Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031350 (pharyngitis)
 2,405 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adult-onset Still' s disease (AOSD) is an uncommon rheumatic disease characterized by high spiking fever, arthritis, an evanescent skin rash and variety of systemic symptoms, though initial onset of pleuropulmonary manifestation is relatively rare and could be responsible for a delay in diagnosis. We report a case of AOSD presenting with pleuritis with concomitant pericardial effusion. A 42-year-old Japanese man was admitted with a spiking fever of 40 degrees C, hyperleucocytosis (21.6 x 10(9)/l), and a high titer of C-reactive protein (16.84mg/dl). Chest X-ray film and computed tomography showed bilateral pleural effusion and massive pericardial effusion which both required tube drainage. Analyses of fluids revealed that both were exudative and sterile, and pleural biopsy showed nonspecific inflammation with mild fibrosis. Neither antibiotics nor antituberculosis drugs were effective. Rash, hepatosplenomegaly, polyarthritis, pharyngitis and right hypochondralgia were accompanied by serum hyperferritinemia. After exclusion of the possibility of infection, other connective tissue disease and malignancy, a diagnosis of AOSD was made. Improvement was not observed with nonsteroidal anti-inflammatory drug and corticosteroid therapy. Double filtration plasmapheresis (DFPP) following steroid pulse therapy alleviated the symptoms and the laboratory data immediately and corticosteroids could be tapered. DFPP is a safe therapeutic procedure and can be an alternative for refractory AOSD.
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PMID:[A case of severe adult-onset Still' s disease presenting with pleuropericarditis]. 1678 97

A 42-year-old bedridden patient suddenly became seriously ill with an unexplained fever (39 degrees C) and hypoxemia (pulse oximetry oxygen saturation: patient, 90%; normal, >98%). He had received the inactivated vaccine for pandemic 2009 H1N1-influenza (pH1N1) 41 days earlier. He had no cough, sore throat, or pharyngitis. Therefore, he did not satisfy the Centers for Disease Control criteria for an "influenza-like illness." Nevertheless, his nasopharyngeal swab was tested by rapid enzyme-linked immunosorbent assay for influenza A and found positive. He was promptly treated with supplemental oxygen and oseltamivir (75 mg twice daily) for 5 days. On day 6, reverse transcriptase-polymerase chain reaction test confirmed the virus to be pH1N1. A chest radiograph was normal on day 1 but revealed bilobar pneumonia on day 2. This was considered bacterial superinfection and empirically treated for 10 days with 3 g of piperacillin and 375 mg of tazobactam. The patient fully recovered. This case of pH1N1 vaccine failure occurred because no vaccine is 100% protective, and immune response may be poorer in patients with chronic medical problems. Vaccine failure was not due to immunodeficiency or improper vaccine handling. We credit this patient's recovery to our facility's heightened surveillance for influenza even among the vaccinated individuals, and also in those without classic influenza-like illness.
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PMID:Serious pH1N1 influenza illness and pneumonia despite inactivated vaccine: success of prompt diagnosis and treatment. 2105 11