We read case report by Cullen et al and found it very interesting. It
was a successfully managed case however, I have certain queries regarding
management in the index case.
1. In a prenatally detected CPAM (previously known as CCAM) with
hydrops detected prior to 32 weeks, there is a well-defined role of
maternal steroids.(1) Even multiple courses of betamethasone can be tried.
Whether it was thought off in inde...
We read case report by Cullen et al and found it very interesting. It
was a successfully managed case however, I have certain queries regarding
management in the index case.
1. In a prenatally detected CPAM (previously known as CCAM) with
hydrops detected prior to 32 weeks, there is a well-defined role of
maternal steroids.(1) Even multiple courses of betamethasone can be tried.
Whether it was thought off in index case or not.
2. Instead of two-dimensional size, measurement of baseline, as well
as subsequent Cyst volume ratio (CVR), is a good indicator of progression/
resolution of the cyst.
References:
1. David M, Lamas-Pinheiro R, Henriques-Coelho T. Prenatal and Postnatal
Management of Congenital Pulmonary Airway Malformation. Neonatology. 2016
Apr 13;110(2):101-15.
1953 born I was never treated with antibiotics as child.
1985 a post-streptococcal-myocarditis was diagnosed in the University
-hospital Goettingen. Treatment with penicillin and oral penicillin-
prophylaxis. Many episodes of respiratory infections, complicated by
arrhythmias.
2004 atrial fibrillation.
2017, July 4., anticoagulation with heparin/coumarin changed the
intra-a...
1953 born I was never treated with antibiotics as child.
1985 a post-streptococcal-myocarditis was diagnosed in the University
-hospital Goettingen. Treatment with penicillin and oral penicillin-
prophylaxis. Many episodes of respiratory infections, complicated by
arrhythmias.
2004 atrial fibrillation.
2017, July 4., anticoagulation with heparin/coumarin changed the
intra-articular pressure at once: Less pain in hand and foot. A severe
polyneuropathy was caused by unknown agents (Could this be a post-
streptococcal-neuritis 2003, in the heat-wave of Southern France, combined
with severe Myocarditis.)
And so many of my patients, seen in 40 years, suffered from recurrent
rheumatic fever attacks. Very often penicillin V could change the disease.
We are all one.
Suffering from streptococcal-reactive diseases.
And penicillin/coumarin still is the best.
Cheap and good.
Thank you for your comments and review of our case. You raise an
interesting point regarding the connection between coniosis and
sarcoidosis. Mineral particles were not originally commented on in our
pathology samples, although the patient did not have characteristic
occupational exposures.
Thank you for your comments and review of our case. You raise an
interesting point regarding the connection between coniosis and
sarcoidosis. Mineral particles were not originally commented on in our
pathology samples, although the patient did not have characteristic
occupational exposures.
I just think useful some further diagnostic qualification starting
from the following description of the histological characterization of the
disease.
"Gastric biopsies revealed severe chronic active granulomatous
gastritis (figure 3). Additional studies from her gastric
biopsies,including gram stain, fungal stain and acid-fast stain, were
negative."
I just think useful some further diagnostic qualification starting
from the following description of the histological characterization of the
disease.
"Gastric biopsies revealed severe chronic active granulomatous
gastritis (figure 3). Additional studies from her gastric
biopsies,including gram stain, fungal stain and acid-fast stain, were
negative."
Possible to research and, if present, characterize mineral particles
inside the biopsed granulomas, following recent hypotheses interpreting
sarcoidosis like a peculiar form of coniosis ?
I have read the phenotype description of a child with aplasia cutis
congenita as well as transverse limb defects; although this association is
not common it is the presentation of Adams Oliver syndrome [OMIM 100300];
in this condition both manifestations are present and often the limb
defects resemble the damage caused by the amniotic band sequence. The
identification is important as patients with Adams Oliver have an
id...
I have read the phenotype description of a child with aplasia cutis
congenita as well as transverse limb defects; although this association is
not common it is the presentation of Adams Oliver syndrome [OMIM 100300];
in this condition both manifestations are present and often the limb
defects resemble the damage caused by the amniotic band sequence. The
identification is important as patients with Adams Oliver have an
identifiable genetic etiology as well as are at risk of further medical
issues ivcluding congenital heart defects; neuronal migration disorders;
ocular manifestations etc
Hello Mam,
I would gladly like to know that the site of metastasis was in the upper
extremity or in the lower extremity?
and if it was upper extremity then at what site?
This is a well written Case Report and helpfully describes some
pathology (as well as the phenomenon of S. aureus disease relapse). It
should be noted, however, that whilst the supporting evidence for i.v.
Linezolid is that it is non-inferior to Vancomycin, it is abundantly clear
in the literature that i.v. Vancomycin is wholly inferior to i.v.
Flucloxacillin. Regarding data on disc penetration, Gibson et al tested
this...
This is a well written Case Report and helpfully describes some
pathology (as well as the phenomenon of S. aureus disease relapse). It
should be noted, however, that whilst the supporting evidence for i.v.
Linezolid is that it is non-inferior to Vancomycin, it is abundantly clear
in the literature that i.v. Vancomycin is wholly inferior to i.v.
Flucloxacillin. Regarding data on disc penetration, Gibson et al tested
this for fluclox in an animal model, but only after a single i.v. bolus.
It is likely that after repeated high doses that fluclox does penetrate,
otherwise there would be thousands of cases in the literature of relapse
with zero cures. Furthermore, the source referenced for penetration of
tissue by Linezolid is actually of skin blisters, not bone, whereas it is
widely accepted that beta-lactams penetrate skin and soft tissue
beautifully.
My conclusion is that whilst this is a helpful addition to the
literature, there are currently no grounds for withholding i.v.
flucloxacillin in invasive MSSA disease and that Linezolid (a
bacteriostatic agent) is a long way from having been validated for this
setting.
A relevant and very well described case, useful for ongoing
comprehension of sarcoidosis'pathogenesis. The "galaxy sign" summons for
a spreading of causal agents (mineral dusts ? bacteria ? others ?)from a
"mother" lesion to surrounding areas, in coherence with recent
interpretations of sarcoidosis as a peculiar, common reaction to different
xenobiotics, particularly in contexts of "heavy" exposomes. Calcification
is a...
A relevant and very well described case, useful for ongoing
comprehension of sarcoidosis'pathogenesis. The "galaxy sign" summons for
a spreading of causal agents (mineral dusts ? bacteria ? others ?)from a
"mother" lesion to surrounding areas, in coherence with recent
interpretations of sarcoidosis as a peculiar, common reaction to different
xenobiotics, particularly in contexts of "heavy" exposomes. Calcification
is a common feature with silicosis.
It could be really interesting which exposures' profile characterized the
patient.
Please, see a recent paper of mine about a case of lung fibrosis in a
woman occupationally exposed to amorphous silica and expoy rosins vapours.
We read case report by Cullen et al and found it very interesting. It was a successfully managed case however, I have certain queries regarding management in the index case.
1. In a prenatally detected CPAM (previously known as CCAM) with hydrops detected prior to 32 weeks, there is a well-defined role of maternal steroids.(1) Even multiple courses of betamethasone can be tried. Whether it was thought off in inde...
Dear Sir,
1953 born I was never treated with antibiotics as child.
1985 a post-streptococcal-myocarditis was diagnosed in the University -hospital Goettingen. Treatment with penicillin and oral penicillin- prophylaxis. Many episodes of respiratory infections, complicated by arrhythmias.
2004 atrial fibrillation.
2017, July 4., anticoagulation with heparin/coumarin changed the intra-a...
I am impressed by the straight forward write up with giving emphasis on practical aspects in field.
Conflict of Interest:
None declared
Dear Reader,
Thank you for your comments and review of our case. You raise an interesting point regarding the connection between coniosis and sarcoidosis. Mineral particles were not originally commented on in our pathology samples, although the patient did not have characteristic occupational exposures.
Best, Ronak V. Patel, MD
Conflict of Interest:
None de...
A very intriguing and well described case !
I just think useful some further diagnostic qualification starting from the following description of the histological characterization of the disease.
"Gastric biopsies revealed severe chronic active granulomatous gastritis (figure 3). Additional studies from her gastric biopsies,including gram stain, fungal stain and acid-fast stain, were negative."
...
Hello, how recent is the case that's just been published about Anisakiasas? Is it recent?
Do you have more details on the case I can read?
Conflict of Interest:
None declared
I have read the phenotype description of a child with aplasia cutis congenita as well as transverse limb defects; although this association is not common it is the presentation of Adams Oliver syndrome [OMIM 100300]; in this condition both manifestations are present and often the limb defects resemble the damage caused by the amniotic band sequence. The identification is important as patients with Adams Oliver have an id...
Hello Mam, I would gladly like to know that the site of metastasis was in the upper extremity or in the lower extremity? and if it was upper extremity then at what site?
Conflict of Interest:
None declared
This is a well written Case Report and helpfully describes some pathology (as well as the phenomenon of S. aureus disease relapse). It should be noted, however, that whilst the supporting evidence for i.v. Linezolid is that it is non-inferior to Vancomycin, it is abundantly clear in the literature that i.v. Vancomycin is wholly inferior to i.v. Flucloxacillin. Regarding data on disc penetration, Gibson et al tested this...
A relevant and very well described case, useful for ongoing comprehension of sarcoidosis'pathogenesis. The "galaxy sign" summons for a spreading of causal agents (mineral dusts ? bacteria ? others ?)from a "mother" lesion to surrounding areas, in coherence with recent interpretations of sarcoidosis as a peculiar, common reaction to different xenobiotics, particularly in contexts of "heavy" exposomes. Calcification is a...
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