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)

The designation of "Infantile Bilateral Striatal Necrosis" (IBSN) was first given by Friede in 1975. However, this unusual condition was first described by Paterson and Carmichael in 1924. The disease is rare with uncertain etiology. The clinical picture includes choreoathetosis, abnormal eye movements, seizures and mental dullness. These circumstances often follow symptoms such as fever, vomiting and impaired consciousness. The final diagnosis is confirmed by pathological examination, which reveals symmetrical degeneration of bilateral basal ganglia. With present technology IBSN can be well demonstrated in the brain Ct scans or MRI scans nowadays. This article reports four cases with clinical manifestations which had appeared before the age of one year. Three cases had prodromal upper respiratory tract infection symptoms with vomiting, while seizure and impaired consciousness ensued. One case had several bouts of pneumonitis followed by seizures, impaired consciousness and abnormal eye movement. Brain sonogram of one of these cases showed hyper-echoic basal ganglia, while CT scans or MRI scans revealed symmetrical hypodensity or signal change over bilateral basal ganglia, respectively. All of these led to a bedridden life. These four cases are reported based on their clinical presentations and brain imaging findings, in spite of the absence of pathological confirmation. Some of the literature are also reviewed. To sum up, IBSN should be kept in mind in the differential diagnosis of symmetrical bilateral basal ganglia lesion after the exclusion of other disorders such as neurometabolic disorders, central nervous system infection, carbon monoxide intoxication, hypoxic-ischemic encephalopathy, tumors and cerebrovascular disorders etc.
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PMID:[Infantile bilateral necrosis of the striatum of corpus: report of four cases]. 151 18

Four hundred and fifty-six patients with signs and symptoms of potential central nervous system infection were evaluated from June 28, 1978, to September 30, 1978. The majority of the children had a relatively brief and mild illness characterized by a constellation of features previously described with central nervous system infections. Fever, headache, and vomiting were typical. Altered sensorium and nuchal rigidity were inconstant. One distinct and another infrequently reported feature of enteroviral disease, hypoglycorrhachia and cerebrospinal fluid pleocytosis in excess of 2,000 cells/mm3, occurred independently or in concert in 18% of the cases. When these unexpected findings were associated with a presumptive clinical diagnosis of aseptic meningitis, watchful observation and repeat lumbar puncture precluded the necessity to administer antibiotics in every case. The possibility of enteroviral aseptic meningitis being a definitive diagnostic entity manageable on a group, yet individual basis utilizing a disposition protocol is discussed.
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PMID:Management of central nervous system infections during an epidemic of enteroviral aseptic meningitis. 735 59

A retrospective analysis of all patients admitted with the diagnostic codes of aseptic or viral meningitis was performed at two institutions over 3 years. Forty-one patients with cerebrospinal fluid confirmation of aseptic meningitis (increased protein; increased white count; negative gram stain; and negative fungal, tuberculosis, and bacterial cultures) were analyzed. All the patients had headache, which was typically severe and bilateral in 39 of the 41 patients. The headache was of abrupt onset or the worst of the patient's life in 24 of the patients. The quality of the headache, when described, was usually throbbing (11 of 14). Nineteen patients had prodromal symptoms, including malaise, myalgia, gastrointestinal symptoms, and urinary tract infections. All had associated symptoms, including nausea (25), vomiting (23), photophobia (18), stiff neck (25), and back pain (11). Thirty patients were febrile. Lumbar puncture was performed for headache and fever unexplained by systemic illness in 30 patients, meningeal signs in 15, headache of abrupt onset or the worst headache ever in 24, neurologic signs or symptoms in 12, and for other reasons in 2. Computerized tomography, when performed, was negative in all cases. Focal neurologic findings were present in 5 patients, a decreased level of consciousness in 6, and papilledema in 1. A severe headache that worsens, is abrupt in onset, or is the worst of the patient's life could be due to aseptic meningitis, bacterial meningitis, or a subarachnoid hemorrhage. Although not universally present, meningeal signs, fever, and neurologic signs or symptoms should alert one to a possible central nervous system infection.
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PMID:Headache associated with aseptic meningitis. 853 Feb 75

A retrospective review of cases seen in the Diarrhea Treatment and Training Unit (DTU) of Bangalore (India) Medical College's Vani Vilas Children's Hospital during 1992-1994 confirmed the efficacy of the standard case management approach. This strategy entails oral rehydration therapy (ORT), continued feeding, and selective use of intravenous fluids and antibiotics. Of the 7966 children (4374 males and 3592 females) reporting to the DTU during the 2-year study period, only 2412 (30.5%) had received oral rehydration solution (ORS) or home-available fluids before admission. Acute watery diarrhea was present in 7316 cases (91.84%). Death occurred in 59 acute watery diarrhea cases, 6 dysentery cases, and 7 persistent diarrhea cases. The average time for cases managed in the ORT area was 2 hours and 45 minutes, while the hospital stay for admitted cases averaged 3 days. In 6957 cases (87.33%), ORS was sufficient treatment. Of the 1009 children (12.67%) who required intravenous fluids, 254 had dehydration attributable to conditions such as persistent vomiting and inability to drink due to oral thrush. Only the 512 children (6.2%) with cholera and dysentery received antibiotics. Of the 72 children who died (case fatality rate, 0.9%), 43 had associated severe malnutrition with pneumonia and anemia, 14 had a central nervous system infection, and 13 had septicemia; in only 2 cases could death be directly ascribed to diarrheal disease. One of these cases was due to shigella encephalopathy and the other to severe dehydration with acidosis. The average cost of treatment per patient was Rs 2.91 when only ORS was used compared with Rs 24.28 when intravenous rehydration was required. The finding that less than one-third of children had received ORS before admission suggests a need for the establishment of more DTUs in large hospitals that can train community-based health personnel in diarrhea case management.
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PMID:Management of diarrhea in a DTU. 905 85

Fifty children, 24 female and 26 male, with ages varying from 6 to 72 months (mean = 23.7 m.) that experienced at least one febrile seizure (FS) entered a prospective study of intermittent therapy with clobazam. Cases with severe neurological abnormalities, progressive neurological disease, afebrile seizures, symptomatic seizures of other nature, or seizures during a central nervous system infection were excluded. Seizures were of the simple type in 25 patients, complex in 20 and unclassified in 5. The mean follow-up period was 7.9 months (range = 1 to 23 m.), and the age at the first seizure varied from 5 to 42 months (mean = 16.8 m.). Clobazam was administered orally during the febrile episode according to the child's weight: up to 5 kg, 5 mg/day; from 5 to 10 kg, 10 mg/day; from 11 to 15 kg, 15 mg/day, and over 15 kg, 20 mg/day. There were 219 febrile episodes, with temperature above 37.8 degrees C, in 40 children during the study period. Twelve children never received clobazam and 28 received the drug at least once. Drug efficacy was measured by comparing FS recurrence in the febrile episodes that were treated with clobazam with those in which only antipyretic measures were taken. Ten children (20%) experienced a FS during the study period. Of the 171 febrile episodes treated with clobazam there were only 3 recurrences (1.7%), while of the 48 episodes treated only with antipyretic measures there were 11 recurrences (22.9%), a difference highly significant (p < 0.0001). Adverse effects occurred in 10/28 patients (35.7%), consisting mainly in vomiting, somnolence and hyperactivity. Only one patient had recurrent vomiting which lead to drug interruption. These effects did not necessarily occurred in every instance the drug was administered, being present in one febrile episode and not in the others. We conclude that clonazepam is safe and efficacious in preventing FS recurrence. It may be an alternative to diazepam in the intermittent treatment of FS recurrence.
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PMID:Treatment of febrile seizures with intermittent clobazam. 962 35

We report on a case of a 13-month-old female infant who was admitted to our department with the chief complaints of drowsiness and vomiting. A history of an unspecified viral infection was reported. Clinical examination was negative for focal neurological signs or signs of central nervous system infection. Initial CT scan revealed obstructive hydrocephalus, and shunting was scheduled. Dexamethasone treatment was started. Eight hours after admission the child almost restored his baseline mental status and the operation was postponed. The dexamethasone treatment was discontinued 3 days later. Follow up CT and MRI scans were normal. We discuss the case and the possible causes of transient hydrocephalus in children.
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PMID:Transient acute obstructive hydrocephalus of unknown origin in a 13-month-old infant. 1699 57

Proliferation of the lymphoid system should arouse suspicion of a potentially serious illness. We present a 4.5-year-old boy who developed fever, vomiting, diarrhea, lymphadenopathy, hepatosplenomegaly, lymphocytosis, anemia, thrombocytopenia, and increased liver enzymes. Lymph node and bone marrow biopsies showed lymphoproliferation, Epstein-Barr virus (EBV) infection, and hemophagocytosis leading to the diagnosis of hemophagocytic lymphohistiocytosis (HLH). Chemotherapy was initiated for HLH with dexamethasone, etoposide, and cyclosporine. Because of a high level of EBV viremia, rituximab was added a few days later and resulted in a remarkable drop in the EBV in the circulation but not in the cerebrospinal fluid. However, the patient succumbed to encephalitis, pneumonia, and cardiopulmonary failure. Autopsy revealed the presence of EBV in the brain, indicating the ineffectiveness of rituximab therapy in treating central nervous system infection with EBV.
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PMID:A boy with fever, lymphadenopathy, hepatosplenomegaly, and lymphocytosis. 1843 Mar 21

A 64-year-old woman with a progressive marginal zone lymphoma for which she had received induction therapy with six courses of rituximab and fludarabine presented with fever while receiving maintenance therapy with rituximab. In addition to the fever she complained of nausea, vomiting, weight loss and fatigue. After an extensive diagnostic procedure no cause was found for the fever. Finally, additional testing showed a positive polymerase chain reaction (PCR) for enterovirus in the cerebrospinal fluid and faeces. Because the immunoglobulin G level of our patient was 4.06 g/l (normal values 5.2 to 16 g/l), she was treated with intravenous immunoglobulins (IVI g) weekly with the goal to maintain an IgG level above 10 g/l. This resulted in a significant rise in anti-enteroviral antibodies from 10 IE /ml to 106 IE /ml. One month after treatment with IVI g, while withholding the rituximab, the PCR for enterovirus on faeces was negative and antibodies to the enterovirus in the serum had returned to normal levels. Rituximab can cause a prolonged B-cell deficiency resulting in hypogammaglobulinaemia. We believe that treatment with ritxumab may have played a significant role in the development of this rare central nervous system infection.
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PMID:Enteroviral encephalitis in a patient with a marginal zone lymphomatreated with rituximab. 2050 71

Cryptococcal meningitis is the most common fatal central nervous system infection in AIDS patients in Sub-Saharan Africa. The purpose of this prospective study conducted from March 2003 to February 2004 in the internal medicine and infectious diseases departments of the Point G University Hospital Center was to investigate the clinical, prognostic and epidemiological profile of Cryptococcus neoformans infection in patients hospitalized for brain and meningeale infection (BMI). Diagnosis of neuromeningeal cryptococcosis (NMC) was based on positive identification of Cryptococcus by direct exam of the cebrospinal fluid (CSF) after India ink staining and/or culture on Sabouraud medium without actidione. During the study period, a total of 569 patients were hospitalized including 235 (41.3%) with HIV infection. Overall C. neoformans was identified in 14 patients. Median patient age was 39 +/- 8 years. There was a male preponderance with a sex ratio of 1.8 (9 men/5 women). Patients with BMI were HIV-positive in 85.7% of cases (n=12) and HIV-negative in 14.3% (n=2). The overall and HIV-specific prevalence of BMI was 2.5% and 5.1% respectively. The CD4 lymphocyte count was between I and 49 cells/mm3 in 64.3% of cases. The main clinical symptoms were cephalea in 85.7% of cases, altered consciousness in 50% and nausea/vomiting in 35.7%. Neurological manifestations (hemiparesis and cranial nerve deficit) were noted in 14.3%. HIV infection is the main purveyor of NMC in Mali. The actual incidence of cryptococcosis is unclear due to the poor sensitivity of diagnostic techniques. This study highlights diagnostic difficulties related to clinical polymorphism and poor technical facilities. Agglutination testing of blood and CSF is recommended, but mortality remains.
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PMID:[Neuromeningeal cryptococcosis in Mali]. 2239 27

An 18-year-old woman presented with a progressively worsening headache, photophobia feverishness and vomiting. Three weeks previously she had returned to the UK from a trip to Peru. At presentation, she had clinical signs of meningism. On admission, blood tests showed a mild lymphopenia, with a normal C reactive protein and white cell count. Chest X-ray and CT of the head were normal. Cerebrospinal fluid (CSF) microscopy was normal. CSF protein and glucose were in the normal range. MRI of the head and cerebral angiography were also normal. Subsequent molecular testing of CSF detected enterovirus RNA by reverse transcriptase PCR. The patient's clinical syndrome correlated with her virological diagnosis and no other cause of her symptoms was found. Her symptoms were self-limiting and improved with supportive management. This case illustrates an important example of viral central nervous system infection presenting clinically as meningitis but with normal CSF microscopy.
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PMID:Confirmed viral meningitis with normal CSF findings. 2503 43


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