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Rajadhyaksha, A.
- Plasmodium Vivax Malaria with Common and Carotid Artery Thrombosis and Antiphospolipid Antibody Syndrome-An Unusual Presentation
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Authors
Affiliations
1 Department of Medicine, Seth G.s. Medical College & Kem Hospital, Parel, Mumbai, IN
1 Department of Medicine, Seth G.s. Medical College & Kem Hospital, Parel, Mumbai, IN
Source
The Indian Practitioner, Vol 70, No 4 (2017), Pagination: 19-21Abstract
In recent years, the association between infection&anti-phospholipid antibody syndrome have been reported in several epidemiologic&experimental studies that support the idea of infectious induction of Anti-phospholipid Syndrome.(1)(2) Herein we report 72 yr premorbidly healthy male presented with P.vivax malaria with multi-organ dysfunction syndrome with ARDS. On 6th day of admission, he developed left side hemiplegia. MRI+MRA (BRAIN) showed Right ACA territory infarct&thrombosed right common&internal carotid artery thrombosis. Autoimmune work-up showed ACLA IgM; APLA IgM; β2-glycoprotein-1 IgM were highly significant titre [58.9 MPL/ml,58.3 U/ml,113.9 RU/ml respectively]. Infections like malaria triggering Anti-phospholipid antibody Syndrome has been described in paediatric age groups. So Plasmodium vivax malaria with hepatic involvement with ARDS with common&internal carotid thrombosis due to secondary APLA Syndrome in geriatric age group is very unusual presentation. We managed this patient with anti-malarials, supportive therapy, anti-coagulation with heparin followed by warfarin overlap with PT/INR monitoring.Keywords
P.Vivax Malaria, Anti-Phospholipid Antibody Syndrome, Carotid Artery Thrombosis.
References
- Cervera R, Asherson RA, Acevedo ML. Antiphospholipid syndrome associated with infections: clinical and microbiological characteristics of 100 patients. Ann Rheum Dis. 2004;63:1312-7.
- Avcin T, Toplak N. Antiphospholipid antibodies in response to infection. Curr Rheumatol Rep. 2007;9:212-8.
- Consigny PH, Cauquelin B, Agnamey P. High prevalence of co-factor independent anticardiolipin antibodies in malaria exposed individuals. Clin Exp Immunol. 2002;127:158-64.
- Tamaria KC, Agrawal S. Splenic infarction in P.vivax malaria. Journal of Indian Paed. 2013;50:886
- Sunil Taneja and Purvi Mittal. Splenic infarction in plasmodium vivax malaria INDIAN PEDIATRICS Volume 51; April 15;2014:320
- Facer CA, Agiostratidou G. High levels of antiphospholipid antibodies in uncomplicated and severe Plasmodium falciparum and in P. vivax malaria. Clin Exp Immunol. 1994;95(2):304–309.
- Young Patient with Right Sided Pleuro-Pancreatic Fistula-An Unusual Presentation
Abstract Views :236 |
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Authors
Affiliations
1 Dept. of Medicine, Seth G S Medical College & KEM Hospital, Mumbai, IN
1 Dept. of Medicine, Seth G S Medical College & KEM Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 70, No 8 (2017), Pagination: 28-30Abstract
Hydrothorax secondary to a pancreaticopleural fistula (PPF) is a rare complication of acute pancreatitis. In patients with a history of pancreatitis, diagnosis is made by detection of amylase in the pleural exudate. Imaging like CT&MRCP aids in the detection of pancreatic ductal disruption. Management includes thoracocentesis and pancreatic duct drainage or pancreatic resection procedures. We present a case of massive right hydrothorax secondary to a PPF due to recurrent acute pancreatitis. Patient was successfully managed by ERCP guided sphincterotomy with removal of stone followed by stenting of pancreatic duct.References
- N.A. Burgess, H.E. Moore, J.O. Williams, M.H. Lewis. A review of pancreatico-pleural fistula in pancreatitis and its management HPB Surg., Volume 5, Issue 2, 1991, pp. 79–86
- R. Materne, P. Vranckx, C. Pauls, E.E. Coche, P. Deprez, B.E. Van Beers Pancreaticopleural fistula: diagnosis with magnetic resonance pancreatography
- B.Y. Safadi, J.M. Marks Pancreatic pleural fistula: the role of ERCP in diagnosis and treatment Gastrointest. Endosc., Volume 51, 2000, pp. 213–215
- J.C. King, H.A. Reber, S. Shiraga, O.J. Hines Pancreaticopleural fistula is best managed by early operative intervention Surgery, Volume 147, Issue 1, 2010, pp. 154–159
- V. Villena, V. Pérez, F. Pozo, A. López-Encuentra, V. Echave-Sustaeta, J. Arenas, P. Martı́n Escribano Amylase levels in pleural effusions: A consecutive unselected series of 841 patients. Chest, Volume 121, 2002, pp. 470–474
- A.R.J. Girbes, P.E. Postmus, W. Jansen, E.J. vd Jaqt, J.H. Kleibeuker. An alcoholic with pleural effusion Eur. Respir. J., Volume 3, 1990, pp. 934–936
- Septic Arthritis and Deep Vein Thrombosis
Abstract Views :201 |
PDF Views:2
Authors
Affiliations
1 Dept of Medicine, Seth G S Medical College & KEM Hosptital, Parel, Mumbai-400012, IN
1 Dept of Medicine, Seth G S Medical College & KEM Hosptital, Parel, Mumbai-400012, IN
Source
The Indian Practitioner, Vol 70, No 9 (2017), Pagination: 46-47Abstract
Acute osteoarticular infections are common in children and rarely complicated with deep vein thrombosis (DVT). This complication can cause significant morbidity and may even be fatal. Herein we report a fourteen year boy presenting with left knee pain and fever since 1 week with acute onset shortness of breath on day of admission. A left lower extremity venous doppler showed deep vein thrombosis of left popliteal vein. MRI knee suggestive of osteomyelitis of left tibia. High-Resolution Computed Tomography showed multiple patchy areas of consolidation with cavitations suggestive of septic emboli. He required prolonged hospital admission and was managed with surgical debridement, antibiotics and anticoagulation.References
- Nelson Textbook of Pediatrics, Volumes 1; Chapter 479; page no 2394 By Robert M. Kliegman, Bonita F. Stanton, Joseph St. Geme, Nina Felice Schor, Richard E. Behrman.
- Review of Orthopaedic By Mark D. Miller, Stephen R. Thompson, Jennifer A. Hart; page no 283.
- K.L. Vander Have, B. Karmazyn, M. Verma, M.S. Caird, R.N. Hensinger, F.A. Farley, et al. Community-associated methicillin-resistant Staphylococcus aureus in acute musculoskeletal infection in children: a game changer J Pediatr Orthop, 29 (2009), pp. 927–931.
- A. Gorenstein, E. Gross, S. Houri, et al. The pivotal role of deep vein thrombophlebitis in the development of acute disseminated staphylococcal disease in children. Pediatrics 2000;106:e87.
- A. Gite, R. Trivedi, U.S. Ali. Deep vein thrombosis associated with osteomyelitis. IndPediatr 2008;45:418-9.
- G. Martinez-Aguilar, A. Avalos-Mishaan, K. Hulten, et al. Community-acquired, methicillinresistant and methicillinsusceptible Staphylococcus aureus musculoskeletal infections in children. Pediatr Infect Dis J 2004;23:701-6.
- Bocchini CE, Hulten KG, Mason EO, Jr., Gonzalez BE, Hammerman WA & Kaplan SL (2006) PantonValentine leukocidin genes are associated with enhanced inflammatory response and local disease in acute hematogenous Staphylococcus aureus osteomyelitis in children. Pediatrics 117(2): 433-40.
- C.D. Newgard, S.H. Inkelis, R. Mink Septic thromboembolism from unrecognized deep venous thrombosis in a child Pediatric Emerg Care, 18 (2002), pp. 192–196.
- A.H. Felman, S.T. Shulman Staphylococcal osteomyelitis, sepsis, and pulmonary disease. Observations of 10 patients with combined osseous and pulmonary infections Radiology, 117 (1975), pp. 649–655.
- Deep venous thrombosis in children with musculoskeletal infections: the clinical evidence. Mantadakis E, Plessa E, Vouloumanou EK, Michailidis L, Chatzimichael A, Falagas ME.Int J Infect Dis. 2012 Apr; 16(4):e236-43. Epub 2012 Feb 22.
- A Case of Rheumatoid Arthritis with Eosinophilia Associated With Seroconversion
Abstract Views :362 |
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Authors
Affiliations
1 Department of Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, IN
1 Department of Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, IN