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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Louse-borne relapsing fever (LBRF) is an acute febrile illness endemic Ethiopia. To date reports of childhood LBRF are few. The demographic, social and clinical features of eighty children with LBRF admitted to Ethio-Swedish Children's Hospital, Addis Abeba between 1989 and 1991 is presented. The mean age of patients was 8.8 years (range 4 months to 15 years). The male to female ratio was 1.2:1. Seventy-seven (97%) patients came from Addis Abeba. They came from poor families living in overcrowded homes. Fever, headache, right upper quadrant pain, chills and rigors were common symptoms. Fever and hepatosplenomegaly were common signs. Three drug regimens were used in the treatment of patients. A combination of penicillin and tetracycline, chloramphenicol alone and erythromycin alone, all given for 3 days. There was only one death. The literature on LBRF in adults is reviewed and the results are compared (1).
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PMID:Relapsing fever in children--demographic, social and clinical features. 145 20

Seventy-two patients with pyogenic liver abscess treated from Jan. 1986 through June 1988 were reviewed retrospectively. The average age was 55 years with a male to female ratio of 1.4:1. Most patients presented with the typical fever, chills and RUQ pain, but unusual signs and symptoms were also common. The right lobe was more commonly involved than left lobe. Biliary tract stone was the most frequent etiology (44.4%) and association with DM was common (37.5%). An elevated alkaline phosphatase and leukocytosis were useful clues to a liver abscess, but diagnosis depended on imaging of an abscess cavity either by echo or CT scan. The average time from onset of Symptoms to diagnosis was 9.3 days and a delay in diagnosis by the doctors was common. The most common complication was septicemia and factors with poor prognosis were old age (greater than or equal to 60 yrs), septicemia, cancer, peritonitis, and serum bilirubin greater than or equal to 5 mg/dl. The overall mortality was 29% with no difference between the group with surgical drains (28.5%) and the group with percutaneous transhepatic aspiration or drains (29.4%).
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PMID:[Pyogenic liver abscess--report of 72 cases]. 237 3

A previously healthy 61-year-old woman was seen with an abnormal chest roentgenogram and a 3-week history of fever, chills, malaise, and right upper quadrant pain. Blood cultures revealed Pasteurella multocida sensitive to penicillin. Liver spleen radioisotope scan and CT scan revealed space occupying lesions in the right lobe of the liver. The patient was a gardener with no pets or animal exposure. This case illustrates P. multocida septicemia and a liver abscess in a patient without animal exposure. In addition, the possibility of soil as another reservoir of infection is raised.
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PMID:Pasteurella multocida liver abscess. 348 81

A retrospective study of 37 patients with liver abscesses evaluated by diagnostic ultrasonography suggests that an abscess evolves from a small solid inflammatory focus to a well defined fluid-filled cavity over a variable time interval. Initial scans on six patients revealed a single nonspecific poorly defined solid liver mass. Following diagnostic aspiration, four of these patients were successfully treated with antibiotics alone. Two other patients with initial subtle solid masses went on to develop a more classical cystic abscess cavity with time. The remaining 31 patients had abscess which appeared initially as fluid-filled or cystic masses with variable internal echogenicity, through transmission, and margination. One-half of the patients presented acutely with fever, right upper quadrant pain, and chills. The remaining patients had a more variable indolent presentation with five patients having a course lasting over one month. Eleven patients had associated biliary tract disease. Drainage was performed on 33 patients, 30 by open surgery and three percutaneously with ultrasound guidance. There were no deaths related to sepsis in our series.
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PMID:Sonographic evaluation of hepatic abscesses. 638 28

Four surgically proven cases of Mirizzi's syndrome are reported and the literature reviewed. The clinical presentation and radiological investigations are described and discussed. All four patients presented with right upper quadrant pain and progressive jaundice. Three patients reported intermittent chills and fever. The percutaneous transhepatic cholangiographic appearances in three cases were diagnostic of this condition. The diagnosis was not made in the fourth case. The important role of the cholangiographer in entertaining the diagnosis and alerting the surgeon to a difficult cholecystectomy is emphasised.
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PMID:Surgical implications of stone impaction in the gall-bladder neck with compression of the common hepatic duct (Mirizzi's syndrome). 667 86

A 56 year-old Korean housewife/farmer/goat keeper suffered from right upper quadrant pain and fever with chills. In the abdominal sonogram and computerized tomography, multiple, 2-3 cm, irregular shaped cavities were observed in the right lobe of liver. A liver biopsy revealed extensive central necrosis with Characot-Leyden crystals surrounded by palisading histiocytes, eosinophil-rich inflammatory infiltration. Worm was not observed. However, the serologic test for Fasciola-specific IgG antibody by micro-ELISA was positive. Prior antibody levels did not differ and eosinophilia persisted 6 and 16 months after praziquantel treatment although the cavitary lesions in the liver disappeared 6 months after the treatment. Reported herein is a human case of invasive fascioliasis diagnosed clinically by a combination of radiological, histopathological and serological studies.
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PMID:A human case of invasive fascioliasis associated with liver abscess. 859 Oct 20

Spontaneous multiple cholecystoenteric fistulas are relatively rare complications of chronic cholecystitis. One cholecystoduodenal and two cholecystocolonic fistulas were observed in a 65-year-old woman whose symptoms included fever, chills, jaundice, diarrhea, and prolonged right upper quadrant pain. Pneumobilia, which is a pathognomonic sign of bilioenteric fistula, was also detected by her plain abdomen X-ray on admission. Both types of fistulas were correctly diagnosed preoperatively by barium enema, upper GI series and endoscopic retrograde cholangiopancreaticography. The patient was referred for surgery and fistulas were identified during laparotomy. Cholecystectomy, division of these fistulas, and primary repair of these bowel defects were successfully performed. The postoperative course was unremarkable. We report this unusual case and briefly review the hypothesized pathogenesis, typical symptomatology, radiographic diagnosis, complications and therapeutic modalities of this condition.
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PMID:Spontaneous multiple cholecystoenteric fistulas--a case report. 1063 65

A case of cystic intraductal papillary cholangiocarcinoma is presented. A 58-year-old male patient presented with fever, chills, epigastric and right upper quadrant pain for 15 days. Clinically and radiologically, he was diagnosed as having liver abscess. After ultrasonography and abdominal computed tomography were taken, percutaneous drainage was performed and pus was drained. Computed tomography revealed a huge, multiloculated, septated cystic lesion in the right lobe of the liver. On the pathologic exam, the cystic lesion was an aneurismally dilated tumor, which spread diffusely and contiguously along the intrahepatic bile duct and microscopically the lesion was composed of a single layer of tall columnar tumor cells with short intraluminal papillary projections. We present the unusual case of intraductal papillary cholangiocarcinoma with aneurismal dilation and with superimposed infection.
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PMID:Intraductal papillary cholangiocarcinoma with aneurismal dilation: a case of the mimicking abscess. 1239 24

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

Background A 56-year-old female presented to the emergency room with a 2-week history of fevers, chills and right upper quadrant pain. She had no sick contacts, had not traveled recently and denied high-risk sexual behavior. The patient had adopted a stray cat 1 month before presentation. Investigations Physical examination; laboratory tests (including complete blood count with differential, complete metabolic panel including liver enzymes, and serum Toxocara serology); chest and abdominal CT scans; and percutaneous liver biopsy. Diagnosis Toxocariasis (visceral larva migrans). Management Supportive care and antihelmintic agents.
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PMID:A case of adult hepatic toxocariasis. 1925 3


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