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2 Result(s) for 'Javier Ticona'
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1.
Hemichorea-Hemiballismus as an Unusual Presentation of Hyperosmolar Hyperglycemic Syndrome
Javier Ticona , Victoria Zaccone, Unaiza Zaman, Daniel Kashani, Zachary Chung, Isabel M. McFarlane
American Journal of Medical Case Reports. 2020 8 (6). doi: 10.12691/ajmcr-8-6-6
Keywords: type 2 diabetes mellitus, movement disorders, chorea, hemiballismus, hyperosmolar hyperglycemic syndrome, basal ganglia
Context: Diabetes mellitus can lead to a diverse array of systemic complications. Poorly managed hyperglycemia can result in serious neurological consequences ranging from peripheral neuropathy to seizures and coma. A rare neurologic disorder seen in acute decompensated type 2 diabetes mellitus (T2DM) is hemichorea-hemiballismus (HCHB). HCHB is a movement disorder primarily associated with cerebrovascular accidents of infarct or hemorrhagic origin. It is a condition that can occur in a diabetic patient, especially when no other signs or symptoms of hyperglycemia are present. It is urgent to recognize HCHB movement disorder quickly as it may be the only presenting sign of hyperglycemia and can alert medical personnel to a possible hyperosmolar hyperglycemic state (HHS). We report an unusual case of HCHB in a patient with HHS, whose only presenting sign was unilateral hyperkinesis, which completely resolved after adequate blood glucose control. Prompt treatment and management of hyperglycemia yields an excellent prognosis in HCHB.
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2.
An Unusual Cause of Neutropenic Fever: Spontaneous Pantoea agglomerans Bacteremia in an Adult
Victoria Zaccone, Mary Lockwood, Javier Ticona , Pedram Jouharian, Michelle Zamora, Christopher Hampton, Baho Sidiqi, Samir Kumar, Isabel M. McFarlane
American Journal of Medical Case Reports. 2020 8 (9). doi: 10.12691/ajmcr-8-9-9
Keywords: pantoea agglomerans, bacteremia, immunocompromised state, HIV, neutropenic fever, malignancy
Context: Neutropenia is a serious complication found in immunocompromised patients, particularly those with cancer and human immunodeficiency virus (HIV). The etiology of neutropenia is multifactorial and can be caused by the direct effects of HIV infection, cytotoxic antineoplastic therapy, and malignancy. The main complication of neutropenia is a bloodstream infection caused by gram-positive bacteria (GPB) and gram-negative bacteria (GNB). GPB, specifically S. epidermidis, tend to affect cancer patients more often than GNB. However, GNB such as Pseudomonas aeruginosa have been associated with more serious infections. We report a case of neutropenic fever caused by a GNB, Pantoea agglomerans, in a 47-year-old Afro-Caribbean man with HIV and metastatic salivary adenocarcinoma. Pantoea agglomerans is a non-spore forming rod typically isolated from plants, fruits, and fecal matter, and is rarely pathogenic in humans. In the current literature, cases of P. agglomerans have been documented primarily in the pediatric population secondary to penetrating wound trauma. To our knowledge, this is the first case of spontaneous neutropenic fever secondary to P. agglomerans bacteremia in an Afro-Caribbean adult male.
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