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Salehi N, Choi ED, Garrison RC. A Case of Miller Fisher Syndrome, Thromboembolic Disease, and Angioedema: Association or Coincidence? AMERICAN JOURNAL OF CASE REPORTS 2017; 18:52-59. [PMID: 28090073 PMCID: PMC5260666 DOI: 10.12659/ajcr.901940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Miller Fisher Syndrome is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered to be a variant of Guillain-Barre Syndrome. Miller Fisher Syndrome is observed in approximately 1-5% of all Guillain-Barre cases in Western countries. Patients with Miller Fisher Syndrome usually have good recovery without residual deficits. Venous thromboembolism is a common complication of Guillain-Barre Syndrome and has also been reported in Miller Fisher Syndrome, but it has generally been reported in the presence of at least one prothrombotic risk factor such as immobility. A direct correlation between venous thromboembolism and Miller Fisher Syndrome or Guillain-Barre Syndrome has not been previously described. CASE REPORT We report the case of a 32-year-old Hispanic male who presented with acute, severe thromboembolic disease and concurrently demonstrated characteristic clinical features of Miller Fisher Syndrome including ophthalmoplegia, ataxia, and areflexia. Past medical and family history were negative for thromboembolic disease, and subsequent hypercoagulability workup was unremarkable. During the course of hospitalization, the patient also developed angioedema. CONCLUSIONS We describe a possible association between Miller Fisher Syndrome, thromboembolic disease, and angioedema.
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Affiliation(s)
- Nooshin Salehi
- Department of Medicine, Riverside University Health System, Moreno Valley, CA, USA
| | - Eric D Choi
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Roger C Garrison
- Department of Medicine, Riverside University Health System, Moreno Valley, CA, USA.,School of Medicine, Loma Linda University, Loma Linda, CA, USA
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Hessulf F, Ljungberg J, Johansson PA, Lindgren M, Engdahl J. Campylobacter jejuni-associated perimyocarditis: two case reports and review of the literature. BMC Infect Dis 2016; 16:289. [PMID: 27297408 PMCID: PMC4907281 DOI: 10.1186/s12879-016-1635-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 06/07/2016] [Indexed: 11/12/2022] Open
Abstract
Background Campylobacter spp. are among the most common bacterial causes of gastroenteritis world-wide and mostly follow a benign course. We report two cases of Campylobacter jejuni-associated perimyocarditis, the first two simultaneous cases published to date and the third and fourth cases over all in Sweden, and a review of the literature. Case presentation A previously healthy 24-yo male (A) presented at the Emergency Department(ED) with recent onset of chest pain and a 3-day history of abdominal pain, fever and diarrhoea. The symptoms began within a few hours of returning from a tourist visit to a central European capital. Vital signs were stable, the Electrocardiogram(ECG) showed generalized ST-elevation, laboratory testing showed increased levels of C-reactive protein(CRP) and high-sensitive Troponin T(hsTnT). Transthoracic echocardiogram (TTE) was normal, stool cultures were positive for C Jejuni and blood cultures were negative. Two days after patient A was admitted to the ED his travel companion (B), also a previously healthy male (23-yo), presented at the same ED with almost identical symptoms: chest pain precipitated by a few days of abdominal pain, fever and diarrhoea. Patient B declared that he and patient A had ingested chicken prior to returning from their tourist trip. Laboratory tests showed elevated CRP and hsTnT but the ECG and TTE were normal. In both cases, the diagnosis of C jejuni-associated perimyocarditis was set based on the typical presentation and positive stool cultures with identical strains. Both patients were given antibiotics, rapidly improved and were fully recovered at 6-week follow up. Conclusion Perimyocarditis is a rare complication of C jejuni infections but should not be overlooked considering the risk of heart failure. With treatment, the prognosis of full recovery is good but several questions remain to be answered regarding the pathophysiology and the male preponderance of the condition.
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Affiliation(s)
- Fredrik Hessulf
- Department of Anaesthesiology and Intensive Care Medicine, Hallands Hospital, Halmstad, Sweden.
| | - Johan Ljungberg
- Department of Internal Medicine, Hallands Hospital, Halmstad, Sweden
| | | | - Mats Lindgren
- Department of Internal Medicine, Hallands Hospital, Halmstad, Sweden
| | - Johan Engdahl
- Department of Internal Medicine, Hallands Hospital, Halmstad, Sweden.,Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kaakoush NO, Castaño-Rodríguez N, Mitchell HM, Man SM. Global Epidemiology of Campylobacter Infection. Clin Microbiol Rev 2015; 28:687-720. [PMID: 26062576 PMCID: PMC4462680 DOI: 10.1128/cmr.00006-15] [Citation(s) in RCA: 846] [Impact Index Per Article: 94.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Campylobacter jejuni infection is one of the most widespread infectious diseases of the last century. The incidence and prevalence of campylobacteriosis have increased in both developed and developing countries over the last 10 years. The dramatic increase in North America, Europe, and Australia is alarming, and data from parts of Africa, Asia, and the Middle East indicate that campylobacteriosis is endemic in these areas, especially in children. In addition to C. jejuni, there is increasing recognition of the clinical importance of emerging Campylobacter species, including Campylobacter concisus and Campylobacter ureolyticus. Poultry is a major reservoir and source of transmission of campylobacteriosis to humans. Other risk factors include consumption of animal products and water, contact with animals, and international travel. Strategic implementation of multifaceted biocontrol measures to reduce the transmission of this group of pathogens is paramount for public health. Overall, campylobacteriosis is still one of the most important infectious diseases that is likely to challenge global health in the years to come. This review provides a comprehensive overview of the global epidemiology, transmission, and clinical relevance of Campylobacter infection.
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Affiliation(s)
- Nadeem O Kaakoush
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Natalia Castaño-Rodríguez
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Hazel M Mitchell
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Si Ming Man
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW, Australia Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Louwen R, Hays JP. Is there an unrecognised role for Campylobacter infections in (chronic) inflammatory diseases? World J Clin Infect Dis 2013; 3:58-69. [DOI: 10.5495/wjcid.v3.i4.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 10/30/2013] [Accepted: 11/16/2013] [Indexed: 02/06/2023] Open
Abstract
Campylobacter species are one of the major causes of global bacterial-related diarrheal disease worldwide. The disease is most frequently associated with the ingestion of contaminated meat, raw milk, pets, contaminated water, and the organism may be frequently cultured from the faeces of chicken and other domesticated farm animals. Of the 17 established Campylobacter species, the most important pathogens for humans are Campylobacter jejuni (C. jejuni), Campylobacter coli (C. coli) and Campylobacter fetus (C. fetus), which are all associated with diarrheal disease. Further, C. jejuni and C. coli are also associated with the neuroparalytic diseases Guillain-Barré syndrome and Miller Fischer syndrome, respectively, whereas C. fetus is linked with psoriatic arthritis. The discovery of both “molecular mimicry” and translocation-related virulence in the pathogenesis of C. jejuni-induced disease, indicates that Campylobacter-related gastrointestinal infections may not only generate localized, acute intestinal infection in the human host, but may also be involved in the establishment of chronic inflammatory diseases. Indeed, pathogenicity studies on several Campylobacter species now suggest that molecular mimicry and translocation-related virulence is not only related to C. jejuni, but may play a role in human disease caused by other Campylobacter spp. In this review, the authors provide a review based on the current literature describing the potential links between Campylobacter spp. and (chronic) inflammatory diseases, and provide their opinions on the likely role of Campylobacter in such diseases.
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Lynch OA, Cagney C, McDowell DA, Duffy G. Occurrence of fastidious Campylobacter spp. in fresh meat and poultry using an adapted cultural protocol. Int J Food Microbiol 2011; 150:171-7. [PMID: 21855156 DOI: 10.1016/j.ijfoodmicro.2011.07.037] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 07/26/2011] [Accepted: 07/30/2011] [Indexed: 02/08/2023]
Abstract
This study used an adapted cultural protocol for the recovery of fastidious species of Campylobacter, to gain a more accurate understanding of the diversity of Campylobacter populations in fresh meats. Chicken (n=185), pork (n=179) and beef (n=186) were collected from supermarkets and butchers throughout the Republic of Ireland. Samples were enriched in Campylobacter enrichment broth for 24h under an atmosphere of 2.5% O(2), 7% H(2), 10% CO(2), and 80.5% N(2). The enriched samples were then filtered onto non-selective Anaerobe Basal Agar supplemented with lysed horse blood using mixed ester filter membranes. Isolates were identified by both genus and species-specific PCR assays and biochemical testing. The incidence of campylobacters on beef (36%) was significantly higher than on pork (22%) or chicken (16%), and far exceeds previously reported prevalence levels. The method was successful in recovering 7 species of Campylobacter, including the fastidious spp. C. concisus and C. mucosalis, from chicken meat, and 10 species, including C. concisus, C. curvus, C. mucosalis, C. sputorum, and C. upsaliensis, from minced beef. The isolation of C. concisus and C. upsaliensis from meat in this study is of particular significance, due to their emerging clinical relevance. The results of this study confirm that the diversity of Campylobacter species on fresh meats is greater than previously reported and highlights the bias of cultural methods towards the recovery of C. jejuni.
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Affiliation(s)
- Orla A Lynch
- Teagasc Food Research Centre, Ashtown, Dublin 15, Ireland
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Kratzer C, Wolf F, Graninger W, Weissel M. Acute cardiac disease in a young patient with Campylobacter jejuni infection: a case report. Wien Klin Wochenschr 2010; 122:315-9. [PMID: 20559889 DOI: 10.1007/s00508-010-1381-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 04/13/2010] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Infectious myocarditis is a life-threatening condition because it can lead to arrhythmia, dilated cardiomyopathy and congestive heart failure. A large number of different infectious causes have been identified as leading to myocarditis, with enteroviral infections being the most common reasons. CASE PRESENTATION We present a rare Austrian case of bacterial-induced myocarditis in a 19-year-old immunocompetent male without any cardiac risk factors. Four days prior to the onset of severe left thoracic pain the patient developed acute gastroenteritis. The initial electrocardiogram showed sinus tachycardia, strain on the right side of the heart and signs of myocardial injury. Cardiac enzyme markers creatine kinase and troponin T were elevated to maximum values of 627 U/l and 0.52 ng/ml. Stool cultures revealed the presence of Campylobacter jejuni as the only source of infection. The clinical diagnosis of bacterial-induced myocarditis was confirmed by specific radiological findings of inflammation using cardiac magnetic resonance imaging. CONCLUSION In recent years, instead of performing endomyocardial biopsies, the clinical diagnosis of bacterial-induced myocarditis can be confirmed by specific radiological findings in combination with positive stool cultures for Enterobacteriaceae. Due to the increasing numbers of Campylobacter infections, myocarditis should be considered as a rare but relevant extraintestinal complication also in immunocompetent patients with Campylobacter jejuni gastroenteritis.
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Affiliation(s)
- Christina Kratzer
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
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Turpie DFS, Forbes KJ, Hannah A, Metcalfe MJ, McKenzie H, Small GR. Food-the way to a man's heart: a mini-case series of Campylobacter perimyocarditis. ACTA ACUST UNITED AC 2010; 41:528-31. [PMID: 19396664 DOI: 10.1080/00365540902913486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Campylobacter jejuni enteritis is 1 of the most common causes of food poisoning. Although an infrequent complication, Campylobacter associated perimyocarditis can have fatal consequences. This article illustrates 2 cases. We examine the types of Campylobacter jejuni responsible and report the observed male preponderance of this complication.
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Affiliation(s)
- David F S Turpie
- Department of Cardiology, University of Aberdeen, Aberdeen RoyalInfirmary, Foresterhill, Aberdeen, UK
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Roca Comas A, Herrero Espinet F, Kauseman K, Ballester Martínez A. Hepatitis en el curso de una gastroenteritis aguda por Campylobacter jejuni. An Pediatr (Barc) 2009; 71:80-1. [DOI: 10.1016/j.anpedi.2009.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 04/14/2009] [Accepted: 04/15/2009] [Indexed: 11/29/2022] Open
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