phenylephrine-hydrochloride and Muscular-Atrophy

A 64-year-old man was referred to our hospital, for a second opinion, with fever, skin lesions and general muscle pain. He has been treated in another hospital with antibiotics on suspicion of erysipelas. A week later skin lesions developed on the metacarpophalangeal and proximal carpophalangeal joints of the hands and nose. His mobility was impaired due to muscle pain and muscle weakness. He also showed proximal muscle atrophy and most importantly a typical heliotrope rash in the eyes. Based on these clinical observations, the most likely diagnosis was dermatomyositis. The diagnosis was confirmed by the presence of increased serum creatine kinase levels and abnormalities in skin and muscle biopsy. Prednisone (70 mg/kg) was initiated, but after 19 days the patient developed a Pneumocystis jiroveci pneumonia. He died of respiratory failure a few days later.

Topics: Dermatomyositis; Exanthema; Fatal Outcome; Hand; Humans; Male; Middle Aged; Muscle Weakness; Muscle, Skeletal; Muscular Atrophy; Myalgia; Nose; Pneumocystis carinii; Pneumonia, Pneumocystis

An epizootic of flaccid trunk paralysis began in free-ranging Zimbabwean elephants (Loxodonta africana) on the southern shore of Lake Kariba in 1989. It involved a selective neuropathy of peripheral nerves supplying the trunk, with axon and myelin degeneration, muscle atrophy, compensatory hypertrophy, and fine endomyseal fibrosis, without inflammatory changes.

Topics: Animals; Brain; Disease Outbreaks; Elephants; Female; Male; Mice; Mice, Inbred BALB C; Muscle Hypotonia; Muscle, Skeletal; Muscular Atrophy; Nose; Paralysis; Peripheral Nerves; Peripheral Nervous System Diseases; Zimbabwe

Topics: Humans; Muscular Atrophy; Nose; Paranasal Sinuses; Radiography; Rhinitis, Atrophic