DOCSLIB.ORG

2012 CDC Case Definitions

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
2012 CDC Case Definitions 2012 Nationally Notifiable Diseases and Conditions and Current Case Definitions Prepared by: The Division of Notifiable Diseases and Healthcare Information (proposed) Public Health Surveillance and Informatics Program Office (proposed) Office of Surveillance Epidemiology and Laboratory Services Centers for Disease Control and Prevention Case Definitions based upon CSTE Position Statements available at www.CSTE.org Suggested Citation 2012 Case Definitions: Nationally Notifiable Conditions Infectious and Non-Infectious Case. (2012). Atlanta, GA: Centers for Disease Control and Prevention 2 Index Nationally Notifiable Infectious and Non-Infectious Conditions Infectious Conditions Anthrax Arboviral neuroinvasive and non-neuroinvasive diseases • California serogroup virus disease • Eastern equine encephalitis virus disease • Powassan virus disease • St. Louis encephalitis virus disease • West Nile virus disease • Western equine encephalitis virus disease Babesiosis Botulism • Botulism, foodborne • Botulism, infant • Botulism, other (wound & unspecified) Brucellosis Campylobacteriosis Chancroid Chlamydia trachomatis infection Cholera Coccidioidomycosis Cryptosporidiosis Cyclosporiasis Dengue • Dengue Fever • Dengue Hemorrhagic Fever • Dengue Shock Syndrome Diphtheria Ehrlichiosis/Anaplasmosis • Ehrlichia chaffeensis • Ehrlichia ewingii • Anaplasma phagocytophilum • Undetermined Free-living Amebae, Infections caused by Giardiasis Gonorrhea Haemophilus influenzae, invasive disease Hansen disease (leprosy) Hantavirus pulmonary syndrome Hemolytic uremic syndrome, post-diarrheal 3 Hepatitis • Hepatitis A, acute • Hepatitis B, acute • Hepatitis B, chronic • Hepatitis B virus, perinatal infection • Hepatitis C, acute • Hepatitis C, past or present HIV infection (AIDS has been reclassified as HIV stage III) • HIV infection, adult/ adolescent (age > = 13 years) • HIV infection, child (age >= 18 months and < 13 years) • HIV infection, pediatric (age < 18 months) Influenza-associated hospitalizations Influenza-associated pediatric mortality Legionellosis Listeriosis Lyme disease Malaria Measles Melioidosis Meningococcal disease Mumps Novel influenza A virus infections Pertussis Plague Poliomyelitis, paralytic Poliovirus infection, nonparalytic Psittacosis Q Fever • Acute • Chronic Rabies • Rabies, animal • Rabies, human Rubella (German Measles) Rubella, congenital syndrome Salmonellosis Severe Acute Respiratory Syndrome-associated Coronavirus (SARS-CoV) disease Shiga toxin-producing Escherichia coli (STEC) Shigellosis Smallpox Spotted Fever Rickettsiosis Streptococcal toxic-shock syndrome Streptococcus pneumoniae, invasive disease 4 Syphilis • Primary • Secondary • Latent • Early latent • Late latent • Latent, unknown duration • Neurosyphilis • Late, non-neurological • Stillbirth • Congenital Tetanus Toxic-shock syndrome (other than Streptococcal) Trichinellosis (Trichinosis) Tuberculosis Tularemia Typhoid fever Vancomycin - intermediate Staphylococcus aureus (VISA) Vancomycin - resistant Staphylococcus aureus (VRSA) Varicella (morbidity) Varicella (deaths only) Vibriosis Viral Hemorrhagic Fevers, due to: • Ebola virus • Marburg virus • Crimean-Congo Hemorrhagic Fever virus • Lassa virus • Lujo virus • New world arenaviruses (Gunarito, Machupo, Junin, and Sabia viruses) Yellow fever Nationally Notifiable Non-Infectious Conditions Cancer Elevated blood lead levels • Child (<16 years) • Adult (≥16 Years) Foodborne disease outbreak Pesticide-related illness, acute Silicosis Waterborne disease outbreak 5 Anthrax (Bacillus anthracis) 2010 Case Definition CSTE Position Statement Number: 09-ID-10 Clinical description Cutaneous Anthrax: An acute illness, or post-mortem examination revealing a painless skin lesion developing over 2 to 6 days from a papular through a vesicular stage into a depressed black eschar with surrounding edema. Fever, malaise and lymphadenopathy may accompany the lesion. Inhalation Anthrax: An acute illness, or post-mortem examination revealing a prodrome resembling a viral respiratory illness, followed by hypoxia, dyspnea or acute respiratory distress with resulting cyanosis and shock. Radiological evidence of mediastinal widening or pleural effusion is common. Gastrointestinal Anthrax: An acute illness, or post-mortem examination revealing severe abdominal pain and tenderness, nausea, vomiting, hematemesis, bloody diarrhea, anorexia, fever, abdominal swelling and septicemia. Oropharyngeal Anthrax: An acute illness, or post-mortem examination revealing a painless mucosal lesion in the oral cavity or oropharynx, with cervical adenopathy, edema, pharyngitis, fever, and possibly septicemia. Meningeal Anthrax: An acute illness, or post-mortem examination revealing fever, convulsions, coma, or meningeal signs. Signs of another form will likely be evident as this syndrome is usually secondary to the above syndromes. Case classification Suspected An illness suggestive of one of the known anthrax clinical forms. No definitive, presumptive, or suggestive laboratory evidence of B. anthracis, or epidemiologic evidence relating it to anthrax. Probable A clinically compatible illness that does not meet the confirmed case definition, but with one of the following: • Epidemiological link to a documented anthrax environmental exposure; 6 • Evidence of B. anthracis DNA (for example, by LRN-validated polymerase chain reaction) in clinical specimens collected from a normally sterile site (such as blood or CSF) or lesion of other affected tissue (skin, pulmonary, reticuloendothelial, or gastrointestinal); • Positive result on testing of clinical serum specimens using the Quick ELISA Anthrax-PA kit; • Detection of Lethal Factor (LF) in clinical serum specimens by LF mass spectrometry • Positive result on testing of culture from clinical specimens with the RedLine Alert test. Confirmed A clinically compatible illness with one of the following: • Culture and identification of B. anthracis from clinical specimens by the Laboratory Response Network (LRN); • Demonstration of B. anthracis antigens in tissues by immunohistochemical staining using both B. anthracis cell wall and capsule monoclonal antibodies; • Evidence of a four-fold rise in antibodies to protective antigen between acute and convalescent sera or a fourfold change in antibodies to protective antigen in paired convalescent sera using Centers for Disease Control and Prevention (CDC) quantitative anti- PA IgG ELISA testing; • Documented anthrax environmental exposure AND evidence of B. anthracis DNA (for example, by LRN-validated polymerase chain reaction) in clinical specimens collected from a normally sterile site (such as blood or CSF) or lesion of other affected tissue (skin, pulmonary, reticuloendothelial, or gastrointestinal). 7 Arboviral neuroinvasive and non­ neuroinvasive diseases 2011 Case Definition CSTE Position Statement Numbers: 10-ID-18, 10-ID-20, 10-ID-21, 10-ID-22, 10-ID-23, 10-ID-24 Subtypes • California Serogroup Viruses, (i.e., California encephalitis, Jamestown Canyon, Keystone, La Crosse, Snowshoe hare, and Trivittatus viruses) • Eastern Equine Encephalitis Virus • Powassan Virus • St. Louis Encephalitis Virus • West Nile Virus • Western Equine Encephalitis Virus Background Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes, ticks, sand flies, or midges. Other modes of transmission for some arboviruses include blood transfusion, organ transplantation, perinatal transmission, consumption of unpasteurized dairy products, breast feeding, and laboratory exposures. More than 130 arboviruses are known to cause human disease. Most arboviruses of public health importance belong to one of three virus genera: Flavivirus, Alphavirus, and Bunyavirus. Clinical description Most arboviral infections are asymptomatic. Clinical disease ranges from mild febrile illness to severe encephalitis. For the purposes of surveillance and reporting, based on their clinical presentation, arboviral disease cases are often categorized into two primary groups: neuroinvasive disease and non-neuroinvasive disease. Neuroinvasive disease Many arboviruses cause neuroinvasive disease such as aseptic meningitis, encephalitis, or acute flaccid paralysis (AFP). These illnesses are usually characterized by the acute onset of fever with stiff neck, altered mental status, seizures, limb weakness, cerebrospinal fluid (CSF) pleocytosis, or abnormal neuroimaging. AFP may result from anterior ("polio") myelitis, peripheral neuritis, or post- infectious peripheral demyelinating neuropathy (i.e., Guillain-Barré syndrome). Less common neurological manifestations, such as cranial nerve palsies, also occur. Non-neuroinvasive disease 8 Most arboviruses are capable of causing an acute systemic febrile illness (e.g., West Nile fever) that may include headache, myalgias, arthralgias, rash, or gastrointestinal symptoms. Rarely, myocarditis, pancreatitis, hepatitis, or ocular manifestations such as chorioretinitis and iridocyclitis can occur. Clinical criteria for diagnosis Arboviral Diseases, Neuroinvasive and Non-Neuroinvasive A clinically compatible case of arboviral disease is defined as follows: Neuroinvasive disease • Fever (≥100.4°F or 38°C) as reported by the patient or a health-care provider, AND • Meningitis, encephalitis, acute flaccid paralysis, or other acute signs of central or peripheral neurologic dysfunction, as documented by a physician, AND • Absence of a more likely clinical explanation. Non-neuroinvasive disease • Fever (≥100.4°F or 38°C)
Load more

Recommended publications
  • Sexually Transmitted Disease (STD) Case Definitions (Source: Centers for Disease Control and Prevention
    Sexually Transmitted Disease (STD) Case Definitions (Source: Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance, 1997. MMWR Morb Mortal Wkly Rep. 1997;46(No. RR-10).) STD Conditions Reportable in Arizona Chancroid (Revised 9/96) Clinical description A sexually transmitted disease characterized by painful genital ulceration and inflammatory inguinal adenopathy. The disease is caused by infection with Haemophilus ducreyi. Laboratory criteria for diagnosis Isolation of H. ducreyi from a clinical specimen Case classification Probable: a clinically compatible case with both a) no evidence of Treponema pallidum infection by darkfield microscopic examination of ulcer exudate or by a serologic test for syphilis performed ≥7 days after onset of ulcers and b) either a clinical presentation of the ulcer(s) not typical of disease caused by herpes simplex virus (HSV) or a culture negative for HSV. Confirmed: a clinically compatible case that is laboratory confirmed Chlamydia Infection (Revised 6/09) Clinical description Infection with Chlamydia trachomatis may result in urethritis, epididymitis, cervicitis, acute salpingitis, or other syndromes when sexually transmitted; however, the infection is often asymptomatic in women. Perinatal infections may result in inclusion conjunctivitis and pneumonia in newborns. Other syndromes caused by C. trachomatis include lymphogranuloma venereum (see Lymphogranuloma Venereum) and trachoma. Laboratory criteria for diagnosis Isolation of C. trachomatis
    [Show full text]
  • WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA).
    [Show full text]
  • 2012 Case Definitions Infectious Disease
    Arizona Department of Health Services Case Definitions for Reportable Communicable Morbidities 2012 TABLE OF CONTENTS Definition of Terms Used in Case Classification .......................................................................................................... 6 Definition of Bi-national Case ............................................................................................................................................. 7 ------------------------------------------------------------------------------------------------------- ............................................... 7 AMEBIASIS ............................................................................................................................................................................. 8 ANTHRAX (β) ......................................................................................................................................................................... 9 ASEPTIC MENINGITIS (viral) ......................................................................................................................................... 11 BASIDIOBOLOMYCOSIS ................................................................................................................................................. 12 BOTULISM, FOODBORNE (β) ....................................................................................................................................... 13 BOTULISM, INFANT (β) ...................................................................................................................................................
    [Show full text]
  • Diagnostic Issues in Systemic Lupus Erythematosis
    266 Postgrad Med J 2001;77:266–285 Postgrad Med J: first published as 10.1136/pmj.77.906.268 on 1 April 2001. Downloaded from SELF ASSESSMENT QUESTIONS Diagnostic issues in systemic lupus erythematosis N Sofat, C Higgens Answers on p 274. A 24 year old woman was diagnosed with sys- (4) What other tests (apart from 24 hour urine temic lupus erythematosis (SLE) based on a creatinine clearance) are available to measure few months’ history of a photosensitive skin the glomerular filtration rate? rash, predominantly on her face, arthralgia The patient had a 24 hour urinary protein col- involving both hands and wrists, a positive lection, which showed a 24 hour protein measure- antinuclear antibody (ANA) test and a raised ment of 1.8 g. There was no evidence of cellular antinative double stranded DNA antibody casts on urine microscopy. Her blood results were binding level. She was treated with oral as below (normal values are in parentheses): hydroxychloroquine 400 mg daily and short x Sodium 134 mmol/l (135–145) courses of prednisolone during flare-ups. x Potassium 4.5 mmol/l (3.5–5.0) She was reviewed in clinic for her regular x Urea 7.0 mmol/l (2.5–6.7) follow up appointment when she was found to x Creatinine 173 µmol/l (70–115) be hypertensive on repeated measurements of x Haemoglobin 108 g/l (115–160) her blood pressure, an average value being x White cell count 4.5 × 109/l (4.0–11.0) 150/90 mm Hg. She was also urine dipstick x Platelets 130 × 109/l (150–400) positive for blood and protein.
    [Show full text]
  • Ear-Nose-Throat Manifestations in Inflammatory Bowel Diseases ANNALS of GASTROENTEROLOGY 2007, 20(4):265-274X Xx 265X
    xx xx Ear-nose-throat manifestations in Inflammatory Bowel Diseases ANNALS OF GASTROENTEROLOGY 2007, 20(4):265-274x xx 265x Review Ear-nose-throat manifestations in Inflammatory Bowel Diseases C.D. Zois, K.H. Katsanos, E.V. Tsianos going activation of the innate immune system driven by SUMMARY the presence of luminal flora. Both UC and CD have a Inflammatory bowel diseases (IBD) refer to a group of chron- worldwide distribution and are common causes of mor- ic inflammatory disorders involving the gastrointestinal tract bidity in Western Europe and northern America. and are typically divided into two major disorders: Crohn’s The extraintestinal manifestasions of IBD, however, disease (CD) and ulcerative colitis (UC). CD is characterized are not of less importance. In some cases they are the first by noncontiguous chronic inflammation, often transmural clinical manifestation of the disease and may precede the with noncaseating granuloma formation. It can involve any onset of gastrointestinal symptoms by many years, playing portion of the alimentary tract and CD inflammation has of- also a very important role in disease morbidity. As multi- ten been described in the nose, mouth, larynx and esopha- systemic diseases, IBD, have been correlated with many gus in addition to the more common small bowel and colon other organs, including the skin, eyes, joints, bone, blood, sites. UC differs from CD in that it is characterized by con- kidney, liver and biliary tract. In addition, the inner ear, tiguous chronic inflammation without transmural involve- nose and throat should also be considered as extraintesti- ment, but extraintestinal manifestations of UC have also been nal involvement sites of IBD.
    [Show full text]
  • Relapsing Polychondritis
    Relapsing polychondritis Author: Professor Alexandros A. Drosos1 Creation Date: November 2001 Update: October 2004 Scientific Editor: Professor Haralampos M. Moutsopoulos 1Department of Internal Medicine, Section of Rheumatology, Medical School, University of Ioannina, 451 10 Ioannina, GREECE. [email protected] Abstract Keywords Disease name and synonyms Diagnostic criteria / Definition Differential diagnosis Prevalence Laboratory findings Prognosis Management Etiology Genetic findings Diagnostic methods Genetic counseling Unresolved questions References Abstract Relapsing polychondritis (RP) is a multisystem inflammatory disease of unknown etiology affecting the cartilage. It is characterized by recurrent episodes of inflammation affecting the cartilaginous structures, resulting in tissue damage and tissue destruction. All types of cartilage may be involved. Chondritis of auricular, nasal, tracheal cartilage predominates in this disease, suggesting response to tissue-specific antigens such as collagen II and cartilage matrix protein (matrillin-1). The patients present with a wide spectrum of clinical symptoms and signs that often raise major diagnostic dilemmas. In about one third of patients, RP is associated with vasculitis and autoimmune rheumatic diseases. The most commonly reported types of vasculitis range from isolated cutaneous leucocytoclastic vasculitis to systemic polyangiitis. Vessels of all sizes may be affected and large-vessel vasculitis is a well-recognized and potentially fatal complication. The second most commonly associated disorder is autoimmune rheumatic diseases mainly rheumatoid arthritis and systemic lupus erythematosus . Other disorders associated with RP are hematological malignant diseases, gastrointestinal disorders, endocrine diseases and others. Relapsing polychondritis is generally a progressive disease. The majority of the patients experience intermittent or fluctuant inflammatory manifestations. In Rochester (Minnesota), the estimated annual incidence rate was 3.5/million.
    [Show full text]
  • Emtree Terms Changed in May 2018
    Emtree Terms Changed in May 2021 1 Emtree Terms Added and Changed (May 2021) This is an overview of new terms added and changes made in the second Emtree release in 2021. Overall, Emtree has grown by 1150 preferred terms (140 drug terms and 1010 non-drug terms) compared with the previous version released in January 2021. In total Emtree now counts 90095 preferred terms. Because the terms added include replacements for existing preferred terms (which become synonyms of the new terms) as well as completely new concepts, the number of terms added exceeds the net growth in Emtree. Other changes could include the merging of two or more existing preferred terms into a single concept. The terms added and changed are summarized below and specified in detail on the following pages. Emtree Terms Added in May 2021 1228 new terms (including 78 replacement terms and promoted synonyms) have been added to Emtree as preferred terms in version May 2021 (compared to January 2021): ◼ 179 drug terms (terms assigned to the Chemicals and Drugs facet). ◼ 1049 non-drug terms (terms not assigned as Chemicals and Drugs). The new terms (including the replacement terms and the promoted synonyms) are listed as Terms Added on the following pages. Note that many of these terms will have been indexed prior to 2021 (typically as candidate terms), sometimes for several years, before they were added to Emtree. Emtree Terms Changed in May 2021 78 terms (39 drug terms and 39 non-drug terms) from Emtree January 2020 have been replaced by 76 different terms in May 2021 (39 drug terms and 37 non-drug terms).
    [Show full text]
  • Autoimmune PUK Is Usually Unilateral and Sectoral
    1 Q Concerning PUK circumferential Autoimmune PUK is usually unilaterallaterality and sectoralextent . 2 A Concerning PUK Autoimmune PUK is usually unilateral and sectoral 3 Concerning PUK Autoimmune PUK 4 Q Concerning PUK Autoimmune PUK is usually unilateral and sectoral improvement vs It often heralds exacerbationworsening of systemic disease 5 A Concerning PUK Autoimmune PUK is usually unilateral and sectoral It often heralds exacerbation of systemic disease 6 Q Concerning PUK With what general category of autoimmune dz is PUK associated? Autoimmune PUKConnective-tissue is usually dz, unilateral especially vasculitides and sectoral It often heralds exacerbation of systemic disease 7 A Concerning PUK With what general category of autoimmune dz is PUK associated? Autoimmune PUKConnective-tissue is usually dz, unilateral especially vasculitides and sectoral It often heralds exacerbation of systemic disease 8 Q Concerning PUK With what general category of autoimmune dz is PUK associated? Autoimmune PUKConnective-tissue is usually dz, unilateral especially vasculitides and sectoral It often heralds exacerbation of systemic disease With which connective-tissue diseases (CTDs) and/or vasculitides has PUK been associated? Pretty much all of them Which three conditions are most likely to present with PUK? Rheumatoid arthritis, Wegener’s granulomatosis, and polyarteritis nodosa If a PUK pt does not carry a CTD/autoimmune diagnosis, what should the ophthalmologist do? Initiate a diagnostic workup (or promptly arrange for a rheumatologist
    [Show full text]
  • Repair of Nasal Deformity Secondary to Congenital Syphilis Through a Coronal Incision
    RepairRepair ofof NasalNasal DeformityDeformity SecondarySecondary toto CongenitalCongenital SyphilisSyphilis ThrouThroughgh aa CoronalCoronal IncisionIncision Angela C. Tsai, BA Jeffrey H. Spiegel, MD, FACS Department of Otolaryngology – Head and Neck Surgery, Boston University School of Medicine, Boston, MA ABSTRACTABSTRACT INTRODUCTIONINTRODUCTION METHODSMETHODS RESULTSRESULTS DISCUSSIONDISCUSSION Objective: Challenges Calvarial bone graft was harvested from the left Patient had significant restoration of his nasal Open Rhinoplasty 1. Describe a novel approach for repair of Underlying defect in the saddle nose is decreased parietal region (see Figure 4). dorsum and greatly improved appearance. (See Although it provides optimal exposure and facilitates saddle nose deformity. septal support resulting in collapse of the nasal dorsum. Graft was then fashioned into a “v” shape that could Figures 2 and 3). precise technique, open rhinoplasty may: 2. Provide an alternative technique for saddle Saddle nose deformity poses various functional and aesthetic rest on the maxillary bone and mimic the native nasal The “tenting” effect provided by the calvarial bones require more extensive dissection and hence nose repair through a coronal incision. 13 challenges, including: bones. resulted in significant improvement in his nasal longer intraoperative time lead to more scar tissue contraction Methods: -nasal obstruction Graft was secured with titanium microplates and airway. -flattened dorsum screws (see Figure 5). The degree of dorsal projection was somewhat cause transcolumellar scarring other complications Literature review and description of a novel -pseudohump Prior to constructing the calvarial bone graft, the soft limited by the amount of soft tissue available, repair of saddle nose deformity in a 39 year old -low tip projection tissue envelope overlying the nasal dorsum was but a highly satisfactory result was achieved.
    [Show full text]
  • Aseptic Meningitis in Relapsing Polychondritis: a Case Report and Literature Review
    Clin Rheumatol DOI 10.1007/s10067-017-3616-7 CASE BASED REVIEW Aseptic meningitis in relapsing polychondritis: a case report and literature review Kai Shen1 & Geng Yin2 & Chenlu Yang1 & Qibing Xie3 Received: 28 December 2016 /Revised: 14 February 2017 /Accepted: 25 March 2017 # International League of Associations for Rheumatology (ILAR) 2017 Abstract Aseptic meningitis is an extremely rare neurologic Introduction complication of relapsing polychondritis (RP). We reported a case of a 58-year-old Chinese female with intractable head- Relapsing polychondritis (RP) is a rare and potentially lethal ache, puffy ears, pleocytosis, and cranial magnetic resonance autoimmune disorder, characterized by recurrent bouts of in- imaging (MRI) showing thickened and enhanced meninges. flammation and destruction of cartilaginous and other She was finally diagnosed of aseptic meningitis due to RP proteoglycan-rich tissues with ears, nose, larynx, and tracheo- after full exclusion of infectious causes. She gradually devel- bronchial tree most commonly involved [1]. Both younger and oped neurosensory hearing loss, vertigo, and saddle nose senile patients can be affected by RP with an incidence of 3.5/ while glucocorticosteroid therapy and combined cyclophos- 100,000 in the USA each year [2]. RP as a systemic disease can phamide could not control her headache. Ultimately, cyclo- also be present with polyarthritis, ocular inflammation, skin sporin Awas tried showing a good response. Only 18 previous lesions, cadiac valvular incompetence, renal diseases, and vas- cases were found in the literature and the clinical manifesta- culitis. Only approximately 3% of RP patients have neurologic tion, cerebrospinal fluid (CSF) characteristics, imaging fea- involvement. Heterogeneous manifestations including palsies tures, and therapy considerations of RP-related aseptic men- of cranial nerves, polyneuritis, meningoencephalitis, hemiple- ingitis were summarized by reviewing the literature.
    [Show full text]
  • Difficulties in Diagnosing and Treating Nasal Rhinoscleroma: a Case Study Trudności W Diagnostyce I Leczeniu Twardzieli Błony Śluzowej Nosa – Opis Przypadku
    Clinical cases Difficulties in diagnosing and treating nasal rhinoscleroma: A case study Trudności w diagnostyce i leczeniu twardzieli błony śluzowej nosa – opis przypadku Paweł Poniatowski1,A–F, Klaudiusz Łuczak1,B,D,F, Kamil Nelke2,B,D–F 1 Department of Maxillo-Facial Surgery, Wroclaw Medical University, Poland 2 Department of Maxillo-Facial Surgery, 4th Military Hospital, Wrocław, Poland A – research concept and design; B – collection and/or assembly of data; C – data analysis and interpretation; D – writing the article; E – critical revision of the article; F – final approval of the article Dental and Medical Problems, ISSN 1644-387X (print), ISSN 2300-9020 (online) Dent Med Probl. 2017;54(4):435–439 Address for correspondence Abstract Kamil Nelke E-mail: [email protected] For many years scleroma was considered to be a neoplastic tumor. First findings of this disease came from the 4th century. In the 18th century it was also called the leprosy of the nose. In 1840, a Polish surgeon was Funding sources None declared the first in the world to describe rhinoscleroma as a “chronic nose cancer”. In late 1877, Jan Mikulicz-Radecki classified this scleroma as rhinoscleroma, an inflammatory disease with the most common occurrence in Conflict of interest the nasal cavity. Because of very rare cases of this disease reported nowadays (endemic), its treatment is None declared challenging. The disease manifests itself as a symptomatic mass causing mostly an obstruction of nasal breathing or even local nose bleeds, and infiltrates the surrounding structures of the nose and sinuses. Received on June 13, 2017 Difficult accurate clinical diagnosis of this disease seems to be the main problem in its early detection and Reviewed on July 28, 2017 treatment.
    [Show full text]
  • Morbo Serpentino
    CLINICAL CARE CONUNDRUM Morbo Serpentino The approach to clinical conundrums by an expert clinician is revealed through the presentation of an actual patient’s case in an approach typical of a morning report. Similarly to patient care, sequential pieces of information are provided to the clinician, who is unfamiliar with the case. The focus is on the thought processes of both the clinical team caring for the patient and the discussant. This icon represents the patient’s case. Each paragraph that follows represents the discussant’s thoughts. Helene Møller Nielsen, MD1*, Shakil Shakar, MD1, Ulla Weinreich MD1, Mary Hansen MD2, Rune Fisker, MD3, Thomas E. Baudendistel, MD4, Paul Aronowitz MD5 1Department of Pulmonary Medicine, Aalborg University Hospital, Aalborg, Denmark; 2Department of Pathology, Aalborg University Hospital, Aal- borg, Denmark; 3Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark; 4Department of Medicine, Kaiser Permanente, Oakland, California; 5Department of Medicine, University of California, Davis, California. A 58-year-old Danish man presented to an urgent respectively, and to assess visual fields. An afferent pupillary care center due to several months of gradually wors- defect would suggest optic nerve pathology. ening fatigue, weight loss, abdominal pain, and changes in Disorders that could unify the constitutional, abdominal, vision. His abdominal pain was diffuse, constant, and and visual symptoms include systemic inflammatory diseas- moderate in severity. There was no association with meals, es, such as sarcoidosis (which has an increased incidence and he reported no nausea, vomiting, or change in bowel among Northern Europeans), tuberculosis, or cancer. While movements. He also said his vision in both eyes was blur- diabetes mellitus could explain his visual problems, weight ry, but denied diplopia and said the blurring did not im- loss, and fatigue, the absence of polyuria, polydipsia, or po- prove when either eye was closed.
    [Show full text]