The West Virginia medical journal
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Review Case Reports
Strongyloides hyperinfection syndrome complications: a case report and review of the literature.
Strongyloidiasis is a major global health challenge that is often underestimated in many countries. In immuno-compromised hosts, an autoinfection can go unchecked with large numbers of invasive Strongyloides larvae disseminating widely and causing hyperinfection, with fatal consequences. This review will highlight a case of gram negative bacteremia complicated by meningitis and Adult Respiratory Distress Syndrome (ARDS) as a fatal outcome of Strongyloides hyperinfection, commonly known to occur in the setting of immunosuppression. ⋯ The clinical course continued to deteriorate with the development of significant neurological dysfunction. Poor nutritional state and ventilator associated pneumonia contributed to this downward trend. After a detailed discussion with the family, life support was discontinued and the patient succumbed to her illness.
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Dog bites of the facial region are increasing in children according to the Center for Disease Control. To evaluate the epidemiology of such injuries in our medical provider region, we undertook a retrospective review of those children treated for facial, head and neck dog bite wounds at a level 1 trauma center. ⋯ Younger (under five years) children sustained more of the injuries requiring medical treatment. Injury Severity Scales were determined as well as victim and payer mix demographics, type and characteristics of injury, and complications from the attack.
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Case Reports
Superior mesenteric artery aneurysm: an uncommon disease with potentially serious complications.
Superior mesenteric artery aneurysms (SMAAs) are visceral arterial aneurysms that can result from a variety of conditions. About half of SMAAs are mycotic and occur subsequent to infective endocarditis. The clinical presentation of SMAA is nonspecific, and some patients may be asymptomatic while others may report mild to severe abdominal pain. ⋯ Although rare, SMAAs are associated with a high risk of death secondary to rupture. They are difficult to detect through physical examination and the history is usually nonspecific. In this report we discuss the etiology of SMAA, diagnostic work-up and treatment options aiming for early diagnosis and management of this potentially fatal condition.
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Leptospirosis, a zoonosis with protean manifestations caused by the spirochete Leptospira interrogans, occurs worldwide. We report a case of leptospirosis presenting as pulmonary alveolar hemorrhage in a young immunocompetent male. This organism should be considered as an important infectious cause of pulmonary alveolar hemorrhage in the appropriate epidemiological setting.