Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ignored.Patient’s concerns:A 37-year-old female presented to the outpatient departmen...Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ignored.Patient’s concerns:A 37-year-old female presented to the outpatient department with flu-like symptoms.Diagnosis:The RT-PCR test for SARS-CoV-2 infection was positive,while complete blood cell and peripheral blood smear showed leukemoid reaction.Intervention:Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation.Outcomes:On the 10th day,the patient was asymptomatic and RT-PCR was negative.So the patient was discharged and leukemoid presentation subsided after clearance of viral disease.Lessons:COVID-19 has a myriad of presentations,and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.展开更多
Pyometra is one of the most common uterine pathologies of intact bitch at middle to advanced age. In the early stages, the disease shows subtle changes, making diagnosis a challenge. In contrast, at later stages, it m...Pyometra is one of the most common uterine pathologies of intact bitch at middle to advanced age. In the early stages, the disease shows subtle changes, making diagnosis a challenge. In contrast, at later stages, it manifests as potentially life-threatening systemic inflammatory response syndrome. Ultrasonographic examination of the uterus aids in the diagnosis, although it has limitation in ascertaining the clinical severity of pyometra. Moreover, differentiation of cystic endometrial hyperplasia from pyometra could not be discerned with greater accuracy. Therefore, false negative diagnosis of pyometra patients leads to development of systemic inflammatory response, which delays administration of therapies and results in deaths during early course of treatment. Further, indiscriminate use of broad-spectrum antimicrobials at higher dose in false positive cases considerably contributes to the rising pool of drug resistant pathogens, thereby increasing the risk of case fatality due to sepsis in a long-term. Monitoring the circulating pro-inflammatory cytokines, acute phase proteins, endotoxin, growth factors and inflammatory mediators is the current trend in pyometra research, especially for developing diagnostic and prognostic biomarkers. The present review deals with the prospects of developing diagnostic and prognostic biomarkers in the canine pyometra.展开更多
文摘Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ignored.Patient’s concerns:A 37-year-old female presented to the outpatient department with flu-like symptoms.Diagnosis:The RT-PCR test for SARS-CoV-2 infection was positive,while complete blood cell and peripheral blood smear showed leukemoid reaction.Intervention:Paracetamol and fexofenadine for flu-like symptoms and leukemoid presentation.Outcomes:On the 10th day,the patient was asymptomatic and RT-PCR was negative.So the patient was discharged and leukemoid presentation subsided after clearance of viral disease.Lessons:COVID-19 has a myriad of presentations,and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.
基金The review article was a part of the work supported by Department of BiotechnologyGovernment of India funded project on "Identification of diagnostic and prognostic biomarkers in cystic endometrial hyperplasia and pyometra led systemic inflammatory response syndrome in dog"(Reference BT/ADV/Canine Health/GADVASU 2017-18, Project Code: OXX04211)
文摘Pyometra is one of the most common uterine pathologies of intact bitch at middle to advanced age. In the early stages, the disease shows subtle changes, making diagnosis a challenge. In contrast, at later stages, it manifests as potentially life-threatening systemic inflammatory response syndrome. Ultrasonographic examination of the uterus aids in the diagnosis, although it has limitation in ascertaining the clinical severity of pyometra. Moreover, differentiation of cystic endometrial hyperplasia from pyometra could not be discerned with greater accuracy. Therefore, false negative diagnosis of pyometra patients leads to development of systemic inflammatory response, which delays administration of therapies and results in deaths during early course of treatment. Further, indiscriminate use of broad-spectrum antimicrobials at higher dose in false positive cases considerably contributes to the rising pool of drug resistant pathogens, thereby increasing the risk of case fatality due to sepsis in a long-term. Monitoring the circulating pro-inflammatory cytokines, acute phase proteins, endotoxin, growth factors and inflammatory mediators is the current trend in pyometra research, especially for developing diagnostic and prognostic biomarkers. The present review deals with the prospects of developing diagnostic and prognostic biomarkers in the canine pyometra.
