Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pasteurella multocida is an opportunistic pathogen causing bacteraemia in patients with liver dysfunction. A fulminant case of acute cholecystitis and septicaemia caused by P multocida, complicated by Waterhouse-Friderichsen syndrome without skin haemorrhage, is reported in a previously healthy 64 year old Chinese woman. The patient presented with a six hour history of sudden onset epigastric pain, vomiting, chills, and rigors. A presumptive diagnosis of cholangitis with septicaemic shock was made. Disease progression was rapid and the patient died within eight hours of symptom onset. This case is further proof that skin and mucosal haemorrhages are not an essential feature of Waterhouse-Friderichsen syndrome and this condition should be suspected in all patients presenting with sudden illness and fulminant septicaemia.
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PMID:Waterhouse-Friderichsen syndrome complicating primary biliary sepsis due to Pasteurella multocida in a patient with cirrhosis. 756 Feb 9

Two young soldiers presented with acute abdomens, then received surgical procedures under initial impression of acute cholecystitis and acute appendicitis respectively. Operative findings did not confirm the initial diagnosis, and the clinical condition did not improve after operation. Scrub typhus was suggested later by clinical manifestations of fever, chills, headache, lymphadenopathy, skin rash and presence of eschar formation; this diagnosis was finally confirmed by positive serologic results of high Weil-Felix OXK agglutination and/or Rickettsia tsutsugammushi immunoflorescence titers in paired sera. Both patients rapidly became afebrile after administration of tetracycline. This unusual presentation with acute abdomen in scrub typhus is emphasized, with caution that the possibility of scrub typhus should be taken considered, especially in patients coming from hyperendemic areas.
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PMID:Unusual presentation of acute abdomen in scrub typhus: a report of two cases. 764 Nov 27

Primary non-Hodgkin lymphoma (NHL) of the gallbladder (GB-NHL) is exceedingly rare. We present our experience on a 78-year-old male with chief complaints of fever, chills, and epigastric dull pain. Abdominal computed tomography (CT) scan showed a few stones and focally thickened gallbladder wall. He received cholecystectomy under the preoperative diagnosis of acute cholecystitis with septic shock, while pathologic examination revealed cholelithiasis and diffuse large B-cell lymphoma without acute inflammation. Staging procedures revealed a stage IE tumour and the patient received adjuvant radiotherapy. Relapse as a large retroperitoneal mass was noted 32 months later and he passed away three years after initial diagnosis. A literature review revealed 20 cases of GB-NHL. We find that, including our current case, the median age is 63 years and 8 of 19 (42%) tumours are associated with gallstones. The mean and median survival of 15 patients with complete follow-up information is 75 and 36 months, respectively. Mucosa-associated lymphoid tissue (MALT) lymphoma seems to carry a longer survival than non-MALT lymphomas.
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PMID:Primary diffuse large B-cell lymphoma of the gallbladder with cholelithiasis masquerading as acute cholecystitis: case report and literature review. 1738 98

Eosinophilic cholecystitis (EC) is a rare entity that presents in a manner comparable to acute cholecystitis. The diagnosis is based on classical symptoms of cholecystitis with the presence of >90% eosinophilic infiltration within the gallbladder. We report the case of a 29-yr-old man who presented with unremitting right upper quadrant pain, chills, and loss of appetite. After confirmation of the diagnosis with ultrasound and hepatobiliary scan (HIDA), a cholecystectomy was performed. Pathologic examination of the excised gallbladder demonstrated submucosal infiltration with eosinophils, consistent with EC. Peripheral eosinophilia was not observed; the subject's blood eosinophil count did not exceed 3% during the period of observation. The patient was discharged with no further symptoms. Cases of EC have been infrequently reported since its original description in 1949. EC has been reported alone or in combination with manifestations such as eosinophilic cholangitis, hypereosinophilic syndromes (HES), and parasitic infestations. The patient described herein gave no indications of such previously suggested causes of EC. This report illustrates an authentic case of idiopathic EC.
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PMID:Eosinophilic cholecystitis, with a review of the literature. 1752 76

Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Misdiagnosis is highly usual, and its macroscopic appearance may often be confused with gallbladder carcinoma. Here we discuss the case of a 56-year-old male who presented in the emergency room with fever, chills, and nausea. The routine laboratory investigations were normal except for elevated white blood cell counts. Abdominal ultrasound showed borderline gallbladder wall thickening. However, after CT scan findings, the suspect diagnosis of acute cholecystitis with possible perforation was made and the cholecystectomy was performed. The definitive diagnosis was delayed until the final pathology result came as a surprise, and later confirmed the histologic diagnosis of XGC. We consider this an important case because of the histopathologic finding of fibrotic thickened gallbladder wall with abundant histiocytes and pericholecystic fat stranding along with perforation and extensive inflammatory changes in the right upper quadrant of the abdomen which is highly suggestive and indicative of XGC in comparison to gallbladder carcinoma (GC). All things considered, clinically and grossly XGC presents in a similar fashion as GC; histopathology confirmed the diagnosis of XGC.
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PMID:Xanthogranulomatous Cholecystitis: A Diagnostic Challenge for Radiologists, Surgeons, and Pathologists. 3298 4