Publications by authors named "Ariana R Tagliaferri"

16 Publications

  • Page 1 of 1

Atypical Stroke-Like Presentation in a Critically-Ill Patient With Serratia marcescens Bullous Cellulitis.

Cureus 2022 Jun 28;14(6):e26404. Epub 2022 Jun 28.

Pulmonary and Critical Care Medicine, St. Joseph's University Medical Center, Paterson, USA.

Skin and soft-tissue infections are common in critically ill patients, especially with gram-positive bacteria such as or species. However, it is imperative to consider gram-negative infections in atypical presentations of bullous cellulitis, where patients do not initially respond to common empiric therapy for skin infections. is a gram-negative organism that manifests in nosocomial settings due to its affinity for moisture-rich environments. This bacteria is often difficult to treat due to extensive antibiotic resistance, and thus treatment is generally catered towards culture sensitivity. Rarely, this bacteria is an infective agent of infective endocarditis. We present a case of a 44-year-old gentleman who presented with stroke-like symptoms and was found to have bullous cellulitis with deep wound cultures growing . This case report highlights an atypical, severe presentation, and aims to provide a literature review of this rare manifestation of in skin and soft-tissue infections. We intend to improve rapid diagnosis and proper treatment for future critically-ill patients with skin and soft-tissue infections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.26404DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9337789PMC
June 2022

Mask-Induced Partial Transection of the External Ear Requiring Complex Surgical Reconstruction.

Cureus 2022 May 27;14(5):e25390. Epub 2022 May 27.

Internal Medicine, St. Joseph Regional Medical Center, Paterson, USA.

During the COVID-19 pandemic, wearing masks to prevent the spread of infection has been imperative. Though many wear N-95 masks with circumferential head straps, the use of surgical ear loop-style masks has increased. Dermatologic complications, such as contact dermatitis, psoriasis, and local irritation, have been described in several reports. One such complication has been pressure injury to the external ear, secondary to friction from the ear loops. While external ear pressure ulcers caused by mask-wearing have already been observed, injuries extensive enough to require surgical reconstruction have yet to be described. Herein, we present a unique case of an elderly male with a severe external ear deformity caused by prolonged, uninterrupted mask-wearing that was treated with a complex ear reconstruction. The pressure caused a full-thickness erosion of the helical and conchal cartilage with partial auricle amputation from constant mask wear. We describe an unusual and interesting problem caused indirectly by the coronavirus pandemic and discuss potential methods to protect oneself against skin injury from mask usage while simultaneously preventing viral transmission.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.25390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236676PMC
May 2022

A Case of a gastropancreatic fistula in the setting of intraductal papillary mucinous neoplasms.

Radiol Case Rep 2022 Aug 11;17(8):2874-2877. Epub 2022 Jun 11.

St. Joseph's University Medical Center, Department of Gastroenterology, 703 Main Street, Paterson, NJ 07503 USA.

Intraductal papillary mucinous neoplasms (IPMN) are mucin producing tumors which arise from epithelial cells of the main pancreatic duct, pancreatic branch ducts, or both. They are characterized by mucin-producing columnar cells, papillary ductal proliferation, cyst formation, and varying degrees of dysplasia. IPMNs are classified as main duct or branch duct based upon the pancreatic duct anatomy which the IPMN is arising from. Additionally, they can be classified based on their histologic subtypes, which carry varying associations with dysplasia and/or malignancy. Many patients have incidentally identified IPMNs, which are asymptomatic. However, patients may also present with pancreatitis, elevation of liver enzymes, dilation of the pancreatic duct or bile duct as well as distention of the ampullary pancreatic orifice(s), due to impaction and obstruction with mucus. This is known as an endoscopically visualized "fish eye" sign. Patients may also develop exocrine and endocrine pancreatic insufficiency and maldigestion. Some studies also suggest that patients with IPMNs may also be at increased risk for gastric, colorectal, biliary, renal cell, and thyroid malignancies. Rarely, IPMNs can be complicated by fistulation between the main pancreatic duct and neighboring organs. Herein, we present an unusual case of simultaneous fistulation to both the gastric body and the duodenum.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radcr.2022.05.046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9198267PMC
August 2022

Liver Abscess Secondary to Crohn's Disease: A Case Report.

Cureus 2022 Mar 14;14(3):e23157. Epub 2022 Mar 14.

Gastroenterology, St. Joseph's Regional Medical Center, Paterson, USA.

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) and extra-intestinal manifestations are common. Although common features of CD include fistulation and abscess formation, they typically manifest exclusively in the lower gastrointestinal (GI) tract and in patients who do not have adequate control over their disease. Pyogenic liver abscess is rare in the general population and is an unusual and extra-intestinal manifestation of CD. Herein, we present a patient with Crohn's ileo-colitis who presented with generalized abdominal pain and fevers and was found to have multiple pyogenic liver abscesses biopsy-proven to be secondary to CD. The patient's liver abscesses were refractory to repeated CT-guided drainage and antibiotic therapy. This paper illustrates a rare condition in the general population and those with CD. We intend to discuss the differences of pyogenic liver abscesses in CD compared to the general population, the rarity of this presentation and propose a unique mechanism by which the patient may have developed this liver abscess. It is common for clinicians to mistake the diagnosis of febrile illness with or without abdominal pain as a simple reactivation of CD, and thus it is important to keep pyogenic liver abscess on the differential even if their disease state is otherwise well controlled.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.23157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007572PMC
March 2022

A Case Report of Recurrent Glomerulonephritis 27 Years After Renal Transplant.

Cureus 2022 Mar 10;14(3):e23041. Epub 2022 Mar 10.

Hematology and Oncology, St. Joseph's Regional Medical Center, Paterson, USA.

Herein we present the case of a patient who was diagnosed with membranoproliferative glomerulonephritis and underwent renal transplant 27 years prior to presentation with new kidney failure. Although our patient did not undergo renal biopsy, it is our thought that she developed recurrent membranoproliferative disease, as she was well maintained on immunosuppressants and steroids for many years. This case is unique, because she was outside of the typical window for both chronic rejection and recurrent disease. This case also raises awareness of the utility of renal biopsy to differentiate these two conditions, which allows physicians to treat accordingly.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.23041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004547PMC
March 2022

A Rare Case of HHV-6 Encephalitis in an Immunocompetent Host: Case Report and Literature Review.

Cureus 2022 Mar 9;14(3):e23007. Epub 2022 Mar 9.

Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA.

Human herpesvirus-6 (HHV-6) is a virus known for causing the highly contagious infection, roseola infantum, and has been associated with causing encephalitis in pediatric patients and less commonly in adult patients as well. Regardless of the patient's age, the primary HHV-6 infection could be complicated by neurological sequelae including encephalitis, acute encephalopathy with biphasic seizures syndrome, or demyelinating disease. HHV-6 encephalitis does occur in an adult as a primary infection or reactivation. However, immunocompromised, hematopoietic stem cell transplantation patients, and solid organ transplant recipients are the most affected population. Here we present a rare case of HHV-6 encephalitis in a 26-year-old healthy immunocompetent male. HHV-6 viral DNA was detected in the cerebrospinal fluid during the acute stage of the disease, and the diagnosis was confirmed by quantitative polymerase chain reaction (PCR). The patient was treated with ganciclovir and had a complete response to treatment without any further complication. The pathophysiology, clinical course, and treatment in otherwise immunocompetent adult patients are also discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.23007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8993705PMC
March 2022

Isolated IgG4 Autoimmune Cholangitis in the Absence of Pancreatitis.

Cureus 2022 Mar 1;14(3):e22754. Epub 2022 Mar 1.

Interventional Gastroenterology, St. Joseph's Regional Medical Center, Paterson, USA.

The IgG4-related disease is an uncommon immune-mediated condition affecting multiple organ systems concomitantly; however, it is very rare for a patient to have isolated IgG4 autoimmune cholangitis or IgG4-related disease confined to the hepatobiliary system. The majority of cases are associated with pancreatitis and are incidentally discovered in the workup of acute or chronic pancreatitis. When it affects the hepatobiliary system, it develops as inflammatory fibrosclerosing cholangitis, which can mimic other hepatobiliary diseases such as primary sclerosing cholangitis. Herein, we present a case of type 1 IgG4 autoimmune cholangitis in the absence of pancreatitis. Our case is particularly unique because type 1 is the most common type associated with autoimmune pancreatitis; however, our patient had type 1 without any evidence of pancreatic involvement. Additionally, like most cases of isolated IgG4 autoimmune cholangitis, our patient was refractory to standard therapy. This case highlights the clinical significance, rarity and severity of isolated IgG4 autoimmune cholangitis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.22754DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970977PMC
March 2022

Delayed Metastasis of Clear Cell Renal Carcinoma to the Colon in the Setting of Benign Kidney Disease.

Cureus 2022 Feb 27;14(2):e22659. Epub 2022 Feb 27.

Colorectal Surgery, Thomas Jefferson University Hospital, Philadelphia, USA.

Clear cell renal carcinoma (CCRC) is a common variant of renal cell carcinoma (RCC), which presents with unpredictable features. The occurrence of RCC in those with autosomal dominant polycystic kidney disease (ADPKD) is debated. Most studies agree that ADPKD does not increase the risk of RCC; however, it makes diagnosing RCC difficult due to the nature of the disease. RCC frequently metastasizes to the lungs, lymph nodes, bones, liver, adrenal glands, and brain, but rarely metastasizes to the colon. In all previous reports, primary RCC was already diagnosed in the kidneys; thus, metastatic CCRC to the colon has never been described in the current literature in the absence of a primary renal tumor. Here, we report a rare presentation of metastatic CCRC wherein a patient with ADPKD presented with an obstructing sigmoid mass six years after bilateral nephrectomy for pathologically benign cysts. Despite a close follow-up after nephrectomy, our patient's non-specific symptoms were attributed to underlying comorbidities and more likely etiologies of back pain, diarrhea, and anemia, thus delaying and complicating the diagnosis of CCRC which subsequently led to metastases at the time of presentation. Although past literature has described CCRC metastases to other parts of the gastrointestinal tract or even described primary clear cell carcinoma of the colon, this is the first case in which a patient with benign cystic renal disease developed CCRC presenting as metastatic disease of the colon, rectum, liver, and lung. This paper will address the manifestations of ADPKD and postulate mechanisms for the unpredictable nature of this patient's RCC metastasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.22659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8963926PMC
February 2022

A Rare Case of Listeria Septicemia and Meningitis in Liver Cirrhosis.

Am J Case Rep 2022 Mar 23;23:e935198. Epub 2022 Mar 23.

Department of Critical Care Medicine, St. Joseph's University Medical Center, Paterson, NJ, USA.

BACKGROUND Sepsis is a leading global cause of mortality, with the most common causative agents being Staphylococcus aureus, Streptococcus pneumoniae, and Escherichia coli. In septic patients with liver cirrhosis, the mortality rates are higher than in the general population due to altered liver function and an excessive innate immune response. In this demographic, sepsis is typically caused by spontaneous bacterial peritonitis or urinary tract infections and the causative agents are very predictable owing to known dysregulated immunological pathways studied in patients with cirrhosis. Listeria monocytogenes is not only a less common cause of sepsis, but also a rare cause in patients with cirrhosis. Moreover, concurrent meningitis and septicemia is even less common in this demographic. CASE REPORT Herein we present a patient with known liver cirrhosis from chronic alcohol use who presented with generalized complaints and was admitted to the Intensive Care Unit with septic shock and concomitant liver failure. Although his changes in mentation were initially attributed to sepsis with superimposed hepatic encephalopathy, he was also diagnosed with meningitis. Cultures from the cerebral spinal fluid and blood serum were positive for Listeria monocytogenes. The patient's family reported that he had not recently consumed deli meat, cheeses, or raw chicken, and there were no known outbreaks in the area at the time of diagnosis. CONCLUSIONS This report illustrates a rare case of concurrent septicemia and meningitis secondary to Listeria monocytogenes in a patient with liver cirrhosis and reviews current literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12659/AJCR.935198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958865PMC
March 2022

A Case of Pseudomembranous Colitis of Unknown Etiology.

Cureus 2022 Feb 4;14(2):e21914. Epub 2022 Feb 4.

Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.

Pseudomembranous colitis (PC) is a nonspecific bowel injury resulting from decreased oxygenation, endothelial damage, and impaired blood flow to the mucosa. Although the most well-known cause of PC is , several diseases and medications can cause or predispose individuals to PC, such as microscopic colitis, infectious organisms, inflammatory conditions, nonsteroidal anti-inflammatory drugs, and chemotherapy agents. Here, we present the case of a patient who completed treatment for infection but developed worsening PC of unknown etiology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.21914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898612PMC
February 2022

A Rare Case of Methicillin-Resistant Staphylococcus aureus (MRSA) Enterocolitis Treated With Oral Vancomycin.

Cureus 2021 Dec 3;13(12):e20143. Epub 2021 Dec 3.

Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA.

Historically, methicillin-resistant Staphylococcus aureus (MRSA) was thought to be the primary pathogen in pseudomembranous enterocolitis associated with antibiotic use or recent abdominal surgery; however, was later identified as another more common pathogen. Since the eclipse of the workup of hospital-acquired diarrhea now utilizes nucleic acid amplification rather than stool cultures and longer includes the investigation of other less common pathogens. Consequently, the diagnosis of MRSA enterocolitis has faded. It is imperative to consider more sinister pathogens not routinely covered in laboratory testing as MRSA enterocolitis infections have been known to progress to severe systemic infections and thus the delay or misdiagnosis can result in inappropriate treatment, prolonged hospitalizations, sepsis and/or death. Herein we present a case of a patient who presented with laboratory diagnosed MRSA enterocolitis in the absence of recent abdominal surgery or antibiotic use and was successfully treated with oral vancomycin.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.20143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723774PMC
December 2021

A Case of Multifactorial Viral Myocarditis.

Cureus 2021 Oct 21;13(10):e18950. Epub 2021 Oct 21.

Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.

We present a case of viral myocarditis in the setting of Coxsackievirus and coronavirus disease 2019 (COVID-19) infection. This case is unique as there were two underlying active infections that could have caused the patient's myocarditis. Though both viruses have been shown to cause myocarditis, it was difficult to differentiate the exact etiology in this particular case. The unique nature of this case presents the opportunity to explore whether further diagnostic workup is warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.18950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604421PMC
October 2021

A rare presentation of undiagnosed multiple sclerosis after the COVID-19 vaccine.

J Community Hosp Intern Med Perspect 2021 15;11(6):772-775. Epub 2021 Nov 15.

Department of Internal Medicine, St. Joseph's Hospital, Paterson, NJ, USA.

Multiple sclerosis (MS) is an auto-immune mediated neurological disorder that affects the central nervous system and leads to myelin sheath destruction. The pathogenesis of MS involves T helper cells causing inflammation and eventual death of the oligodendrocytes. Etiologies for the development of MS include a combination of genetic, environmental, and immune factors. Vaccines have been proposed to increase the immune response and have reportedly activated some autoimmune disorders. Although certain vaccines such as hepatitis B have been associated with MS, studies have refuted these cases. We present a rare case of a 32-year-old patient who presented with symptoms and suggestive of MS a few days after receiving the COVID vaccine. Laboratory and imaging findings confirmed the diagnosis of MS, and she was started on steroids and discharged in a stable condition a few days after.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/20009666.2021.1979745DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604537PMC
November 2021

A Case of Cytomegalovirus Encephalitis in Cluster of Differentiation Four Cell Counts Greater Than 50.

Cureus 2021 Oct 6;13(10):e18550. Epub 2021 Oct 6.

Hematology and Oncology, St. Joseph's University Medical Center, Paterson, USA.

Although cytomegalovirus (CMV) encephalitis is a common viral infection, it is rarely reported in immunocompromised patients with cluster of differentiation four (CD4) cell counts greater than 50. Herein, we present a case of CMV encephalitis co-infected with Epstein-Barr virus (EBV) in a human immunodeficiency virus (HIV) patient with a CD4 cell count of 145. In addition, the patient was also infected with syphilis and tuberculosis. This case report will discuss the complications of untangling the differential diagnosis in an immunocompromised host with multiple infections, specifically, how it was difficult to identify the exact etiology of this patient's encephalopathy. We will address the plausible explanations for this unusual presentation, including CD4 dysfunction, latent and re-infections, and synergism seen with the co-infections in HIV patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.18550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570985PMC
October 2021

A Case of COVID-19 Vaccine Causing a Myasthenia Gravis Crisis.

Cureus 2021 Jun 10;13(6):e15581. Epub 2021 Jun 10.

Pulmonology and Critical Care, St. Joseph's Regional Medical Center, Paterson, USA.

Myasthenia gravis is a rare disease of the neuromuscular junction subsequently affecting the bulbar, respiratory, and extremity skeletal muscles. It is an autoimmune disease in which antibodies target the acetylcholine receptor (AChR), preventing transmission of the excitatory cascade during muscle contraction. Myasthenia gravis is typically well controlled using acetylcholinesterase inhibitors, steroids, immunosuppressant agents, and/or thymectomies. However, exacerbations can be induced by infection or medications. This is particularly important during the coronavirus disease 2019 (COVID-19) pandemic in which myasthenia gravis patients have been known to have poorer outcomes. We report a very rare presentation of a myasthenia gravis crisis induced by the Moderna COVID-19 vaccine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.15581DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272681PMC
June 2021

Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome.

Cureus 2020 Aug 24;12(8):e9984. Epub 2020 Aug 24.

General Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, USA.

Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis, characterized by painful and erythematous papules, pustules or vesicles that rapidly become ulcerative and necrotic. These ulcers have multiple sub-types and can develop anywhere on the body. There are different postulations as to the mechanisms of development for each sub-type. More than half of patients with PG have an underlying disease, with the highest prevalence being inflammatory bowel disease (IBD), followed by inflammatory arthritis and hematological disorders. Post-operative PG should be considered in any patient undergoing surgery who subsequently develops characteristic necrotic lesions with delayed wound healing, fever and severe localized pain. The clinical manifestations and treatment may differ slightly depending on the type and cause of PG. Herein, we present a patient with myelodysplastic syndrome and arthritis, who underwent surgery for diverticulosis complicated by colovaginal fistula formation, and subsequently developed a very prolonged course of post-operative pyoderma gangrenosum. This report will address the types of PG, their various manifestations and pathogenesis, as well as the management specific to patients with myelodysplastic syndrome. It is our intent to better understand the sub-types in order to predict and prevent post-operative PG.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.9984DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511067PMC
August 2020
-->