FREELY ACCESSIBLE CLINICAL CASES IN LSP TEACHING

Natália Gachallová

Týden CJV 2024

Synopsis

Context

Methodology

The New England Journal of Medicine





A child inhaling food

Corpus alienum bronchi lateris sinistri

          Infans cum tussi et stridore

                   Status post bronchoscopiam in situ

          Extractio corporis alieni

Suspicio obstructionis respiratoriae partialis bronchi lateris sinistri







Case 21-2021: A 33-Year-Old Pregnant Woman with Fever, Abdominal Pain, and Headache

https://www.nejm.org/doi/full/10.1056/NEJMcpc2107344

Presentation of the case

A 33-year-old pregnant woman with ulcerative colitis was admitted to this hospital during the
summer at 10 weeks of gestation because of fever, nausea, vomiting, abdominal pain and tenderness,
and headache. A review of systems was notable for fatigue, mild headache, neck pain, and
photophobia. The patient reported no hematochezia, pelvic pain, vaginal bleeding, dysuria, or joint
pain. Ulcerative colitis had been diagnosed 11 years earlier […] exacerbations of ulcerative
colitis reoccurred approximately every year and were associated with fevers, rigors, nausea,
vomiting, abdominal pain, and bloody diarrhea. Doppler ultrasonography of the abdomen revealed mild
fullness in the pelvicalyceal system on the right side that is probably a physiologic finding in
pregnancy. There was trace fluid in the right lower quadrant; however, the appendix was not
visualized.

Implementation

Follow-up context

This patient’s presentation has several key features that are consistent with listeria infection.
In an immunocompetent host, ingestion of food contaminated with listeria typically results in
asymptomatic infection or mild febrile gastroenteritis. However, this patient is at increased risk
for invasive listeria infection because she is pregnant, has an inflammatory bowel disease, and
takes immunosuppressive therapy.





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