northern Australia. In September 2017, after Hurricane Maria impacted the Dolphin Discovery facility in the Federation of St. Kitts and Nevis, a juvenile male bottlenose dolphin (Tursiops truncatus) died within 96 hr of presenting with acute anorexia, lethargy, and respiratory distress. Histopathology demonstrated necrohemorrhagic bronchopneumonia, necrotizing hepatitis, splenitis, and lymphadenitis, with intralesional Gram-negative bacilli. B. pseudomallei was confirmed by bacteriological culture and DNA sequencing. This case emphasizes the challenges of melioidosis diagnosis, the importance of awareness for both early detection and efficacious treatment, and recognition in tropical regions where it has been either not reported or underreported. To the authors' knowledge, this is the first case of cetacean melioidosis in the Caribbean Islands, an often severe and fatal disease with increasing prevalence on the American continent.
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PMID:MELIOIDOSIS IN A BOTTLENOSE DOLPHIN (TURSIOPS TRUNCATUS) AFTER A HURRICANE IN THE CARIBBEAN ISLANDS. 3254 77