RESUMO
Acute disseminated encephalomyelitis (ADEM) is exceptionally uncommon, with approximately 3 pediatric cases reported in the United States each year. Given the uncommon nature of ADEM, most of the current data rely heavily on case reports. The overwhelming majority of cases have been reported after an acute viral infection or vaccination. Although up to 90% of cases exhibit full remission after intravenous steroids, those in which treatment is delayed can display debilitating sequelae. Here, we present a case of ADEM in a 7-year-old boy who presented with double vision and imbalance with no recent history of acute viral infections or vaccinations.
Assuntos
Diplopia/etiologia , Encefalomielite Aguda Disseminada/diagnóstico por imagem , Transtornos Neurológicos da Marcha/etiologia , Administração Intravenosa , Blefaroptose/etiologia , Criança , Diplopia/diagnóstico , Encefalomielite Aguda Disseminada/líquido cefalorraquidiano , Encefalomielite Aguda Disseminada/tratamento farmacológico , Transtornos Neurológicos da Marcha/diagnóstico , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Esteroides/administração & dosagem , Esteroides/uso terapêutico , Resultado do TratamentoRESUMO
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness. After further investigation he was diagnosed with a mixed anaerobic epidural abscess. The evaluation and management of chronic sinusitis are based on the presence of symptoms concerning for complication. Prompt investigation of complicated sinusitis is essential in preventing debilitating and fatal sequelae. Our case study underscores the importance of early diagnosis and appropriate management.
Assuntos
Abscesso Epidural/diagnóstico por imagem , Infecções Pneumocócicas/diagnóstico por imagem , Compressão da Medula Espinal/diagnóstico por imagem , Antibacterianos/uso terapêutico , Cateterismo Periférico , Ceftriaxona/uso terapêutico , Drenagem , Abscesso Epidural/complicações , Abscesso Epidural/microbiologia , Abscesso Epidural/terapia , Humanos , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pescoço , Infecções Pneumocócicas/complicações , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/terapia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Streptococcus pneumoniae/isolamento & purificação , Tomografia Computadorizada por Raios XRESUMO
Host cell factor-1 (HCF-1) is a conserved regulator of the longevity and stress response functions of DAF-16/FOXO. SKN-1 transcription factor is an evolutionarily conserved xenobiotic stress regulator and a pro-longevity factor. Here, we demonstrate that SKN-1 contributes to the enhanced oxidative stress resistance incurred by hcf-1 mutation in C. elegans. HCF-1 prevents the nuclear accumulation of SKN-1 and represses the transcriptional activation of SKN-1 specifically at target genes involved in cellular detoxification pathways. Our findings reveal a novel and context-specific regulatory relationship between two highly conserved longevity and stress response factors HCF-1 and SKN-1.
