Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 7-year-old female patient presented to our pediatric emergency department with 5 days of fever, sore throat, abdominal pain, vomiting, headache, and 2 days of periorbital swelling. Her initial laboratory evaluation revealed a negative monospot test, neutropenia, atypical lymphocytosis, and thrombocytopenia in addition to transaminitis and proteinuria. An abdominal ultrasound obtained identified hepatosplenomegaly, moderate ascites, acalculous cholecystitis, and a distended appendix with periappendiceal fluid. She was admitted to gastroenterology for further management with antibiotics and surgery and hematology consults. Ultimately, Epstein-Barr virus polymerase chain reaction was positive. This case highlights an atypical presentation of Epstein-Barr virus and the collaborative approach to diagnosis.
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PMID:A Pediatric Patient With Ascites, Proteinuria, and Thrombocytopenia: A Rare Presentation for a Common Illness. 3146 81

BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production leading to inflammation in multiple organs; it commonly affects young women in their child-bearing years. Clinical manifestations are diverse and range from mild arthritis to diffuse alveolar hemorrhage (DAH). DAH is a rare and devastating complication of SLE that carries a mortality rate of up to 50%, despite aggressive therapy. CASE REPORT A 21-year-old primigravida at 16 weeks gestation presents with a productive cough, rash, sore throat, and high-grade fever. Chest x-ray suggested multifocal pneumonia. Patient deteriorated despite antibiotics and intravenous (IV) fluids. She developed worsening anemia, leukopenia, and thrombocytopenia. Autoimmune workup was positive for Coombs, antinuclear antibody, anti-smith antibody, and hypocomplementemia. Skin biopsy was consistent with SLE. SLE vasculitis was suspected. She required mechanical intubation for rapid respiratory deterioration, with CT thorax suggesting ARDS. Bronchoscopy was done and confirmed DAH. Her course was further complicated with retinopathy and acute pancreatitis associated with SLE. She was treated with IV steroids, IV cyclophosphamide, and plasmapheresis, with significant clinical improvement and successful extubation. She delivered a healthy baby at 32 weeks gestation. CONCLUSIONS Early recognition and initiation of treatment is critical to survival in DAH and requires a high index of clinical suspicion. Treatment includes high-dose steroids, cyclophosphamide, and plasma exchange. Pregnancy increases the risk of adverse outcome in SLE. Seven cases of DAH in pregnant patients with SLE have been reported. Here, we report a catastrophic presentation of DAH, acute pancreatitis, and retinopathy in a pregnant patient with newly diagnosed SLE.
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PMID:Lupus-Induced Vasculitis and Multiple Organ Dysfunction Syndrome as the First Presentation of Systemic Lupus Erythematosus (SLE) in Pregnancy. 3228 23

Influenza is a very common cause of upper respiratory illness, rarely presented with bicytopenia, and is being wrongly treated with antimicrobials many-a-times. We report a case of 36-year-old North-Indian man, physician by profession who presented with a 5-day history of typical upper respiratory tract symptoms (sore throat, irritative cough, hoarseness of voice, coryza) and high-grade fever for which he took antibiotics (initially levofloxacin for 2-days, followed by azithromycin) after self-prescription. He developed hematological involvement (leukopenia and thrombocytopenia) for which he was admitted. Throat swab tested positive for Influenza B by RT-PCR. This case highlights a rare presentation of influenza as bicytopenia which rapidly improved with oseltamivir given for 5-days. This is also a classic case of lack of antimicrobial stewardship practice by a physician while self-treating viral pharyngitis. There is a pressing need to create more awareness regarding appropriate use of antimicrobial resources among doctors, only then will others follow.
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PMID:Influenza B presenting with bicytopenia in an adult - An unusual presentation and failure of antimicrobial stewardship by a practicing physician. 3310 60


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