Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Oct 2020
Case Reports[Quadruple negative SARS-CoV-2-PCR: still COVID-19 pneumonia!]
A 78-year-old man fell ill with weakness, coughing and fever 19 days after a cruise in early April 2020 and was admitted 4 days later with increasing shortness of breath. ⋯ In case of a high degree of clinical suspicion in combination with typical findings of thoracic imaging, the suspected diagnosis COVID-19 disease should be maintained even in case of multiple negative SARS-CoV-2-PCR. Seroconversion occurs a few days to 2 weeks after the onset of symptoms and can be used to confirm the diagnosis.
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Dtsch. Med. Wochenschr. · Oct 2020
Case Reports[Infection of the orbita due to Delftia acidovorans after a cat scratch].
A 60 years old woman experienced a cat scratch 34 months ago on the left eyelid. Chronic, progredient skin lesions and headache developed. Treatments with cortisone, pimecrolimus, pregabalin and metamizole were not successful. After 24 months the patient complained of severe bulbus pain in the left eye, increased eye movement pain, and high photosensitivity. There were granulomatous papules in the area of the eye. ⋯ D. acidovorans has not yet appeared as a zoonotic pathogen but should be included in the case of injury by animals in the differential diagnostic considerations.
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Peripheral arterial disease (PAD) of the upper extremity is much less frequent and aetiologically more heterogeneous than lower extremity PAD. The clinical approach to patients with upper extremity PAD must consider a range of distinctive features regarding symptoms, physical findings and diagnostic strategies. ⋯ Arteriosclerotic subclavian artery obstruction, large vessel vasculitis, thoracic outlet syndrome and secondary Raynaud's phenomenon are four pivotal causes and manifestations of upper extremity PAD. These four entities are exemplarily discussed.