American family physician
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Otitis externa, green nail syndrome, toe web infections, hot tub folliculitis, superinfections in chronic antibiotic-treated acne and infectious eczematoid dermatitis are examples of mild cutaneous infections due to Pseudomonas aeruginosa. These may occur in otherwise healthy persons. In persons with lowered resistance, more severe infections such as malignant otitis externa, blastomycosis-like pyoderma and necrotizing fasciitis are observed. Ecthyma gangrenosum, the pathognomonic skin sign of Pseudomonas septicemia, occurs in debilitated or terminally ill patients and must be treated immediately.
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Peripheral nerve entrapment syndromes must be identified early through careful clinical examination and appropriate diagnostic studies. These neuropathies cause significant pain and disability, but the impairment of nerve function is usually reversible in the early stages. Electromyography and nerve conduction studies are helpful in the differential diagnosis and in localizing the site of entrapment. The carpal tunnel is the most common site of median nerve entrapment, and the cubital tunnel is the most frequent site of ulnar nerve compression.
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American family physician · Oct 1983
Case ReportsNeurogenic claudication due to pseudospondylolisthesis.
Pseudospondylolisthesis is a subluxation of the lumbar vertebrae due to incompetent facet joints. The resulting stenosis of the lumbar spinal canal may impinge on the nerve roots of the cauda equina and induce neurogenic claudication. This syndrome is difficult to distinguish clinically from lower extremity claudication of vascular etiology. Accurate diagnosis requires radiographic examination of the spine.
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The diagnosis of alcoholic coma is made only when there is a high blood alcohol level and signs of bilateral cortical dysfunction, without focal neurologic signs, and when all other metabolic and structural causes of coma have been ruled out. The ethanol-induced hypoglycemic coma of youth appears to result from the failure of gluconeogenesis to release glucose into the bloodstream. If the hypoglycemia is not immediately corrected, permanent and possibly lethal brain damage will result.
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Henoch-Schönlein purpura commonly occurs in children at about age five. There is no known etiologic agent. ⋯ Although there is no specific treatment, steroids may help prevent serious gastrointestinal complications. Prognosis is good, except for those patients with advancing renal disease.