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Biomedical subjects

Chakradhar M Reddy

Publications and source records attributed to Chakradhar M Reddy.

5 recordsLinked to original sources
PubMed2005

Neuroimaging as a guide to predict outcomes for patients with coccidioidal meningitis.

Sixty-two patients with coccidioidal meningitis underwent neuroimaging. Magnetic resonance imaging detected neuroimaging abnormalities in 76% of patients, and computed tomography scanning detected neuroimaging abnormalities in 41.6%. The most common abnormal neuroimaging findings were hydrocephalus (51.6%), basilar meningitis (46.8%), and cerebral infarction (38.7%). Significantly elevated mortality rates were associated with hydrocephalus and hydrocephalus coexisting with infarction. Basilar meningitis did not influence outcome. Patients without neuroimaging abnormalities had a mortality rate of 7.7%.

Adolescent↗
PubMed2005

Coccidioidal pericarditis: a case presentation and review of the literature.

BACKGROUND: Pericardial involvement with Coccidioides immitis is an infrequent occurrence with a relatively unfavorable prognosis. METHODS: A case of coccidioidal pericarditis is presented along with a review of the medical literature on coccidioidal pericarditis to give the clinician a better understanding of the various presentations, complications and outcomes of this disease. Medline (National Library of Medicine, Bethesda) was electronically searched covering the years 1966-2003 using search words coccidioidomycosis and pericarditis. RESULTS: Sixteen patients were identified from the literature review and one new patient was added. All the patients were males with a mean age of 37.5 years. Chest pain, dyspnea and cough were the most common presenting symptoms. Five patients had evidence of pericardial tamponade, pulsus paradoxus was noted in three patients and three patients presented with pericardial constriction. One patient had Kussmaul's sign, one patient had pericardial frictional rub and another had pericardial knock. Cardiomegaly on chest x-ray was present in ten patients; EKG was noted to have low voltage in five and ST segment elevation in four patients. Delayed hypersensitivity to coccidioidal antigen was reported in nine patients and positive in eight patients. Complement fixation titers were positive in all 11 patients in whom it was assayed. Fifty-three percent of the patients with coccidioidal pericarditis died. CONCLUSION: Coccidioidal pericarditis is a rare disease entity that has a relatively unfavorable prognosis, yet many patients present with diagnostic clues to this disorder. An enhanced understanding of the clinical features of coccidioidal pericarditis may lead to improved outcomes.

Adult↗
PubMed2004

Hypercalcemia in patients with disseminated coccidioidomycosis.

OBJECTIVE: Granulomatous disorders may be associated with hypercalcemia. In sarcoidosis, the pathogenesis of hypercalcemia has been clarified, whereas in other granulomatous disorders, such as coccidioidomycosis, the mechanism is unclear. We present 13 patients with coccidioidomycosis and hypercalcemia to illustrate the clinical course and the mechanism of hypercalcemia. METHODS: We retrospectively reviewed all patients admitted to Kern Medical Center, a 270-bed public hospital, from 1990 through 1997 with coccidioidomycosis and a serum calcium level of greater than 10.5 mg/dL on at least 3 occasions. In addition, no other causes for hypercalcemia were identified. RESULTS: The mean highest serum calcium level was 12.7 +/- 1.8 mg/dL. All patients had disseminated disease. Six patients were nonambulatory and 4 had bone involvement. Of the 9 patients in whom parathyroid hormone was measured, it was normal in 6 and suppressed in 3. Of the 9 patients in whom 25-hydroxyvitamin D was measured, it was normal in 6, suppressed in 2, and elevated in 1. Of the 7 patients in whom 1,25-dihydroxyvitamin D was measured, it was normal in 3 and suppressed in 4. Urinary calcium was elevated in 2 patients, both of whom were ambulatory. Nonambulatory patients had significantly higher serum calcium levels (14.3 +/- 1.0 mg/dL) than ambulatory patients (11.3 +/- 0.46 mg/dL) (P<0.001). CONCLUSIONS: The mechanism of hypercalcemia in coccidioidomycosis is unrelated to increased production of 1,25-dihydroxyvitamin D. Nonambulatory status is associated with higher mean serum calcium.

Adult↗