J Rheumatol
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A case of Acremonium species arthritis in a previously healthy child is reported. This fungus has frequently been implicated in cases of mycetoma and keratomycosis in the tropics, and invasive disease has occurred almost exclusively in immunocompromised patients. The acute presentation of this illness and its successful treatment with IV amphotericin-B are highlighted to alert physicians to this pathogen.
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A 26-year-old man with acute leukemia, treated with chemotherapy, developed emphysematous septic arthritis, due to Streptococcus milleri, affecting the right knee and both shoulders. A review of the literature revealed that intraarticular gas formation is a rarely reported complication of septic arthritis. This could be the 2nd reported case of emphysematous septic arthritis due to S. milleri.
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Case Reports
Retropharyngeal hematoma as a new cause of acute upper airway obstruction in rheumatoid arthritis.
A patient with severe rheumatoid arthritis (RA) receiving chronic anticoagulation therapy developed acute life threatening airway obstruction. The source of obstruction was a retropharyngeal hematoma compressing the upper airway rather than acute laryngeal dysfunction from the patient's RA. Our case illustrates a new cause of acute stridor and airway obstruction in RA. Publications on upper airway obstruction in RA and airway obstruction secondary to retropharyngeal hematoma are discussed.
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Rheumatology training is essential for family practice residents, but major inadequacies have been described in current programs. In an effort to guide the design of our own rheumatology curriculum, all patient visits to a family health center over a 15-week period were surveyed. ⋯ Osteoarthritis and regional joint pain were the 2 most frequent problems noted, whereas systemic and inflammatory rheumatic diseases were unusual. Rheumatology curricula for family physicians should stress evaluation, management and prevention of problems in those defined areas.
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Case Reports
Mixed connective tissue disease with pulmonary hypertension: a clinical and pathological study.
Clinical and autopsy findings of 2 cases with mixed connective tissue disease (MCTD) associated with severe pulmonary hypertension are reported. Both cases showed marked intimal and medial thickening in small and medium sized pulmonary arteries. In one of the cases plexiform lesions, endarteritis obliterans, and fibrous intimal thickening of the pulmonary veins were recognized. In some cases with MCTD, pulmonary hypertension develops due to pulmonary vascular lesions which are similar to those of primary pulmonary hypertension.