Issue - Southern Medical Association

Case Report

Dialysis-Related Amyloidosis Manifested as Masses in the Buttocks

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…

Case Report

Eosinophilic Pleural Effusion Associated With Valproic Acid Administration

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.

Case Report

A Trial of Labor Complicated by Uterine Rupture Following Amnioinfusion

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…

Current Concepts

Antibiotic Resistance in Bacteria

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…

Case Report

Herniation of the Urinary Bladder: A Complication of Traumatic Pubic Symphysis Diastasis

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…

Case Report

Central Pontine Myelinolysis in a Patient with Bulimia

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…

Case Report

Cyclosporine-Induced Worsening of Hepatic Dysfunction in a Patient With Crohn’s Disease and Enterocutaneous Fistula

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…

Primary Article

Analysis of 11 Cases of Delusions of Parasitosis Reported to the Mississippi Department of Health

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….

Case Report

Dermatomyositis: Remission Induced With Combined Oral Cyclosporine and High-Dose Intravenous Immune Globulin

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…

Case Report

Disseminated Toxoplasmosis as a Cause of Diarrhea

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…

Primary Article

Epidemiology of Nontyphoidal Salmonellae at a Tertiary Care Center in Northeast Florida

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…

Case Report

Septicemic Shock From Urinary Tract Infection Caused by Staphylococcus epidermidis

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…

Clinical Review

Stiff-Man Syndrome Revisited

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…

Primary Article

Therapists’ Attitudes About Treating Patients With Eating Disorders

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…

Primary Article

Thionamides Alter the Efficacy of Radioiodine Treatment in Patients With Graves’ Disease

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…

Case Report

Positional Compression of Vertebral Artery Shown by Magnetic Resonance Angiography

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.

Primary Article

Prophylactic Nasogastric Tube Decompression: Is Its Use Justified?

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…

Case Report

Congenital Indifference to Pain: Long-term Follow-up of Two Cases

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…

Case Report

Primary Angiosarcoma of the Spleen: A Case Report and Review of the Literature

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…

Primary Article

Cerebrospinal Fluid and Peripheral White Blood Cell Response to Acute Cerebral Ischemia

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…

Case Report

Primary Psoas Abscess Due to Methicillin-Resistant Staphylococcus aureus Concurrent With Septic Arthritis of the Hip Joint

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…

Case Report

Cryptococcal Pneumonia Simulating Chronic Eosinophilic Pneumonia

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.

Primary Article

Catfish Stings in Mississippi

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.

Acknowledgment

ACKNOWLEDGMENT

Correspondence

Diagnosing Angiotropic Large Cell Lymphoma

Editorial

EMERGING DRUG-RESISTANT BACTERIA: THE WAKE-UP CALL HAS COME

Correspondence

Hiccups Due to Gastroesophageal Reflux

Correspondence

Medicinal Arsenic Poisoning: 27-Year Follow-up

Editorial

THE JOURNAL’S JOURNEY TO THE FUTURE

Correspondence

Thrombotic Thrombocytopenic Purpura and HIV Infection