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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...
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Elsberg Syndrome in Varicella Zoster Virus Infection.

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Elsberg syndrome, a rare spinal cord condition, can be caused by varicella-zoster virus reactivation. Early diagnosis through clinical and investigative findings is crucial for effective management of this lumbosacral radiculitis.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Spinal Cord Disorders

Background:

  • Elsberg syndrome (ES) is characterized by acute-to-subacute lumbosacral radiculitis, potentially involving myelitis of the conus medullaris.
  • Herpes simplex virus type 2 (HSV-2) is a common etiology, but other pathogens can also cause ES.

Purpose of the Study:

  • To report a case of Elsberg syndrome secondary to varicella-zoster virus (VZV) reactivation.
  • To highlight the importance of considering ES in the differential diagnosis of acute lumbosacral radiculitis.

Main Methods:

  • A case report of a 70-year-old female patient presenting with symptoms consistent with ES.
  • Diagnostic workup included magnetic resonance imaging (MRI) of the spine, cerebrospinal fluid (CSF) analysis, and electroneuromyography (ENMG).

Main Results:

  • The patient presented with herpes zoster affecting the right L5-S2 dermatomes, accompanied by radiculitis and conus medullaris myelitis.
  • VZV reactivation was identified as the cause of ES in this case.

Conclusions:

  • Elsberg syndrome is an important consideration in patients with acute lumbosacral radiculitis, occurring in approximately 10% of such cases.
  • A comprehensive diagnostic approach combining clinical presentation and investigations is essential for accurate ES diagnosis.