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  • 1.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Serrander, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
    Progressive multifocal leukoencephalopathy after heart transplantation: 4 years of clinically stable infection on low-dose immunosuppressive therapy2017In: Oxford Medical Case Reports, E-ISSN 2053-8855, Vol. 2017, no 2, p. 15-17Article in journal (Refereed)
    Abstract [en]

    Progressive multifocal leukoencephalopathy (PML), caused by reactivation of JC-virus is a relatively rare complication seen in patients with compromised immune system. There are no evidence-based treatment available and prognosis is poor. Withdrawal of immunosuppressant can result in further neurological deterioration and for patients with solid organ transplantations, fatal graft rejection. We report a 52-year-old women that presented with seizures within 1 month after heart transplantation. Initial diagnosis was vascular disease. After clinical deterioration 10 months after transplantation, further examinations led to the diagnosis. Minimizing tacrolimus, to a concentration of 2 ng/ml, and extensive physical therapy has improved the physical capacity of the patient. The patient has now been clinically stable for 4 years and extended survival for 5 years. This case adds to the limited adult cases of PML within the population of heart transplant recipients and the need for increased awareness to minimize diagnosis delay.

  • 2.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Suutari, Anne-Marie
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Abdulhadi, Karim
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Broda, Wojciech
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Csegedi, Melinda
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Salmonella enteritidis causing myocarditis in a previously healthy 22-year-old male2018In: Oxford Medical Case Reports, E-ISSN 2053-8855, Vol. 2018, no 12, p. 447-451, article id omy106Article in journal (Refereed)
    Abstract [en]

    Myocarditis is mostly caused by viral infections and rarely caused by bacterial pathogens, especially in immunocompetent individuals. Bacterial myocarditis due to Salmonella is rare, especially in countries with improved sanitation that minimize contamination of Salmonella typhi serotypes. We here present a case of a previous healthy 22-year-old male that came to the emergency room with chest pain. His symptoms occurred after a period of profuse diarrhea, fever and hematochezia. Magnetic resonance imaging confirmed the diagnosis of myocarditis. Stool culture was positive for Salmonella enteritidis. Myocarditis due to Salmonella is rare but may still occur in western countries. The inter-individual response to the pathogens and its virulence mechanisms and male gender is factors for developing myocarditis. We here add to the numbers of cases with myocarditis due to S. enteritidis. A higher suspicion and more frequent ECG and troponin testing might result in an increase of patients with subclinical myocarditis.

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