Medicine
-
Case Reports
Fatal pulmonary infection with respiratory syncytial virus in an immunocompromised adult patient: A case report.
Respiratory syncytial virus (RSV) is a single-stranded negative-sense RNA virus that belongs to the family of paramyxoviruses. RSV is the most common pathogen that causes acute lower respiratory tract infection in infants and young children. However, its incidence in immunocompromised adults remains unclear. In the present study, we report an adult patient with chronic nephropathy, who received long-term immunosuppressants and died of rapid respiratory failure due to RSV infection. ⋯ RSV infection should be fully considered in adults who are immunocompromised or have underlying diseases, such as nephropathy patients receiving long-term immunosuppressants, especially in the presence of respiratory symptoms and computed tomography (CT) chest findings of diffuse ground-glass opacities.
-
Observational Study
Desmoplastic melanoma versus spindle cell melanoma: Incidence and survival, 1973 to 2017.
Desmoplastic melanoma (DM) and spindle cell melanoma (SCM) are 2 rare subtypes of melanoma. This study aims to investigate these 2 melanomas comprehensively by comparison. Cases were identified in the Surveillance, Epidemiology, and End Results (SEER) database (1973-2017). ⋯ The chance of DSS and OS of SCM were significantly higher comparing to DM for female patients (HR = 1.268, for OS; HR = 1.711, for DSS), patients age ≤65 years (HR = 1.290, for OS; HR = 1.638, for DSS), No-Spanish-Hispanic-Latino patients (HR = 1.098, for OS; HR = 1.426, for DSS), patients with skin tumor (HR = 1.174; for OS; HR = 1.444; for DSS) and patients who received surgery (HR = 1.091; for OS; HR = 1.398, for DSS). DM and SCM mostly occurred in white people' skin at 60 to 80 years old and eye and orbit was another most affected site for SCM. SCM had slightly higher occurrence in women and the risk of DSS and OS were significantly higher comparing to DM depending on the women, patients age ≤65 years, patients with skin tumor, No-Spanish-Hispanic-Latino patients and patients who received surgery.
-
Spontaneous and repeated hepatic ruptures caused by hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome are uncommon but life-threatening conditions that rarely occur early in the second trimester of pregnancy. ⋯ HELLP syndrome without hypertension and the recurrence of an intrahepatic rupture at an extremely premature gestational age are rare. This patient's findings suggested HELLP syndrome, which was subsequently diagnosed. This patient's clinical course highlights the difficult decisions made by clinicians for mothers and fetuses.
-
Hansen disease is an infectious chronic disease with various clinical manifestations. Its joint performance may easily mimic rheumatoid arthritis. ⋯ The correct diagnosis of Hansen disease involving joints depends on the combination of medical history, careful physical examination, and laboratory examination.