Gene/Protein Disease Symptom Drug Enzyme Compound
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23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of gold-induced enterocolitis and a review of the literature are reported. Gold-induced enterocolitis appears to be an uncommon reaction, occurring in middle-aged females who have received low doses of gold preparations. Symptoms may include fever, nausea, vomiting, abdominal cramps, and diarrhea with or without blood. The whole of the gastrointestinal tract may be involved and fatal cases occur. The diagnosis of a primary enteropathic arthropathy may be suggested. Cessation of gold, glucocorticoids and supportive therapy are indicated. The mechanism of the reaction is still unknown.
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PMID:Gold-induced enterocolitis. Case report and literature review. 81 78

A 58 year old Chinese male, one week after arriving in Canada from Hong Kong, presented with acute abdominal pain and diarrhoea which was rapidly followed by Escherichia coli infection causing septicaemia and meningitis. His past history revealed bronchial asthma for 15 years treated with steroids. At laparotomy, 7 days after the onset of symptoms, he was found to have extensive haemorrhagic infarction of the small bowel and right colon. Examination of the fibrosed mesenteric vessels revealed numerous filariform larvae of Strongyloides stercoralis, within the walls, and in all layers of bowel wall. The role of the parasite in the production of obliterative arteritis in this fatal case of haemorrhagic enteropathy is discussed. Clinical strongyloidiasis, in uncomplicated cases, varies from mild to severe with gastroenteritis, nausea, colicky abdominal pain, electrolyte imbalance and symptoms of malabsorption syndrome (MARCIAL-ROJAS, 1971). In malnourished individuals and patients with debilitating infections, either newly acquired or asymptomatic latent infection with S. stercoralis can assume severe dimensions (BROWN and PERNA, 1958; HUGHTON and HORN, 1959). Similarly, in patients on steroid (CRUZ et al., 1966; WILLIS and MWOKOLO, 1966; NEEFE et al., 1973) and immunosuppressive therapy for lymphomatous diseases or deficient in immune response (ROGERS and NELSON, 1966; RIVERA et al., 1970), systemic strongyloidiasis is often fatal. The increased frequency of auto-infection in such patients with a breached immune barrier is, however, unclear. Further complications of this infection due to severe enterocolitis result in sepsis, bacteraemia and meningitis (BROWN and PERNA, 1958; HUGHTON and HORN, 1959). This paper presents a fatal case of S. stercoralis infection which illustrates an uncommon if not unique, mechanism in its production of haemorrhagic enteropathy leading to sepsis and death.
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PMID:Fatal bowel infarction and sepsis: an unusual complication of systemic strongyloidiasis. 122 84

Flucytosine is an antifungal agent useful in combination with amphotericin B in the treatment of several deeply invasive mycoses. The potentially dose-limiting, hematologic, gastrointestinal, and hepatic toxicities of flucytosine lead to a reluctance to use it in myelosuppressed patients. To investigate the safety and tolerability of flucytosine in this setting, we evaluated its use in 17 patients with cancer or aplastic anemia during a 2 1/2-year period at our institution and reviewed the literature describing mechanisms of action, resistance, in vitro and in vivo antifungal activity, clinical antifungal activity, pharmacokinetics, and toxicity. The combination of amphotericin B plus flucytosine eradicated the mycosis in 12 (71%) of 17 patients, whereas 3 (18%) of 17 died of progressive fungal infection. Serial serum levels of flucytosine measured by a creatinine iminohydrolase assay permitted reliable dosage adjustment. During therapy, only 2 (12%) of 17 patients had elevated mean serum levels of flucytosine (> 100 micrograms/mL) and 3 (18%) other patients had transiently elevated levels. Paired serum samples (n = 45) obtained at steady state during therapy with orally administered flucytosine showed similar peak and trough levels. Adverse effects of flucytosine therapy included one case each of reversible nausea, diarrhea, elevated transaminase levels, and thrombocytopenia. No cases of bone marrow aplasia, enterocolitis, hepatitis, or death due to flucytosine toxicity were encountered. We conclude that flucytosine in combination with amphotericin B is well tolerated in myelosuppressed patients when serum flucytosine levels are serially monitored.
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PMID:Evolving role of flucytosine in immunocompromised patients: new insights into safety, pharmacokinetics, and antifungal therapy. 145 31

Neutropenic enterocolitis is a recognized complication of immunosuppression or chemotherapy for leukemia. It presents as severe abdominal pain and tenderness, fever, and diarrhea associated with granulocytopenia. Gastrointestinal symptoms associated with chemotherapy for head and neck neoplasms include nausea and emesis, but not acute abdominal distress. We present, to our knowledge, the first case of neutropenic enterocolitis in a patient receiving cisplatin and fluorouracil chemotherapy for metastatic head and neck cancer.
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PMID:Neutropenic enterocolitis. A new complication of head and neck cancer chemotherapy. 229 18

Neutropenic enterocolitis is a symptom complex of fever, abdominal pain, distention, nausea, vomiting, diarrhea, and bloody stools occurring in a patient with a low neutrophil count and is most often seen in patients with acute leukemia after a course of chemotherapy. In most cases, neutropenic enterocolitis is a self-limited condition, but complications of transmural intestinal necrosis and bowel perforation may occur in a small number of patients. Surgical management should be reserved for those patients with bowel wall necrosis or perforation; however, early identification of these patients is difficult. We report our experience with the use of diagnostic peritoneal lavage in three patients with the symptoms and signs of neutropenic enterocolitis. In each case, Gram's stain of lavage fluid revealed no evidence of polymicrobial contamination of the peritoneal cavity. All three patients were managed medically, with resolution of their abdominal symptoms. Peritoneal lavage is helpful in excluding bowel perforation and avoiding unnecessary surgical intervention in patients with neutropenic enterocolitis.
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PMID:Selective management of patients with neutropenic enterocolitis using peritoneal lavage. 238 Dec 15

A 36-year-old woman developed neutropenia following chemotherapy for inoperable carcinoma of the cervix. She suffered acute abdominal pain, nausea, vomiting, and peritonitis of rapid onset. The right hemicolon and 15 cm of terminal ileum were resected at laparotomy and this showed marked edema of the cecum and ileo-cecal valve associated with superficial ulceration of the valve. There was necrosis of submucosal tissues and the muscle wall which contained a large number of Gram-positive bacilli. These showed positive membrane immunofluorescence with specific anti-Clostridium septicum antisera. We identify a case of enterocolitis due to Clostridium septicum infection. This is associated with neutropenia and is often fatal due to the rapid course of and failure to recognize the infection.
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PMID:Clostridium septicum infection in neutropenic enterocolitis. 321 99

Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the phase of severe neutropenia. The symptoms may then localize to the right lower quadrant with an associated increase in systemic toxicity. The diagnosis can be confirmed in these and other less specific cases by serial reexamination and abdominal radiographs, ultrasonography, computerized tomograms, or radionucleotide scans. The mainstay of management is complete bowel rest with nasogastric suction and total parenteral nutrition. Broad-spectrum combination antibiotics are essential, as is the avoidance of laxatives or antidiarrheal agents. Granulocyte support may be helpful. Patients with a history of nonspecific gastrointestinal complaints or of true typhlitis, successfully managed nonoperatively, should have prophylactic bowel rest and total parenteral nutrition instituted at the beginning of further chemotherapy. Patients with ongoing severe systemic sepsis who do not respond to chemotherapy and those with overt perforation, obstruction, massive hemorrhage, or abscess formation require surgical intervention. All necrotic material must be resected, usually by a right hemicolectomy, ileostomy, and mucous fistula. Divided ileostomy for less severe cases may be useful. Failure to remove the necrotic focus in these severely immunocompromised patients is fatal. With adequate recognition of typhlitis and its precipitating factors, the incidence of complications can be reduced through prevention and timely surgical intervention. Although typhlitis developed in a quarter of our acute myeloblastic leukemia patients, use of this combined approach was successful in all cases.
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PMID:Typhlitis: selective surgical management. 345 80

Oneself presents the result of the prospective study from evaluate the morbility of the partial exchange-transfusion (exchange-dilution) to effect in two forms in newborn with polycythemia. The A group was newborn in the which extraction of blood volume was on peripheric vein is oneself administration crystalloid solution for another periphery vein; the B group was utilized umbilical vein to remove blood volume for another periphery vein is administration the crystalloid. To have 20 newborn in each group; to predisponent prenatal factors global were toxemic (12%); the plethora was the more frequent sing (55%) and nausea in (37%). Were not encountered difference in both groups for: gestational age, weight, birth rate, trophism, polycythemia type (asymptomatic vs symptomatic); neither to have difference in the seric electrolytes, protein and vital signs before and after procedure. Were encountered more infections process in the B group (P < 0.05). Were concluded what the exchange-dilution for polycythemia in newborn of term must be for periphery vein exclusive with security of not production metabolic and hemodynamic changes and without risk for sepsis and/or enterocolitis for manipulation of umbilical vessels.
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PMID:[Comparison of 2 methods of partial exchange transfusion in newborns with polycythemia: peripheral-peripheral and central-peripheral]. 837 43

Salmonella typhimurium phage type (PT) or definitive type (DT) 104 is a virulent pathogen for humans and animals, particularly cattle. It has been isolated increasingly from humans and animals in the United Kingdom and several other European countries and, more recently, in the United States and Canada. Humans may acquire the infection from foods of animal origin contaminated with the infective organism. Farm families are particularly at risk of acquiring the infection by contact with infected animals or by drinking unpasteurized milk. The symptoms in cattle are watery to bloody diarrhea, a drop in milk production, pyrexia, anorexia, dehydration and depression. Infection may result in septicemic salmonellosis and, upon necropsy, a fibrinonecrotic enterocolitis may be observed. The infection occurs more commonly in the calving season than at other times. Feedlot cattle and pigs may also be affected. Prolonged carriage and shedding of the pathogen may occur. Symptoms in humans consist of diarrhea, fever, headache, nausea, abdominal pain, vomiting, and, less frequently, blood in the stool. Salmonella typhimurium DT104 strains are commonly resistant to ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline.
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PMID:Salmonella typhimurium DT104: a virulent and drug-resistant pathogen. 975 92

A 76-year-old man was admitted to our hospital with abdominal pain, nausea, and vomiting. The patient was diagnosed as ileus by abdominal radiography, which showed an enlarged bowel and an air-fluid level. Computed tomography of the abdomen showed a thickened intestinal wall. His general status suddenly worsened, and he was placed on a respirator and catecholamines to prevent acute respiratory distress syndrome, septic shock, and disseminated intravascular coagulation. He had continuous fresh anal bleeding. Total colonoscopy showed bloody stool originating from the ileum. Emergency operation was performed for hemorrhagic shock under general anesthesia. Intraoperative jejunal endoscopy revealed deep linear ulcers with bleeding in the jejunum, and 30 cm of the jejunum was resected. Histopathologic examination revealed cytomegalic cells with intranuclear inclusion bodies in the tissues surrounding the ulcers, and it was diagnosed as cytomegaloviral enterocolitis with hemophagocytic syndrome in a non-compromised adult.
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PMID:Virus-associated hemophagocytic syndrome and hemorrhagic jejunal ulcer caused by cytomegalovirus infection in a non-compromised host; a case report of unusual entity. 1508 89


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