NUT midline carcinoma with cutaneous metastases

Departments of Dermatology and Pathology, Penn State Hershey Medical Center, Hershey, Pennsylvania.
Journal of the American Academy of Dermatology (Impact Factor: 4.45). 08/2012; 67(2):323-4. DOI: 10.1016/j.jaad.2011.02.034
Source: PubMed
2 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rabies is a viral zoonosis that causes approximately 50,000 to 100,000 deaths per year worldwide. Most deaths occur in developing countries. Dogs are the major vector, especially in developing countries. The virus is usually transmitted to humans by infected saliva through the bite of a rabid animal; the incubation period averages 30 to 90 d. Hyperexcitability, autonomic dysfunction, hydrophobia, and aerophobia are characteristic of encephalitic rabies, which accounts for 80% of cases. The paralytic form is characterized by flaccid paralysis in the bitten limb, which ascends symmetrically or asymmetrically. Once symptoms develop, the disease is invariably fatal. Animal rabies can be controlled by proper induction of herd immunity, humane removal of stray animals, promotion of responsible pet ownership through education, and enactment of leash laws. Preexposure vaccination with modern cell culture vaccine is recommended for people at high risk of exposure to rabies and for travelers who spend longer than 1 mo in countries where rabies is a constant threat, or who travel in a country where immediate access to appropriate care is limited. Postexposure prophylaxis consists of prompt and thorough wound cleansing and immunization with modern cell culture vaccine, together with administration of rabies immune globulin to those individuals who have not previously received preexposure prophylaxis.
    Advances in Therapy 11/2007; 24(6):1340-7. DOI:10.1007/BF02877781 · 2.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: During 2006, 49 states and Puerto Rico reported 6,940 cases of rabies in animals and 3 cases in humans to the CDC, representing an 8.2% increase from the 6,417 cases in animals and 1 case in a human reported in 2005. Approximately 92% of the cases were in wildlife, and 8% were in domestic animals. Relative contributions by the major animal groups were as follows: 2,615 raccoons (37.7%), 1,692 bats (24.4%), 1,494 skunks (21.5%), 427 foxes (6.2%), 318 cats (4.6%), 82 cattle (1.2%), and 79 dogs (1.1%). Compared with numbers of reported cases in 2005, cases in 2006 increased among all groups except cattle. Increases in numbers of rabid raccoons during 2006 were reported by 11 of the 20 eastern states where raccoon rabies was enzootic, and reported cases increased by 3.2% overall, compared with 2005. On a national level, the number of rabies cases in skunks during 2006 increased by 6.1% from the number reported in 2005. Once again, Texas reported the greatest number (n = 351) of rabid skunks and the greatest overall state total of animal rabies cases (889). No cases of rabies associated with the dog/coyote rabies virus variant were reported. The last identified case of this canine rabies virus variant was identified in March 2004, along the US/Mexico border. With 2006 marking the second year of no apparent transmission of the dog/coyote variant, these findings from surveillance data support the contention that the canine rabies virus variant is no longer in circulation in the United States. Total number of cases of rabies reported nationally in foxes increased 13.6%, compared with 2005. Increases in the number of reported rabid foxes were attributable to greater numbers of foxes reported with the Arctic fox rabies virus variant in Alaska, the Texas gray fox rabies virus variant in Texas, and the raccoon rabies virus variant in Virginia. The 1,692 cases of rabies reported in bats represented a 14.5% increase, compared with numbers reported in 2005, making bats the second most reported rabid animal behind raccoons. Cases of rabies in cats, dogs, horses and mules, and sheep and goats increased 18.2%, 3.9%, 12.8%, and 22.2%, respectively, whereas cases reported in cattle decreased 11.8%. In Puerto Rico, reported cases of rabies in mongooses increased 9.2%, and rabies in domestic animals, presumably attributable to spillover infection from mongooses, increased 20%. Three cases of human rabies were reported from Texas, Indiana, and California during 2006. The cases in Indiana and Texas were attributed to bat rabies virus variants, whereas the case in California was attributed to an exposure to a dog in the Philippines.
    Journal of the American Veterinary Medical Association 09/2007; 231(4):540-56. DOI:10.2460/javma.231.4.540 · 1.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We report the survival of a 15-year-old girl in whom clinical rabies developed one month after she was bitten by a bat. Treatment included induction of coma while a native immune response matured; rabies vaccine was not administered. The patient was treated with ketamine, midazolam, ribavirin, and amantadine. Probable drug-related toxic effects included hemolysis, pancreatitis, acidosis, and hepatotoxicity. Lumbar puncture after eight days showed an increased level of rabies antibody, and sedation was tapered. Paresis and sensory denervation then resolved. The patient was removed from isolation after 31 days and discharged to her home after 76 days. At nearly five months after her initial hospitalization, she was alert and communicative, but with choreoathetosis, dysarthria, and an unsteady gait.
    New England Journal of Medicine 07/2005; 352(24):2508-14. DOI:10.1056/NEJMoa050382 · 55.87 Impact Factor