ABSTRACT: A 40-year-old man had enlarging painful gluteal masses that developed after 17 years of hemodialysis. Pathologic examination revealed extensive deposition of β2-microglobulin amyloid. A bladder biopsy done during evaluation for possible transplantation also showed amyloid deposits. This constellation of findings has not been reported in a patient with (β2-microglobulin…
ABSTRACT: A case of eosinophilic pleural effusion with peripheral blood eosinophilia is presented. No cause of the pleural effusion was found, but on cessation of valproic acid therapy, both the pleural effusion and eosinophilia resolved. Valproic acid should be added to the list of drugs associated with pleural fluid eosinophilia.
ABSTRACT: Amnioinfusion has become accepted in the management of intrapartum cord compression, meconium-stained fluid, and oligohydramnios. Limited experience exists regarding amnioinfusion in patients undergoing a trial of labor after cesarean section and its potential complications. We report a case of trial of labor in which uterine rupture occurred following intrapartum…
ABSTRACT: Antibiotic resistance in bacteria has emerged as a medical catastrophe. This results from the speed at which bacteria multiply and are spread, and the ease with which they can change their genetic material or acquire new genes. They exert biochemical resistance by preventing entry of the drug, by rapidly…
ABSTRACT: Bladder rupture and urethral disruption are relatively common injuries associated with pelvic trauma; however, bladder herniation into a pubic symphysis diastasis is an unusual sequelae of pelvic trauma. We report a case of anterior bladder wall herniation into a traumatic pubic diastasis and review the literature. Recommendations focusing on…
ABSTRACT: Central pontine myelinolysis is classically described in alcoholics or other malnourished individuals after correction of severe hyponatremia. A patient with bulimia developed central pontine myelinolysis after correction of severe hyponatremia and hypokalemia. Early symptoms of abnormal affect and dystonia made initial diagnosis elusive. The spectrum of neurologic signs and…
ABSTRACT: Cyclosporine recently has become part of the treatment regimen for patients with refractory inflammatory bowel disease, though it is still considered investigational for that purpose. However, little attention has been given to the potential hepatotoxicity associated with cyclosporine administration. This can be especially significant in patients with preexisting abnormalities…
ABSTRACT: Delusions of parasitosis (DOP) is a psychiatric disorder in which people have an unshakable false belief that they are infested with arthropod parasites. To rid themselves of the “bugs” patients with DOP may become desperate and quit their jobs, burn furniture, abandon homes, and use pesticides dangerously and repeatedly….
ABSTRACT: Dermatomyositis is an uncommon idiopathic chronic inflammatory disorder. Oral corticosteroids are the treatment of choice. A few patients become resistant to steroids. We describe two patients who, after failure to respond to oral and high-dose intravenous corticosteroids, received a combination of oral cyclosporine and high-dose intravenous immune globulin, with…
ABSTRACT: Disseminated toxoplasmosis in patients with acquired immunodeficiency syndrome is often a central nervous system disease but may be seen as myocarditis or pneumonitis. Toxoplasmic colitis is a rarity. We report a case of toxoplasma colitis in a patient with diarrhea and hypokalemia. The microorganisms were identified in the colonic…
ABSTRACT: Nontyphoidal salmonellae (NTS) are often isolated from stool specimens of individuals having evaluation of gastroenteritis. The significance of isolation of NTS in a stool specimen from previously healthy individuals with gastroenteritis is not clear. The purpose of this study was to determine which serotypes were being isolated most frequently…
ABSTRACT: Staphylococcus epidermidis septicemia from a urinary source is rare. Two male patients had septicemic shock caused by S epidermidis urinary tract infection. Both patients had recently had indwelling urethral catheterization during severe illness. Bacteremia due to S epidermidis may be life-threatening. Although most cases of S epidermidis bacteremia are…
ABSTRACT: Stiff-man syndrome is a rare disorder characterized by involuntary axial rigidity and continuous motor unit activity on electromyography. Recent studies propose an autoimmune etiology of this disorder because antibodies directed against glutamic acid decarboxylase and pancreatic islet cells have been detected. Favorable responses to plasmapheresis have been reported, and…
ABSTRACT: The attitudes of 90 therapists toward patients with an eating disorder were explored by questionnaire. Topics included therapist's treatment desires, countertransference, treatment approaches, and prognosis. Twenty-eight respondents (31%) desired not to treat such patients. Analysis of those who did not desire to treat these patients showed that (1) more…
ABSTRACT: Thionamides are often used acutely to control the symptoms of thyrotoxicosis associated with Graves' disease before definitive treatment with radioiodine. Several reports have suggested that pretreatment with thionamides reduces the efficacy of radioiodine therapy in patients with Graves' disease, but other data refute this. This study retrospectively reviewed the…
ABSTRACT: This report of a woman with positional dizziness is apparently the first to describe position-dependent vertebral artery compression shown by magnetic resonance angiography. This noninvasive technique may be helpful in the differential diagnosis of positional dizziness.
ABSTRACT: To evaluate the need for routine prophylactic nasogastric tube decompression following gastrointestinal surgery, we retrospectively reviewed the cases of 177 patients. The patients were classified as those not receiving nasogastric tubes, those whose tubes were removed within 48 hours postoperatively, and those whose tubes remained for more than 48…
ABSTRACT: We are reporting the cases of two brothers with congenital indifference to pain, previously reported by one of us in 1965. This represents a nearly 30-year follow-up. In this rare disorder of pain perception, all other sensory modes are intact. Management includes early recognition of the condition, prevention of…
ABSTRACT: We describe a 47-year-old man with shoulder pain, multiple bony lesions, and a 1-cm lesion in the spleen. T-l facetectomy revealed a poorly differentiated malignant neoplasm. Several months after chemotherapy, multiple splenic lesions were found by computed tomography and liver-spleen scan. A splenectomy showed a malignant spindle-cell neoplasm forming…
ABSTRACT: We prospectively evaluated the inflammatory response to acute cerebral ischemia in 57 patients who were seen within 72 hours of ictus. All subjects had cerebrospinal fluid examination, complete blood count, sedimentation rate determination, and body temperature monitoring. Correlation analysis was done between these measurements and infarct volume, which was…
ABSTRACT: We report an unusual case of a primary psoas abscess due to community acquired methicillin-resistant Staphylococcus aureus in an immunocompetent man. The course of the disease was indolent, expressed as septic arthritis of the hip joint. When the diagnosis was made, 3 months after symptoms began, the patient was…
ABSTRACT: We report two cases of cryptococcal pneumonia in which the roentgenographic picture closely mimicked that for chronic eosinophilic pneumonia. Caution in the use of corticosteroids based on this roentgenographic pattern is stressed.
ABSTRACT: We reviewed a series of 83 catfish sting cases from inland hospitals (Belzoni and Indianola) and a coastal hospital (Pascagoula) to identify the type and severity of injury, as well as the type of treatment and its effectiveness. Oral cephalosporin was adequate in treating early infections.
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