2 research outputs found
Hemosuccus Pancreaticus in the Era of Capsule Endoscopy and Double Balloon Enteroscopy Complicated by Multifocal Mycobacterium chelonae/abscessus Infection
Hemosuccus pancreaticus is a rare etiology of obscure gastrointestinal bleeding characterized by bleeding into the pancreatic duct. The diagnosis may be delayed for months to years, due to the episodic nature of bleeding and failure to consider the diagnosis. Patients often undergo multiple endoscopies and radiologic evaluations prior to diagnosis. Incidental gastrointestinal findings may lead to unnecessary endoscopic and surgical interventions. This report describes a patient with hemosuccus pancreaticus diagnosed in the era of video capsule endoscopy and double balloon enteroscopy, whose management was complicated by multifocal Mycobacteria chelonae/abscessus infection
Brief Report - Atypical Manifestations of Typhoid Fever
BACKGROUND: High fever, toxaemia, constipation during first week of
fever, complicated by encephalopathy and perforation during third week
of fever are the typical manifestations of typhoid fever. However, the
classical presentation of typhoid fever has considerably changed now.
AIM: To study atypical presentations of typhoid fever. SETTING: A
teaching unit of a hospital in South India METHOD: All culture-positive
adult patients of typhoid fever admitted over a period of seven years
were studied RESULTS: Thirty-two adult patients were admitted. Fifteen
(46.9%) patients presented with atypical manifestations. Atypical
manifestations observed were burning micturition with normal urine
examination (n= 5, 15.6%) diarrhoea in first week (6.2%),
encephalopathy in first week (3.1%), isolated hepatomegaly (6.2%),
pneumonitis (3.1%) and bone marrow depression (6.2%). Out of 32
Salmonella typhi culture positive patients, 10 (31.3%) patients had
multidrug resistant (MDR) strain. Patients with MDR strains had
atypical manifestations (5/10=50%) not significantly more often than
patients having multidrug sensitive strains (10/22=45.5%) (Z <2).
All patients responded to treatment. CONCLUSION: It appears atypical
manifestations do not necessarily mean a worse prognosis in typhoid
fever. Patients having high fever presenting with pneumonia, early
encephalopathy, early diarrhoea or bone marrow depression in a typhoid
endemic area, should be suspected for this disease