Biomedical subjects
Publications and source records attributed to Ilias Migdalis.
A case of spontaneous peritonitis caused by Leminorella grimontii in a 63-year-old man with cirrhosis is reported. To our knowledge, L. grimontii has never been reported as a cause of spontaneous bacterial peritonitis. The patient responded to antimicrobial therapy. Clinical and therapeutic implications are discussed.
The present study aimed to determine the serum carcinoembryonic antigen (CEA), CA 19-9, CA 50 and alpha-fetoprotein (alpha-FP) levels between patients with myelodysplastic syndromes (MDS) at diagnosis and controls to clarify their potential clinical significance. A case-control investigation was conducted over a three year period, covering 95 MDS cases and 95 age- and gender-matched controls. Mean serum CEA levels were significantly higher (P = 0.0002) in MDS patients at diagnosis than in hospital controls. Adjusting for age, gender, tobacco consumption, serum CA 19-9, CA 50 and alpha-FP levels, there is statistically significant evidence that serum CEA values are associated with increased risk of MDS (odds ratio = 2.33, 95% confidence interval = 1.56 - 3.49). Six patients with MDS developed malignancies 4-9 months after the diagnosis of myelodysplasia. Serum CEA could be used as marker together with other important diagnostic tools for evaluating an underlying or developing malignancy in patients suffering from MDS.
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BACKGROUND: Left ventricular pseudoaneurysm is a rare and extremely fatal complication of acute myocardial infarction. It is defined as a rupture of the myocardium contained by epicardial adhesions or the epicardial wall. CASE REPORT: A 76-year-old woman was brought to our department suffering from acute pulmonary edema and left ventricular pseudoaneurysm. This condition was caused by an unrecognized high lateral myocardial infarction, which was diagnosed and treated conventionally. Four years after the diagnosis was made, the patient is in good physical condition. The presentation, imaging findings, and the prognosis of such cases are briefly discussed. We have especially focused on the imaging techniques currently used to confirm the diagnosis and on the fact that although the patient refused to have an operation (most appropriate for the diagnosis), she still lives in good physical condition (NYHA II). CONCLUSIONS: We report a case of post infarction pseudoaneurysm along with review of the literature on the subject. We discuss the role of computed tomography and magnetic resonance imaging to ascertain the diagnosis and the algorithm of therapeutic management. Based on current literature, we believe that surgical resection is the treatment of choice for patients in whom a pseudoaneurysm is detected within three months after myocardial infarction, for patients with other indications for cardiac surgery, and for symptomatic patients with ventricular tachycardia or recurrent embolism related to the pseudoaneurysm. Optimum medical therapy is the only alternative in those high-risk patients who refuse surgical operation.
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Pseudomonas luteola is uncommonly implicated in clinical infections, but it constitutes a significant nosocomial pathogen causing mainly infections associated with foreign material. This report describes an unusual case of a Pseudomonas luteola strain that infected and caused cutaneous abscess and bacteraemia in a previously healthy man.
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We report herein a case of a 20-year-old previously healthy man who presented, 25 days after the onset of clinically and serologically confirmed Epstein-Barr virus (EBV) infectious mononucleosis, Fusobacterium necrophorum septicemia. The diagnosis of postanginal septicemia was confirmed by repeated demonstration of fusiform, obligate anaerobic, Gram-negative bacilli in anaerobic blood cultures, identified as F. necrophorum 15 days after admission. This case report aims at underlining the need of taking into consideration the possibility of severe Fusobacterium septicemia in previously healthy patients following EBV infectious mononucleosis in order to prevent increased mortality and morbidity.
Stenotrophomonas maltophilia is rarely implicated in clinical infections but it constitutes a significant nosocomial pathogen, especially in immunocompromised patients. This report describes the first case of a generalised infection caused by S. maltophilia that included bacteremia, wound and respiratory tract infection in a patient suffering from burns. Given the emergence of S. maltophilia nosocomial infections, especially in patients with burns, isolation of the bacterium from blood cultures should prompt the commencement of adequate antibiotic treatment.
The case is described of a 36 year-old man who presented with progressive proximal muscle weakness and weight loss. His serum creatine phosphokinase (CPK) levels were markedly elevated. The muscle biopsy showed lipid storage myopathy. The muscle carnitine concentration was extremely low (5.6% of normal levels), establishing the diagnosis of myopathic carnitine deficiency. The disorder was considered as primary because there were no indications of any other identifiable condition which could result in a secondary carnitine deficiency. The patient was treated with oral L-carnitine (2 g per day) and showed rapid improvement. Primary myopathic carnitine deficiency is a curable disorder and therefore it should always be considered as a potential diagnosis in cases of myopathy in young adults.