Southern medical journal
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Southern medical journal · Mar 1999
Case ReportsNear fatal acute respiratory distress syndrome in a patient with human ehrlichiosis.
Human ehrlichiosis is not a common cause of acute respiratory distress syndrome (ARDS). Physicians should be aware of this life-threatening but treatable entity. ⋯ We describe a case of ARDS resulting from human ehrlichiosis. A unique feature in our case was that despite the early use of doxycycline, the patient had near fatal ARDS that responded dramatically to high doses of steroids.
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Southern medical journal · Mar 1999
ReviewColorectal cancer screening: an overview of available methods and current recommendations.
Screening asymptomatic persons for colorectal cancer may decrease the incidence and mortality of this disease. ⋯ Colorectal cancer is a common malignancy in the United States, is curable when detected at an early stage, and is potentially preventable. The acceptance of colorectal cancer screening by patients and physicians has been suboptimal. while there remains little debate about the potential for screening to reduce mortality from colorectal cancer, debate continues about the cost-effectiveness of colorectal cancer screening when applied to the general population.
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Southern medical journal · Mar 1999
Case ReportsEhrlichiosis with severe pulmonary manifestations despite early treatment.
It is generally thought that if patients with ehrlichiosis are treated promptly, life-threatening illness can be avoided. We report a patient who sought medical attention 1 day after the onset of symptoms, was immediately given doxycycline, and still had serious illness with generalized edema, pulmonary infiltrates, acute respiratory distress syndrome, and noncardiogenic pulmonary edema, while receiving replacement intravenous fluids. This case alerts physicians to the serious end of the disease spectrum that can occur even though patients are given prompt, appropriate drug treatment at the onset of illness. Further studies are needed to clearly define the mechanisms involved in pulmonary complications and generalized edema, including noncardiogenic pulmonary edema, in patients with ehrlichiosis.
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Southern medical journal · Mar 1999
Case ReportsPurulent pericarditis misdiagnosed as septic shock.
Septic shock is common, with approximately 200,000 cases recognized annually. This syndrome is so well characterized that when a patient is febrile and in shock, septic shock may be diagnosed without regard to alternative possibilities. Purulent pericarditis is a relatively rare disorder in which fever and hypotension are common. Classic signs and symptoms, such as chest pain, pericardial friction rub, pulsus paradoxus, and elevation of jugular venous pressure, are seen in only 50%. ⋯ Consideration of purulent pericarditis is important in cases diagnosed as septic shock. Clinicians should be aware that patients with purulent pericarditis may not exhibit classic signs and symptoms, and a high index of suspicion is necessary for appropriate management.
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Southern medical journal · Mar 1999
Comparison of internal medicine, pediatric, and medicine/pediatrics applicants and factors influencing career choices.
A reemergence of medical students choosing primary care is occurring, with medicine/pediatrics as an increasingly popular option. We compared applicants to pediatrics, medicine, and medicine/pediatrics and the factors that influence career choice. ⋯ Differences in applicants applying to primary care programs may be used to target particular applicants and to counsel medical students on career choice.