Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective review of therapeutic failures of miconazole in three patients is presented. Miconazole, a new imidazole derivative, is a broad-spectrum antifungal agent purportedly effective topically, orally, and parenterally against a number of species of fungi. Three patients with the following culturally proven deep fungal infections were treated with miconazole: (i) destructive arthritis (Sporothrix schenckii), (ii) meningoencephalitis (Cryptococcus neoformans), and (iii) disseminated aspergillosis (Aspergillus fumigatus). All the organisms were susceptible in vitro to 1.56 mug or less of miconazole per ml using a broth dilution technique. In each patient, miconazole administered intravenously in dosages of 30 mg/kg per day failed to control or eradicate infection. Miconazole serum levels ranged from <0.5 to 4.35 mug/ml as determined by radial diffusion bioassay. Cerebrospinal fluid levels were virtually undetectable. In one patient (C. neoformans), miconazole was given intraventricularly in doses of 15 mg without response. Therapeutic failures were attributed to suboptimal body fluid levels of miconazole. The reason(s) for such low levels of activity was not clear, but may have been poor penetrance into tissues, in vitro inactivation, and/or unusually rapid excretion. Untoward reactions from miconazole included fever, chills, nausea, vomiting, and phlebitis.
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PMID:Therapeutic failures with miconazole. 35 23

Angiostrongyliasis cantonensis is a disease commonly seen in Taiwan, especially in children during the summer rainy season. Most of the cases reported in other countries were adults and their clinical manifestations were different from children. Studies on special clinical characteristics of angiostrongyliasis cantonensis among 82 children in Taiwan were performed. Thirty-eight (46.3%) were male and 44 (53.7%) females, and 87% could be traced to a history of contact with the intermediate host, the giant African snail, Achatina fulica, which plays a major role in transmission. The incubation period (average: 13.2 days) was shorter in children than in adults (average: 16.5 days). In about one-third (30.5%) of the total cases, the clinical form was meningoencephalitis, which was higher than in adult cases seen in Thailand (5%). The most common clinical symptom was fever (91.5%), followed by vomiting and headache. The percentages of sixth and seventh cranial neuropathy associated with the disease were 19.5% and 11.0% respectively. Ophthalmologic fundoscopy showed that 25.0% with papilledema which was significantly higher than seen in adults (12%) in Thailand. Most of the cases in this study had peripheral leukocytosis (above 10,000/mm3) and eosinophilia (above 10%); the percentages were 82.9% and 84.1%, respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 82 cases was 41.5%; 141 worms were collected from one female patient using a pumping method. In the recent 2 years, albendazole and levamisole were used clinically with good result.
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PMID:Clinical studies on angiostrongyliasis cantonensis among children in Taiwan. 182 85

All cases of mumps meningoencephalitis diagnosed at our institution during the past 15 years were reviewed. There were 24 cases, 16 between 1973 and 1977, 3 between 1978 and 1985 and 5 in 1986 to 1988. Four of the recent cases occurred 19 to 26 days after receipt of a new mumps vaccine (Urabe Am 9 strain) released in Canada in 1986. The remaining 20 cases were clustered in winter and spring. The average age was 6.2 years and the ratio of males to females was 5:1. Clinical presentations were fever (90%), vomiting (90%), meningismus (70%), headache (65%), parotitis (50%) and seizures (30%). The mean cerebrospinal fluid white blood cell count was 513/mm3 (lymphocyte predominance); 55% of patients had a cerebrospinal fluid protein level of greater than 0.4 g/liter, and the cerebrospinal fluid:blood glucose ratio was greater than 0.4 in all. Two patients had adverse sequelae. The clinical and laboratory features of these cases were not significantly different from the vaccine-associated cases.
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PMID:Clinical and epidemiologic features of mumps meningoencephalitis and possible vaccine-related disease. 259 49

A 13 year old boy died after a three day illness with severe headache, explosive vomiting, fever and progressive loss of consciousness. The autopsy revealed purulent and necrotizing meningoencephalitis mainly involving the basal regions and posterior fossa and on microscopic examination numerous trophozoites of Naegleria were seen in the meninges and necrotic brain tissue. The trophozoites were identified as Naegleria fowleri by immunoperoxidase staining. This case as well as others previously reported in Mexico and the documented presence of Naegleria species from several sources indicate that primary amebic meningoencephalitis should be considered in the differential diagnosis of cases with neurological symptoms of sudden onset.
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PMID:[Primary amebic meningoencephalitis caused by Naegleria fowleri in an adolescent from Huetamo, Michoacan, Mexico]. 260 77

A 35-year-old woman developed temporal lobe seizures. Isolated dilatation of the right temporal horn was demonstrated by computed tomography. She was asymptomatic for the next 10 months while on anticonvulsants before severe headaches, vomiting, and mental confusion prompted hospitalization. Both temporal horns were now dilated, there was marked periventricular edema, and cryptococci were cultured from the ventricular fluid. She succumbed after prolonged systemic and intrathecal antifungal therapy, having developed isolation and dilatation of both frontal horns and third and fourth ventricles. Cryptococcal or other fungal meningoencephalitis should be considered in the differential diagnosis of isolated dilatations of the ventricular chambers as noted in the present case.
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PMID:Septation and focal dilatation of ventricles associated with cryptococcal meningoencephalitis. 348 42

A clinicopathologic case of acute diffuse lymphocytic meningoencephalitis in a 8-year-old child is reported. Clinical picture started 7 days prior to death and was characterized by fever and occipital cephalea followed by worsening of general conditions, vomiting and generalized convulsive crisis together with cardiopulmonary arrest and coma. The pathologic examination showed alterations only in the brain, namely pronounced cerebral edema and inflammatory infiltrate, predominantly lymphocytic, perivascular, particularly in the white matter, in all regions analyzed. This case is compared to the ones described in the literature and the etiopathogenesis of acute diffuse lymphocytic meningoencephalitis is discussed. The necessity of making public cases of non-bacterial acute encephalitis is emphasized, due to the fact that most of them remain with undetermined etiology.
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PMID:[Acute diffuse lymphocytic meningoencephalitis: a clinico-pathological report of a case]. 359 37

A four-year old girl developed signs of increased intracranial pressure (head-ache, vomiting, ataxia, tremor, papilledema, cranial suture spread). Abacterial meningoencephalitis due to herpes virus was diagnosed, while the initially suspected brain tumor was ruled out. Without specific therapy the patient recovered completely; even the cranial suture spread disappeared. This case report demonstrates an unusual and more benign course of central nervous herpes virus infection.
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PMID:[High intracranial pressure with the spreading of the cranial sutures as a leading symptom of herpes simplex meningitis]. 403 18

A case of cryptococcosis simulating brain tumor was reviewed. A 66-year-old female was admitted to our hospital with chief complaint of vertigo, gait disturbance and dysarthria. These symptoms started about one year before admission and worsened. Vomiting and urinary incontinence appeared. Neurological examination revealed left cerebellar ataxia and dysarthria. In plain CT (computerized tomography) irregular ill-defined low density area was noted in the cerebellar vermis and bilateral cerebellar hemispheres. And slight ventricular dilatation was found. Irregular shape of ring-like enhancement corresponding to capsule and patchy or mottled enhancement inside the tumor were seen. Suboccipital craniectomy was performed and yellowish necrotic tumor with hard capsule was removed. Histological diagnosis was not neoplasm or tuberculoma. Postoperatively liver function progressively worsened. She died due to disseminated intravascular coagulation. Autopsy revealed typical liver cirrhosis without malignant change. 3.0 X 2.5 cm sized, slightly hard, yellowish lesion was found on upper part of cerebellar hemispheres. This had extremely necrotic tissue and a great number of cryptococcus neoformans were found. And other intracranial lesion was not confirmed. Finding of pulmonary cryptococcosis was not gained. Our case is very rare because of solitary cerebellar abscess and absence of meningitic episode or pulmonary cryptococcosis. There are three types of inflammation in cerebral cryptococcosis. The commonest manifestation is the meningitic type, the second mode is granulomatous lesion and the third and the least presentation is intracranial abscess formation. CT reveals various findings according to clinical stage. CT findings are those of meningitis, meningoencephalitis, granuloma and abscess. Cryptococcal granuloma or abscess often simulates brain abscess, glioma and metastatic brain tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of cerebral cryptococcosis, with special reference to computerized tomography findings]. 646 65

A case of primary amoebic meningoencephalitis caused by Naegleria, from Sisaket province of Thailand is first reported. A 5-year old Thai with boy a history of swimming in a pond along a rice field before the onset of this illness, was admitted to the provincial hospital for chief complaints of headache, high fever, vomiting and drowsiness for 4 days. On admission he had convulsions and became comatosed with signs of meningeal irritation. The cerebrospinal fluid was similar to pyogenic meningitis but numerous amoebae were found and identified as Naegleria sp. Unfortunately, specific treatment was not administered promptly, the patient died 3 days after admission.
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PMID:Primary amoebic meningoencephalitis: a first reported case in Thailand. 667 29

Rocky Mountain spotted fever occurs during seasonal tick activity. A history of exposure to tick-containing habitats within the 3- to 12-day incubation period is a key epidemiological factor. The signs of fever, headache, myalgia, nausea, vomiting, and anorexia at onset of infection are difficult to distinguish from those of self-limited viral infections. Rash usually appears later and, if present, progresses through a sequence of stages and distribution that are never pathognomonic. The effects of disseminated Rickettsia rickettsii infection of endothelial cells include increased vascular permeability, edema, hypovolemia, hypotension, prerenal azotemia, and, in life-threatening cases, pulmonary edema, shock, acute tubular necrosis, and meningoencephalitis. In severe cases, fluid management is a challenge. The clinical diagnosis, which is difficult, is rarely assisted by laboratory findings because antibodies are usually detected only in convalescence, and immunohistologic methods for detection of rickettsiae are unavailable in most clinics. Doxycycline is the treatment of choice except for pregnant or allergic patients, who are treated with chloramphenicol.
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PMID:Rocky Mountain spotted fever: a seasonal alert. 761 84


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