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Biomedical subjects

Ravi K Bobba

Publications and source records attributed to Ravi K Bobba.

18 recordsLinked to original sources
PubMed2006

Tongue discoloration in an elderly kidney transplant recipient: Treatment-related adverse event?

BACKGROUND: With the increased occurrence of methicillin-resistant staphylococcus aureus infections, linezolid treatment might be administered more often. New rare adverse events are likely to follow. CASE SUMMARY: A 65-year-old man (weight, 91 kg; height, 185 cm) presented to the emergency department at the University of Virginia-affiliated Salem Veterans Affairs Medical Center, Salem, Virginia, after a recent (8 weeks) kidney transplantation with a 24-hour history of fatigue, chills, arthralgias, increased urinary frequency, and onset of tongue discoloration. Two days before admission, he completed a 14-day course of linezolid 600 mg PO BID for ampicillin-resistant enterococcal urinary tract infection. He was afebrile on admission and the dorsal aspect of his tongue was blackened centrally, browner peripherally, with normal pink mucosa on the periphery. Based on the Naranjo probability scale, the calculated score for tongue discoloration as a drug-related adverse event was 7 out of a maximum score of 13 points, designating it as a probable cause. The patient's tongue discoloration improved moderately during the hospital stay and resolved 6 months after the discontinuation of linezolid. CONCLUSIONS: We report a rare association of linezolid and tongue discoloration in an elderly kidney transplant recipient that improved with discontinuation. We present this case to increase clinicians' awareness of the potential adverse event.

Acetamides↗
PubMed2006

Diagnostic challenge posed by the clinical presentation of foot drop in a patient with Hodgkin's lymphoma.

We report the case of a 56-year-old male with Hodgkin's disease who was being treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and who presented with paresthesias, bilateral leg weakness, and foot drop. MRI revealed a paravertebral abscess with intraspinal extension that was drained and treated with vancomycin. Foot drop was persistent after the treatment. The objective of this case report is to highlight the diagnostic challenge posed by the clinical presentation of foot drop in a medical patient with multiple co-morbidities.

Journal Article↗
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

Polysplenia in an elderly male: diagnostic approaches and review of the literature.

Polysplenia is a congenital disorder affecting the asymmetric organs, including the heart, lungs, bronchi, liver, stomach, pancreas, intestines, and spleen. Primary manifestations are heterogeneous and can include congenital heart disease, atypical placement of major abdominal organs, biliary atresia, and intestinal malrotation. Knowledge of these congenital abnormalities will enhance patient care. In this report, we present an elderly, asymptomatic individual with polysplenia to highlight the cardinal features and management issues.

Journal Article↗
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

Unilateral breast enlargement as a presenting feature of small cell carcinoma of the lung.

Breast enlargement associated with carcinoma of the lung is most commonly a paraneoplastic manifestation of non-small cell carcinoma. Hormonally mediated proliferation of the glandular component of the breast leads to unilateral or bilateral enlargement. This report describes a patient with small cell carcinoma of the lung who presented with unilateral breast enlargement related to superior vena cava obstruction.

Aged↗