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 2-year-old female Quarter Horse was evaluated for hind limb lameness, fever (40 degrees C [104 degrees F]), and lethargy of 2 weeks' duration. Hypoproteinemia characterized by hypoalbuminemia and hyperfibrinogenemia was detected. Abdominal ultrasonography revealed thickening of the right dorsal colon wall. Treatment was instituted for putative right dorsal coliis. Lameness evaluation localized signs of pain to the lumbar vertebrae or pelvis. Radiography performed with the horse standing and nuclear scintigraphy revealed no abnormalities. Ventrodorsal pelvic radiography revealed a focal area of bony lysis and proliferation involving the cranial portion of the pubic symphysis. Aspiration yielded purulent exudate containing Rhodococcus equi, which was susceptible to erythromycin. Treatment included surgical debridement of the abscess and oral administration of erythromycin and rifampin. The horse's hind limb lameness completely resolved within 20 days. Infections of the pubic symphysis should be considered when lameness localized to the pelvis is associated with fever and an inflammatory leukogram.
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PMID:Osteomyelitis of the pelvis caused by Rhodococcus equi in a two-year-old horse. 1268 88

In this article we describe the main clinicopathological findings of some tick-transmitted diseases observed in Italy, due to Ehrlichia canis and Babesia canis, and most rarely Anaplasma phagocytophilum and Anaplasma platys. Canine monocytic ehrlichiosis (CME) is a multisystemic disorder that is characterized by various clinical signs. Acutely-infected dogs show various clinical and haematological abnormalities including fever, lymphadenopathy, anorexia, lethargy, depression and thrombocytopenia. Many dogs with CME evolve in to an asymptomatic or chronically symptomatic carrier states. In Italy there are very few cases of Canine Granulocytic Ehrlichiosis (CGE) and all are attributed to A. phagocytophilum. The early manifestations of CGE are usually mild and consist in acute onset of fever and depression with or without thrombocytopenia. Lameness due to polyarthritys is also possible. Other clinical manifestations most rarely described are very similar to those reported in chronic form of E. canis infections. There are very few studies about clinicopathological findings of canine babesiosis in Italy. In our country this infection is caused by Babesia canis (large form of parasite) subspecies B. canis canis and B. canis vogeli. These two subspecies are morphologically indistinguishable. Clinical signs reflect the intravascular and extravascular haemolysis due to the life cycle of the parasite. The most common haematological abnormalities found in canine babesiosis are anaemia and thrombocytopenia. It is important to point out that co-infection between two or more agents is possible. In this case it is very difficult to attribute the clinical signs and haematological and/or biochemical abnormalities to a single specific agent.
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PMID:Tick-transmitted diseases in dogs: clinicopathological findings. 1688 15

Background: Giant cell arteritis/temporal arteritis (GCA) is an inflammatory condition that affects large to medium vessels such as the aorta and its primary branches. Patients classically present with fatigue, fever, headache, jaw claudication and in severe cases, may suffer either transient (amaurosis fugax) or permanent visual loss. The reference standard for diagnosis is the temporal artery biopsy (TAB) and the mainstay of treatment is with immunosuppression. Our patient JG, presented with a range of non-specific symptoms that mimicked generalised sepsis, but was ultimately diagnosed with GCA through effective, methodical multi-disciplinary team (MDT) work. Clinical case: JG, an 81 year old gentleman, presented acutely with a 3-4 weeks history of fatigue, lethargy, pyrexia and a marked inflammatory response suggestive of a sepsis but without a clear primary source or clinical features of vasculitis. His inflammatory markers were markedly raised although his erythrocyte sedimentation rate (ESR) was not elevated. He was initially treated for sepsis of unknown origin however, body imaging after admission suggested a possible infection around a previous aortic graft site. This was refuted in subsequent 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET/CT) scanning. Microbiological, parasitic, as well as autoimmune assays were unremarkable. He underwent a TAB which was diagnostic for GCA and as a result, was started on oral corticosteroids with immediate symptom relief. He was discharged and followed up on an outpatient basis. Conclusions: This case highlights how a vasculitis can present with a range of non-specific symptoms that may resemble a fever of unknown origin (FUO)/sepsis that can lead to a delay in making the correct diagnosis. It also highlights the importance of considering a diagnosis of vasculitis in patients who present with a FUO where there is no clear focus of infection. Delays in diagnosis and management of these conditions can potentially lead to significant irreversible morbidity.
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PMID:A Stab in the Dark: A Case Report of an Atypical Presentation of Giant Cell Arteritis (GCA). 3101 Oct 74