Enteric fever (typhoid or paratyphoid) is a common infectious disease worldwide, especially in developing countries like Bangladesh. Typhoid fever caused by the gram negative bacterium Salmonella typhi that may have a wide spectrum of clinical presentations. We report a case of a 17 year old previously healthy college boy who presented with fever, abdominal pain and shortness of breath later on who was eventually diagnosed as having typhoid fever complicated by acute pancreatitis, hepatitis and severe pulmonary hypertension. Enteric fever presenting as acute pancreatitis and pulmonary hypertension is a rare entity and must be considered in endemic areas like Bangladesh, in patients presenting with fever and concomitant severe abdominal pain and shortness of breath, as any delay in timely institution of treatment can prove fatal. There are very few case reports in the world which have depicted this unusual association.Bangladesh Crit Care J March 2015; 3 (1): 36-38
A B S T R A C TSystemic lupus erythematosus (SLE) is a chronic, inflammatory,autoimmune, multisystem connective multi system connective tissuedisease characterized by various autoantibodies to nuclear and cytoplasmicantigens and commonly affects the joints and a variety of organs due to anover activation of the body's immune system. There is wide heterogeneity inpresentation of SLE patients, including lung, central nervous system, skin,kidney, and hematologic manifestations. The presence of antinuclearantibodies (ANA) in serum is generally considered a decisive diagnostic signof SLE. However, a small subset of SLE patients who had the typical clinicalfeatures of SLE was reported to show persistently negative ANA tests. Ourreport describes a 24-yr-old female who presented with the clinicalmanifestations of SLE such as malar rash, photosensitivity, arthritis, oralulcer, and proteinuria. The serum autoantibodies were all negative exceptanti ribosomal P. She was also positive for lupus anticoagulantanti -coagulant. She was treated with oral prednisolone , hydroxychloroquinewith topical tacrolimus, and improved significantly. Three months after,repeat ANA, and anti-ds DNA showed persistent negativity, but lupus anti -coagulant remained positive. This case suggests that ANA may not berequired in the pathogenesis of SLE.
Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder of the gastrointestinal tract of unknown aetiology. It is characterized by eosinophilic infiltration of the bowel wall starting from esophagus to rectum most commonly stomach and duodenum, peripheral eosinophilia and various gastrointestinal manifestations. Symptoms mainly depend on the affected digestive segments and the involvement of the different layers of the digestive wall. Diagnosis requires a high index of suspicion and exclusion of various disorders that are associated with peripheral eosinophilia. We report a case of 32 years young man with abdominal pain, vomiting and loose motion, ultimately diagnose as a case of eosinophilic gastroenteritis with involvement of duodenum, proximal jejunum and colon who responded well to steroid.
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