Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Brucellosis has always been an unusual disease in children and, concomitant with the control of the disease in domestic animals, reports have become sparse. The pediatrician, therefore, may not be aware of the protean clinical manifestations of childhood brucellosis. In 1973, nine cases occurred during a three-month period in El Paso, Texas. All cases were marked by spiking fevers and lethargy of four days to four weeks in duration. Tender hepatomegaly or splenomegaly was striking in seven patients. Other characteristics included epistaxis, arthralgia, myalgia, and weight loss. Leukopenia and leukemoid reaction were found in five patients. All of the patients tested had elevated liver enzymes. Febrile agglutinins were invaluable in screening for an early clue to diagnosis. When Brucella abortus antigen agglutinated serum from patients with a positive screen in dilutions greater than 1:320, a presumptive diagnosis of brucellosis was made. Brucella was isolated from the blood or bone marrow in seven patients and the time of incubation proved crucial for successful recovery. Bacterial blood cultures are usually discarded at ten days of age, as were cultures from the only two patients from whom the organism was not recovered. All of the cultures incubated for 12 to 15 days grew B. melitensis, an unusual causative species in the United States. However, several patients admitted eating cheese from the State of Chihuahua, Mexico, made from unpasteurized goat's milk, the presumed source of the infection. Within one to three days, all patients responded dramatically to antibiotics; tetracycline was given orally for 21 days and streptomycin intramuscularly for 14 days. Pediatricians caring for patients in areas where consumption of unpasteurized milk products is likely would do well to consider brucellosis in a child with obscure fever or toxic hepatosplenomegaly.
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PMID:Brucellosis in childhood. 80 83

One-hundred-and-fifty-seven children admitted with brucellosis at Abha, Saudi Arabia, were studied prospectively. Ninety-two per cent gave a history of animal contact, usually with sheep or goats, or ingesting raw milk, milk products, or raw liver. Three-quarters of the patients had an acute or subacute presentation with diverse symptomatology: fever (100 per cent), malaise (91 per cent), anorexia (68 per cent), cough (20 per cent), abdominal symptoms (20 per cent), arthralgia (25 per cent). Hepatomegaly (31 per cent), splenomegaly (55 per cent), and lymphadenopathy (18 per cent) were common findings. Organ complications were rare except for arthritis (36 per cent) which usually presented as a peripheral oligoarthritis involving the hips and knees. All patients had significant agglutination titres; B. melitensis was grown from the blood in 7 of 16 (44 per cent) patients. Haematological variations were common, but non-specific: anaemia (64 per cent), thrombocytopenia (28 per cent), leucopenia (38 per cent), leucocytosis (12 per cent), and elevated erythrocyte sedimentation rate (81 per cent). Varying combinations of rifampicin, co-trimoxazole, tetracycline, and streptomycin resulted in a prompt pyrexial response (mean: 3.8 days), and a slower response in the arthropathy and hepatosplenomegaly. Relapses were related to poor compliance, use of a single drug or a shorter duration of chemotherapy. Brucellosis is a common childhood problem in southwestern Saudi Arabia as in other parts of the country and the Middle East. It should be considered in every child from an endemic area presenting with a febrile illness and a history of animal contact.
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PMID:Childhood brucellosis in southwestern Saudi Arabia: a 5-year experience. 152 11

An 18-year-old Turkish farmer was admitted to the hospital because of fever, painful scrotal swelling, generalized lymph-node enlargement and splenomegaly. After an incubation period of six days Brucella melitensis was isolated in blood culture. The diagnosis of acute brucellosis with lymphadenopathy, splenomegaly and epididymitis was made. He was treated with doxycycline and Rifampicin for six weeks and recovered completely. Three months after therapy he felt well. A relapse did not occur.
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PMID:[Fever, swelling of testis and epididymis, poly-lymphadenopathy, splenomegaly]. 187 75

The phenomenological reevaluation of cellular immunity to L. monocytogenes and B. abortus revealed that the inflammatory reactions accompanying both infections, i.e. DTH, splenomegaly and granulomatous inflammation, are mediated exclusively by CD4+ T cells. On the other hand, as shown in the acute Listeria-model as well as in the more chronic murine Brucellosis, specific CD8+ T cells are able to mediate protective mechanisms in the absence of any granulomatous monocyte accumulation. In an attempt to determine the cytokines responsible for monocyte accumulation and antibacterial protection we could show that IFN-gamma and TNF, both discussed as proinflammatory as well as macrophage activating cytokines, both can be produced in a T-cell-dependent as well as in a T-cell-independent manner. The ability of listeria-specific CD8+T cells to secrete TNF and IFN-gamma in response to listerial antigen argues against a role of these cytokines as mediators of granuloma formation.
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PMID:T cell subsets in granulomatous inflammation and immunity to L. Monocytogenes and B. abortus. 190 13

Reactive hemophagocytic syndrome (RHS) or hemophagocytic histiocytosis is a disease with anatomo-pathological features of systemic proliferation of non-neoplastic histiocytes, with prominent hemophagocytosis, associated to infection of other diseases. The cases of three patients afflicted with RHS are presented. 2 of them secondary to a brucellosis and the other of unknown origin. The clinical features were similar: high fever, wasting, and splenomegaly. Pancytopenia existed together with liver disfunction, CID and hyperferremia. Marrow infiltration of reactive histiocytes with important hemophagocytic phenomenon, demonstrated by aspirated and bone marrow biopsies, were observed in all cases. Studies of the immunology system were performed, showing changes in two of them. All of them fully recovered after antibiotic treatment.
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PMID:[The reactive hemophagocytic syndrome associated with infection: a study of 3 cases]. 210 68

33 children (22 girls) with brucellosis seen between 1972-1988 were studied retrospectively. All but 1 were Bedouins. The mean age at diagnosis was 9.8 years (range: 17 months-17 years). Duration of illness prior to diagnosis was less than 1 week in 13 (39%), 1-4 weeks in 8 (24%) and 1-3 months in 10 (30%). In 2 cases the symptoms lasted 6 and 8 months, respectively, before diagnosis. Presenting symptoms included fever (85%), articular involvement (65%), hepatomegaly (45%) and splenomegaly (33%). Less common manifestations were anorexia (30%) and weight loss (15%) cases. Meningoencephalitis developed in 2 patients and uveitis and glomerulonephritis in 1 each. Diagnosis was based on positive agglutination titers (greater than 160), which were found in all. Brucella melitensis was isolated in blood cultures in 8 of the 33. 18 were treated with tetracycline and 9 with tetracycline and streptomycin, all of whom responded well. 3 of the 6 treated with trimethoprimsulphamethoxazole were only cured when therapy was changed to tetracycline in 2 and tetracycline plus streptomycin in 1. All patients recovered without sequelae. We conclude that brucellosis due to Brucella melitensis is endemic among the Bedouin of the Negev. An increased incidence of brucellosis among hospitalized children has been noted in the past 2 years, indicating the need for diagnostic awareness.
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PMID:[Childhood brucellosis in the Negev]. 228 18

We prospectively studied 339 patients diagnosed of brucellosis over a six year period in order to evaluate the clinical and serological characteristics of brucellosis in the elderly. 319 patients (94.1%) were under 65 years of age (group A), and 20 patients (5.9%) were older than 65 (group B). No patient in group B developed splenomegaly as opposed to 69 (21.6%) in group A (p less than 0.05). The percentage of positive blood cultures (Brucella melitensis isolated in all cases) was 72.1% in group A and 60% in group B. The mean titer of IgM antibodies measured by indirect immunofluorescence test was significantly lower in the elderly patients, with no other differences in serologic response between the two groups. 103 patients (32.2%) in group A and seven patients (35%) in group B developed some complications; spondylitis was more common and severe among group B patients. There was no therapeutic failure or relapse among patients over 65. We conclude that clinical, bacteriological and serological characteristics and the outcome of brucellosis in the elderly are similar to those seen in younger patients.
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PMID:Serology, clinical manifestations and treatment of brucellosis in different age groups. 236 66

Gastrointestinal manifestations of brucellosis in 340 Saudi Arabian patients are reported. Sixty seven per cent of patients presented with gastrointestinal disturbances. The most frequent symptoms were anorexia (40%), abdominal pain (16%), vomiting (11%), and diarrhoea (6%). Hepatomegaly (32%), splenomegaly (29%) and abdominal tenderness (15%) were major abnormalities on physical examination. In endemic areas for brucellosis, gastrointestinal disturbances in the presence of fever of obscure etiology, should raise the possibility of brucellosis.
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PMID:Gastrointestinal manifestations of brucellosis in Saudi Arabian patients. 262 79

Forty patients with brucellosis were hospitalized and clinical and laboratory findings of patients were recorded, treatment regimens were discussed. Twenty-five of the patients were males and 15 of the patients were females. Leukopenia 21.62%, anemia 27.02% and ESR elevation 83.87% were found. Fever and exhaustion were present all of the patients. Arthralgia, nonproductive cough, gastrointestinal symptoms, headache and night sweating were the other common symptoms. Hepatomegaly, splenomegaly, hepatosplenomegaly and ronchus were imported physical examination findings. First choice treatment solution was tetracycline-streptomycin combination and this combination succeed 89.19 in percent. Relapses were treated with rifampicin.
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PMID:[Brucellosis: clinical and laboratory findings and treatment in 40 patients]. 344 17

Of 452 patients with brucellosis, 169 (111 male and 58 female) had osteoarticular complications. Brucella melitensis was isolated from the blood in 7.7% of the cases. Fever, chills, arthralgia, backache, high levels of C-reactive protein, positive rheumatoid factor, and splenomegaly were more frequent in osteoarticular brucellosis than in nonosteoarticular disease. Arthritis occurred in the hip joint in 90 cases (53%), knees in 61 (36%), sacroiliacs in 33 (20%), ankles in 25 (15%), elbows in nine (5.3%), shoulders in eight (5%), wrists in six (3.5%), and sternoclavicular arthritis occurred in three cases (1.8%). Spondylitis occurred in 10 cases (6%), osteomyelitis in four (2.4%), and tendinitis or bursitis in two (1.2%). Treatment with tetracycline or trimethoprim-sulfamethoxazole (TMP-SMZ) alone (four to eight weeks) or in combination with streptomycin (two to four weeks) resulted in a relapse rate of 16.6%. No relapses occurred in seven patients treated with repeated four- to six-weeks courses of rifampin plus tetracycline or TMP-SMZ plus streptomycin.
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PMID:Osteoarticular complications of brucellosis: a study of 169 cases. 349 50


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