• Title/Summary/Keyword: Intermittent Fever

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A Case of Pyogenic Liver Abscess Caused by Staphylococcus epidermidis in a Healthy Child (건강한 소아에서 발생한 Staphylococcus epidermidis에 의한 화농성 간농양 1례)

  • Gwak, Ji Hye;Eem, Yeun Joo;Choi, Ui Yoon;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.36-40
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    • 2013
  • Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring $7.0{\times}6.5$ cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.

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Malignant Degeneration and Hepatic Metastasis Ten Years after Internal Drainage of a Choledochal Cyst - a Case Report - (내배액술을 시행한 담관 낭종에서 발생한 악성 변성 및 간 전이 - 1예 보고 -)

  • Ji, Moon-Jong;Yoon, Hyuk-Jin;Kang, Shin-Yong;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.186-191
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    • 2005
  • A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

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Trichinosis Imitating an Inflammatory Systematic Disease

  • Kosmidou, Maria;Papamichail, Georgios;Klouras, Eleftherios;Tsamis, Konstantinos;Sarmas, Ioannis;Rapti, Iro;Milionis, Haralampos
    • Parasites, Hosts and Diseases
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    • v.59 no.5
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    • pp.497-499
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    • 2021
  • Trichinellosis (trichinosis) is a parasitic infection caused by nematodes of the genus Trichinella. Pigs are the most common source of human infection. We describe a case of a 47-year-old woman presented with a wide range of intermittent symptoms including prolonged fever, dry cough, diarrhea, rash, myalgias and arthralgias. The patient was attended by physicians with various medical specialties such as dermatologists, rheumatologists and allergiologists, but they did not establish a certain diagnosis because of the gradual onset of symptoms, raising the suspicion of a systematic disease. After extensive work up, the diagnosis of trichinosis was established with femoral muscle biopsy compatible with inflammatory myopathy of parasitic etiology with trichinosis to be the predominant diagnosis. Despite the significant delay of diagnosis for almost three months, patient was treated successfully with no further complications. Trichinellosis is a food-borne treatable infection. Preventive measures include community education especially in zones where parasite prevalence is increased, improvement of farming and cooking techniques.

Acute Tubular Necrosis associated with the Ketogenic Diet in a Child with Intractable Epilepsy

  • Yoo, Kee Hwan;Yim, Hyung Eun
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.48-52
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    • 2019
  • The ketogenic diet (KD) has been used as an effective antiepileptic therapy for intractable childhood epilepsy. However, various adverse effects have been reported with use of the KD. We report a case of a child who developed acute tubular necrosis subsequent to therapy with KD. A 5-year-old girl had myoclonic epilepsy with developmental delay. She was under the treatment with antiepileptic drugs since the age of 3 months and on the KD during the past 18 months. Proteinuria persisted intermittently with the initiation of the KD and subsequently increased in the past 2 months. She was admitted with intermittent mild fever, vomiting, and lethargy for the past 3-4 weeks. At the time of admission, she presented with hypertriglyceridemia, heavy proteinuria, renal Fanconi syndrome, and acute kidney injury. Renal sonography showed a marked increase in the size and parenchymal echogenicity of both kidneys. A renal biopsy revealed acute tubular necrosis accompanied by early interstitial fibrosis. After the withdrawal of the KD and supportive therapy, without changing other anticonvulsants and their dosages, improvement of renal function was observed. Proteinuria had disappeared after 1 month and kidney size returned to normal after 8 months. It is hypothesized that the KD can induce and/or aggravate the renal tubulointerstitial injury in some patients who are under the treatment with anticonvulsants.

A study on Toxoplasmosis in dogs (견의 Toxoplasmosis에 관한 연구)

  • Lee, Cheong-San;Kwak, Hak-Koo;Park, Kyung-Jae;Jang, Hwan
    • Korean Journal of Veterinary Service
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    • v.21 no.1
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    • pp.29-39
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    • 1998
  • This study was carried out to investigate the prevalence of antibody against Toxoplasma gondii in the dog by Latex agglutination test and Indirect fluorescent antibody test. Two month-old dogs were infected intraperitoneally with T gondii to observe histopathological and immunohisto-chemical changes. Results obtained through this experiment were summarized as follows ; 1. Among the serum samples of 163 heads of the dog, 10 samples(6.1%) were positive. 2. In the sex, 6 heads (7.1%) out of 84 female dogs and 4 heads(5.1%) out of 79 male dogs were positive. However, there were no significant differences between the male and female. 3. Overall proportion of agreement between indirect fluorescent antibody and Latex agglutination test in 163 sera of dogs was 97.5%. 4. When 2 month-old dogs were infected intraperitoneally with T gondii, main clinical signs were intermittent fever, dyspnea, diarrhea. In general, the infected dogs recovered closely on the 11th day of post-inoculation. 5. At necropsy, petechial and ecchymotic hemorrages and swelling in small intestine, lung, spleen, liver and kidney were observed. 6. In histopathological observation, interstitial pneumonia, hyperemia and hemorrhages in lung were observed. Focal necrosis of hepatocytes, the neutrophil and basophil in the renal tubular epithelium were observed. 7. By immunohistochemical staining using Vectorstain ABC kit, the positive cells were recognized in the lung and the liver. 8. By indirect fluorescent antibody test, the Toxoplasma antibodies in the infected dogs were detected on the 15th day of postinoculation.

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Two Attenuated Cases of Methicillin-Resistant Staphylococcus aureus Infection Treated by Oriental Internal Medicine (한방처치를 통한 Methicillin내성 포도구균 감염의 음성화 및 약독화 2례)

  • Ko, Chang-Nam;Yun, Sung-Woo;Park, Sung-Wook;Lee, Hyung-Chel;Lee, Sang-Wook
    • The Journal of Internal Korean Medicine
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    • v.23 no.2
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    • pp.298-305
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    • 2002
  • These cases were performed on the bases of clinical consideration about patients who had Methicillin-Resistant Staphylococcus aureus(MRSA) infection. One patient was a 67-years-old women who had sequela of inter cranial hemorrhage & inter ventricular hemorrhage, hypertention, urinary tract infection and pneumonia. Clinical symptoms were intermittent fever, sputum, Lt. side hemiparesis and dysphagia. She was chronic, repeated infection state. It could be regarded as "unpreparedness of the spirit which animates and controls the universe; 正氣虛", the oriental term which indicates a condition of chronic disease or general weakness. According to the oriental medicine principle, oriental medicine was taken such as Wunggunza-tang(六君子湯) and the patient had taken a turn for the better. After 3 months, MRSA infection diappeared. The other patient was a 43-years-old women who had Both brain stem infarction, Lt. cerebellar infarction, hypercholesterolemia, urinary tract infection and pneumonia, Clinical symptoms were quadriplegia, dysphagia(levin tube insert state), aphasia, respiration disorder(tracheostomy cannular keep state) and sputum. She was chronic, repeated infection state. It could be regarded as "unpreparedness of spleen energy, unpreparedness of both energy and blood; 脾氣虛, 氣血兩虛", the oriental term which indicates a condition of chronic disease or immunodeficiency. According to the oriental medicine principle, oriental medicine was taken such as Bojungyggi-tang(補中益氣湯), Palmul-tang(八物湯) and the patient had taken a turn for the better. After I month, MRSA was turned into Escherichia coli.

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Clinical Study on 1 Case of Soyangyin Patient Diagnosed as Crohn's Disease (크론씨병으로 진단된 소양인 환자 치험 1 례)

  • Lee, Seung-Hyun;Park, Darn-Seo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.5
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    • pp.1346-1351
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    • 2007
  • Crohn' disease is an auto-immune disease characterized by intermittent chronic diarrhea, high fever, weight loss, abdominal spastic pain or abdominal discomfort which is followed by granulomatous necrosis and cicatrical inflammation. It is also called segmental enteritis or granulomatous enteritis. In western medicine the exact cause is undefined, however it is presumed as an immunological unbalance in alimentary tract commoonly occured in ileum portion of small intestitine or ascending colon and therefore immuno suppressive agents(usually steroids) and anti-inflammatory drugs are prescribed. In case of emergency such as ileus, perforation of intestinal wall surgical methods are considered. In oriental medicine this falls under the category of diarrhea(泄瀉), dysentery(痢疾), splenic diarrhea(脾泄). As to the pathological mechanism the abnormal ascending and descending circulation of stomach and splenic energy(脾不升淸, 胃不下降) the hepatic stagnation(肝鬱氣滯) and dysfunction of small intestine in expelling urine and feces(小陽淸獨不利) all together causes such condition. Main treatments are inducing diuresis(利小便), warming kindey to reinforce yang(溫賢助陽), nourishing the middle energy to invigorate spleen(補中健脾), elimination of the dampness by cooling(淸熱燥濕). In this case the patient was diagnosed as soyangyin(少陽人) constitution and herb medicine soyangyin Hyongbangjihwan-tang(少陽人 荊防地黃湯), Sa-am acupuncture Sojangjeonggyeok(小腸政格) was applied. There was an significant improve in chief complaints and general conditions.

Pathogenecity on experimentally infected dogs with Babesia gibsoni (Babesia gibsoni의 실험적 감염 개에 대한 병원성)

  • Suh, Myung-deuk;Chung, Mi-ra
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.587-599
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    • 2000
  • This study was conducted to observe the severity of the disease and pathogenecity of Babesia gibsoni parasite on the splenectomized dogs(SPD) and nonsplenectomized(intact) dogs (NSPD) experimentally infected with B gibsoni. The average prepatent period was 4 days in the SPD and 8 days in the NSPD, respectively. Peak parasitaemia(PE) ranged from 26% to 34% of erythrocytes infected in the SPD and from 4% to 5% in the NSPD. Latent parasitaemia was still detectable 40 days as low as under 1.0% of erythrocytes infected after the initial parasitaemia in the SPD. Blood packed cell volume(PCV) decreased to as little as 6.4% to 6.9% in the SPD. The clinical signs were mild fever and anemia in the NSPD, remissions and exacervations of temperature, intermittent or spike-like increases of temperature, progressive polychromatophilic macrocytic anemia with anisocytosis, icterus, marked loss of appetite, rarely haemoglobinuria, and deep brown-yellowish urine in the SPD. Gross pathologic changes mainly involved slightly enlargement of liver and spleen in the NSPD and marked enlargement of liver in the SPD. Anatomic changes associated with the disease included diffuse periportal and centrilobular hephatitis, and membranoproliferative glomerulonephritis. Hyaline droplets, resulting protein metabolic alterations, were found in the convoluted ephithelium of the kidney. The density of lymphocytes within the liver sinusoids was markedly increased. Aggregates of large monocytes and macrophages were demonstrated in the centrilobular veins of the liver. The density of these cells in the centrilobular veins were greatest in the SPD. The forms of B gibsoni parasite found in the acute stage of SPD were large signet ring form, small signet ring form, pyriform, elongated form, comma form, head-phone form, oval form, peared form, racket-like form, amoeboid form, triangle form, quartered form, dot form, band form and multiple, and rosette form, et al. The severity of the disease and pathogenecity of B gibsoni parasite were mild in the NSPD but fatal in the SPD.

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A Case of Hughes-Stovin Syndrome (Hughes-Stovin Syndrome 1예)

  • Kim, Joo-In;Lee, Young-Min;Yum, Ho-Kee;Choi, Soo-Jeon;Choi, Seok-Jin;Yang, Young-Il;Sung, Kyu-Bo;Kim, Dong-Soon;Lee, Bong-Choon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.96-101
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    • 1996
  • Hughes-Stovin Syndrome is an exceedingly rare combination of distal pulmonary arterial aneurysm and deep vein thrombosis, mostly found in young patients. There are striking similarities between the vascular manifestation of Behçet's disease and Hughes-Stovin Syndrome. It has been suggested that they may have a similar pathogenesis. Most patients died of massive hemoptysis due to rupture of aneurysm. Recently we have experienced the first case of Hughes-Stovin Syndrome in Korea. A 37 year old male patient was admitted because of recurrent hemoptysis and intermittent fever. He had a history of recurrent aphthous ulcers and erythema nodosum-like skin rash, But no other findings of Behcet's disease was found. Angiography showed multiple pulmonary arterial aneurysm and deep vein thrombosis in Right lower extremity. Histologic examination of specimens of open lung biopsy revealed leukocytoclastic angiitis. Pulmonary arterial aneurysms were successfully treated by coil embolization and he is in good condition with corticosteroid and cyclophosphamide therapy.

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Pathological observation on the piglets experimentally infected with Aujeszky′s disease virus isolated in Korea (국내 분리 오제스키병 바이러스 접종자돈의 병리학적 관찰)

  • Park, Nam-Yong;Chung, Chi-Young;Kim, JIn-Ho;Yoon, Jin-Gyu;Park, Young-Seok
    • Korean Journal of Veterinary Pathology
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    • v.2 no.2
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    • pp.117-125
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    • 1998
  • Pathological studies were performed on the five piglets experimentally infected with Aujeszky's disease virus(pseudorabies), NYJ isolate, isolated from the naturally infected pigs in Korea: two piglets were inoculated intramuscularly, two piglets intranasally, and one piglet subcutaneously at the dose of 1$m\ell$ per animal with the 105.5 $TCID_50$/0.1ml titer. Clinical signs included dyspnea, high fever(>$41^{\circ}C$), anorexia, vomiting, diarrhea or constipation, ataxia, circling movement, posterior paralysis, intermittent convulsion, and coma followed by death although some variations by age and inoculated routes were observed. Gross features included multiple necrotic foci in the liver, congestion and hemorrhage in the lymph nodes and spleen, petechial hemorrhage in the kidney, hemorrhagic pneumonia, marked meningeal congestion, severe sub meningeal hemorrhage in the spinal cord, excessive cerebrospinal fluid retention, and muscular necrosis at the inoculated area. Microscopically, non suppurative meningoencephalitis with gliosis and perivascular cuffing in CNS, ganglioneuritis, necrohemorrhagic splenitis, necrotic hepatitis, tonsillitis and rhinitis, hemorrhagic or interstitial pneumonia, and non-suppurative myositis in the injected area were observed. Eosinophilic intranuclear inclusion bodies were found in a variety of tissues the including the liver, kidney, adrenal gland, spleen, lymph nodes, tonsil, and lung. Ultrastructurally, virus particles were confirmed in nucleus and cytoplasms of pneumocytes around the necrotic areas.

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