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)

A two-year-old, female Lhasa apso presented with an acute onset of fever, anorexia, lethargy, prescapular and mandibular lymphadenopathy, otitis externa, and a dermatitis involving the perioral and auricular skin. Histopathological examination of affected skin and a mandibular lymph node was diagnostic for juvenile cellulitis. Extensive hematological, serological, urine, skin, and fecal testing together with special staining, immunofluorescence, and electron microscopic examination of skin and lymph node biopsies failed to reveal an underlying etiology. After 15 weeks the condition resolved completely. This represents the first adult case of a dermatosis fitting the clinical, histological, and clinicopathological description ascribed to juvenile cellulitis.
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PMID:A dermatosis resembling juvenile cellulitis in an adult dog. 763 52

An 8-week-old, male Labrador retriever presented for acute onset of left hind limb lameness. This rapidly progressed to juvenile cellulitis, characterized by dermatitis of the face, otitis externa, regional lymphadenopathy, lethargy, and depression. The puppy made a full recovery on glucocorticoid therapy.
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PMID:Juvenile cellulitis in a puppy. 1275 35

Skull base osteomyelitis (SBO) is a serious and rare condition most commonly seen in elderly diabetic or immunocompromised patients as a complication of otitis externa. We present the case of a previously healthy 3-year-old girl who presented to the paediatric emergency department with vomiting, fever, lethargy, headache and left-sided facial nerve palsy. The initial CT head revealed left-sided otitis media with otomastoiditis and she was managed with intravenous antibiotics and myringotomy with grommet insertion with initial improvement. Two weeks later she re-presented having deteriorated and a dedicated mastoid CT and temporal bone MRI showed SBO. She underwent urgent cortical mastoidectomy where microbiological analysis of the cultures and specimen grew Candida albicans She was subsequently treated with long-term antifungals and antibiotics, and eventually recovered with good effect. The diagnostic dilemma and the empirical treatment of such a rare case are discussed.
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PMID:Rare case of a 3-year-old with Candida skull base osteomyelitis: lessons to be learnt. 3096 48

Acute otitis media (AOM) is the most common diagnosis in childhood acute sick visits. By three years of age, 50% to 85% of children will have at least one episode of AOM. Symptoms may include ear pain (rubbing, tugging, or holding the ear may be a sign of pain), fever, irritability, otorrhea, anorexia, and sometimes vomiting or lethargy. AOM is diagnosed in symptomatic children with moderate to severe bulging of the tympanic membrane or new-onset otorrhea not caused by acute otitis externa, and in children with mild bulging and either recent-onset ear pain (less than 48 hours) or intense erythema of the tympanic membrane. Treatment includes pain management plus observation or antibiotics, depending on the patient's age, severity of symptoms, and whether the AOM is unilateral or bilateral. When antibiotics are used, high-dose amoxicillin (80 to 90 mg per kg per day in two divided doses) is first-line therapy unless the patient has taken amoxicillin for AOM in the previous 30 days or has concomitant purulent conjunctivitis; amoxicillin/clavulanate is typically used in this case. Cefdinir or azithromycin should be the first-line antibiotic in those with penicillin allergy based on risk of cephalosporin allergy. Tympanostomy tubes should be considered in children with three or more episodes of AOM within six months or four episodes within one year with one episode in the preceding six months. Pneumococcal and influenza vaccines and exclusive breastfeeding until at least six months of age can reduce the risk of AOM.
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PMID:Otitis Media: Rapid Evidence Review. 3152 61