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有 multiorgan 机能障碍的自发的败血症为 Pantoe agglomerans 的一张新面孔？

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Asian Pacific Journal of Tropical Medicine 2012年第1期5卷 83-84页

作者： Kushal Naha Ramamoorthi Mukhyaprana Prabhu Department of Medicine Kasturba HospitalManipal-576 104KarnatakaIndia

Pantoe agglomerans(***) is an unusual cause for sepsis in immunocompetent individuals,especially in the absence of characterislic risk *** report one such case occurring in a farmer,manifesting with severe *** severe nature of illness and the apparently spontaneous origin of septicemia underline the pathogenic potential of this organism. When coupled with the ubiquity of the organism,there is a definite possibility that this disease may become increasingly frequent in the near future,especially in agronomic countries like India,further studies on the epidemiology and natural history of this disease are required.

关键词： Pantoe agglomerans Spontaneous septicemia multi-organ dysfunction

Paraneoplastic syndromes in cholangiocarcinoma

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World Journal of Hepatology 2020年第11期12卷 897-907页

作者： Saad Ur Rahman Muhammad Khawar Sana Zabreen Tahir Aamir Ali Pir Ahmad Shah Department of Medicine King Edward Medical UniversityLahore 54000PunjabPakistan Department of Neurology Brigham and Women’s HospitalBostonMA 02115United States Department of Radiology Beth Israel Deaconess Medical CenterBostonMA 02215United States Department of Medicine University of Texas Health Science CenterSan AntonioTX 78229United States

Paraneoplastic syndromes are the symptoms or signs which result from damage to tissues that are distant from the site of malignancy,due to complex interactions between the body’s immune system and malignant ***(CCA)is an aggressive epithelial malignancy of hepatobiliary tree and it is found to be associated with various paraneoplastic *** syndromes can present as dermatological,neurological,renal,hematological,or multi-systemic *** suspicion and timely recognition of these syndromes can lead to early diagnosis of covert malignancies like *** management plan remains the removal of the underlying cause which in this case is CCA.

关键词： Cholangiocarcinoma Paraneoplastic syndrome Malignancy Immune system Biliary tree multi-organ

Predictive value of cytokines for developing complications after polytrauma

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World Journal of Critical Care Medicine 2016年第3期5卷 187-200页

作者： Anne-Britt E Dekker Pieta Krijnen Inger B Schipper Department of Trauma Surgery Leiden University Medical Center

AIM: To investigate posttraumatic cytokine alterations and their value for predicting complications and mortality in polytraumatized patients. METHODS: Studies on the use of specific cytokines to predict the development of complications and mortality were identified in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Of included studies, relevant data were extracted and study quality was ***: Forty-two studies published between 1988 and 2015 were identified, including 28 cohort studies and 14 "nested" case-control studies. Most studies investigated the cytokines interleukin(IL)-6, IL-8, IL-10 and tumor necrosis factor(TNF-a). IL-6 seems related to muliorgan dysfunction syndrome, multiorgan failure(MOF) and mortality; IL-8 appears altered in acute respiratory distress syndrome, MOF and mortality; IL-10 alterations seem to precede sepsis and MOF; and TNF-a seems related to MOF. CONCLUSION: Cytokine secretion patterns appear to be different for patients developing complications when compared to patients with uneventful posttraumatic course. More research is needed to strengthen the evidence for clinical relevance of these cytokines.

关键词： multiple trauma Cytokine Acute respiratory distress syndrome Sepsis Muli-organ dysfunction syndrome multi-organ failure

Severe scrub typhus infection: Clinical features, diagnostic challenges and management

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World Journal of Critical Care Medicine 2015年第3期4卷 244-250页

作者： John Victor Peter Thomas I Sudarsan John Anthony J Prakash George M Varghese Medical Intensive Care Unit Christian Medical College Department of Microbiology Christian Medical College Department of Infectious Diseases Christian Medical College

Scrub typhus infection is an important cause of acute undifferentiated fever in South East Asia. The clinical picture is characterized by sudden onset fever with chills and non-specific symptoms that include headache, myalgia, sweating and vomiting. The presence of an eschar, in about half the patients with proven scrub typhus infection and usually seen in the axilla, groin or inguinal region, is characteristic of scrub typhus. Common laboratory findings are elevated liver transaminases, thrombocytopenia and leukocytosis. About a third of patients admitted to hospital with scrub typhus infection have evidence of organ dysfunction that may include respiratory failure, circulatory shock, mild renal or hepatic dysfunction, central nervous system involvement or hematological abnormalities. Since the symptoms and signs are non-specific and resemble other tropical infections like malaria, enteric fever, dengue or leptospirosis, appropriate laboratory tests are necessary to confirm diagnosis. Serological assays are the mainstay of diagnosis as they are easy to perform; the reference test is the indirect immunofluorescence assay(IFA) for the detection of Ig M antibodies. However in clinical practice, the enzyme-linked immuno-sorbent assay is done due to the ease of performing this test and a good sensitivity and sensitivity when compared with the IFA. Paired samples, obtained at least two weeks apart, demonstrating a ≥ 4 fold rise in titre, is necessary for confirmation of serologic diagnosis. The mainstay of treatment is the tetracycline group of antibiotics or chloramphenicol although macrolides are used alternatively. In mild cases, recovery is complete. In severe cases with multi-organ failure, mortality may be as high as 24%.

关键词： Rickettsia Diagnosis Management Outcome multi-organ failure