Science.gov

Sample records for case presentation zastosowanie

  1. Skin spiradenocarcinoma - case presentation.

    PubMed

    Rebegea, Laura Florentina; Firescu, Dorel; Dumitru, Mihaela; Pătraşcu, Anca

    2016-01-01

    Malignant eccrine spiradenoma is an extremely rare skin tumor of sweat gland origin. The available literature data indicates that spiradenocarcinoma nearly uniformly arises from a benign preexisting spiradenoma. Etiology is unknown but previous trauma is believed being an implicated factor. The article presents the clinical observation of a 34-year-old female patient, diagnosed with cutaneous spiradenocarcinoma of the left thigh, treated multidisciplinary: surgery and chemoradiotherapy. The presentation includes clinical, histopathological and therapeutic diagnosis aspects, arisen difficulties of histological diagnosis and literature data regarding treatment options for this type of tumor. In this case, surgery followed by second surgery intervention was performed due to the continuing development of local disease. After surgery, the patient performed external beam radiotherapy (EBRT) to tumoral bed (total dose of 50 Gy) and inguinal lymph nodes (total dose of 50 Gy), followed by six cycles of chemotherapy (CMT) (Carboplatin + Paclitaxel) with complete response. At the moment, the patient shows no evidence of recurrence or metastatic disease during the follow-up. PMID:27151731

  2. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  3. Cystosarcoma phylloides: a case presentation.

    PubMed

    Orsini, J M; Perloff, M; Rybak, B

    1981-01-01

    A case of cystosarcoma phylloides is presented here showing the natural history of this disease both clinically and pathologically from 1962 through 1979, and demonstrating the management of this disease by surgery and by chemotherapy with the use of adriamycin at 25 mg/m2 daily, times three days, every 28 days, which to out knowledge has not been used in this particular setting. PMID:6272077

  4. [Premature newborn: a case presentation].

    PubMed

    Pastor Rodríguez, Jesús David; Pastor Bravo, María Del Mar; López García, Visitación; Cotes Teruel, María Isabel; Mellado, Jesús Eulogio; Cárceles, José Jara

    2010-01-01

    A case is presented of a premature newborn of 27 weeks gestation and weighing 420 grams who was delivered as a result of a maternal pre-eclampsia and retarded intra-uterine growth. During the 125 days of hospitalisation, an individual care plan based on the Virginia Henderson model was devised and applied to both the child and her parents using NANDA diagnostics, interventions according to the NIC classification, and the expected results according to the NOC classification. The Marjory Gordon functional patterns were used for the initial assessment. By applying the pre-term newborn (PTNB) plan, all their needs were provided and were modified throughout the hospital stay, with new needs that were added to the established ones. These required a continuous assessment with the subsequent adapting of the care plan. Likewise, the care required by the parents varied from the initial grief due to the possible loss of their child to learning the alarm signs and the home care that their child would need. The child was finally discharged weighing 2900 grams and with normal neurological and psychomotor development, although with a lower weight appropriate to her age. Currently, at 2 years old, the child has a normal neurological and psychomotor development, but with weight and size lower than the P(3) percentile. She requires speech therapy treatment due to paralysis of the right vocal cord. PMID:20605104

  5. Geopolymers in Construction / Zastosowanie Geopolimerów W Budownictwie

    NASA Astrophysics Data System (ADS)

    Błaszczyński, Tomasz Z.; Król, Maciej R.

    2015-03-01

    Within the framework of quests of supplementary and "healthier" binders to the production of concrete followed the development of geopolymers in construction. However the practical application of these materials is still very limited. The production of each ton of cement introduces one ton of CO2 into the atmosphere. According to various estimations, the synthesis of geopolymers absorbs 2-3 times less energy than the Portland cement and causes a generation of 4-8 times less of CO2. Geopolymeric concretes possess a high compressive strength, very small shrinkage and small creep, and they possess a high resistance to acid and sulphate corrosion. These concretes are also resistant to carbonate corrosion and possess a very high fire resistance and also a high resistance to UV radiation. W ramach poszukiwania zastępczych i "zdrowszych" spoiw do produkcji betonu nastąpił rozwój geopolimerów w budownictwie. Jednakże praktyczne zastosowanie tych materiałów jest jeszcze nadal bardzo ograniczone. Produkcja każdej tony cementu wprowadza do atmosfery tonę CO2. Według różnych szacunków, synteza geopolimerów pochłania 2-3 razy mniej energii, niż cementu portlandzkiego oraz powoduje wydzielenie 4-8 razy mniejszej ilości CO2. Do tego betony geopolimerowe posiadają wysoką wytrzymałość na ściskanie, bardzo mały skurcz i małe pełzanie oraz dają wysoką odporność na korozję kwasową i siarczanową. Betony te są także odporne na korozję węglanową i posiadają bardzo wysoką odporność ogniową, a także wysoką odporność na promieniowanie UV.

  6. Anorexia Nervosa or Not? A Case Presentation

    PubMed Central

    Swanson, Richard W.; Haight, Kenneth R.

    1989-01-01

    The authors of this article present a case of diabetic gastroparesis, initially diagnosed as anorexia nervosa. They compare the symptoms and signs of diabetic gastroparesis with the diagnostic criteria for anorexia nervosa and discuss treatment with domperidone. PMID:21248884

  7. Case Presentations from the Addiction Academy.

    PubMed

    Laes, JoAn R; Wiegand, Timothy

    2016-03-01

    In this article, a case-based format is used to address complex clinical issues in addiction medicine. The cases were developed from the authors' practice experience, and were presented at the American College of Medical Toxicology Addiction Academy in 2015. Section I: Drug and Alcohol Dependence and Pain explores cases of patients with co-occurring pain and substance use disorders. Section II: Legal and Policy Issues in Substance Use Disorders highlights difficult legal and policy questions in addiction medicine. Section III: Special Populations and Addictive Disorders delves into the complexity of addiction in special populations (pregnant, pediatric, and geriatric patients). PMID:26586253

  8. Brucellosis presenting as myelofibrosis: first case report.

    PubMed

    Bakri, Faris G; Al-Bsoul, Nazzal M; Magableh, Ahmad Y; Shehabi, Asem; Tarawneh, Musleh; Al-Hadidy, Azmy M; Abu-Fara, Mohammed A; Awidi, Abdallah S

    2010-02-01

    We describe the case of a 29-year-old woman who presented with pancytopenia and myelofibrosis. Brucella melitensis was identified in her blood. The patient recovered completely with doxycycline and rifampin. A repeat bone marrow biopsy showed hypercellularity without myelofibrosis. Bone marrow findings in cases of pancytopenia due to brucellosis reveal normocellularity, hypercellularity, hemophagocytosis, or granuloma. To our knowledge this is the first report of brucellosis causing myelofibrosis. Brucellosis should be considered as a possible cause of myelofibrosis in endemic areas. PMID:19501533

  9. Intrapartum diagnostic of Roberts syndrome - case presentation.

    PubMed

    Socolov, Răzvan Vladimir; Andreescu, Nicoleta Ioana; Haliciu, Ana Maria; Gorduza, Eusebiu Vlad; Dumitrache, Florentin; Balan, Raluca Anca; Puiu, Maria; Dobrescu, Mihaela Amelia; Socolov, Demetra Gabriela

    2015-01-01

    Roberts syndrome is a rare disease, with multiple limb and skeletal abnormalities (called "pseudothalidomide disease"). There are only around 150 cases described in literature. We present a case of Roberts syndrome, diagnosed in moment of delivery, after a pregnancy without prenatal follow-up. The stillborn baby was naturally delivered by a 17-year-old primiparous woman at 38 weeks of amenorrhea. The pregnancy was not followed due to socioeconomic and family situation, and no prenatal ultrasound was performed. The male baby has 2650 g and presented several morphological abnormalities and tight double umbilical abdominal loop. The macroscopic evaluation showed: dolichocephaly, hypoplastic inferior maxilla with micrognathia, antimongoloid palpebral slant, pterygium colli, abnormal and lower implanted ears, superior limbs phocomelia, syndactyly at lower left limb and tetradactyly in all limbs, bilateral cryptorchidism, pancreatic aplasia. Roberts syndrome is a rare genetic disease with recessive autosomal transmission generated by mutations in ESCO2 gene, located on chromosome 8. The disease should be easy to diagnose by antenatal ultrasound examination, but in our case, the lack of prenatal follow-up determined the diagnostic at term. We believe consider this case is an argument towards introducing ultrasound-screening compulsory to all pregnancies. To identify a possible genetic mutation, further investigations of the parents are in progress, but classically the disease has a recessive autosomal transmission. PMID:26193234

  10. Peutz-Jeghers syndrome: case presentation.

    PubMed

    Costa, J

    1977-07-01

    The different aspects of the Peutz-Jeghers syndrome are discussed following a case presentation of a 36-year-old woman with Peutz-Jeghers syndrome, sex cord tumor with annular tubules of Scully, mucinous metaplasia of tubal epithelium, and adenocarcinoma of the endocervix. The latter two findings have not been described with the syndrome and an attempt is made to correlate them with Peutz-Jeghers syndrome. PMID:876533

  11. Electrocutions--treatment strategy (case presentation).

    PubMed

    Ungureanu, M

    2014-01-01

    Electrical injuries are a form of trauma with extreme gravity and a unique pathophysiology: they affect the entire organism. A wide range of voltages may cause electrical accidents. Complications should be anticipated and prevented in order to minimize the complication risk and assure a vital, functional and esthetic prognosis as good as possible. The article presents a case treated in our clinic together with the unique particular clinical situation and algorithm that led to a favorable result. PMID:25729443

  12. Uncommon Presentation of Triploidy: A Case Report.

    PubMed

    Uzun, Işil; Pata, Özlem; Unlu, Cihat; Tokat, Fatma; Ozdemir, Mucize

    2015-10-01

    A 28-year-old woman presented in her first pregnancy was admitted with severe hyperemesis gravidarium. Increased nuchal translucency with cardiac anomaly and omphalocele at the first trimester was observed at the ultrasound examination. Chorionic villus biopsy confirmed triploidy. The combination of type I and type II triploidy patterns were seen together in the second trimester of the pregnancy. Although the symptoms due to increased human chorionic levels occured, at the pathologic investigation there were no molar changes in the placenta. Here we report a case of uncommon presentation of triploidy. PMID:26557571

  13. Erythema nodosum - presentation of three cases.

    PubMed

    Starba, Aleksandra; Chowaniec, Małgorzata; Wiland, Piotr

    2016-01-01

    Erythema nodosum (EN) is a well-known form of panniculitis. It may occur as an idiopathic form and also can be induced by certain clinical conditions such as infections and granulomatous diseases such as sarcoidosis. Erythema nodosum may be accompanied by general symptoms such as fever, weakness, and severe pain, but skin lesions resolve without skin damage. Erythema nodosum occurrence is for the clinician a signal for a wider diagnosis and determination of the cause of occurrence of symptoms. The article presents three cases of EN with different causes and treatment. PMID:27407285

  14. Erythema nodosum – presentation of three cases

    PubMed Central

    Starba, Aleksandra; Wiland, Piotr

    2016-01-01

    Erythema nodosum (EN) is a well-known form of panniculitis. It may occur as an idiopathic form and also can be induced by certain clinical conditions such as infections and granulomatous diseases such as sarcoidosis. Erythema nodosum may be accompanied by general symptoms such as fever, weakness, and severe pain, but skin lesions resolve without skin damage. Erythema nodosum occurrence is for the clinician a signal for a wider diagnosis and determination of the cause of occurrence of symptoms. The article presents three cases of EN with different causes and treatment. PMID:27407285

  15. Glabellar dermoid cyst: A case presentation.

    PubMed

    Celik, Tuba

    2016-09-01

    Dermoid cysts are one of the most common non-inflammatory space-occupying orbital lesions in the pediatric population. They are ectodermal cysts which may contain squamous epithelium with dermal contents such as skin, hair follicles, sebaceous glands, or sweat glands. Dermoid cyts are often innocent, however complications such as inflammation of the fistula or preseptal cellulitis are occasionally seen. We present a case of a 6-year-old girl with a glabellar dermoid cyst and describe the appropriate investigations and definitive treatment. PMID:26885559

  16. Clinical presentation of pili torti - Case report*

    PubMed Central

    Yang, Jeane Jeong Hoon; Cade, Karine Valentim; Rezende, Flavia Cury; Pereira, José Marcos; Pegas, José Roberto Pereira

    2015-01-01

    Pili torti also known as ‘twisted hairs’ (Latin: pili=hair; torti=twisted) is a rare, congenital or acquired clinical presentation, in which the hair shaft is flattened at irregular intervals and twisted 180º along its axis. It is clinically characterized by fragile, brittle, coarse and lusterless hairs, due to uneven light reflection on the twisted hair surface. Pili torti may be associated with neurological abnormalities and ectodermal dysplasias. There is no specifi c treatment for this condition, but it may improve spontaneously after puberty. We report a case of pili torti in a child who presented fragile, brittle, diffi cult to comb hair. The patient had no comorbidities. PMID:26312667

  17. Norwegian crusted scabies: an unusual case presentation.

    PubMed

    Maghrabi, Michael M; Lum, Shireen; Joba, Ameha T; Meier, Molly J; Holmbeck, Ryan J; Kennedy, Kate

    2014-01-01

    Scabies is a contagious condition that is transmitted through direct contact with an infected person and has been frequently associated with institutional and healthcare-facility outbreaks. The subtype Norwegian crusted scabies can masquerade as other dermatologic diseases owing to the heavy plaque formation. Successful treatment has been documented in published reports, including oral ivermectin and topical permethrin. Few case studies documenting the treatment of Norwegian crusted scabies have reported the use of surgical debridement as an aid to topical and/or oral treatment when severe plaque formation has been noted. A nursing home patient was admitted to the hospital for severe plaque formation of both feet. A superficial biopsy was negative for both fungus and scabies because of the severity of the plaque formation on both feet. The patient underwent a surgical, diagnostic biopsy of both feet, leading to the diagnosis of Norwegian crusted scabies. A second surgical debridement was then performed to remove the extensive plaque formation and aid the oral ivermectin and topical permethrin treatment. The patient subsequently made a full recovery and was discharged back to the nursing home. At 2 and 6 months after treatment, the patient remained free of scabies infestation, and the surgical wound had healed uneventfully. The present case presentation has demonstrated that surgical debridement can be complementary to the standard topical and oral medications in the treatment of those with Norwegian crusted scabies infestation. PMID:24370484

  18. Melioidosis presenting as lymphadenitis: a case report

    PubMed Central

    2014-01-01

    Background Melioidosis is an infection caused by the facultative intracellular gram-negative bacterium; Burkholderia pseudomallei. It gives rise to protean clinical manifestations and has a varied prognosis. Although it was rare in Sri Lanka increasing numbers of cases are being reported with high morbidity and mortality. Here we report a case of melioidosis presenting with lymphadenitis which was diagnosed early and treated promptly with a good outcome. Case presentation A 53-year-old Sinhalese woman with diabetes presented with fever and left sided painful inguinal lymphadenitis for one month. She had undergone incision and drainage of a thigh abscess three months previously and had been treated with a short course of antibiotics. There was no record that abscess material was tested microbiologically. She had neutrophil leukocytosis and elevated inflammatory markers. Initial pus culture revealed a scanty growth of “Pseudomonas sp.” and Escherichia coli which were sensitive to ceftazidime and resistant to gentamicin. Due to the history of diabetes, recurrent abscess formation and the suggestive sensitivity pattern of the bacterial isolates, we actively investigated for melioidosis. The bacterial isolate was subsequently identified as B. pseudomallei by polymerase chain reaction and antibodies to melioidin antigen were found to be raised at a titre of 1:160. The patient was treated with high dose intravenous ceftazidime for four weeks followed by eradication therapy with cotrimoxazole and doxycycline. As the patient was intolerant to cotrimoxazole, the antibiotics were changed to a combination of co-amoxyclav and doxycycline and continued for 12 weeks. The patient was well after 6 months without any relapse. Conclusions Melioidosis is an emerging infection in South Asia. It may present with recurrent abscesses. Therefore it is very important to send pus for culture whenever an abscess is drained. However, it should be noted that the reporting laboratory may

  19. [Dermatoses in pregnancy. Presentation of a case].

    PubMed

    Uceda, M E; Guillén, M

    2014-01-01

    Family physicians usually follow up pregnancies in which no special incidences are expected to occur. Cutaneous pruritus is a common symptom in pregnant women, on most occasions without further consequences. However, noteworthy is a group of very rare pathologies known as pregnancy dermatoses, some of which may have potentially severe complications, mainly for the fetus and the pregnancy outcome, and also, to a lesser degree, for the mothers and other future pregnancies. It is essential to know how to manage the pruritus, and how to take an adequate clinical history in order to diagnose these severe conditions. The case of a pregnant woman who consulted for pruriginous dermatoses (pemphigoid gestationis) is presented to illustrate this topic. A description of the diagnostic process, differential diagnosis, treatment and outcome, is included. PMID:24468304

  20. [Neonatal Dengue. Presentation of clinical cases].

    PubMed

    Romero-Santacruz, Edith; Lira-Canul, Janeth Jaqueline; Pacheco-Tugores, Fredy; Palma-Chan, Adolfo Gonzalo

    2015-05-01

    Dengue is an infectious disease caused by a flavivirus, with four serotypes, transmitted by the mosquito Aedes aegypti. In Mexico it is a public health problem, especially in the region of central and southeast of the country. The disease can be asymptomatic or present serious forms and even death. It is confirmed by detection of the NS1 Antigen; IgM antibodies, polymerase chain reaction and virus isolation. The vertical transmission to de newborn has been little studied. 7 cases in neonates from November to December 2011 are reported. All patients were male, obtained by caesarean section between 34 and 40 weeks of gestation, whose mothers were enrolled with fever and symptoms associated with dengue disease and serology positive for dengue. Six with positive AgNS1 and one positive IgM; one mother died. All the newborns had positive serology for dengue, 4 with positive AgNS1 and 3 positive IgM. The clinical features of the newborn ranged from asymptomatic to one serious dengue fever, shock and hemorrhage. The symptomatic 6 attended with thrombocytopenia, changes in temperature and unspecific disturbance. The severity of mothers conditioned disrepair product at birth, but not with subsequent gravity of the new born. Vertical trasmission of dengue should be suspected in risk areas, to maintain vigilance and to give early treatment. Also is neccesary promote the realization of specific diagnostic and therapeutic guidelines to the neonatal period. PMID:26233977

  1. [Lipoid pneumonia: presentation of a case].

    PubMed

    Alvarez-Cordovés, M M; Mirpuri-Mirpuri, P G; Rocha-Cabrera, P; Pérez-Monje, A

    2013-03-01

    We report a case of lipoid pneumonia treated in our Health Centre. It is a disease that occurs rarely, but is important in Primary Care. This condition has been known since 1925, when it was first described by Laughlen, who described a case of lipoid pneumonia secondary to an injection of oil in the nasopharyngeal area. Today it is a rarity, and it is most frequently associated with the use of oil-based nasal drops (which are now decreasing in use). Its aetiology may be endogenous or exogenous. Although the pathological diagnosis is generally the most important, sometimes a lesion in the chest X-ray can lead us to suspect it due to the patient's history. This was a case of acute lipoid pneumonia in a young patient, who periodically performed as a "fire eater". PMID:23452539

  2. The Teacher as Researcher: Presenting Your Case.

    ERIC Educational Resources Information Center

    Brumbaugh, Kenneth E; Poirot, James L.

    1993-01-01

    Discusses presentations as a format teachers can use for dissemination of research findings. The sixth in a series on the teacher as researcher, the article covers identifying the target audience; organizing and practicing a presentation; and choosing appropriate audio-video technologies. A sidebar provides a generalized presentation outline. (KRN)

  3. Case report: Patient presenting with Cushing's disease

    PubMed Central

    Shaver, Dawn

    2015-01-01

    Backgound: Cushing's syndrome is a rare disease that is caused by the overproduction of cortisol by the adrenal glands. This can be caused by a tumor of the adrenal glands, the lungs or the pituitary gland. When a pituitary tumor produces too much ACTH (adrenocorticotropic hormone), it causes the overproduction of cortisol by the adrenal glands. When the pituitary is the source of the over production, it is called Cushing's disease. Case Description: A 32-year-old female who developed symptoms of Cushing's about one and a half years prior to her visit at a large teaching hospital in the Mid-Atlantic. Her symptoms included amenorrhea, facial hair and acne, and back pain. She had previously been diagnosed with polycystic ovarian syndrome. Conclusion: Cushing's disease is a rare disease, which can be successfully treated by experienced pituitary specialists. PMID:26069847

  4. Antisynthetase syndrome: two cases presenting orofacial manifestations.

    PubMed

    Gormley, M; Scully, C

    2014-03-01

    Antisynthetase syndrome is a rare autoimmune disease that is characterised by inflammatory myositis, and interstitial lung disease or chronic arthropathy, or both. To the best of our knowledge, orofacial manifestations have not previously been reported. We present 2 patients with orofacial disease: one with aphthous-like oral ulceration and the other with hyposalivation. PMID:24377442

  5. Granite School District Case Presentation; VIDCA '73.

    ERIC Educational Resources Information Center

    Hess, Donald C.

    An outline of an instructional media project for grades Kindergarten through 12 is presented. The author describes the major steps involved in the program by which educational television (ETV) productions and 16mm films were transferred to videotape cassettes so that they could be used more easily to enrich curriculum and to support library and…

  6. 33 CFR 50.4 - Presentation of case.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Presentation of case. 50.4 Section 50.4 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL COAST GUARD RETIRING REVIEW BOARD § 50.4 Presentation of case. (a) The applicant may present his case:...

  7. Rare Hernias Presenting as Acute Abdomen- A Case Series

    PubMed Central

    Ulahannan, Sansho Elavumkal; Kurien, John S; Joseph, Aneesh; Kurien, Annie Sandhya; Varghese, Sandeep Abraham; Thomas, Bindhya; Varghese, Fobin

    2016-01-01

    Hernia is an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. It can be divided into internal, external and diaphragmatic hernias. Most of them can be asymptomatic. If they become symptomatic they can present with features of intestinal obstruction, incarceration or strangulation. In this case series we compare the incidence of these rare presentations of hernias with world literature and to warn surgeons not to cut the obstructing band in cases of internal hernias. In this case series, we review the clinical details of 7 rare presentations of hernia, who presented with various types of hernias to a tertiary care centre in Kerala over a period of one year. Of these 7 cases 6 cases were internal hernias (3 left paraduodenal hernias, 2 transmesentric hernias, and 1 pericaecal hernia) and a case of spigelian hernia above the level of umbilicus. All of them presented as acute abdomen in the emergency department. Among these 7 cases, only one case was diagnosed preoperatively. Three patients had bowel gangrene and had to undergo resection- anastomosis of the bowel. The survival rate among these cases was 100% as compared to 50% in the world literature if they had been left untreated. Even though internal hernias are a rare entity, we need to have it as a differential diagnosis in case of intestinal obstruction, in a previously non-operated abdomen. PMID:27134943

  8. 29 CFR 2700.63 - Evidence; presentation of case.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Evidence; presentation of case. 2700.63 Section 2700.63 Labor Regulations Relating to Labor (Continued) FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION PROCEDURAL RULES Hearings § 2700.63 Evidence; presentation of case. (a) Relevant evidence, including...

  9. Some rare presentations of hydatid cysts: two case reports.

    PubMed

    Zaidi, Syed H

    2009-01-01

    Hydatid disease is a considerable health problem worldwide. Two case reports of relatively uncommon presentations of the disease are presented.The first case is that of a 25 years old female from region of Afghanistan that borders Pakistan's Baluchistan province. She presented with cough, hemoptysis and left hypochondrium pain due to concurrent involvement of the right lung and the spleen due to hydatid disease, whilst sparing the liver.The second case is that of a 32 years male from the same region of Afghanistan as above. He presented with upper abdominal discomfort, postprandial vomiting and jaundice due to a hydatid cyst involving the head of the pancreas only. PMID:19149905

  10. Acute appendicitis presenting as small bowel obstruction: two case reports

    PubMed Central

    2009-01-01

    Acute appendicitis is a common surgical problem however the diagnosis is often overlooked when it presents as a small bowel obstruction. In this report we present two cases of elderly patients who presented with small bowel obstruction and raised inflammatory markers. Both patients were successfully treated with a laparotomy, adhesiolysis and appendicectomy and went on to make a good recovery. PMID:20062683

  11. HYDROGEOLOGIC CASE STUDIE(PRESENTATION FOR MNA WORKSHOP)

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  12. A case of rectal neuroendocrine tumor presenting as polyp

    PubMed Central

    RAKICI, Halil; AKDOGAN, Remzi Adnan; YURDAKUL, Cüneyt; CANTURK, Neşe

    2015-01-01

    Neuroendocrine tumor (NET) is detected in the examination of polypectomy material, presenting as rectal polyp. Since this is a rare case, we aimed to summarize the approach to rectal NET’s. PMID:25625492

  13. Analysis of the Digital Evidence Presented in the Yahoo! Case

    NASA Astrophysics Data System (ADS)

    Kwan, Michael; Chow, Kam-Pui; Lai, Pierre; Law, Frank; Tse, Hayson

    The “Yahoo! Case” led to considerable debate about whether or not an IP address is personal data as defined by the Personal Data (Privacy) Ordinance (Chapter 486) of the Laws of Hong Kong. This paper discusses the digital evidence presented in the Yahoo! Case and evaluates the impact of the IP address on the verdict in the case. A Bayesian network is used to quantify the evidentiary strengths of hypotheses in the case and to reason about the evidence. The results demonstrate that the evidence about the IP address was significant to obtaining a conviction in the case.

  14. A case of acquired Gitelman syndrome presenting as hypokalemic paralysis

    PubMed Central

    Kulkarni, M.; Kadri, P.; Pinto, R.

    2015-01-01

    We report a case of a young female patient who presented with weakness of upper and lower limbs. On evaluation, she had hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria. Anti-Ro (SSA) antibody was positive. She had an acquired Gitelman syndrome due to primary Sjögren's syndrome (SS). SS presenting with features of Gitelman syndrome is very rare. PMID:26199478

  15. A case of acquired Gitelman syndrome presenting as hypokalemic paralysis.

    PubMed

    Kulkarni, M; Kadri, P; Pinto, R

    2015-01-01

    We report a case of a young female patient who presented with weakness of upper and lower limbs. On evaluation, she had hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria. Anti-Ro (SSA) antibody was positive. She had an acquired Gitelman syndrome due to primary Sjögren's syndrome (SS). SS presenting with features of Gitelman syndrome is very rare. PMID:26199478

  16. Syphilis presenting as isolated cervical lymphadenopathy: two related cases.

    PubMed

    van Crevel, Reinout; Grefte, Johanna M M; van Doorninck, Damiaen; Sturm, Patrick

    2009-01-01

    Two young adult brothers, with no apparent risk for sexually transmitted infections (STI), presented with unilateral cervical lymphadenitis. Syphilis was diagnosed by fine-needle aspiration cytology in one case, and subsequent serology and revision of a resected lymph node in the second case. Clinicians should have a high index of suspicion and a low diagnostic threshold in patients with unexplained lymphadenopathy, even in the absence of a history of primary syphilis, or obvious risk for STI. PMID:18649948

  17. Steinert's syndrome presenting as anal incontinence: a case report

    PubMed Central

    2011-01-01

    Introduction Myotonic dystrophy (MD) or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. Case Presentation We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45. Conclusions In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. PMID:21838873

  18. Femicide in Italy: national scenario and presentation of four cases.

    PubMed

    Bonanni, Elisa; Maiese, Aniello; Gitto, Lorenzo; Falco, Pietro; Maiese, Adamo; Bolino, Giorgio

    2014-03-01

    Femicide is defined as the killing of a woman by a man because she is a woman. The incidence of femicide has increased over the past few years and accounted for 30.9% of all homicides in 2011 in Italy. Certain features are usually present including asphyxiation as the mechanism of death, an intimate partner as murderer, and a history of sentimental relationship between the victim and the offender. In this paper, we analyse the Italian experience of femicide comparing it with the international scenario. We present four cases of femicide showing peculiar mechanisms of death resulting from various methods of asphyxiation. In all the cases, there had been a relationship between the victim and the offender. We discuss the mechanism of asphyxiation used to kill the women, emphasizing the necessity of a careful evaluation of all data available to reach the correct conclusion in atypical cases of femicide. PMID:24619844

  19. Early onset marfan syndrome: Atypical clinical presentation of two cases

    PubMed Central

    Ozyurt, A; Baykan, A; Argun, M; Pamukcu, O; Halis, H; Korkut, S; Yuksel, Z; Gunes, T; Narin, N

    2015-01-01

    Early onset Marfan Syndrome (eoMFS) is a rare, severe form of Marfan Syndrome (MFS). The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system. PMID:26929908

  20. A case of DIPNECH presenting as usual interstitial pneumonia.

    PubMed

    Chatterjee, Kshitij; Kamimoto, Jorge Jo; Dunn, Andrew; Mittadodla, Enchala; Joshi, Manish

    2016-01-01

    Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare disease that is classically described as presenting with cough, dyspnea, and wheezing in non-smoker middle aged females. Pulmonary function tests commonly demonstrate an obstructive pattern and CT of chest usually reveals diffuse air trapping with mosaic pattern. We present a case of patient with DIPNECH manifesting with restrictive pattern and as usual interstitial pneumonia on imaging. PMID:27238180

  1. Imaging presentation of complicated diabetic ketoacidosis: a case report.

    PubMed

    Escobar, Eduardo; Mullenix, Philip S; Sapp, Jason E

    2012-12-01

    Spontaneous pneumomediastinum is a fairly uncommon complication of diabetic ketoacidosis. Knowledge of the clinical and radiographic manifestation is important for the proper management of patients since the disease usually follows a benign evolution. We report a case of a 20-year-old soldier who presented with a pneumomediastinum that was initially falsely attributed to a motor vehicular crash. PMID:22684306

  2. X-linked Ichthyosis Presenting as Erythroderma: A Rare Case

    PubMed Central

    Das, Anirban; Mishra, Vivek; Shome, Kaushik; Sen, Arpita

    2015-01-01

    X-linked ichthyosis is a rare form of dermatological disease and when it presents as erythroderma it is even rarer. History of consanguineous marriage and prolonged labor during birth of patient, generalized scaling which gets better in summer months, flexural involvement, cryptorchidism made a diagnosis of X-linked ichthyosis. We report this case because of its rarity as erythroderma. PMID:26538699

  3. Antiphospholipid syndrome presenting as progressive neuropsychiatric disorders: two case reports

    PubMed Central

    Li, Chien-Hsun; Chou, Mei-Chuan; Liu, Ching-Kuan; Lai, Chiou-Lian

    2013-01-01

    The antiphospholipid syndrome (APS) is a rare form of autoimmune coagulopathy. In this syndrome, the most common neurologic abnormality is transient ischemic attack. This can be easily overlooked if a patient presents with progressive neuropsychiatric disorders, such as depression or dementia. We report two cases of young women, aged 35 and 22 years, presenting with progressive depression and mental decline over a certain period. The neuropsychological diagnoses of the two patients were, respectively, dementia with disinhibition and borderline dementia with depression. Brain magnetic resonance imaging showed multiple old infarcts with encephalomalacia in the former case, and only one cortical hemorrhagic infarction, over the right temporoparietal lobe, observed in the latter case. The outcomes of the two cases were also very different. Progressive neuropsychiatric disorders are increasingly observed in the young; therefore, APS and other autoimmune diseases should be considered during the differential diagnosis. Brain imaging examinations may prevent a delay in the detection of a structural lesion and facilitate the early intervention with good prognosis. Careful investigations by experts from different disciplines are always encouraged in complicated cases. PMID:23723705

  4. Two cases of an atypical presentation of necrotizing stomatitis

    PubMed Central

    2015-01-01

    Purpose The purpose of this report was to describe the clinical and microbiological characteristics of two rare cases of necrotizing stomatitis, and the outcomes of a non-invasive treatment protocol applied in both cases. Methods We report two cases of necrotizing stomatitis in a rare location in the hard palate of a 40-year-old woman and a 28-year-old man. Neither had a relevant medical history and both presented with highly painful ulceration in the palate and gingival margin that was accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to the lesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribed to both patients in addition to two daily oral rinses of 0.2% chlorhexidine. Results In both cases, radiological examination ruled out bone involvement, and exfoliative cytology revealed a large inflammatory component and the presence of forms compatible with fusobacteria and spirochetes. There was a rapid response to treatment and a major improvement was observed after 48 hours, with almost complete resolution of the ulcerated lesions and detachment of necrotic areas with partial decapitation of gingival papillae. Conclusions Necrotizing periodontal lesions can hinder periodontal probing and the mechanical removal of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively. PMID:26734496

  5. [An atypical measles case presenting with severe cervical spasm].

    PubMed

    Oztoprak, Nefise; Celebi, Güven; Temiz, Ekrem

    2006-10-01

    Atypical measles is characterized by high fever, headache, myalgia and atypical rash, in patients who were vaccinated against measles. In this report a 22 years old male patient presenting with severe cervical and shoulder muscles spasms, purpuric and petechial lesions on palm, sole and whole body, has been presented. The patient had not an underlying disease or immunosuppression, and he had experienced single dose of measles vaccine when he was nine months old. Diagnosis of atypical measles was based on the clinical and serological findings (by measles IgM and IgG positivity). The aim of the presentation of this case was to emphasize that atypical measles should be considered for differential diagnosis in the cases complaining of muscle spasms and atypical skin rashes even if vaccinated against measles. PMID:17205700

  6. Adrenal insufficiency presenting as bilateral rigid auricles: a case report

    PubMed Central

    2014-01-01

    Introduction Stiff ears appear to be a warning sign for adrenal insufficiency. This remarkable and rare sign has not been described to present in adrenal insufficiency in the setting of critical care. Case presentation We present the case of a 68-year-old Caucasian male who underwent a thymoma resection and suffered from preoperative weight loss and lack of strength. The perioperative phase was characterised by hypotension and sputum stasis due to muscle weakness, which caused two readmissions to the intensive care unit. His physical examination showed two fully rigid auricles. In retrospect, our patient suffered from secondary adrenal insufficiency and hypogonadism. Conclusions The bilateral rigid auricles appeared to be a warning sign for adrenal insufficiency. This remarkable sign is easily checked, and should prompt a higher index of suspicion towards adrenal insufficiency and other hormonal deficiencies. PMID:25209544

  7. Neuroblastoma in an adult: case presentation and literature review.

    PubMed

    Smith, Laura; Minter, Steve; O'Brien, Paul; Kraveka, Jacqueline M; Medina, Ana Maria; Lazarchick, John

    2013-01-01

    Neuroblastoma is the most common malignancy in children less than one year of age, but is rare in adults. Adult neuroblastoma differs from pediatric cases by lacking classical features including low incidence of MYCN amplification, elevated urinary catecholamimes, and MIBG avidity. The diagnosis may not be initially considered because of the rarity, which emphasizes the importance of immunohistochemical staining and cytogenetic testing in aiding the diagnosis. We present a case of neuroblastoma in a 39-year-old woman who failed to respond to intensive therapy for this malignancy and died within a year after diagnosis. PMID:23462610

  8. Postanoxic myoclonus: two case presentations and review of medical management.

    PubMed

    Budhram, Adrian; Lipson, David; Nesathurai, Shanker; Harvey, David; Rathbone, Michel P

    2014-03-01

    Postanoxic myoclonus is a rare manifestation after an anoxic event, with fewer than 150 cases reported in the literature. The condition is characterized by myoclonic jerks, which are worse on action than at rest, and postural lapses, ataxia, and dysarthria. The disability caused by postanoxic myoclonus can be profound, and treatment in the rehabilitation setting is exceptionally challenging. We present 2 patients who suffered from postanoxic myoclonus after an anoxic event, both of whom were successfully treated with a combination of levetiracetam, valproic acid, and clonazepam. These cases act as a framework for discussing the management of postanoxic myoclonus in the clinical setting. PMID:24060492

  9. Mixed Phenotypic Acute Leukemia Presenting as Mediastinal Mass-2 Cases.

    PubMed

    Vardhan, Rig; Kotwal, Jyoti; Ganguli, Prosenjit; Ahmed, Rehan; Sharma, Ajay; Singh, Jasjit

    2016-06-01

    Mixed phenotype acute leukemia symbolizes a very small subset of acute leukemia that simply cannot be allocated as lymphoid or myeloid lineage. The 2008 World Health Organisation classification established stringent standard for diagnosis of mixed phenotype acute leukemia, accentuating myeloperoxidase for myeloid lineage, cytoplasmic CD3 for T lineage and CD19 with other B markers for B lineage obligation. Mixed phenotype leukemia is rare and 3-5 % of acute leukmias of all age groups, is associated with poor outcome with overall survival of 18 months. We wish to present two cases of mixed phenotypic acute leukemia who presented with mediastinal masses, were suspected to be T cell lymphoma/leukemia clinically and radiologically. In one case, tissue diagnosis was given as lymphoma for which treatment was given. These cases show that patients diagnosed as lymphoma on histopathology can be cases of mixed phenotype acute leukemia and varying specific treatment protocols and follow up are required. Awareness of these entities will help in proper diagnosis and treatment. PMID:27408360

  10. Mitochondrial myopathy presenting as fibromyalgia: a case report

    PubMed Central

    2012-01-01

    Introduction To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy. Treatment of the mitochondrial myopathy resulted in resolution of symptoms. This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia. Case presentation Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points. Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms. A six-minute walk study demonstrated an elevated lactic acid level (5 mmol/L; normal < 2 mmol/L). Biochemical and genetic studies from a muscle biopsy revealed a mitochondrial myopathy. Our patient was started on a compound of coenzyme Q10 (ubiquinone) 200 mg, creatine 1000 mg, carnitine 200 mg and folic acid 1 mg to be taken four times a day. She gradually showed significant improvement in her symptoms over a course of several months. Conclusions This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy. This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms. PMID:22325469

  11. Fascioliasis: 3 cases with three different clinical presentations.

    PubMed

    Arslan, Ferhat; Batirel, Ayşe; Samasti, Mustafa; Tabak, Fehmi; Mert, Ali; Özer, Serdar

    2012-06-01

    Fascioliasis, which is a zoonotic infestation caused by the trematode Fasciola hepatica (liver fluke), is primarily a disease of herbivorous animals such as sheep and cattle. Humans become accidental hosts through ingesting uncooked aquatic plants such as watercress. It presents a wide spectrum of clinical pictures ranging from fever, eosinophilia and vague gastrointestinal symptoms in the acute phase to cholangitis, cholecystitis, biliary obstruction, extrahepatic infestation, or asymptomatic eosinophilia in the chronic phase. However, it may often be overlooked, especially in the acute phase, because of vague symptoms. As a result of newly introduced serological assays facilitating the diagnosis, there has been an increase in the number of reported cases. Here, we report the clinical and laboratory assessment and therapeutic approach of a series of three cases diagnosed (in order of) one week, three months and one and a half years after presentation of the first symptoms of the disease. PMID:22798118

  12. Intimal pulmonary artery sarcoma presenting as dyspnea: case report

    PubMed Central

    Hsing, Jeff M; Thakkar, Snehal G; Borden, Ernest C; Budd, George T

    2007-01-01

    Background We report a case of pulmonary sarcoma which is a rare cause of the common symptom of dyspnea. Case presentation A fifty-one year old previously healthy male presented to the emergency room with complaints of dyspnea on exertion. A cardiac workup including an exercise stress test was negative but an echocardiography showed pulmonary stenosis. Cardiac MRI showed a large mass extending from the pulmonic valve to both the right and left pulmonary arteries suggestive of sarcoma. A complete resection and repair of the pulmonary artery was done and adjuvant chemotherapy with doxorubicin and ifosfamide was recommended. The patient is currently disease free after eighteen months. Conclusion Pulmonary artery sarcomas are a difficult diagnosis. The diagnosis may remain elusive for some time until the proper imaging techniques are utilized to make a diagnosis. Earlier and accurate diagnosis may lead to earlier interventions and improve survival. PMID:17603895

  13. A rare case of multiple myeloma initially presenting with pseudoachalasia.

    PubMed

    Lazaraki, Georgia; Nakos, Andreas; Katodritou, Eirini; Pilpilidis, Ioannis; Tarpagos, Anestis; Katsos, Ioannis

    2009-01-01

    Pseudoachalasia is a rare clinical entity with clinical, radiographic, and manometric features often indistinguishable from achalasia. Primary adenocarcinomas arising at the gastroesophageal junction or a tumor of the distal esophagus are the most frequent causes of pseudoachalasia. Rarely, processes other than esophagogastric cancers including chronic idiopathic intestinal pseudo-obstruction, amyloidosis, sarcoidosis, Chagas' disease, vagotomy, antireflux surgery, pancreatic pseudocysts, von Recklinghausen's neuroinomatosis, gastrointestinal stromal tumor, and other malignancies and rare genetic syndromes, may lead to the development of pseudoachalasia. Secondary achalasia is extremely rare, with less than 100 cases reported in the literature so far. Gastrointestinal manifestations in primary or secondary amyloidosis include abdominal pain, diarrhea, constipation, malabsorption, obstruction, motility disturbance, intestinal infarction, perforation, and hemorrhage; however, gastrointestinal tract involvement is asymptomatic in most instances. We present here a rare case of multiple myeloma initially presenting with dysphagia because of esophageal amyloidosis and manometric findings typical of achalasia. PMID:19207546

  14. Sarcoidosis Presenting as Isolated Gingival Enlargement: A Rare Case Entity

    PubMed Central

    Aggarwal, Jaihans; Chopra, Deepak; Bagga, Sukhchain; Sethi, Kanika

    2014-01-01

    Sarcoidosis is a non-caseating granulomatous disease . It is a multiorgan inflammatory disorder of unknown etiology. Conditions affecting skin or other organs frequently involve oral cavity and rarely manifest as gingival disease. Here we are reporting a rare case in which gingival hyperplasia was the initial symptom which finally led to the diagnosis of sarcoidosis. Oral mucous membrane needs to be examined carefully as it may constitute in presenting first sign of systemic sarcoidosis. PMID:25584337

  15. ADHD presenting as recurrent epistaxis: a case report.

    PubMed

    Rather, Yasir H; Sheikh, Ajaz A; Sufi, Aalia R; Qureshi, Ateeq A; Wani, Zaid A; Shaukat, Tasneem S

    2011-01-01

    Epistaxis is an important otorhinolaryngological emergency, which usually has an apparent etiology, frequently local trauma in children. Here we present a case report wherein the epistaxis was recalcitrant, and proved to have a psychiatric disorder as an underlying basis. The child was diagnosed with Attention Deficit/Hyperactivity Disorder, hyperactive type, which led to trauma to nasal mucosa due to frequent and uncontrolled nose picking. Treatment with atomoxetine controlled the patient's symptoms and led to a remission of epistaxis. PMID:21513567

  16. Pontine Infarct Presenting with Atypical Dental Pain: A Case Report

    PubMed Central

    Goel, Rajat; Kumar, Sanjeev; Panwar, Ajay; Singh, Abhishek B

    2015-01-01

    Orofacial pain’ most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of ‘orofacial pain’ are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of ‘orofacial pain’ remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of ‘atypical odontalgia’. ‘Atypical odontalgia’ is reported to be prevalent in 2.1% of the individuals. ‘Atypical orofacial pain’ and ‘atypical odontalgia’ can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of ‘atypical orofacial pain’ and ‘atypical odontalgia’. There are a few isolated case reports of acute pontine stroke resulting in ‘atypical orofacial pain’ and ‘atypical odontalgia’. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain. PMID:26464604

  17. Pontine Infarct Presenting with Atypical Dental Pain: A Case Report.

    PubMed

    Goel, Rajat; Kumar, Sanjeev; Panwar, Ajay; Singh, Abhishek B

    2015-01-01

    Orofacial pain' most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of 'orofacial pain' are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of 'orofacial pain' remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of 'atypical odontalgia'. 'Atypical odontalgia' is reported to be prevalent in 2.1% of the individuals. 'Atypical orofacial pain' and 'atypical odontalgia' can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of 'atypical orofacial pain' and 'atypical odontalgia'. There are a few isolated case reports of acute pontine stroke resulting in 'atypical orofacial pain' and 'atypical odontalgia'. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain. PMID:26464604

  18. Pectoralis Minor Syndrome: Case Presentation and Review of the Literature

    PubMed Central

    Wehbe, Mohammad Rachad; Elias, Elias; Kutoubi, Muhammad Aghiad

    2016-01-01

    We present a case of a healthy young female with axillary vein compression caused by the pectoralis minor muscle. Diagnosis was made by clinical findings and dynamic venography. After pectoralis minor tenotomy, the patient had total resolution of her symptoms. Compression of the axillary vein by the pectoralis minor is a rare entity that needs a careful exam and imaging to reach its diagnosis and establish the appropriate treatment. PMID:27429830

  19. A case of Carney complex presenting as acute testicular pain

    PubMed Central

    Alleemudder, Adam; Pillai, Rajiv

    2016-01-01

    We describe the case of a 7-year-old boy who presented with testicular pain but was found to have bilateral testicular lesions later confirmed as Sertoli cell tumors. Genetic testing confirmed a PRKAR1A gene mutation consistent with Carney complex, a rare genetic disorder characterized by skin lesions, myxomas, and multiple endocrine neoplasms. A review of the condition is made highlighting the association with testicular tumors, particularly of Sertoli cell origin. PMID:27453662

  20. A case of Carney complex presenting as acute testicular pain.

    PubMed

    Alleemudder, Adam; Pillai, Rajiv

    2016-01-01

    We describe the case of a 7-year-old boy who presented with testicular pain but was found to have bilateral testicular lesions later confirmed as Sertoli cell tumors. Genetic testing confirmed a PRKAR1A gene mutation consistent with Carney complex, a rare genetic disorder characterized by skin lesions, myxomas, and multiple endocrine neoplasms. A review of the condition is made highlighting the association with testicular tumors, particularly of Sertoli cell origin. PMID:27453662

  1. Turner's tooth with unique radiographic presentation: a case report.

    PubMed

    Lakshman, Anusha Rangare; Kanneppady, Sham Kishor; Castelino, Renita Lorina

    2014-01-01

    Hypoplasia--the result of a disruption in the enamel matrix formation process--causes a defect in the quality and thickness of enamel. Enamel formation is a complex and highly regulated process. Enamel defects have been associated with a broad spectrum of etiologies, including genetic, epigenetic, systemic, local, and environmental factors. An enamel defect in the permanent teeth caused by periapical inflammatory disease in the overlying primary tooth is referred to as Turner's tooth (also known as Turner's hypoplasia). This article presents a case of Turner's hypoplasia of the first mandibular premolar, with an unusual radiographic presentation. PMID:25184717

  2. Cobalamin deficiency presenting as obsessive compulsive disorder: case report.

    PubMed

    Sharma, Vivek; Biswas, Devdutta

    2012-01-01

    Cobalamin deficiency commonly presents with a wide range of neuropsychiatric manifestations ranging from myelopathy, neuropathy, optic neuritis and dementia to mood disorders, chronic fatigue and psychosis even without classical hematological abnormalities like anemia and macrocytosis. However, obsessive compulsive disorder (OCD) in relation to vitamin B12 deficiency has not been described so far. We report a case of middle-aged man presenting with OCD, low serum cobalamin and a positive family history of vitamin B12 deficiency who responded well to methylcobalamin replacement. PMID:22227032

  3. Clinical presentation of pili torti--Case report.

    PubMed

    Yang, Jeane Jeong Hoon; Cade, Karine Valentim; Rezende, Flavia Cury; Pereira, José Marcos; Pegas, José Roberto Pereira

    2015-01-01

    Pili torti also known as 'twisted hairs' (Latin: pili=hair; torti=twisted) is a rare, congenital or acquired clinical presentation, in which the hair shaft is flattened at irregular intervals and twisted 180º along its axis. It is clinically characterized by fragile, brittle, coarse and lusterless hairs, due to uneven light reflection on the twisted hair surface. Pili torti may be associated with neurological abnormalities and ectodermal dysplasias. There is no specific treatment for this condition, but it may improve spontaneously after puberty. We report a case of pili torti in a child who presented fragile, brittle, difficult to comb hair. The patient had no comorbidities. PMID:26312667

  4. [Occupational asthma related to wheat. Presentation of one case].

    PubMed

    Galindo-Pacheco, Lucy Vania; Toral-Villanueva, Rodrigo; Segura-Méndez, Nora Hilda

    2013-01-01

    Allergy to wheat proteins is the most common type of occupational asthma caused by cereals. Its incidence based on international reports is about 1-2.4/1000 cases among workers per year. In Mexico there is an underdiagnosis of occupational asthma > 99%. During the period 2009-2012 we recorded 5 cases of occupational asthma, 40% of them caused by cereals. This is the case of a 38 year old male, baker for 24 years exposed to wheat flour. In his workplace he used to wear surgical mask and there are no exhaust fans. He initiated 10 years ago with sneezing, itching, hyaline rhinorrhea and nasal obstruction. The following year he presented mild to moderate dyspnea, chest tightness, cough and wheezing during working hours, which improved during his days off. Pulmonary function tests were confirmatory of asthma, with negative skin prick tests to aeroallergens. Specific bronchial challenge was performed with wheat flour resulting positive with a decrease in VEF1 greater than 20%. Pharmacological treatment was provided and was sent to occupational medicine service for evaluation. The case was qualified as an occupational disease with a permanent partial disability of 25%, receiving a financial compensation. He returned to work in the same company but in a different area without wheat flour exposure. The diagnosis of occupational asthma is mainly clinical, according to Brooks¥ criteria, and a bronchial positive challenge test will confirms the diagnosis. PMID:24008108

  5. Recognizing Presentations of Pemphigoid Gestationis: A Case Study

    PubMed Central

    2014-01-01

    Introduction. Pemphigoid gestationis (PG) is an autoimmune blistering disease that occurs in approximately 1 in 50,000 pregnancies. Failing to recognize PG may lead to inadequate maternal treatment and possible neonatal complications. Case Report. At 18 weeks of gestation, a 36-year-old otherwise healthy Caucasian G4P1 presented with pruritic papules on her anterior thighs, initially treated with topical steroids. At 31 weeks of gestation, she was switched to oral steroids after her rash and pruritus worsened. The patient had an uncomplicated SVD of a healthy female infant at 37 weeks of gestation and was immediately tapered off steroid treatment, resulting in a severe postpartum flare of her disease. Discussion. This case was similar to reported cases of pruritic urticarial papules followed by blisters; however, this patient had palm, sole, and mucous membrane involvement, which is rare. Biopsy for direct immunofluorescence or ELISA is the preferred test for diagnosis. Previous case reports describe severe postdelivery flares that require higher steroid doses. Obstetrical providers need to be familiar with this disease although it is rare, as this condition can be easily confused with other dermatoses of pregnancy. Adequate treatment is imperative for the physical and psychological well-being of the mother and infant. PMID:25506008

  6. Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review

    PubMed Central

    Khan, Yasir; Mansour, Iyad; Ong, Eric; Shrestha, Manish

    2015-01-01

    Multiple myeloma is a malignant plasma-cell disorder that primarily involves the bone marrow, but extramedullary involvement is becoming increasingly common (Bladé et al., 2012) both at initial presentation and follow-up. Most common initial presentations for multiple myeloma include generalized fatigue, renal insufficiency, bone pain, and recurrent bacterial infections. We present a case of a healthy 55-year-old man that presented to the emergency department with a three-week history of anorexia and jaundice without any past medical history. Patient's initial labs were significant for hyperbilirubinemia and elevated liver function enzymes (AST, ALT, ALP, and GGT). Additional laboratory workup was significant for mild hypercalcemia and increased protein gap. MRI and ERCP suggested primary sclerosing cholangitis but were not diagnostic. Liver biopsy illustrated plasma-cell infiltration and bone marrow biopsy diagnosed multiple myeloma with extramedullary disease. Patient was started on dexamethasone, bortezomib, and cyclophosphamide, but, despite this aggressive regimen, the patient continued to decline. We take this opportunity to present this atypical presentation of a common hematological malignancy and review the associated literature. PMID:26221143

  7. Systemic tuberculosis presenting with acute transient myopia: a case report

    PubMed Central

    Aslam, Sher A; Kashani, Shahram; Morley, Roland K

    2008-01-01

    Introduction Transient myopia has been reported to occur in a number of conditions, either ocular in origin or associated with an underlying systemic cause. We present a rare case of this abnormality occurring in the setting of systemic tuberculosis. Case presentation A 29-year-old Indian woman presented with sudden onset blurred distance vision and fever. Examination revealed visual acuity of counting fingers in both eyes improving to 6/9 with pinhole with N5 reading acuity. Anterior segment examination revealed narrow angles on gonioscopy. Posterior segments were normal. Systemic examination revealed a fluctuant mass in her left loin, aspiration of which yielded pus which was culture-positive for Mycobacterium tuberculosis. The Mantoux test elicited a strongly positive reaction. Chest X-ray and magnetic resonance imaging of the brain were unremarkable. Computed tomography scan and magnetic resonance imaging of the spine and abdomen revealed a large psoas abscess communicating with the loin mass. Two vertebrae were involved but not the spinal cord or canal. Conclusion Transient myopia is a rare presenting feature of systemic tuberculosis. A postulated mechanism in this patient is that development of a uveal effusion related to systemic tuberculosis caused anterior rotation of the iris-lens diaphragm, thereby inducing narrowing of the angle and acute myopia. PMID:19014689

  8. [A case of astrocytoma of corpus callosum presented diagnostic dyspraxia].

    PubMed

    Koshimizu, K; Takeyama, E; Takeyama, E; Kizuki, H; Tei, H; Kubo, O

    1995-08-01

    A case of astrocytoma whose first clinical presentation was diagnostic dyspraxia was reported. A 38-year-old right-handed male experienced funny motion of his left hand triggered by voluntary movement of his right hand. One day, he tried to insert a coin into the vending machine with his right hand, then the left hand was against the other. One month after that event, he experienced headache and vertigo. On admission, there were no abnormal findings on neurological examination. On neuropsychological examination, he was cooperative, well orientated and attentive, and there were no callosal disconnection symptoms. Frontal lobe function tests were slightly impaired. T1-weighted MRI demonstrated irregular mixed signal intensity mass lesion extending from the genu to the body of the corpus callosum and the cingulate gyrus. This lesion was slightly enhanced with Gd-DTPA. Biopsy was performed and histological diagnosis was fibrillary astrocytoma. After irradiation and chemotherapy, he was discharged from the hospital without evident neurological deficit. About 20 cases of diagnostic dyspraxia have been reported and almost all of them were caused by cerebro-vascular disease. This is the first case of brain tumor who presented diagnostic dyspraxia. PMID:7546921

  9. Unusual presentations of eosinophilic gastroenteritis: two case reports.

    PubMed

    Leal, Regina; Fayad, Leonardo; Vieira, Daniella; Figueiredo, Teresa; Lopes, Aldemae; Carvalho, Roberta; Dantas-Corrêa, Esther; Schiavon, Leonardo; Narciso-Schiavon, Janaína

    2014-06-01

    Eosinophilic gastroenteritis is a rare disease that is characterized by eosinophil infiltration in one or multiple segments of the gastrointestinal tract. The etiology of this condition remains unknown. Eosinophilic gastroenteritis has heterogeneous clinical manifestations that depend upon the location and depth of infiltration in the gastrointestinal tract, and eosinophilia may or may not be present. This article reports two cases of eosinophilic gastroenteritis. The first is that of a 49-year-old woman with abdominal pain, ascites, eosinophilia, and a history of asthma. The second case is that of a 69-year-old male with a history of loss of appetite, belching, postprandial fullness, heartburn, and a 5-kilogram weight loss over a period of 9 months; ultimately, the patient was diagnosed with a gastric outlet obstruction due to pyloric stenosis. The rare character of eosinophilic gastroenteritis and its varied clinical presentations often lead to delayed diagnoses and complications. Case reports may help to disseminate knowledge about the disease, thereby increasing the likelihood of early diagnosis and intervention to prevent complications. PMID:25141324

  10. Child Who Presented with Facial Hematohidrosis Compared with Published Cases

    PubMed Central

    Jafar, Ali

    2016-01-01

    Hematohidrosis is a rare condition in which an individual sweats blood from intact, unbroken skin. The aetiology of hematohidrosis is not clear, although various theories exist to explain such a phenomenon. The general consensus however in the literature relates the finding to dermal capillary blood vessels that rupture under extreme emotional or physical stress exuding blood through the skin. In this case report we disclose a case of 12-year-old girl who presented with unusual painless bleeding from her face, eye, and tear duct. The condition was investigated intensively during hospital admission for a cause, and no actual cause was speculated. The management mostly involved supportive care and medical advice. PMID:27051537

  11. Pulmonary adenocarcinoma presenting with penile metastasis: a case report

    PubMed Central

    2012-01-01

    Introduction Penile metastases are an extremely rare occurrence, and most primary malignancies are located in the urinary bladder, prostate, rectum, and rectosigmoid. Although very few cases of penile metastases have been reported, those of lung cancer as the primary tumor are very rare. Among the latter, squamous cell carcinomas constitute the majority, whereas adenocarcinomas are almost exceptions. To the best of our knowledge, only two cases have been reported. Case presentation We report the case of a 59-year-old Greek man who presented with persistent cough and chest pain that had started one month prior to a medical appointment. A physical examination, complete laboratory work-up, computed tomography scanning (of the chest, brain, and abdomen), pelvic magnetic resonance imaging, penile ultrasonography, bone scanning, and histological analyses were conducted. Afterward, a lung adenocarcinoma metastatic to the bones, brain, adrenals, lymph nodes, and penis was diagnosed. The primary lesion was a mass of 4cm in diameter in the apical segment of the lower lobe of the right lung. The patient was treated with bone and brain radiotherapy and various cycles of first- and second-line chemotherapy, and partial response was achieved five months after the initial appointment. Conclusions Although these metastatic sites are well known to occur from a primary pulmonary malignancy, penile metastasis is extremely rare. Its identification requires prompt awareness by the physician despite the dismal prognosis. Furthermore, since the penis usually is omitted from the physical examination and lung cancer is the leading cause of cancer-related deaths, more penile metastases may be detected in the future, making early detection and appropriate management of great importance. PMID:22909155

  12. Chronic granulomatous disease presenting as hemophagocytic lymphohistiocytosis: a case report.

    PubMed

    Valentine, Gregory; Thomas, Tessy A; Nguyen, Trung; Lai, Yi-Chen

    2014-12-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent infections and a dysregulated inflammatory response. Infection-triggered hemophagocytic lymphohistiocytosis (HLH), which manifests itself as pathologic hyperactive inflammation, has been observed in subjects with CGD. However, there have been no reports of HLH as the initial presentation with subsequent diagnosis of CGD. Furthermore, the primary therapeutic strategy for HLH focuses on immunosuppressive therapies, which limits immune-mediated tissue damage. With immunodeficiency, this therapeutic strategy may worsen the outcome. This article discusses an 8-week-old Hispanic male who presented with fever of unknown origin. The initial diagnostic evaluation demonstrated pathologic hyperactive inflammation, meeting the HLH-2004 diagnostic criteria without an identified infectious etiology. Immunosuppressive therapy was initiated, with subsequent disseminated candida septic shock and sepsis-induced multisystem organ failure. Additional evaluations ultimately established the diagnosis of CGD. We transitioned to an immune-enhancing strategy with granulocyte and immunoglobulin infusions, and intensified antifungal therapies. These interventions ultimately led to the clearance of the fungal infection and the resolution of the hyperactive inflammatory state. This case represents the first reported case of HLH as the presenting finding leading to the subsequent diagnosis of CGD. It serves as a reminder that both immunodeficiency and inflammatory disorders may share features of pathologic hyperactive inflammation and highlights the conundrum that clinicians face when treating HLH in the setting of an unresolved infection. In this case report, we demonstrate that immune-enhancing therapies may aid in the control and the clearance of the infection, thus paradoxically decreasing the pathologic hyperactive inflammatory response. PMID:25422023

  13. Abdominal actinomycosis presenting as appendicitis: two case reports and review.

    PubMed

    Liu, Ken; Joseph, David; Lai, Ken; Kench, James; Ngu, Meng Chong

    2016-01-01

    Abdominal actinomycosis (AA) is a rare infection caused by filamentous Gram-positive anaerobic bacteria Actinomyces. We report two cases of adults with AA who initially presented with clinical and radiological features of appendicitis. Both patients underwent appendicectomy with histopathology diagnostic for actinomycosis of the appendix and subsequently completed prolonged courses of oral penicillin. AA is a rare differential diagnosis for appendicitis and should be considered especially in patients with a chronic, indolent course and nonspecific abdominal symptoms. A high index of suspicion may avoid unnecessary surgery, as treatment with prolonged antibiotic therapy is very effective. PMID:27147718

  14. Linear Darier's disease: A case with bilateral presentation

    PubMed Central

    Bordoloi, Anal Jyoti; Barua, Khagendra Narayan

    2015-01-01

    Darier's disease is an autosomal dominant genodermatosis characterized by a persistent eruption of hyperkeratotic greasy papules mainly over the seborrheic sites of the body, usually associated with nail abnormalities and sometimes with mucous membrane lesions. The lesions typically occur in the younger age group and are associated with pruritus. We report here an atypical case of Linear Darier's disease with bilateral presentation in a middle-aged adult that could be confused with conditions such as lichen planus, inflammatory linear verrucous epidermal nevus, and wart. PMID:26500868

  15. Intracranial Tuberculoma Presenting as Atypical Eclampsia: A Case Report

    PubMed Central

    Murugesan, Sharmila; Pradeep, Sunitha; John, Lopamudra; Kolluru, Vasavi

    2016-01-01

    Occurrence of eclampsia before 20 weeks of pregnancy and after 48 hours of delivery in the absence of typical signs of hypertension and or proteinuria is termed as atypical eclampsia. Atypical or non-classic eclampsia will have some symptoms of eclampsia but without the usual proteinuria or hypertension. All patients with atypical onset should undergo neurological evaluation to rule out neurologic causes of seizures. Cerebral tuberculosis is a rare and serious form of disease secondary to haematogenous spread of Mycobacterium tuberculosis. Here we present a case of cerebral tuberculoma with seizures in late pregnancy mimicking eclampsia.

  16. Unusual Presentation of Light Chain Deposition Disease: A Case Report

    PubMed Central

    Uppal, Mayank; Amitabh, Vindu; Agrawal, Usha

    2016-01-01

    Light Chain Deposition Disease (LCDD) is a rare disease characterized by deposition of monoclonal non-amyloid light chains in multiple organs. We report an unusual histologic manifestation of LCDD in a 55-year-old female patient, who presented with nephrotic syndrome and an increased serum creatinine. This case of LCDD had features of cast nephropathy on biopsy which is diagnostic of myeloma kidney, when the patient was clinically asymptomatic. Serum electrophoresis showed no abnormal band. There was no other evidence of a B-cell clonal disorder or amyloidosis. Following chemotherapy, improvement in renal function correlated with a reduction in circulating light-chain levels. PMID:27437235

  17. [Chronic subdural hematoma presenting visual disturbance: a case report].

    PubMed

    Hasegawa, S; Manabe, H; Shimizu, T; Itoh, C; Suzuki, S

    2001-03-01

    The authors reported a rare case of chronic subdural hematoma presenting bilateral visual impairment caused by papilledema. A 49-year-old man was admitted to our department due to left blurred vision. On admission, ophthalmological examination revealed visual acuity disturbance on the left eye, bilateral nasal visual field defect and papilledema. CT scan and MRI demonstrated bilateral subdural hematoma. No remarkable findings were detected on cerebral angiography. After evacuation of bilateral subdural hematomas, his visual symptoms recovered. In this report, we discuss the mechanism of visual impairment caused by chronic subdural hematoma. PMID:11296405

  18. Metastatic prostate cancer initially presenting as chylothorax: A case report

    PubMed Central

    YANG, YU-JIN; SEO, MINJUNG; JEON, HEE-JEONG; NOH, JIN-HEE; PARK, SEOL HOON; CHOI, YUNSUK; JO, JAE-CHEOL; BAEK, JIN HO; KOH, SU-JIN; KIM, HAWK; MIN, YOUNG JOO

    2016-01-01

    Chylothorax is caused by disruption or obstruction of the thoracic duct, which results in leakage of chyle in the pleural space. The most common etiologies are malignancy and trauma. Among the causative malignancies, lymphoma is the most common, followed by primary lung cancer, mediastinal tumors, and other metastatic malignancies. Conversely, prostate cancer has rarely been reported as the cause of chylothorax. We herein report a case of metastatic prostate cancer initially presenting as chylothorax, with disappearance of the pleural effusion after the initiation of androgen deprivation therapy. Moreover, we also discuss the various rare manifestations of metastatic prostate cancer, including chylothorax. PMID:27313861

  19. Abdominal actinomycosis presenting as appendicitis: two case reports and review

    PubMed Central

    Liu, Ken; Joseph, David; Lai, Ken; Kench, James; Ngu, Meng Chong

    2016-01-01

    Abdominal actinomycosis (AA) is a rare infection caused by filamentous Gram-positive anaerobic bacteria Actinomyces. We report two cases of adults with AA who initially presented with clinical and radiological features of appendicitis. Both patients underwent appendicectomy with histopathology diagnostic for actinomycosis of the appendix and subsequently completed prolonged courses of oral penicillin. AA is a rare differential diagnosis for appendicitis and should be considered especially in patients with a chronic, indolent course and nonspecific abdominal symptoms. A high index of suspicion may avoid unnecessary surgery, as treatment with prolonged antibiotic therapy is very effective. PMID:27147718

  20. [Rare syndromes in intensive care medicine : Presentation of two cases].

    PubMed

    Gierlinger, A; Siostrzonek, P; Reisinger, J

    2016-06-01

    This article presents two cases of young women with spontaneous life-threatening bleeding events. Both had a history of gastrointestinal rupture or arterial dissection. Based on their medical history and genetic testing, Ehlers-Danlos syndrome (EDS) IV (vascular type) was diagnosed. In this very rare disorder which accounts for only 5 % of all EDS cases, fibroblasts synthesize reduced and abnormal procollagen type III. This is caused by mutations in the COL3A1 gene coding for type III procollagen. Life expectancy in these patients is significantly reduced. In many cases spontaneous arterial ruptures or dissections and organ ruptures are the first manifestations of this disease. More than 80 % of patients with EDS IV suffer from a severe complication before 40 years of age. Treatment options are very limited. Most important is to avoid invasive procedures (open surgery as well as endovascular interventions) because of its high morbidity and mortality. Celiprolol, a cardioselective β‑blocker, seems to have a beneficial effect by reducing the incidence of vascular complications. PMID:27259332

  1. Nontraumatic Myositis Ossificans of Hip: A Case Presentation

    PubMed Central

    Ozcan, Muhammed Sefa

    2016-01-01

    In most of the cases trauma is the leading etiology and the nontraumatic myositis ossificans (MO) is a very rare condition. We present an MO case without any trauma occurring. A 36-year-old female patient with a history of pain and restriction of range of motion of the left hip was admitted. Hip motions were restricted with 10–60° of flexion, 10° of internal rotation, 20° of external rotation, 10° of abduction, and 10° of adduction. There was no history of trauma and familial involvement. The biopsy of the lesion revealed mature bone tissue confirming our diagnosis of MO. The mass was removed surgically and postoperatively the patient was treated with a single dose radiotherapy with 800 gyc. MO is a benign and well differentiated bone formation or in other words heterotopic ossification of the muscle tissue. It has a prevalence of less than 1/1 million. Trauma is the most frequent etiological factor seen in almost 60–75% of the cases. Nontraumatic MO is very rare in the literature. Our patient had no history of trauma or familial involvement. Combination of the surgical excision with radiotherapy in the treatment of the MO of the hip may give satisfactory results. PMID:27437157

  2. Nontraumatic Myositis Ossificans of Hip: A Case Presentation.

    PubMed

    Oc, Yunus; Ozcan, Muhammed Sefa; Sezer, Hasan Basri; Kilinc, Bekir Eray; Eren, Osman Tugrul

    2016-01-01

    In most of the cases trauma is the leading etiology and the nontraumatic myositis ossificans (MO) is a very rare condition. We present an MO case without any trauma occurring. A 36-year-old female patient with a history of pain and restriction of range of motion of the left hip was admitted. Hip motions were restricted with 10-60° of flexion, 10° of internal rotation, 20° of external rotation, 10° of abduction, and 10° of adduction. There was no history of trauma and familial involvement. The biopsy of the lesion revealed mature bone tissue confirming our diagnosis of MO. The mass was removed surgically and postoperatively the patient was treated with a single dose radiotherapy with 800 gyc. MO is a benign and well differentiated bone formation or in other words heterotopic ossification of the muscle tissue. It has a prevalence of less than 1/1 million. Trauma is the most frequent etiological factor seen in almost 60-75% of the cases. Nontraumatic MO is very rare in the literature. Our patient had no history of trauma or familial involvement. Combination of the surgical excision with radiotherapy in the treatment of the MO of the hip may give satisfactory results. PMID:27437157

  3. A Case of Good's Syndrome Presenting with Pulmonary Tuberculosis.

    PubMed

    Chaudhuri, Arunabha Datta; Tapadar, Sumit Roy; Dhua, Aparup; Dhara, Palash Nandan; Nandi, Saumen; Choudhury, Sabyasachi

    2015-01-01

    Adult onset immunodeficiency associated with thymoma is a rare condition. The combination of hypogammaglobulinemia, reduced number of peripheral B and CD4+ T cells, along with thymoma constitutes Good's syndrome (GS). This immunodeficiency condition is often complicated with opportunistic infection with organisms, like bacteria (Haemophilus influenzae, Streptococcus pneumonia etc), viruses (Cytomegalovirus, Herpes simplex etc), fungi and protozoa. We present an unusual case of Good's syndrome with pulmonary tuberculosis (PTB). A 40-year-old man presented with sputum-positive PTB and was started on anti-tuberculosis treatment. Subsequently, he developed symptoms and findings consistent with thymoma and other components of Good's syndrome. Although patients of Good's syndrome are susceptible to various opportunistic infections, infection with Mycobacterium tuberculosis is uncommon. Evidence of recurrent infections or some opportunistic infection in a thymoma patient should trigger a suspicion of Good's syndrome. PMID:27164735

  4. An Unusual Case Presentation of the May–Thurner Syndrome

    PubMed Central

    O’Laughlin, Michael C.; Levens, Benjamin J.

    2016-01-01

    Summary: A 56-year-old woman underwent abdominoplasty with no immediate complications. She had no known bleeding history nor any relevant past surgical history. Adequate preventive measures for venous thromboembolism were performed, including sequential compression devices, good hydration, and early ambulation. At 17 days post operation, the patient presented to the emergency room complaining of left leg swelling and sharp, shooting pain radiating down her left leg. Workup in the Emergency Room revealed significant venous thrombosis involving complete occlusion of the major veins of the left leg. There were no indications of cardiopulmonary compromise. Angiography revealed an anatomical variant consistent with May-Thurner Syndrome (MTS). This variant first described in 1957 may present in up to one-quarter of patients, more commonly in young women. This case appears to the first reported of MTS occurring in association with a postoperative complication of abdominoplasty. Diagnosis and management considerations are discussed. PMID:27482484

  5. An Atypical Case of Eosinophilic Gastroenteritis Presenting as Hypovolemic Shock.

    PubMed

    Martillo, Miguel; Abed, Jean; Herman, Michael; Abed, Elie; Shi, Wenjing; Munot, Khushboo; Mankal, Pavan Kumar; Gurunathan, Rajan; Ionescu, Gabriel; Kotler, Donald P

    2015-01-01

    Eosinophilic gastroenteritis is an uncommon condition characterized by focal or diffuse infiltration of eosinophils in the gastrointestinal tract in the absence of secondary causes. The pathogenesis of this condition is not well understood and its clinical presentation depends on the segment and layer of the gastrointestinal tract affected. The definition of eosinophilic gastroenteritis may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not standardized. We present the case of a 59-year-old male who came to the hospital with hypovolemic shock and lethargy secondary to severe diarrhea. Laboratory analysis was significant for peripheral eosinophilia, and pathology from both the duodenum and colon showed marked eosinophilic infiltration. PMID:26078733

  6. The problem of insufficient incisal display: a case presentation.

    PubMed

    Castillo, Rodrigo

    2010-01-01

    Enhancement of facial beauty is one of the primary elective goals of patients seeking dental care. Frequently, improvements in natural beauty can be expected to follow restoration of ideal relationships between the denture and the facial soft tissues. A very important feature in a youthful appearance is the incisal tooth display; the amount of maxillary incisal exposure gradually decreases with age, accompanied by a gradual increase in mandibular incisal exposure. However, this problem could be present in young people where the effects of age should not be apparent yet. There are some other factors that could accelerate this process. The present case illustrates the improvement and rejuvenation of an unesthetic young smile through restorative treatment. PMID:20589259

  7. An Atypical Case of Eosinophilic Gastroenteritis Presenting as Hypovolemic Shock

    PubMed Central

    Martillo, Miguel; Abed, Jean; Herman, Michael; Abed, Elie; Shi, Wenjing; Munot, Khushboo; Mankal, Pavan Kumar; Gurunathan, Rajan; Ionescu, Gabriel; Kotler, Donald P.

    2015-01-01

    Eosinophilic gastroenteritis is an uncommon condition characterized by focal or diffuse infiltration of eosinophils in the gastrointestinal tract in the absence of secondary causes. The pathogenesis of this condition is not well understood and its clinical presentation depends on the segment and layer of the gastrointestinal tract affected. The definition of eosinophilic gastroenteritis may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not standardized. We present the case of a 59-year-old male who came to the hospital with hypovolemic shock and lethargy secondary to severe diarrhea. Laboratory analysis was significant for peripheral eosinophilia, and pathology from both the duodenum and colon showed marked eosinophilic infiltration. PMID:26078733

  8. [Skin reaction to carbamazepine or DRESS syndrome: a case presentation].

    PubMed

    Cabrera Fundora, Emigdio Jesús; Cabrera Osorio, Yuliet; Cabrera Osorio, Claudia

    2016-01-01

    Carbamazepine is a frequently used drug that can produce adverse reactions like vertigo, somnolence and severe skin reactions like Drug Rash with Eosinophilia and Systemic Symptoms Syndrome (DRESS Syndrome). This syndrome is characterized by a late-appearing, slow-progressing cutaneous eruption accompanied by atypical lymphocytes, eosinophilia, and systemic symptoms such as fever, lymphadenopathy, hepatic compromise, and renal dysfunction that can be severe enough to cause death. We present a case that aims to highlight the importance of an early diagnosis of DRESS syndrome to adjust therapy and improve survival. The patient is a female patient prescribed carbamazepine for trigeminal neuralgia who presented with skin lesions, which were initially attributed to a hypersensitivity reaction. The lesions worsened in spite of treatment and systemic symptoms ensued. A diagnosis of DRESS syndrome was proposed and steroid treatment was initiated with rapid improvement. PMID:26938717

  9. An Unusual Case Presentation of the May-Thurner Syndrome.

    PubMed

    O'Laughlin, Michael C; Levens, Benjamin J; Levens, David J; Ring, David H

    2016-06-01

    A 56-year-old woman underwent abdominoplasty with no immediate complications. She had no known bleeding history nor any relevant past surgical history. Adequate preventive measures for venous thromboembolism were performed, including sequential compression devices, good hydration, and early ambulation. At 17 days post operation, the patient presented to the emergency room complaining of left leg swelling and sharp, shooting pain radiating down her left leg. Workup in the Emergency Room revealed significant venous thrombosis involving complete occlusion of the major veins of the left leg. There were no indications of cardiopulmonary compromise. Angiography revealed an anatomical variant consistent with May-Thurner Syndrome (MTS). This variant first described in 1957 may present in up to one-quarter of patients, more commonly in young women. This case appears to the first reported of MTS occurring in association with a postoperative complication of abdominoplasty. Diagnosis and management considerations are discussed. PMID:27482484

  10. Neonates presenting with severe complications of frenotomy: a case series

    PubMed Central

    2012-01-01

    Introduction Tongue-tie or ankyloglossia is an anatomic variation in which the lingual frenulum is thick, short or tight. It may be asymptomatic, or present with complications like breast feeding difficulties or speech, dental and cosmetic problems. The treatment of this condition, where indicated, is frenotomy. This procedure usually has few or no complications. However, when it is done by untrained personnel, it may lead to life-threatening complications. This paper highlights complications that could arise from improper treatment of ankyloglossia. Case presentation Case 1 was a one-day-old male neonate, a Nigerian of Igbo ethnicity, who was admitted with bleeding from the mouth and passage of dark stools after clipping of the frenulum by a traditional birth attendant. He was severely pale and in hypovolemic shock, with a severed frenulum which was bleeding actively. His packed cell volume was 15%. He was resuscitated with intravenous fluids and a blood transfusion. The bleeding was controlled using an adrenaline pack. He also received antibiotics. He was discharged five days later. Case 2 was a three-day-old male neonate, a Nigerian of Ikwerre ethnicity, who was admitted with profuse bleeding from a soft tissue injury under the tongue, after clipping of the frenulum by a community health worker. He was severely pale and lethargic. He was resuscitated with intravenous fluids and a blood transfusion. The bleeding vessel was ligated with repair of the soft tissue. He also received antibiotics and was discharged home one week later. Conclusion Treatment of tongue-tie, a benign condition, when done by untrained personnel may result in life-threatening complications. Clinicians should pay more attention to parents' worries about this condition and give adequate counseling or refer them to trained personnel for surgical intervention where clinically indicated. PMID:22394653

  11. The TRAP (twin reversed arterial perfusion) sequence - case presentation.

    PubMed

    Mărginean, Claudiu; Mărginean, Maria Oana; Mureşan, Daniel; Zahiu, LuminiŢa; Horváth, Emőke

    2016-01-01

    We present a particular case of TRAP (twin reversed arterial perfusion) syndrome, which has a very rarely association of the simultaneous existence of a rudimentary malformed heart and brain, and also other malformations like abdominal wall abnormality, absent bladder with present kidneys, and absence of the lungs, which appear only in a few cases on the receptor twin from this sequence, malformations incompatible with life. A Caucasian 26-year-old pregnant woman, at the first pregnancy, with a monochorionic-diamniotic pregnancy, 26 weeks of gestation was referred to our hospital, for polyhydramnios. The patient delivered a living female newborn, weighing 950 g, with an Apgar score of 2 at one minute - the donor fetus and a second female newborn with multiple malformations, no signs of life and who weighed 2300 g - the receptor fetus. The anatomopathological examination confirmed the TRAP sequence associated with severe facial dysmorphism, bilateral phocomelia and cardiac malformations (rudimentary hypoplastic, univentricular) and a vascular anastomosis between the two umbilical cords. Anemia and cardiac complications which can lead to cardiac failure, appear early during pregnancy and caused the death of the pumping twin. We emphasize that in our case of TRAP sequence, the ultrasound examination established the diagnosis of the syndrome with high accuracy. Therefore, we can conclude that the existence of a rudimentary heart and a vascular anastomosis between the two umbilical cords supports the apparition of TRAP sequence. The early diagnosis of this pathology, the observation of the pregnancy with the help of weekly ultrasounds and the intrauterine interventions can increase the survival chances of the donor fetus from the TRAP sequence. PMID:27151718

  12. Urolithiasis presenting as right flank pain: a case report

    PubMed Central

    Chung, Chadwick; Stern, Paula J.; Dufton, John

    2013-01-01

    Background: Urolithiasis refers to renal or ureteral calculi referred to in lay terminology as a kidney stone. Utolithiasis is a potential emergency often resulting in acute abdominal, low back, flank or groin pain. Chiropractors may encounter patients when they are in acute pain or after they have recovered from the acute phase and should be knowledgeable about the signs, symptoms, potential complications and appropriate recommendations for management. Case presentation: A 52 year old male with acute right flank pain presented to the emergency department. A ureteric calculus with associated hydronephrosis was identified and he was prescribed pain medications and discharged to pass the stone naturally. One day later, he returned to the emergency department with severe pain and was referred to urology. He was managed with a temporary ureteric stent and antibiotics. Conclusion: This case describes a patient with acute right flank and lower quadrant pain which was diagnosed as an obstructing ureteric calculus. Acute management and preventive strategies in patients with visceral pathology such as renal calculi must be considered in patients with severe back and flank pain as it can progress to hydronephrosis and kidney failure. PMID:23483000

  13. Thrombotic thrombocytopenic purpura presenting with pathologic fracture: a case report.

    PubMed

    Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Unlu, Serkan; Ertem, Kadir; Nizam, Ilknur

    2014-08-01

    Thrombotic thrombocytopenic purpura is an acute syndrome with abnormalities in multiple organ systems, which becomes manifest with microangiopathic hemolytic anemia and thrombocytopenia. The hereditary or acquired deficiency of ADAMTS-13 activity leads to an excess of high molecular weight von Willebrand factor multimers in plasma, leading to platelet aggregation and diffuse intravascular thrombus formation, resulting in thrombotic thrombocytopenic purpura. Thrombotic lesions occurring in TTP leads to ischemia and convulsion. Depending on the properties of the bony tissue, fractures are divided into three groups as traumatic, pathological, and stress fractures. A pathologic fracture is a broken bone caused by disease leading to weakness of the bone. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as cancer, infections, inherited bone disorders, or a bone cyst. We herein report a case with a pathologic fracture due to convulsion secondary to thrombotic thrombocytopenic pupura. Thrombotic lesions occurring in TTP may lead to ischemia and convulsion, as in our patient and pathological fractures presented in our case report may occur as a result of severe muscle contractions associated with convulsive activity. Thrombotic thrombocytopenic pupura is a disease that involves many organ systems and thus may have a very wide spectrum of clinical presentations. PMID:25113918

  14. Erythrodermic atopic dermatitis with late onset–case presentation

    PubMed Central

    Lancrajan, C; Bumbacea, R

    2010-01-01

    Atopic dermatitis is a chronic inflammatory disease, usually associated with a personal or family history of atopic diseases such as AD, allergic rhinitis or asthma that most commonly arise in childhood and present with elevated IgE serum in up to 85% of patients. The severity of AD is based on the extent of affected areas, itch intensity and appearance of skin lesions. Here, we present the case of a 21–year–old female patient with generalized erythematous eczematous skin lesions, flexural lichenifications accompanied by intense pruritus, painful fissures and erosions resulting from scratching. She also presented erythematous plaques with thin scales on the scalp. The patient had no personal or familial history of AD, allergic rhinitis or asthma and the onset of cutaneous symptoms presented severe exacerbation in the last 2 months of the last 3 years. The main laboratory findings were–high serum eosinofilia (2,400/µL) and very high total IgE serum (11449UI/L). The flare remission was induced with systemic treatment (corticotherapy, oral H1 antihistamines, and antibiotherapy) and topical therapy (UVB 311nm, topical glucocorticoids and hydration). It is very important to recognize AD as a cause of erythroderma, especially in a patient with a late onset of the disease, in order to treat it promptly and to prevent ulterior recurrences, by educating the patient to have an adequate life style and to treat the recurrences at the very first symptoms. PMID:20302202

  15. Bacterial endocarditis presenting as acute vertebral osteomyelitis: 14 cases.

    PubMed

    Ninet, J; Gayet, J L; Etienne, J; Bonvoisin, B; Vignon, E; Berthou, J D; Delahaye, J P; Pasquier, J; Delaye, J; Normand, J

    1984-10-01

    Association between bacterial endocarditis (BE) and vertebral osteomyelitis (VO) has infrequently been noted. In a retrospective analysis of BE (280 cases) and VO (150 cases) 14 cases were found to have this association. There were 12 males and 2 females, ages ranging from 39 to 72 years, mean age 56.6. Blood cultures were positive for Streptococcus viridans (6 cases). Str. faecalis (4 cases), staphylococcus (2 cases), Gram negative bacteria (1 case). Organism was not isolated in one case. Fever and severe back pain antedate the diagnosis of VO 3.5 and 2.5 months. X rays films of the spine and bone scans (4 cases) revealed lumbar (6 cases) or cervical (4 cases), or dorsal (3 cases) or combined cervical and dorsal (1 case) locations. History of murmur (4 cases) and development of mitral (8 cases) or aortic (4 cases) or combined mitral and aortic (2 cases) insufficiencies were consistent with concomitant BE. Echocardiogram revealed vegetations in 6 out of 9 cases. Patients received antibiotic therapy for 3.5 months. Ten patients were cured with antibiotics only, 4 required valve replacement. One died. Thus age, sex, history of heart disease, valvular involvement, duration of symptoms prior to admission and bacteriological pictures are the same in BE with VO as in BE without VO. Survival rates are also the same if early recognition of BE and VO with prompt and prolonged antibiotic therapy may prevent severe haemodynamic or vertebral problems. PMID:6519073

  16. An unusual presentation of anetoderma: a case report

    PubMed Central

    Aghaei, Shahin; Sodaifi, Manouchehr; Aslani, Fatemeh Sari; Mazharinia, Nazila

    2004-01-01

    Background Anetoderma is a benign condition with focal loss of dermal elastic tissue resulting in localized areas of flaccid or herniated saclike skin. Currently, anetoderma is classified as either primary (idiopathic), or secondary anetoderma (which is associated with a variety of skin conditions, penicillamine use, or neonatal prematurity). Lesions appear on the upper arms, trunk, and thighs. Case presentation We report a 14-year-old boy, which was noticed to have had multiple, white, non-pruritic areas on the acral sites of upper and lower extremities for two years. In physical examination, the patient had normal mental development. Skin lesions consisted of scattered, white to skin-colored papules, less than 1 cm in diameter, and with central protrusion, with distribution on dorsal part of the index finger, forearms, distal portion of thighs and calves. Lesions were detected neither on the trunk nor the proximal areas of extremities. There are no sensory changes associated with the lesions. Otherwise, his general health was good. He did not have any medication consumption history. Family history was negative. Laboratory examinations were within normal limits. Skin biopsy from one of his lesions was done, that confirmed the diagnosis of anetoderma. Conclusions In summary, we report a case of anetoderma on unusual sites of the skin. We could not find similar reports of anetoderma developing on distal extremities without involvement of the upper trunk and proximal arms, in the medical literature. PMID:15318943

  17. Spontaneous live unilateral twin ectopic pregnancy – A case presentation

    PubMed Central

    Mahsood, Shazia; Shelton, Hannah; Zaedi, Khaled; Economides, DL

    2014-01-01

    The incidence of ectopic pregnancy has increased in recent years and now is around one in 100 pregnancies. However, the incidence of live twin ectopic pregnancy in a spontaneous conception is still quite rare. A 34-year-old gravida 3, para 0 presented in the Early Pregnancy Unit with a positive pregnancy test, lower abdominal pain and vaginal spotting. Her quantitative serum Beta hCG was high, and the transvaginal scan revealed an empty uterine cavity with a twin ectopic pregnancy in the left adnexa with cardiac activity in both embryos. The patient was taken for laparoscopic surgery and a left ampullary twin pregnancy was confirmed. She underwent a left salpingectomy and is well on a one-year follow-up. This case report discusses the incidence, diagnoses and treatment of ectopic pregnancies in general.

  18. Endobronchial Carcinoid Tumour with Extensive Ossification: An Unusual Case Presentation.

    PubMed

    Osmond, Allison; Filter, Emily; Joseph, Mariamma; Inculet, Richard; Kwan, Keith; McCormack, David

    2016-01-01

    Carcinoid tumour is a well-known primary endobronchial lung neoplasm. Although calcifications may be seen in up to 30% of pulmonary carcinoid tumours, near complete ossification of these tumours is an unusual finding. Such lesions can prove diagnostically challenging at the time of intraoperative frozen section as the latter technique requires thin sectioning of the lesion for microscopic assessment. We present an unusual case of endobronchial carcinoid tumour with extensive ossification in a 45-year-old male. Preliminary intraoperative diagnosis was achieved through the alternative use of cytology scrape smears. The final diagnosis was confirmed after decalcification of the tumour. The prognostic implications of heavily ossified carcinoid tumours remain elusive. Long-term clinical follow-up of these patients is recommended. PMID:27610135

  19. Endobronchial Carcinoid Tumour with Extensive Ossification: An Unusual Case Presentation

    PubMed Central

    Filter, Emily; Joseph, Mariamma; Inculet, Richard; Kwan, Keith; McCormack, David

    2016-01-01

    Carcinoid tumour is a well-known primary endobronchial lung neoplasm. Although calcifications may be seen in up to 30% of pulmonary carcinoid tumours, near complete ossification of these tumours is an unusual finding. Such lesions can prove diagnostically challenging at the time of intraoperative frozen section as the latter technique requires thin sectioning of the lesion for microscopic assessment. We present an unusual case of endobronchial carcinoid tumour with extensive ossification in a 45-year-old male. Preliminary intraoperative diagnosis was achieved through the alternative use of cytology scrape smears. The final diagnosis was confirmed after decalcification of the tumour. The prognostic implications of heavily ossified carcinoid tumours remain elusive. Long-term clinical follow-up of these patients is recommended. PMID:27610135

  20. [Primary hypokalemic periodic paralysis. Presentation of 18 cases].

    PubMed

    Ariza-Andraca, C R; Frati-Munari, A C; Ceron, E; Chavez de los Rios, J M; Martinez-Mata, J

    1993-01-01

    The clinical features of 16 males and 2 females with hypokalemic periodic paralysis (HPP) are presented. Five patients had familial HPP, 4 thyrotoxic HPP and 9 sporadic disease. The age of onset ranged from 6 to 42 years. Clinical pictures varied from paraparesis to severe quadriplegia. The disease onset was earlier in familial HPP (p < 0.05) while sporadic cases showed the most severe, albeit shorter paralysis (p < 0.05). On admission, serum potassium levels ranged from 1.5 to 3.3 mEq/L; they did not correlate with the severity of paralysis. Glucose-insulin provocation test was positive in 5/5 patients. Oral potassium chloride and amiloride were useful to prevent paralysis. Contrasting with reports from USA and Europe, in México, HPP is not exceptional, and should be considered in the differential diagnosis of acute paralysis. PMID:7926395

  1. Retroperitoneal mass presenting as recurrent inguinal hernia: A case report

    PubMed Central

    Tardu, Ali; Yagci, Mehmet Ali; Karagul, Servet; Ertugrul, Ismail; Kayaalp, Cuneyt

    2016-01-01

    Introduction Retroperitoneal masses presenting as an inguinal hernia are rare conditions. Presentation of case A 53 year old male admitted with the symptoms of weight loss, abdominal discomfort and left sided recurrent inguinal hernia. Physical examination demonstrated an abdominal mass in the left flank and an irreducible, painless scrotal mass. He had a history of left sided inguinal hernia surgery six years ago. Computed tomography revealed a large enhancing left sided retroperitoneal mass invading the colon, pancreas and kidney and it was going down towards the left scrotum. Unblock tumor resection including the neighboring organs (left kidney, left colon, distal pancreas with spleen) was performed. Scrotal extension of the tumor was also excised and the inguinal canal was repaired primarily. Histopathology of the mass was myxoid-liposarcoma. The patient has disease free, without hernia recurrence but poor in renal function after twenty months follow-up. Discussion Large retroperitoneal tumors may grow towards the inguinal region and they can mimic an inguinal hernia. An irreducible, painless and hard scrotal mass should be considered from this perspective. PMID:26812669

  2. A case of cystinuria presenting with cerebellar ataxia and dementia.

    PubMed

    Tohge, Rie; Sakamoto, Shinichi; Takahashi, Makio

    2016-08-01

    Cystinuria normally manifests as recurrent urinary stones and renal dysfunction, but can present to neurologists with ataxia, posterior column impairment, intellectual deficiency and pyramidal and extrapyramidal signs; the neuroradiological features include cerebellar, brainstem and cerebral atrophy. It is an autosomal recessive disease caused by a transport disorder of cystine and dibasic amino acids in renal proximal tubules. Most cases have an SLC3A1 and/or SLC7A9 gene mutation but some recent Japanese patients have had distinct heterozygous gene mutations. We report a patient with cystinuria with a heterozygous P482L mutation in the SLC7A9 gene, presenting with atrophy in the cerebellum, brainstem and cerebrum and with no urinary stones. Cystine, an amino acid comprising two cysteine molecules, is transported into cells via a cystine transporter. It is essential for producing hydrogen sulfate and the cellular antioxidant glutathione: these exert neuroprotection in astrocytes and cerebellar Purkinje cells. Although cystinuria is a metabolic disorder associated with renal dysfunction, we suspect that a trafficking defect of transporter rBAT-BAT1 in brain might cause neuronal degeneration, leading to cerebellar and cerebral atrophy. PMID:26929440

  3. Lassa fever presenting as acute abdomen: a case series.

    PubMed

    Dongo, Andrew E; Kesieme, Emeka B; Iyamu, Christopher E; Okokhere, Peter O; Akhuemokhan, Odigie C; Akpede, George O

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission. PMID:23597024

  4. Lassa fever presenting as acute abdomen: a case series

    PubMed Central

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission. PMID:23597024

  5. Multiple myeloma presenting as an intracranial plasmacytoma: a case report.

    PubMed

    Terada, Tadashi

    2009-01-01

    Multiple myeloma presenting as an intracranial tumor (plasmacytoma) is very rare. An 81-year-old woman was admitted to our hospital because of gait disturbance. A blood laboratory test revealed a mildly increased lactate dehydrogenase (236 IU/L) and glucose (121 mg/dl). Blood protein fractions were normal. Brain computed tomography and magnetic resonance imaging revealed an intracranial mass (5 x 4 x 3 cm) in the brain base next to the clavus, and it was clinically diagnosed as chordoma. An excision of the brain tumor was performed. Imaging modalities including ultrasound, x-ray, computed tomography, magnetic resonance imaging and positron emission tomography did not reveal any tumors other than the brain tumor. The tumor was soft, fragile, and bloody. Microscopically, a monotonous proliferation of atypical plasma cells with hyperchromatic nuclei was recognized. Histochemically, the tumor cells were pyroninophilic and the congo-red stain revealed amyloidosis. Immunohistochemically, the tumor cells were positive for kappa-chain and negative for cytokeratin, epithelial membrane antigen, vimentin, CD45, CD20, CD45RO, lambda-chain, IgM, IgA, IgG, synaptophysin, chromogranin, S100 protein, desmin, alpha-smooth muscle antigen, myoglobin, p53 protein, and glial fibrillary acidic protein. The Ki-67 labeling was 11%. Intracranial plasmacytoma was pathologically diagnosed. The patient was treated by adjuvant chemoradiation, and entered into the complete remission stage. However, multiple metastases emerged in the vertebral bones and ribs six months after the remission. A diagnosis of multiple myeloma was made. The urine revealed Bence-Jones protein of monoclonal IgG kappa-chain type, but blood M protein was not recognized. The patient's condition gradually deteriorated. The patient died of respiratory failure due to bronchopneumonia 18 months after the admission. The present case indicates that multiple myeloma may manifest as an intracranial brain tumor (plasmacytoma). PMID

  6. A case of hypereosinophilic syndrome presenting with intractable gastric ulcers

    PubMed Central

    Park, Tae Young; Choi, Chang Hwan; Yang, Suh Yoon; Oh, In Soo; Song, In-Do; Lee, Hyun Woong; Kim, Hyung Joon; Do, Jae Hyuk; Chang, Sae Kyung; Cho, Ah Ra; Cha, Young Joo

    2009-01-01

    We report a rare case of hypereosinophilic syndrome (HES) presenting with intractable gastric ulcers. A 71-year-old man was admitted with epigastric pain. Initial endoscopic findings revealed multiple, active gastric ulcers in the gastric antrum. He underwent Helicobacter pylori (H pylori) eradication therapy followed by proton pump inhibitor (PPI) therapy. However, follow-up endoscopy at 4, 6, 10 and 14 mo revealed persistent multiple gastric ulcers without significant improvement. The proportion of his eosinophil count increased to 43% (total count: 7903/mm3). Abdominal-pelvic and chest computed tomography scans showed multiple small nodules in the liver and both lungs. The endoscopic biopsy specimen taken from the gastric antrum revealed prominent eosinophilic infiltration, and the liver biopsy specimen also showed eosinophilic infiltration in the portal tract and sinusoid. A bone marrow biopsy disclosed eosinophilic hyperplasia as well as increased cellularity of 70%. The patient was finally diagnosed with HES involving the stomach, liver, lung, and bone marrow. When gastric ulcers do not improve despite H pylori eradication and prolonged PPI therapy, infiltrative gastric disorders such as HES should be considered. PMID:20027690

  7. [Heterotopic pregnancy in intrauterine insemination. Presentation of a case].

    PubMed

    Kably Ambe, A; Garza Rios, P; Serviere Zaragoza, C; Delgado Urdapilleta, J

    1992-04-01

    The heterotopic (ectopic and orthotopic simultaneous) pregnancy shows a frequency of 1 to 15,000 to 1 to 30,000 gestations. The clinical diagnosis is difficult due to the lack of precise indicators, as to diagnose an intrauterine pregnancy eliminates the possibility of ectopic pregnancy. The methods of Assisted Reproduction seem to be factors that have influenced on the increment of this type of gestations. A case of a 32 year patient with primary sterility by pelvic adhesions process, that was surgically treated, as there was no pregnancy after surgery, she was given intrauterine insemination with her husband's semen (IU) pregnancy was obtained, determined at 15 days of menstrual lack by presence of subunit B of HCG in serum and vaginal ultrasound that confirmed gestational sac. One month after she presented at Urgencies with an acute abdominal condition; laparotomy was done and salpingectomy was carried out for ruptured tubal pregnancy confirmed by histopathology. The evolution on intrauterine pregnancy was normal culminating with cesarean section at week 35 by inminence of eclampsia/Mother and child in good conditions. PMID:1601314

  8. Clinical Presentation of Acute Pulmonary Embolism: Survey of 800 Cases

    PubMed Central

    Miniati, Massimo; Cenci, Caterina; Monti, Simonetta; Poli, Daniela

    2012-01-01

    Background Pulmonary embolism (PE) is a common and potentially fatal disease that is still underdiagnosed. The objective of our study was to reappraise the clinical presentation of PE with emphasis on the identification of the symptoms and signs that prompt the patients to seek medical attention. Methodology/Principal Findings We studied 800 patients with PE from two different clinical settings: 440 were recruited in Pisa (Italy) as part of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED); 360 were diagnosed with and treated for PE in seven hospitals of central Tuscany, and evaluated at the Atherothrombotic Disorders Unit, Firenze (Italy), shortly after hospital discharge. We interviewed the patients directly using a standardized, self-administered questionnaire originally utilized in the PISAPED. The two samples differed significantly as regards age, proportion of outpatients, prevalence of unprovoked PE, and of active cancer. Sudden onset dyspnea was the most frequent symptom in both samples (81 and 78%), followed by chest pain (56 and 39%), fainting or syncope (26 and 22%), and hemoptysis (7 and 5%). At least one of the above symptoms was reported by 756 (94%) of 800 patients. Isolated symptoms and signs of deep vein thrombosis occurred in 3% of the cases. Only 7 (1%) of 800 patients had no symptoms before PE was diagnosed. Conclusions/Significance Most patients with PE feature at least one of four symptoms which, in decreasing order of frequency, are sudden onset dyspnea, chest pain, fainting (or syncope), and hemoptysis. The occurrence of such symptoms, if not explained otherwise, should alert the clinicians to consider PE in differential diagnosis, and order the appropriate objective test. PMID:22383978

  9. Dermatosis as the initial presentation of gastric cancer: two cases

    PubMed Central

    Ge, Wei; Teng, Bu-Wei; Yu, De-Cai; Zheng, Li-Ming; Ding, Yi-Tao

    2014-01-01

    Paraneoplastic dermatoses are known to be certain dermatosis related with tumor. The common paraneoplastic dermatoses are acanthosis nigricans, acquired ichthyosis, dermatomyositis, erythroderma, and so on. Here we report two cases of paraneoplastic dermatoses associated with gastric cancer. One case was a 57-year-old man with dermatomyositis and proved to be associated with gastric cancer through stomachoscopy. The other was a 66-year-old man with erythroderma and proved to be associated with gastric cancer through stomachoscopy. Both cases were treated with radical total gastrectomy with lymphadenectomy (D2) and esophagojejunostomy of Roux-en-Y. The skin symptom of both cases had improved a lot but still existed after operation. Paraneoplastic dermatoses can be seen as the early manifestation of visceral carcinomas. As a result, gastric cancers should be excluded in the patients with paraneoplastic dermatoses. PMID:25400431

  10. Unusual presentation of filariasis as an abscess: A case report.

    PubMed

    Ahuja, Mukta; Pruthi, Sonam Kumar; Gupta, Renu; Khare, Pratima

    2016-01-01

    Bancroftian filariasis, a tropical and subtropical disease caused by Wuchereria bancrofti, is transmitted by the culex mosquito. The disease is conventionally diagnosed by the demonstration of microfilaria in peripheral blood smear. Microfilaria and adult filarial worms have been incidentally detected in fine needle aspiration cytology (FNAC) in various locations. The disease may be missed if one is not aware of the possibility, particularly in cases where eosinophilia is absent. Therefore, clinicians and pathologists need to be more vigilant in the endemic zones for early diagnosis and the treatment of filariasis. We report here an unusual case of filariasis in a 17-year-old female with a swelling in the lower part of the left arm on the flexor surface. This highlights the chances of finding microfilaria in cytology of an unsuspected case at an unusual site. This case, in addition, stresses the fact that microfilaria may be associated with an abscess even in the absence of eosinophilia. PMID:27011444

  11. Unusual presentation of filariasis as an abscess: A case report

    PubMed Central

    Ahuja, Mukta; Pruthi, Sonam Kumar; Gupta, Renu; Khare, Pratima

    2016-01-01

    Bancroftian filariasis, a tropical and subtropical disease caused by Wuchereria bancrofti, is transmitted by the culex mosquito. The disease is conventionally diagnosed by the demonstration of microfilaria in peripheral blood smear. Microfilaria and adult filarial worms have been incidentally detected in fine needle aspiration cytology (FNAC) in various locations. The disease may be missed if one is not aware of the possibility, particularly in cases where eosinophilia is absent. Therefore, clinicians and pathologists need to be more vigilant in the endemic zones for early diagnosis and the treatment of filariasis. We report here an unusual case of filariasis in a 17-year-old female with a swelling in the lower part of the left arm on the flexor surface. This highlights the chances of finding microfilaria in cytology of an unsuspected case at an unusual site. This case, in addition, stresses the fact that microfilaria may be associated with an abscess even in the absence of eosinophilia. PMID:27011444

  12. Anaphylaxis cases presenting to primary care paramedics in Quebec.

    PubMed

    Kimchi, Nofar; Clarke, Ann; Moisan, Jocelyn; Lachaine, Colette; La Vieille, Sebastien; Asai, Yuka; Joseph, Lawrence; Mill, Chris; Ben-Shoshan, Moshe

    2015-12-01

    Data on anaphylaxis cases in pre-hospital settings is limited. As part of the Cross Canada Anaphylaxis Registry (C-CARE), we assessed anaphylaxis cases managed by paramedics in Outaouais, Quebec. A software program was developed to prospectively record demographic and clinical characteristics as well as management of cases meeting the definition of the anaphylaxis. Univariate and multivariate logistic regressions were compared to assess factors associated with severity of reactions and epinephrine use. Among 33,788 ambulance calls of which 23,486 required transport, 104 anaphylaxis cases were identified (anaphylaxis rate of 0.31% [95%CI, 0.25%, 0.37%] among all ambulance calls and 0.44% [95%CI, 0.36%, 0.54%] among those requiring transport). The median age was 46.8 years and 41.3% were males. The common triggers included food (32.7% [95%CI, 24.0%, 42.7%]), drugs (24.0% [16.4%, 33.6%]), and venom (17.3% [10.8%, 26.2%]). Among all reactions, 37.5% (95%CI, 28.4%, 47.6%) were severe. Epinephrine was not administered in 35.6% (95%CI, 26.6%, 45.6%) of all cases. Males were more likely to have severe reactions (Odds ratio [OR]: 2.50 [95%CI, 1.03, 6.01]). Venom-induced reactions and severe anaphylaxis were more likely to be managed with epinephrine (OR: 6.9 [95%CI, 1.3, 35.3] and 4.2 [95%CI, 1.5, 12.0], respectively). This is the first prospective study evaluating anaphylaxis managed by paramedics. Anaphylaxis accounts for a substantial proportion of the cases managed by paramedics in Outaouais, Quebec and exceeds prior reports of the proportion of Quebec emergency room visits attributed to anaphylaxis. Although guidelines recommend prompt use of epinephrine for all cases of anaphylaxis, more than a third of cases did not receive epinephrine. It is crucial to develop educational programs targeting paramedics to promote the use of epinephrine in all cases of anaphylaxis regardless of the specific trigger. PMID:26734462

  13. An atypical case of tularemia presented with pseudoptosis.

    PubMed

    Celik, T; Kosker, M; Kirboga, K

    2014-08-01

    We report an unusual case of tularemia involving pseudoptosis associated with deterioration of the lymphatic drainage system extending from the upper eyelid to the preauricular lymph nodes. A 16-week pregnant patient was admitted with an absess on the neck, preauricular lymphadenopathy, and pseudoptosis on the left side. The micro-agglutination test was positive for Francisella tularensis antibody at a titer of 1/200. The absess was surgically drained and oral cefuroxime was given for 6 weeks. Two weeks after drainage, the pseudoptosis improved due to the recovery of lymphatic drainage system of the eyelid and remission of the absess on the neck. Our case report contributes to the medical literature on tularemia during pregnancy and informs healthcare professionals on the management of the infection in such cases. PMID:24659144

  14. Geothermal Exploration Case Studies on OpenEI (Presentation)

    SciTech Connect

    Young, K.; Bennett, M.; Atkins, D.

    2014-03-01

    The U.S. Geological Survey (USGS) resource assessment (Williams et al., 2008) outlined a mean 30 GWe of undiscovered hydrothermal resource in the western United States. One goal of the U.S. Department of Energy's (DOE) Geothermal Technology Office (GTO) is to accelerate the development of this undiscovered resource. DOE has focused efforts on helping industry identify hidden geothermal resources to increase geothermal capacity in the near term. Increased exploration activity will produce more prospects, more discoveries, and more readily developable resources. Detailed exploration case studies akin to those found in oil and gas (e.g. Beaumont and Foster, 1990-1992) will give developers central location for information gives models for identifying new geothermal areas, and guide efficient exploration and development of these areas. To support this effort, the National Renewable Energy Laboratory (NREL) has been working with GTO to develop a template for geothermal case studies on the Geothermal Gateway on OpenEI. In 2012, the template was developed and tested with two case studies: Raft River Geothermal Area (http://en.openei.org/wiki/Raft_River_Geothermal_Area) and Coso Geothermal Area (http://en.openei.org/wiki/Coso_Geothermal_Area). In 2013, ten additional case studies were completed, and Semantic MediaWiki features were developed to allow for more data and the direct citations of these data. These case studies are now in the process of external peer review. In 2014, NREL is working with universities and industry partners to populate additional case studies on OpenEI. The goal is to provide a large enough data set to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

  15. Case Study: Revising a Formal Case Study Presentation as an Independent Research Project

    ERIC Educational Resources Information Center

    Field, Patrick R.

    2013-01-01

    This article examines the process of researching and revising a case study presentation on an individual who experienced anesthetic awareness during an abdominal surgery and eventually committed suicide. Topics addressed include the author's selection of an undergraduate student with a science and teaching background to work on the case…

  16. Broad-Spectrum Behavior Therapy with Children: A Case Presentation

    ERIC Educational Resources Information Center

    Keat, Donald B.

    1972-01-01

    The purpose of the case study was to report how a therapist can adapt a variety of behavioral techniques (both classical and operant conditioning) to meet the needs of emotionally disturbed elementary school aged children in one-to-one relationships. (Atuhor)

  17. Capecitabine cardiac toxicity presenting as effort angina: a case report.

    PubMed

    Lestuzzi, Chiara; Crivellari, Diana; Rigo, Fausto; Viel, Elda; Meneguzzo, Nereo

    2010-09-01

    We report a case of capecitabine-induced cardiotoxicity (effort angina) in a woman with metastatic breast carcinoma. Due to cancer progression, rechallenge of therapy with capecitabine was attempted, using several strategies in order to prevent cardiotoxicity. The most (even if not fully) effective strategy was reducing capecitabine dosage together with nitrates, calcium-channel blockers and trimetazidine therapy. PMID:20093950

  18. [Measles and subcutaneous emphysema. Presentation of 3 cases].

    PubMed

    Montesano-Delfín, J R; Mascareñas-Ponce, A

    1991-03-01

    This is a three case study report of children with measles which later progressed to bronchopneumonia and subcutaneous emphysema. All three children were from farming families, and none had been previously vaccinate against measles. For a period of six months, 183 cases of measles were treated at our hospital of which only three worsened to subcutaneous emphysema, demonstrating an incidence rate of 1.6%; they also showed to have bronchopneumonia, with severe coughing episodes; which made us recall the possible physiopathology principle of the pressure gradient theory behind this complication proposed by Bloch in 1968. The factors related to our patients suggested a more severe and aggresive type of measles with a greater probability of having complications. The prognostic value of the severity of this type of measles in the presence of subcutaneous emphysema is limited and its management should be primarly focused on treating the added bronchial problem. PMID:2064747

  19. [Horseshoe kidney, stone disease and prostate cancer: a case presentation].

    PubMed

    Hermida Pérez, J A; Bermejo Hernández, A; Hernández Guerra, J S; Sobenes Gutierrez, R J

    2013-01-01

    The horseshoe kidney is the most common congenital renal fusion anomalies. It occurs in 0.25% of the population, or 1 in every 400 people. It is more frequent in males (ratio 2:1). The most observed complication of horseshoe kidney is stone disease, although there may be others such as, abdominal pain, urinary infections, haematuria, hydronephrosis, trauma and tumours (most commonly associated with hypernephroma and Wilms tumour). We describe a case of a male patient with horseshoe kidney, stone disease and adenocarcinoma of the prostate. One carrier of this condition who suffered a transitional cell carcinoma of the prostate was found in a review of the literature. PMID:24315083

  20. Is surgical intervention avoidable in cases of emphysematous gastritis? A case presentation and literature review

    PubMed Central

    Szuchmacher, Mauricio; Bedford, Tyler; Sukharamwala, Prashant; Nukala, Melanie; Parikh, Neil; DeVito, Peter

    2013-01-01

    INTRODUCTION Gas located within the gastric wall is a rare finding that is associated with a mortality rate of 50%. It confers two main diagnoses: gastric emphysema and emphysematous gastritis. Due to its high mortality rate, emphysematous gastritis must be differentiated from gastric emphysema early to avoid adverse outcomes and plan the management of these patients. PRESENTATION OF CASE We introduce a 55 year-old male who presents with diffuse abdominal pain associated with fever, nausea, vomiting, and diarrhea. Patient has positive peritoneal signs with fever and leukocytosis. Air in the gastric wall and portal venous system was visualized on Computed Tomography (CT). The patient underwent emergent laparotomy which showed normal bowel with few adhesions. DISCUSSION Various etiologies can cause gas within the gastric wall but concomitant air in the hepatic venous system is highly suspicious for emphysematous gastritis. CT imaging is the most sensitive and specific way to differentiate emphysematous gastritis versus gastric emphysema. Although rare, there are many cases of emphysematous gastritis that undergo prompt surgical exploration. Recently, however, medical treatment has become more common and surgical management reserved for complications. CONCLUSION We conclude by stating that this case of emphysematous gastritis, due to gastric ulcers, would have no difference in outcome if treated medically instead of surgically. Historically, patients with emphysematous gastritis warranted surgical intervention. More recently, case reports of emphysematous gastritis are favoring conservative management. The consensus still remains that there is no standard approach for these patients and most patients in extremis are undergoing surgical intervention. PMID:23537915

  1. A Rare Case of Cutaneous Leishmaniasis Presenting as Rhinophyma

    PubMed Central

    Bandyopadhyay, Arghya; Bose, Kousik

    2015-01-01

    Cutaneous leishmaniasis(CL) is referred to a group of diseases because of the varied clinical presentation, ranging from small cutaneous nodule to wide spread mucosal destruction. The nose is rarely involved by CL in even in endemic region. In this report we describe a rare rhinophymatous presentation of CL from a non-endemic region which was diagnosed by fine needle sampling and treated with Miltefosine. PMID:26351477

  2. A rare case of Turner's syndrome presenting with Mullerian agenesis.

    PubMed

    Vaddadi, Suresh; Murthy, Ramana S V; Rahul, C H; Kumar, Vinod L

    2013-10-01

    Turner's syndrome also called as Ullrich Turner's syndrome, is a disease of unclear pathogenesis characterized by complete or partial absence of one sex chromosome, with or without cell line mosaicism in a phenotypic female with short stature. Various anomalies result in a constellation of features, of which the most disturbing is primary amenorrhea due to gonadal dysgenesis. Hormone therapy in these patients can often result in successful menstruation, and scope for subsequent pregnancy because of anatomically normal uterus and vagina. Coexisting Mullerian agenesis in these patients can jeopardize the chances of future pregnancy as they have associated structural abnormalities of the uterus and vagina. We report a rare case of middle-aged female with Turner's syndrome and Mullerian agenesis having absent secondary sexual characters and missing uterus with incompletely formed vagina. PMID:24672170

  3. [Prader-Willi syndrome. Presentation of a case].

    PubMed

    Muñoz-Domingo, Elena; Montilla-Pérez, Manuel; Muñoz-Lomas, Fernando; Jiménez Vaquero, César

    2013-01-01

    We report the case of a term infant of 39+1, born by emergency cesarean section due to suspected fetal distress with an Apgar test 4/6/8 and axial hypotonia with weak reflexes. After 52 days of hospitalization an individualized care plan was developed and applied based on Marjory Gordon's functional patterns model and NANDA domains. We used the NANDA diagnoses, interventions according to nursing interventions classification (NIC), and the expected results as classified by nursing outcomes (NOC). Through the care plan, the identified diagnoses and potential complications were resolved. Progress was slow but favorable, stimulating sucking and achieving a good breastfeeding latch, with an appropriate weight gain, decreased muscle stiffness, and increased response to stimuli. PMID:24268785

  4. Embryo with XYY syndrome presenting with clubfoot: a case report

    PubMed Central

    Tsakalidis, Christos; Tampakoudis, George P; Papastergiou, Maria N; Tzevelekis, Fillipos; Pados, George; Assimakopoulos, Efstratios A

    2009-01-01

    Talipes equinovarus (clubfoot) is a skeletal anomaly of the embryo’s legs, with a frequency of 1-3:1000 living born babies. It may occur as an independent anomaly, or as part of a syndrome with concomitant chromosomal abnormalities. XYY syndrome is a quite rare sex chromosomal abnormality with 47, XYY karyotype. Prenatal diagnosis is usually accidental because the syndrome is not associated with increased prevalence of sonographically detectable defects. The possibility of co-existence of skeletal anomalies in embryos with 47, XYY karyotype is scant, with only a few cases reported in the literature. An amniocentesis was performed in an embryo at the 21st week of gestation because clubfoot was detected in the 2nd trimester scan, and the embryo was found to have abnormal karyotype of 47, XYY. Current opinions and management dilemmas are discussed. PMID:19918427

  5. Embryo with XYY syndrome presenting with clubfoot: a case report.

    PubMed

    Athanatos, Dimitrios; Tsakalidis, Christos; Tampakoudis, George P; Papastergiou, Maria N; Tzevelekis, Fillipos; Pados, George; Assimakopoulos, Efstratios A

    2009-01-01

    Talipes equinovarus (clubfoot) is a skeletal anomaly of the embryo's legs, with a frequency of 1-3:1000 living born babies. It may occur as an independent anomaly, or as part of a syndrome with concomitant chromosomal abnormalities.XYY syndrome is a quite rare sex chromosomal abnormality with 47, XYY karyotype. Prenatal diagnosis is usually accidental because the syndrome is not associated with increased prevalence of sonographically detectable defects. The possibility of co-existence of skeletal anomalies in embryos with 47, XYY karyotype is scant, with only a few cases reported in the literature.An amniocentesis was performed in an embryo at the 21(st) week of gestation because clubfoot was detected in the 2(nd) trimester scan, and the embryo was found to have abnormal karyotype of 47, XYY. Current opinions and management dilemmas are discussed. PMID:19918427

  6. Alopecia areata: Clinical presentation, diagnosis, and unusual cases.

    PubMed

    Finner, Andreas M

    2011-01-01

    Alopecia areata (AA) is a nonscarring hair loss disorder with a 2% lifetime risk. Most patients are below 30 years old. Clinical types include patchy AA, AA reticularis, diffuse AA, AA ophiasis, AA sisiapho, and perinevoid AA. Besides scalp and body hair, the eyebrows, eyelashes, and nails can be affected. The disorder may be circumscribed, total (scalp hair loss), and universal (loss of all hairs). Atopy, autoimmune thyroid disease, and vitiligo are more commonly associated. The course of the disease is unpredictable. However, early, long-lasting, and severe cases have a less favorable prognosis. The clinical diagnosis is made by the aspect of hairless patches with a normal skin and preserved follicular ostia. Exclamations mark hairs and a positive pull test signal activity. Dermoscopy may reveal yellow dots. White hairs may be spared; initial regrowth may also be nonpigmented. The differential diagnosis includes trichotillomania, scarring alopecia, and other nonscarring hair loss disorders such as tinea capitis and syphilis. PMID:21689244

  7. Gastric Duplication Cyst Presenting as Acute Abdomen: A Case Report

    PubMed Central

    Sheikh, Afzal

    2010-01-01

    Gastric duplication cysts are rare variety of gastrointestinal duplications. Sometimes they may present with complications like hemorrhage, infection, perforation, volvulus, intussusception and rarely neoplastic changes in the gastric duplication cyst. We present one and half year old male child who developed sudden abdominal distension with pain and fever for two days. Ultrasound revealed a cystic mass in the hypochondrium and epigastric regions. On exploration an infected and perforated gastric duplication cyst was found. Surgical excision of most part of cyst wall with mucosal stripping of the rest was performed. Histopathology confirmed the diagnosis of gastric duplication cyst. Early surgical intervention can result in good outcome. PMID:22953249

  8. Creating Case Study Presentations: A Survey of Senior Seminar Students

    ERIC Educational Resources Information Center

    Field, Patrick

    2005-01-01

    The Senior Seminar in Biology course at Kean University teaches students who have taken core biology courses and achieved senior status to research primary literature on current topics in biology and produce a traditional seminar presentation that includes a written report and a clear and comprehensive oral talk with ensuing discussion. Senior…

  9. Digital device in postextraction implantology: a clinical case presentation.

    PubMed

    Borgonovo, A E; Rigaldo, F; Battaglia, D; Re, D; Giannì, A B

    2014-01-01

    Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy) with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy). The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany) and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy) and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient's discomfort. However, it is still necessary for scientific

  10. Digital Device in Postextraction Implantology: A Clinical Case Presentation

    PubMed Central

    Borgonovo, A. E.; Rigaldo, F.; Battaglia, D.; Giannì, A. B.

    2014-01-01

    Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy) with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy). The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany) and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy) and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient's discomfort. However, it is still necessary for scientific

  11. Transfer of space technologies past and present: the Russian case.

    PubMed

    Pankova, Lyudmila

    2002-12-01

    Since the end of the 1980's transfer of government sponsored high technology space goods and services to other sectors, industry, and eventually non-government use has been a growing concern of the Russian policy makers. Today the real and functional transformation of this field is on the agenda. The paper is organized as follows. The first section analyzes the evolution of the common approach to technology transfer, looks at the main obstacles to this processes as a whole, and in the space sector in particular. The second section examines the Russian space R&D sector from the point of view of its role and place in the Russian scientific and technological base. New mechanisms of technology transfer are then considered. Here, problems of conversion, commercialization, dual-use, and internationalization are examined in the context of space technology transfer. Furthermore, issues of innovation in technology transfer are discussed. The new networks that are forming through which technologies diffuse is considered. The paper then turns to legislative and regulatory problems, including the discussion of the main principles of the Russian space transfer code, which is now being drafted. It is necessary to underline, that in the Russian case, official statistics still do not help analyze the question of technology transfer. PMID:14983845

  12. Parathyroid cyst presenting as acute pancreatitis: report of a case.

    PubMed

    Kim, Mi-Young; Chung, Cho-Yun; Kim, Jong-Sun; Myung, Dae-Seong; Cho, Sung-Bum; Park, Chang-Hwan; Kim, Young; Joo, Young-Eun

    2013-12-01

    We report the first case of hypercalcemia-induced acute pancreatitis caused by a functioning parathyroid cyst in a 67-year-old man. Laboratory investigation revealed increased serum amylase and lipase, increased serum ionized calcium and parathyroid hormone (PTH) levels, and decreased serum phosphate, indicating pancreatitis and primary hyperparathyroidism (PHPT). Abdominal computed tomography (CT) revealed mild swelling of the pancreatic head with peri-pancreatic fat infiltration and fluid collection around the pancreatic tail. Ultrasonography and CT of the neck showed a cystic lesion at the inferior portion of the left thyroid gland, suggesting a parathyroid cyst. There was no evidence of parathyroid adenoma by 99mTc sestamibi scintigraphy. PHPT caused by a functioning parathyroid cyst was suspected. The patient underwent surgical resection of the functioning parathyroid cyst owing to his prolonged hypercalcemia. At 3 weeks after the operation, his serum levels of PTH, total calcium, ionized calcium, inorganic phosphate, amylase, and lipase were normalized. At the follow-up examinations, he has remained asymptomatic. PMID:24400215

  13. [Case of Borrelia brainstem encephalitis presenting with severe dysphagia].

    PubMed

    Kawano, Yuji; Shigeto, Hiroshi; Shiraishi, Yoshimasa; Ohyagi, Yasumasa; Kira, Jun-Ichi

    2010-04-01

    We report the case of a 30-year-old man who developed severe dysphagia owing to neuroborreliosis. He showed dysphagia, diplopia, hiccups, and walking difficulty Neurological examination revealed mild disturbance of consciousness, diplopia on left lateral gaze, left-side-dominant blephaloptosis, gaze-evoked horizontal nystagmus on left lateral gaze, mild bilateral muscle weakness, palatoplegia, dysphagia, dysarthria, and truncal ataxia An increased pharyngeal reflex caused dysphagia in this patient. An EEG revealed intermittent high amplitude slow wave activity. However, head MRI, blood count, serum chemistry, and cerebrospinal fluid examination showed no abnormality. Initially, brainstem encephalitis with unknown etiology was diagnosed. The hiccups, diplopia, and ptosis were improved by corticosteroid therapy, but other symptoms were refractory to corticosteroid therapy and IVIg. After these immunotherapies, anti-Borrelia IgG and IgM antibodies were found to be positive, and symptoms, including dysphagia, were improved by doxycycline and cefotaxime. Because the clinical symptoms of Borrelia infection are widely variable, neuroborreliosis should be considered in patients with brainstem encephalitis refractory to conventional immunotherapies. PMID:20411811

  14. Disseminated gonococcal infection presenting as vasculitis: a case report.

    PubMed

    Jain, Sangita; Win, Htet Nwe; Chalam, Venkat; Yee, Lian

    2007-01-01

    A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted. PMID:17213353

  15. Cutaneous polyarteritis nodosa presented with digital gangrene: a case report.

    PubMed

    Choi, Seung Won; Lew, Sogu; Cho, Sung Do; Cha, Hee Jeong; Eum, Eun A; Jung, Hyun Chul; Park, Jae Hoo

    2006-04-01

    Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated. PMID:16614534

  16. Cystic endosalpingiosis presenting as chronic back pain, a case report

    PubMed Central

    2013-01-01

    A 48-year old woman presented with chronic back pain. Previous examinations had been inconclusive. Gynaecological examination revealed large cystic masses on the fundus uteri and left adnexa. Laparoscopy and histopathology showed unusually extensive cystic endosalpingiosis covering the serosa-coated uterine surface as well as the adnexa on both sides. After uneventful laparoscopic-assisted vaginal hysterectomy the patient quickly recovered and was relieved of her chronic backache. Virtual slides http://www.diagnosticpathology.diagnomx.eu/vs/1501709091077524. PMID:24299296

  17. A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia

    PubMed Central

    Valcour, Victor; Haman, Aissa; Cornes, Susannah; Lawall, Carson; Parsa, Andrew T; Glaser, Carol; Yagi, Shigeo; Tihan, Tarik; Bhatnagar, Julu; Geschwind, Michael

    2009-01-01

    SUMMARY Background A 70-year-old immunocompetent male presented to a memory disorders clinic with a 7-month illness that had begun with somatic complaints including transient right temporal head pain, left buttock pain, and right conjunctival injection. About 3 months after the first signs of illness, the patient had begun to develop insidious cognitive and behavioral decline, which progressed most rapidly in the 2 months before presentation. An assessment completed during hospitalization for intermittent fevers and confusion had not revealed an infectious etiology, although mild pleocytosis in the cerebrospinal fluid had been noted. Upon presentation to the memory disorders clinic, the patient was disoriented, distractible, laughed at inappropriate moments, and followed only one-step commands. He had hypophonic speech and had mildly increased axial tone. He scored 5 out of 30 on the Mini Mental State Examination and was admitted for expedited evaluation. Investigations Physical examination, brain MRI, electroencephalogram, lumbar puncture, autoimmune and paraneoplastic testing, cerebral angiogram, cerebrospinal fluid analysis, enterovirus group-specific reverse transcriptase polymerase chain reaction assay, and RNA sequencing in brain biopsy samples. Diagnosis Enteroviral meningoencephalitis. Management Intravenous steroids with oral taper and intravenous immunoglobulin. PMID:18477991

  18. Rebuilding for Sustainability: Case Studies in the Making (Presentation)

    SciTech Connect

    Billman, L.

    2013-06-01

    NREL has made significant contributions to communities suffering from natural disasters since 2007 in terms of technical assistance regarding energy efficiency and renewable energy options. NREL's work has covered all aspects of energy, including energy opportunities in community planning, policy design, new program design, and specific project design and implementation for energy related to electricity generation, building energy use, and transportation. This presentation highlights work done in New Orleans following Hurricane Katrina; Greensburg, Kansas, following a devastating tornado; and New York and New Jersey following Hurricane Sandy.

  19. A case of Currarino's syndrome presenting as neonatal bowel obstruction.

    PubMed

    Sekaran, Prabhu; Brindley, Nicola

    2012-08-01

    We describe a male infant presenting in the neonatal period with bowel obstruction who had features of anal stenosis, a presacral teratoma, and a sacral anomaly consistent with Currarino's syndrome. Initial management involved a defunctioning colostomy followed by a posterior sagittal excision of the teratoma and repair of the anorectal defect. The proband's eldest sister is also affected with features of Currarino's syndrome but was diagnosed later in life. The proband, his sister, and the mother have been identified to have the HLXB9 mutation mapped to chromosome 7q36. PMID:22901924

  20. A rare case of fish odor syndrome presenting as depression

    PubMed Central

    Khan, Shahbaz Ali; Shagufta, K.

    2014-01-01

    A young lady presents to the psychiatry out-patient department with depressive symptoms. Evaluation revealed long standing stressor in the form of a foul odor emanating from her body and over a period of time resulting in social withdrawal and depression with significant impairment of day-to-day functioning. A diagnosis of trimethylaminurea (fish odor syndrome) and adjustment disorder was arrived at. Careful empathetic handling with psychoeducation, behavioral and cognitive counseling and a short course of antidepressants helped her improve significantly with return to almost normal functioning. PMID:24891709

  1. Case 231: Retroperitoneal Adrenal Teratoma Presenting as Trichoptysis.

    PubMed

    Bhatia, Vikas; Sharma, Sanjiv; Sood, Shikha; Mardi, Kavita; Venkat, Bargawee

    2016-07-01

    History A 24-year-old woman from a rural village presented with vague left hypochondrium pain and a cough for the past 2 years. She had a history of occasionally expectorating hairlike strands with her cough. Because the patient was from a rural area, she first consulted with the village priest, as she presumed her illness to be some supernatural phenomenon. The priest advised her to collect the strands for religious rituals ( Fig 1 ). She collected these strands for some time; however, because her cough worsened, she visited the hospital. General physical examination findings were within normal limits. On palpation, there was evidence of a vague lump in the left hypochondrial region. At ultrasonography (US) (images not shown), a large mass with heterogeneous echotexture was seen in the left suprarenal region; cystic areas and calcification were present. Chest radiography (images not shown) revealed bronchiectatic changes, with consolidation in the left lower zone. Results of a blood examination, including assessment of renal function, liver function, and complete blood count, were within normal limits. Unenhanced and contrast material-enhanced computed tomography (CT) images of the chest and abdomen were obtained. PMID:27322977

  2. A case of secondary syphilis presenting as multiple pulmonary nodules.

    PubMed

    Kim, Se Joong; Lee, Ju-Han; Lee, Eung-Seok; Kim, Il-Hwan; Park, Hyung Joo; Shin, Chol; Kim, Je Hyeong

    2013-03-01

    Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement. PMID:23526483

  3. Juvenile otosclerosis: a case presentation and review of the literature.

    PubMed

    Markou, Konstantinos; Stavrakas, Marios; Karkos, Petros; Psillas, Georgios

    2016-01-01

    Otosclerosis in childhood and adolescence or juvenile otosclerosis is a rare disorder resulting in conductive hearing loss. A 9-year-old boy presented to our clinic, suffering from moderate hearing loss. According to his parents, his hearing acuity had progressively deteriorated over the past 2 years. Otoscopy and tympanometry revealed bilateral secretory otitis media and the patient underwent bilateral grommet insertion. However, he continued to report of hearing loss and a right exploratory tympanotomy was performed. Stapedial fixation was confirmed, being compatible with juvenile otosclerosis, and we proceeded to a right stapedotomy. One year later, follow-up showed satisfactory outcome with an air-bone gap closure to 10 dB. Juvenile otosclerosis with the coexistence of persistent secretory otitis media can be overlooked. Affected children from 9 years of age are strongly motivated to undergo stapes surgery for juvenile otosclerosis, following parental consent. PMID:27084899

  4. Biotinidase deficiency: two cases of very early presentation.

    PubMed

    Haagerup, A; Andersen, J B; Blichfeldt, S; Christensen, M F

    1997-12-01

    Two infants with early presentation of biotinidase deficiency (age 3 weeks and 2 weeks) are described. On admission, both children had severe neurological symptoms. In the first patient, magnetic resonance imaging (MRI) of the brain showed frontal and temporal atrophy, and in the second patient, CT of the brain showed diffuse periventricular hypodensities, particularly in the frontal region. Oral treatment with biotin (15mg and 10mg per day respectively) made all symptoms disappear within a few weeks. On follow-up 13 and 16 months later, both children were still asymptomatic on this treatment. Their psychomotor development was normal. MRI and CT of the brain had normalized. Later, a moderate hearing loss was detected in the first patient. In biotinidase deficiency, early diagnosis and treatment with oral biotin are essential in order to prevent irreversible damage to the central nervous system and early death from metabolic acidosis. Neonatal screening for biotinidase deficiency would fulfil this goal. PMID:9433861

  5. [Renal staghorn calculi in small children - presentation of two cases].

    PubMed

    Krzemień, Grażyna; Szmigielska, Agnieszka; Jankowska-Dziadak, Katarzyna; Pańczyk-Tomaszewska, Małgorzata

    2016-01-01

    Urolithiasis in children occurs with the incidence of 0.1-5%. Risk factors such as metabolic disorders, recurrent urinary tract infections and/or congenital abnormalities of urinary tract are detected in 75-85% of children with urolithiasis. Staghorn calculi is associated with delayed diagnosis and treatment of urinary tract infection caused by specific organisms, which produce the enzyme urease, promoting generation of ammonia and hydroxide from urea. We present two boys with staghorn calculi recognized in 8th and 31st month of age. The reason for performing ultrasonography was urinary tract infection in both boys. The younger child was previously healthy, with no symptoms of urolithiasis, the older one had recurrent urinary tract infections caused by Proteus mirabilis, episodes of anxiety and abdominal pain. Laboratory test and imaging studies excluded congenital abnormalities in the urinary tract and typical metabolic causes of urolithiasis in both boys. Treatment of infection-related stones in the younger child included two extracorporeal shock-wave lithotripsy (ESWL). In the older child, both ESWL and operation were performed. Staghorn calculi were composed of mixtures of magnesium ammonium phosphate (struvite) and calcium carbonate (apatite) and confirmed to be identified as infection-related stones. During follow-up in a nephrology outpatient clinic, values of blood pressure, renal ultrasonography, kidney function test were normal and no symptoms of urinary tract infections were clinically present. In patients with recurrent urinary tract infections, urolithiasis should be taken into consideration. The majority of staghorn calculi is often asymptomatic and can be diagnosed with an ultrasonography study performed routine or during urinary tract infection. PMID:27416622

  6. Rhetorical Structure and Linguistic Features of Case Presentations in Case Reports in Taiwanese and International Medical Journals

    ERIC Educational Resources Information Center

    Hung, Hsuan; Chen, Pi-Ching; Tsai, Jing-Jane

    2012-01-01

    The case presentation is the core section of a medical case report. Issues in the teaching of case report writing have recently been the subject of great interest in medical education, especially in the era of globalization. Given that Taiwanese medical students, residents and junior physicians are requested to write case reports in English and…

  7. Unusual presentation of uncommon disease: anorexia nervosa presenting as wernicke-korsakoff syndrome-a case report from southeast Asia.

    PubMed

    Mushtaq, Raheel; Shoib, Sheikh; Shah, Tabindah; Bhat, Mudasir; Singh, Randhir; Mushtaq, Sahil

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome. PMID:24963430

  8. Unusual Presentation of Uncommon Disease: Anorexia Nervosa Presenting as Wernicke-Korsakoff Syndrome—A Case Report from Southeast Asia

    PubMed Central

    Mushtaq, Raheel; Shah, Tabindah; Bhat, Mudasir; Mushtaq, Sahil

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome. PMID:24963430

  9. Teaching Business French through Case Studies: Presentation of a Marketing Case.

    ERIC Educational Resources Information Center

    Federico, Salvatore; Moore, Catherine

    The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

  10. Otorrhagia as the initial presentation of an internal carotid artery aneurysm in the middle ear. Case presentation

    PubMed Central

    PETRI, MARIA; DINESCU, VERONICA; NECULA, VIOLETA; COSGAREA, MARCEL

    2016-01-01

    Middle ear aneurysms are rare and difficult to treat. The case of a 50-year-old female who presented with left otorrhagia caused by an internal carotid aneurysm is reported. She had no medical history of tinnitus, vertigo, otalgia or otorrhea. Middle ear surgery was effective in resolving bleeding and did not cause any permanent neurological deficit. High resolution computed tomography angiography is the technique of choice and, in some cases, can be complemented with a magnetic resonance angiography. Misdiagnosis of the internal carotid artery aneurysm may lead to serious morbidity because of bleeding or vascular occlusion. The use of modern imaging techniques explain the current relative increase in frequency. PMID:27152084

  11. Landmark Cases of American Public School Education: How the Past Has Influenced the Present

    ERIC Educational Resources Information Center

    Christensen, Jenna S.

    2009-01-01

    Landmark cases have shaped the way present American public schools function. Because of this, one would wonder what influences brought about those landmark cases and this study shows a strong relationship between those cases and events which happened in social history. The language of those cases has also been a factor in public schools because of…

  12. Developing Oral Case Presentation Skills: Peer and Self-Evaluations as Instructional Tools

    PubMed Central

    Williams, Dustyn E.; Surakanti, Shravani

    2016-01-01

    Background: Oral case presentation is an essential skill in clinical practice that is decidedly varied and understudied in teaching curricula. Methods: We developed a curriculum to improve oral case presentation skills in medical students. Results: As part of an internal medicine clerkship, students receive instruction in the elements of a good oral case presentation and then present a real-world case in front of a video camera. Each student self-evaluates his/her presentation and receives evaluations from his/her peers. We expect peer and self-evaluation to be meaningful tools for developing skills in oral presentation. Conclusion: We hope to not only improve the quality of oral case presentations by students but also to reduce the time burden on faculty. PMID:27046408

  13. Effective case presentations--an important clinical skill for nurse practitioners.

    PubMed

    Coralli, Connie H

    2006-05-01

    Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation-introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case-are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text. PMID:16681708

  14. A case of Hallervorden-Spatz disease presenting as catatonic schizophrenia

    PubMed Central

    Pawar, Yogesh; Kalra, Gurvinder; Sonavane, Sushma; Shah, Nilesh

    2013-01-01

    Hallervorden-Spatz disease belongs to a group of disorders characterized by predominant involvement of basal ganglia. These cases may present to the psychiatrist with symptoms of depression, nervousness and rarely other psychotic symptoms. Very few cases of this disease have been reported from India. We report a case of Hallervorden-Spatz disease that presented to the psychiatry outpatient department with catatonia. This case highlights how presentation of Hallervorden-Spatz disease may overlap with catatonic symptoms and hence a high index of suspicion is required to make an accurate diagnosis. PMID:24459313

  15. Postirradiation Leiomyosarcoma of Rectum Presenting as a Polyp: Case Report and Review of the Literature.

    PubMed

    Jayakumar, Rajeswari; Basu, Prithwijit Patrick; Huang, Tao; Axiotis, Constantine A

    2016-04-01

    Radiation-induced leiomyosarcomas of the gastrointestinal tract are rare. Very few cases have been documented to date. The histological similarity to gastrointestinal stromal tumor has raised doubts if many of the cases originally reported to be leiomyosarcoma before the widespread use of CD117 were indeed gastrointestinal stromal tumors. We present a case of post-irradiation leiomyosarcoma presenting as a rectal polyp and review the literature. PMID:26582771

  16. A case of asymptomatic pancytopenia with clinical features of hemolysis as a presentation of pernicious anemia.

    PubMed

    Kollipara, Venkateswara K; Brine, Patrick L; Gemmel, David; Ingnam, Sisham

    2016-01-01

    Pernicious anemia is an autoimmune disease with a variety of clinical presentations. We describe a case of pernicious anemia presenting with pancytopenia with hemolytic features. Further workup revealed very low vitamin B12 levels and elevated methylmalonic acid. It is important for a general internist to identify pernicious anemia as one of the cause of pancytopenia and hemolytic anemia to avoid extensive workup. Pernicious anemia can present strictly with hematological abnormalities without neurological problems or vice versa as in our case. PMID:27609735

  17. A case of recurrent desmoplastic malignant melanoma presenting as empyema with underlying lung mass

    PubMed Central

    Patil, Mangaladevi S.; Day, Kristopher M.; Aswad, Bassam I.; Hart, Jesse; Ng, Thomas

    2016-01-01

    Desmoplastic malignant melanoma (DMM) is an extremely rare subtype of cutaneous melanoma that has diverse clinical presentations. We describe the unique case of a 57-year-old man presenting with empyema secondary to vascular occlusion from metastatic DMM. Only two other cases of DMM presenting as a lung mass have been previously reported in the literature. This report highlights potential insidious pathology of DMM, which requires a high clinical suspicion to properly diagnose and manage. PMID:27106614

  18. A case of recurrent desmoplastic malignant melanoma presenting as empyema with underlying lung mass.

    PubMed

    Patil, Mangaladevi S; Day, Kristopher M; Aswad, Bassam I; Hart, Jesse; Ng, Thomas

    2016-01-01

    Desmoplastic malignant melanoma (DMM) is an extremely rare subtype of cutaneous melanoma that has diverse clinical presentations. We describe the unique case of a 57-year-old man presenting with empyema secondary to vascular occlusion from metastatic DMM. Only two other cases of DMM presenting as a lung mass have been previously reported in the literature. This report highlights potential insidious pathology of DMM, which requires a high clinical suspicion to properly diagnose and manage. PMID:27106614

  19. A Case of Primary HIV Type 1 and Cytomegalovirus Coinfection Presenting with Widespread Clinical Disease

    PubMed Central

    Kim, Joseph Y.; Singer, Elyse J.; Bonelli, Laura; Klausner, Jeffrey D.

    2015-01-01

    Coinfection of HIV-1 and cytomegalovirus (CMV) may occur given the shared routes of transmission, and the clinical presentations of each process overlap. We present a case of acute HIV-1 and CMV coinfection presenting with an acute febrile illness complicated by meningitis, hepatitis, and retinopathy. This and other similar cases demonstrate the need to consider CMV coin-fection in acute HIV-1 disease, particularly in situations with significant end-organ damage. PMID:24476962

  20. Primary Paranasal Tuberculosis in a Diabetic Mimicking Odontogenic Infection: A Rare Case; A Unique Presentation.

    PubMed

    Gupta, Amit; Mehendirratta, Monica; Sareen, Chanchal; Aggarwal, Anju

    2016-03-01

    The incidence of Tuberculosis (TB) is high especially in developing countries but primary para-nasal TB is still a rarity. The latter often remains quiescent until it reaches an advanced stage and offers a diagnostic challenge. In the present case report maxillary sinus TB mimicked a destructive periodontitis induced space infection, thus causing a delay in treatment. The present case report describes clinical presentation, diagnosis, management and outcome of a 50-year-old diabetic/HIV seronegative patient with histopathologically confirmed case of maxillary sinus TB. PMID:27135017

  1. Primary Paranasal Tuberculosis in a Diabetic Mimicking Odontogenic Infection: A Rare Case; A Unique Presentation

    PubMed Central

    Mehendirratta, Monica; Sareen, Chanchal; Aggarwal, Anju

    2016-01-01

    The incidence of Tuberculosis (TB) is high especially in developing countries but primary para-nasal TB is still a rarity. The latter often remains quiescent until it reaches an advanced stage and offers a diagnostic challenge. In the present case report maxillary sinus TB mimicked a destructive periodontitis induced space infection, thus causing a delay in treatment. The present case report describes clinical presentation, diagnosis, management and outcome of a 50-year-old diabetic/HIV seronegative patient with histopathologically confirmed case of maxillary sinus TB. PMID:27135017

  2. "Talking Walls": Presenting a Case for Social Justice Poetry in Literacy Education

    ERIC Educational Resources Information Center

    Ciardiello, A. Vincent

    2010-01-01

    This paper presents a case for reading and writing social justice poetry in the childhood educational curriculum. Social justice poetry uses verse to protest unfair and unjust living conditions in society. An historical case study shows how social justice poetry was used to combat social injustice in the United States. Specifically, it shows how…

  3. Uncommon Case of Intrapericardial Nontyphoidal Salmonella Infection in a Preterm Baby Presenting As a Cardiac Tumor.

    PubMed

    Bobylev, Dmitry; Sarikouch, Samir; Meschenmoser, Luitgard; Hohmann, Dagmar; Beerbaum, Philipp; Horke, Alexander

    2016-04-01

    We report a case of an intrapericardial infection resulting from Salmonella Tennessee in a 2-month-old baby, which, upon initial presentation, was masked by a cardiac tumor. The diagnosis was confirmed after successful surgical resection of the mass. Transmission of the infection may have occurred between mother and child in utero, rendering this case extremely unusual. PMID:27000580

  4. Malignant lymphoma of spleen presenting as acute pancreatitis: A case report

    PubMed Central

    Wu, Chao-Ming; Cheng, Lung-Chih; Lo, Gin-Ho; Lai, Kwok-Hung; Cheng, Chia-Ling; Pan, Wen-Cheng

    2007-01-01

    This is a case report of a patient who presented with acute pancreatitis without the common causes. A pancreatic biopsy revealed large B cell lymphoma. Spleen lymphoma with pancreatic involvement inducing acute pancreatitis, which is a rare disorder, was diagnosed. Here we also review the few similar cases reported in the literature. PMID:17659747

  5. The oral case presentation: toward a performance-based rhetorical model for teaching and learning

    PubMed Central

    Chan, Mei Yuit

    2015-01-01

    The oral case presentation is an important communicative activity in the teaching and assessment of students. Despite its importance, not much attention has been paid to providing support for teachers to teach this difficult task to medical students who are novices to this form of communication. As a formalized piece of talk that takes a regularized form and used for a specific communicative goal, the case presentation is regarded as a rhetorical activity and awareness of its rhetorical and linguistic characteristics should be given due consideration in teaching. This paper reviews practitioners’ and the limited research literature that relates to expectations of medical educators about what makes a good case presentation, and explains the rhetorical aspect of the activity. It is found there is currently a lack of a comprehensive model of the case presentation that projects the rhetorical and linguistic skills needed to produce and deliver a good presentation. Attempts to describe the structure of the case presentation have used predominantly opinion-based methodologies. In this paper, I argue for a performance-based model that would not only allow a description of the rhetorical structure of the oral case presentation, but also enable a systematic examination of the tacit genre knowledge that differentiates the expert from the novice. Such a model will be a useful resource for medical educators to provide more structured feedback and teaching support to medical students in learning this important genre. PMID:26194482

  6. The oral case presentation: toward a performance-based rhetorical model for teaching and learning.

    PubMed

    Chan, Mei Yuit

    2015-01-01

    The oral case presentation is an important communicative activity in the teaching and assessment of students. Despite its importance, not much attention has been paid to providing support for teachers to teach this difficult task to medical students who are novices to this form of communication. As a formalized piece of talk that takes a regularized form and used for a specific communicative goal, the case presentation is regarded as a rhetorical activity and awareness of its rhetorical and linguistic characteristics should be given due consideration in teaching. This paper reviews practitioners' and the limited research literature that relates to expectations of medical educators about what makes a good case presentation, and explains the rhetorical aspect of the activity. It is found there is currently a lack of a comprehensive model of the case presentation that projects the rhetorical and linguistic skills needed to produce and deliver a good presentation. Attempts to describe the structure of the case presentation have used predominantly opinion-based methodologies. In this paper, I argue for a performance-based model that would not only allow a description of the rhetorical structure of the oral case presentation, but also enable a systematic examination of the tacit genre knowledge that differentiates the expert from the novice. Such a model will be a useful resource for medical educators to provide more structured feedback and teaching support to medical students in learning this important genre. PMID:26194482

  7. Cauda equina syndrome as the initial presenting clinical feature of medulloblastoma: a case report

    PubMed Central

    2012-01-01

    Introduction Medulloblastoma is one of the most common pediatric brain malignancies. The usual presenting clinical features are related to posterior fossa syndrome or/and hydrocephalus. Cauda equina syndrome is a very rare presentation for this disease. Case presentation We describe the case of a three-year-old boy with cauda equina syndrome as the initial presenting clinical feature for medulloblastoma. He was initially diagnosed as having a spinal tumor by magnetic resonance imaging scan. Subsequently, a cranial magnetic resonance imaging scan revealed a posterior fossa tumor with features of dissemination. He had substantial improvement after treatment. This case report is complemented by a literature review related to this unusual presentation. Conclusions Medulloblastoma primarily presenting with cauda equina syndrome is very rare. However, spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management. PMID:22620685

  8. A case of hypersensitivity to progesterone presenting as an eczematous eruption.

    PubMed

    Tammaro, A; Tuchinda, P; Pigliacelli, F; Halvorson, C; Kao, G; Persechino, S; Gaspari, A A

    2016-05-01

    Hypersensitivity to progesterone is a rare condition, and it represents a hypersensitivity reaction to endogenous progesterone. Here we report a case of a woman who presented to our attention for evaluation of a rash for a few years on her posterior elbows, forearms, and right lateral lower extremity. We report this case because it describes a rare clinical entity, with an atypical clinical presentation pemphigoid-like, that is rarely described in literature. PMID:27152606

  9. A neonatal case of chronic granulomatous disease, initially presented with invasive pulmonary aspergillosis.

    PubMed

    Saito, Sachiko; Oda, Arata; Kasai, Masashi; Minami, Kisei; Nagumo, Haruo; Shiohara, Masaaki; Ogiso, Yoshifumi; Kawakami, Yoshiyuki

    2014-03-01

    Chronic granulomatous disease (CGD) often presents with infectious illness, such as repeating bacterial and fungal infections, due to the inability to generate superoxide, which would destroy certain infectious pathogens, and is usually diagnosed in childhood. We describe a CGD case diagnosed in neonatal period, who initially presented with invasive aspergillosis. Neonatal invasive pulmonary aspergillosis is very rare and, to the best of our knowledge, this might be the youngest case in Japan. PMID:24674387

  10. Molar Pregnancy Presents as Tubal Ectopic Pregnancy: A Rare Case Report.

    PubMed

    Beena, Devi; Teerthanath, S; Jose, Varsha; Shetty, Jayaprakash

    2016-01-01

    The incidence of hydatidiform mole is 1 per 1000 pregnancies. The occurrence of hydatidiform mole in ruptured tubal pregnancy is very rare. We report an unusual case of molar pregnancy in the right fallopian tube which presented as an adherent adnexal mass. The present case conveys the importance of histological examination of products of conception which helps the pathologist to provide an appropriate diagnosis, thereby the clinician can offer appropriate counseling and follow up to the patient. PMID:26894078

  11. Molar Pregnancy Presents as Tubal Ectopic Pregnancy: A Rare Case Report

    PubMed Central

    Teerthanath, S; Jose, Varsha; Shetty, Jayaprakash

    2016-01-01

    The incidence of hydatidiform mole is 1 per 1000 pregnancies. The occurrence of hydatidiform mole in ruptured tubal pregnancy is very rare. We report an unusual case of molar pregnancy in the right fallopian tube which presented as an adherent adnexal mass. The present case conveys the importance of histological examination of products of conception which helps the pathologist to provide an appropriate diagnosis, thereby the clinician can offer appropriate counseling and follow up to the patient. PMID:26894078

  12. Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature.

    PubMed

    Slater, R; Amatya, U; Shorthouse, A J

    2008-09-01

    Inguinal hernia and colonic carcinoma are common surgical conditions, yet carcinoma of the colon occurring within an inguinal hernia sac is rare. Of 25 reported cases, only one was a perforated sigmoid colon carcinoma in an inguinal hernia. We report two cases of sigmoid colon carcinoma, one of which had locally perforated. Each presented within a strangulated inguinal hernia. Oncologically correct surgery in these patients presents a technical challenge. PMID:18798013

  13. Myelodysplastic Syndrome and Autoimmunity: A Case Report of an Unusual Presentation of Myelodysplastic Syndrome

    PubMed Central

    Merrill, Andrea L.; Smith, Hedy

    2011-01-01

    Myelodysplastic syndrome (MDS) commonly presents asymptomatically or with symptomatic cytopenias. However, autoimmune phenomena in association with MDS have been well described in several case reports and case series. Typically, these autoimmune phenomena take the form of vasculitides, arthritis, connective tissue diseases, pulmonary infiltrates, or polymyalgia rheumatica. We present the case of a woman with MDS (karyotype 46,XX,+1,der(1;7)(q10;p10)[20], that evolved with an additional trisomy 8 clone) and a novel spectrum of autoimmune diseases including acute fibrinous and organizing pneumonia (AFOP) and lacrimal gland pseudotumor. PMID:22937307

  14. Presentation of Two Cases with Early Extracranial Metastases from Glioblastoma and Review of the Literature

    PubMed Central

    Johansen, Maria Dinche; Rochat, Per; Law, Ian; Scheie, David; Poulsen, Hans Skovgaard; Muhic, Aida

    2016-01-01

    Extracranial metastases from glioblastoma are rare. We report two patients with extracranial metastases from glioblastoma. Case 1 concerns a 59-year-old woman with multiple metastases that spread early in the course of disease. What makes this case unusual is that the tumor had grown into the falx close to the straight sinus and this might be an explanation to the early and extensive metastases. Case 2 presents a 60-year-old man with liver metastasis found at autopsy, and, in this case, it is more difficult to find an explanation. This patient had two spontaneous intracerebral bleeding incidents and extensive bleeding during acute surgery with tumor removal, which might have induced extracranial seeding. The cases presented might have hematogenous spreading in common as an explanation to extracranial metastases from GBM. PMID:27247816

  15. Diverticular disease of the colon presenting as pyometra: a case report

    PubMed Central

    2014-01-01

    Introduction Pyometra can be caused by various etiologies. We present a rare case of diverticular disease of the colon presenting as pyometra. This type of presentation can be challenging even for an astute clinician. Case presentation A 74-year-old Caucasian woman with a history of pyometra was referred to our gynecology clinic as an urgent case. She was obese, diabetic and hypertensive. Due to the patient profile and the clinical presentation, clinicians were misled toward a diagnosis of possible endometrial cancer. After further investigations, she was found to have colouterine fistula secondary to a diverticular abscess of the sigmoid colon. Conclusions Persistent vaginal discharge due to pyometra can be caused by diverticular disease of the colon. Clinicians should be aware of this important differential diagnosis. PMID:24886345

  16. A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

    PubMed Central

    Parikh, Sameer; Lu, Lee

    2008-01-01

    Polyarteritis nodosa is a rare necrotizing vasculitis that can be progressive and fatal, and its initial presenting symptom may be leg claudication due to peripheral vascular ischemia. To date, there have been fewer than ten case reports of polyarteritis nodosa presenting as peripheral vascular disease. We report a case of a 38-year-old man initially diagnosed to have premature peripheral vascular disease who presented 1 year later with symptoms consistent with giant cell arteritis and subsequently developed bowel ischemia leading to a fatal outcome. Based on the autopsy and the patient’s clinical course, the final diagnosis was polyarteritis nodosa. This case illustrates the challenges in diagnosing polyarteritis nodosa and the importance of considering vasculitis in young patients presenting with atypical presentations of diseases such as peripheral vascular disease or giant cell arteritis. PMID:18560943

  17. Primary myelolipoma presenting as a nasal cavity polyp: a case report and review of the literature

    PubMed Central

    2012-01-01

    Introduction Myelolipomas are rare, benign tumors comprising mature adipose tissue and hematopoietic elements. The vast majority occur within the adrenal glands, but extra-adrenal myelolipomas have also been reported in the presacral region, retroperitoneum, mesentery, stomach, spleen, liver, mediastinum and lungs. Here, we present a case of primary myelolipoma occurring in an unusual site: the nasal cavity. To the best of our knowledge, we believe that this location for extra-adrenal myelolipoma has not been previously described in the literature. Case presentation We report a case of primary myelolipoma occurring in the nasal cavity of a 48-year-old Asian woman. We describe the etiology, pathology and differential diagnosis of extra-adrenal myelolipomas, and review the literature. Conclusions We chose to present this case because of its unusual location. Although myelolipomas are rare, we conclude that they it should be considered in the differential diagnosis of lesions in this site. PMID:22584001

  18. Burkitt's lymphoma presenting with hypopituitarism: a case report and review of literature

    PubMed Central

    Sobah, Shahada A H

    2014-01-01

    Summary Hypopituitarism is a rare presentation of Burkitt's lymphoma (BL). The purpose of this report is to present a case of BL presenting with panhypopituitarism and to review other case reports of lymphoma presenting with pituitary dysfunction to highlight the distinguishing features of these cases from other benign aetiologies of pituitary dysfunction such as non-functioning pituitary adenomas. We reviewed a total of 11 cases of lymphoma presenting with pituitary dysfunction published from 1998 to 2013 including the present case. The demographics, clinical presentations, laboratory features, radiological findings, histological diagnosis, treatment administered and outcomes were described. Of the total number of patients, 45.5% of the cases had diffuse large B-cell lymphoma while 27.3% had BL. Anterior pituitary dysfunction was more common than posterior pituitary dysfunction at presentation. The other common associated presenting symptoms were painful ophthalmoplegia, cranial nerve palsies and constitutional symptoms. Hypothalamic–pituitary abnormalities were often demonstrated radiologically to be associated with cavernous sinus and/or stalk involvement. All patients who completed immunochemotherapy responded haematologically. Pituitary dysfunction also improved in most cases although the recovery tended to be partial. In conclusion, a high index of suspicion of underlying malignancy, such as lymphoma, should be present in patients presenting with acute pituitary dysfunction associated with painful ophthalmoplegia, rapidly evolving neurological features, radiological features atypical of a pituitary adenoma and constitutional symptoms. An early diagnosis is essential as prompt initiation of definitive therapy will induce disease remission and recovery of pituitary dysfunction. Learning points Hypopituitarism may be the presenting symptom of lymphoma in the absence of associated overt symptoms or signs of a haematological malignancy resulting in delay in

  19. A Composite Case Study of an Individual with Anger as a Presenting Problem

    ERIC Educational Resources Information Center

    Santanello, Andrew P.

    2011-01-01

    This article presents a composite case study of a 45-year-old Caucasian male with anger as a presenting problem. Mr. P is technically self-referred but admits that he ultimately decided to seek treatment at his girlfriend's insistence. He reports experiencing frequent, intense anger episodes, usually occasioned by minor inconveniences. These anger…

  20. Delayed presentation of an arteriovenous malformation after cerebellar hemangioblastoma resection—Case report

    PubMed Central

    Bennett, E. Emily; Otvos, Balint; Kshettry, Varun R.; Gonzalez-Martinez, Jorge

    2016-01-01

    Introduction Haemangioblastoma has been uncommonly reported to occur in coexistence either temporally or spatially with the development of an arteriovenous malformations (AVM). We present a case of a delayed AVM following haemangioblastoma resection. Presentation of case 44 year old female initially presented with a several week history of headaches, vertigo and nausea and emesis and was found to have a cystic lesion with a solid enhancing component on Magnetic Resonance Imaging (MRI) in the superior aspect of the vermis. She underwent gross total resection and final pathology was consistent with WHO grade I haemangioblastoma. One year later, patient re-presented with headaches, dizziness and left trochlear nerve palsy with rotary nystagmus. Imaging revealed a left posterior tentorial paramedian cerebellar vascular nidus with venous drainage into the left transverses sinus suspicious for arteriovenous malformation. She underwent gross total resection of the lesion. Final pathology confirmed the diagnosis of an arteriovenous malformation. Discussion Recent research supports both haemangioblastoma and AVM are of embryologic origin but require later genetic alterations to develop into symptomatic lesions. It is unclear in our case if the AVM was present at the time of the initial haemangioblastoma resection or developed de novo after tumor resection. However, given the short time between tumor resection and presentation of AVM, de novo AVM although possible, appears less likely. Conclusion AVM and haemangioblastoma rarely presents together either temporally or spatially. We present a case of a delayed AVM following haemangioblastoma resection. More research is needed to elucidate the rare intermixture of these lesions. PMID:27086272

  1. 76 FR 17485 - Pricing for America the Beautiful Five Ounce Silver Bullion Coin Presentation Case

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY United States Mint Pricing for America the Beautiful Five Ounce Silver Bullion Coin Presentation Case... is announcing the price of the America the Beautiful Five Ounce Silver Bullion Coin Presentation...

  2. Schistosomiasis Presenting as a Case of Acute Appendicitis with Chronic Mesenteric Thrombosis.

    PubMed

    Mosli, Mohammed H; Chan, Wilson W; Morava-Protzner, Izabella; Kuhn, Susan M

    2016-01-01

    The manifestations of schistosomiasis typically result from the host inflammatory response to parasitic eggs that are deposited in the mucosa of either the gastrointestinal tract or bladder. We present here a case of a 50-year-old gentleman with a rare gastrointestinal presentation of both schistosomal appendicitis and mesenteric thrombosis. PMID:27366174

  3. Primary Seminal Vesicle Adenocarcinoma Presenting With Bilateral Orbital Metastasis: A Case Report

    PubMed Central

    Sterling, Matthew E.; Kovell, Robert C.; Jaffe, William I.

    2016-01-01

    Seminal vesicle (SV) adenocarcinoma is a rare and poorly understood malignancy. Symptoms are non-specific and prognosis is extremely poor. Herein we present a case report of a primary SV clear cell adenocarcinoma with bilateral orbital metastases at the time of initial presentation treated with multimodal therapy including radiotherapy and multi-drug chemotherapy. PMID:27175340

  4. Dystonia an unusual presentation in pediatric moyamoya disease: Imaging findings of a case.

    PubMed

    Kumar, Suresh; Sharma, Sudhir; Jhobta, Anupam; Sood, Ram Gopal

    2016-01-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation. PMID:27606018

  5. Cavum septum pellucidum in a case of schizophrenia presenting with self-mutilating behavior

    PubMed Central

    Umesh, Shreekantiah; Bose, Swarnali; Khanra, Sourav; Das, Basudeb; Nizamie, S. Haque

    2015-01-01

    Cavum septum pellucidum (CSP) is a neurodevelopmental anomaly, which is commonly reported in schizophrenia patients. Various symptoms of schizophrenia, including thought disturbances have been associated with CSP. We present a rare case of undifferentiated schizophrenia with CSP who presented with self-mutilating behaviors. PMID:26257488

  6. Case Report of an Anthrax Presentation Relevant to Special Operations Medicine.

    PubMed

    Winkler, Stephen; Enzenauer, Robert W; Karesh, James W; Pasteur, Nshimyimana; Eisnor, Derek L; Painter, Rex B; Calvano, Christopher J

    2016-01-01

    Special Operations Forces (SOF) medical personnel function worldwide in environments where endemic anthrax (caused by Bacillus anthracis infection) may present in one of three forms: cutaneous, pulmonary, or gastrointestinal. This report presents a rare periocular anthrax case from Haiti to emphasize the need for heightened diagnostic suspicion of unusual lesions likely to be encountered in SOF theaters. PMID:27450596

  7. Cerebellar haemangioblastoma presenting with dizziness in pregnancy: case report and review of the literature

    PubMed Central

    Kenyon, Anna P; Haider, Salman; Ashkan, Keyoumars; Nelson-Piercy, Catherine

    2009-01-01

    Cerebral neoplasms are uncommon in pregnancy but should be considered in any pregnant woman with new onset neurological symptoms and signs. We report a case of cerebellar haemangioblastoma presenting in pregnancy and discuss the clinical presentation, diagnosis, surgical management and medical literature surrounding the condition.

  8. Silent sinus syndrome presenting after a roller coaster ride: a case report.

    PubMed

    Singman, Eric L; Matta, Noelle S; Silbert, David I

    2014-01-01

    This is a case presentation of a 39-year-old male who presents with silent sinus syndrome. He was initially diagnosed by a neuroophthalmologist, and at first, the patient's otolaryngologist disagreed. The patient had a significant reduction in his symptoms with surgical and orthoptic intervention. PMID:25313122

  9. Dystonia an unusual presentation in pediatric moyamoya disease: Imaging findings of a case

    PubMed Central

    Kumar, Suresh; Sharma, Sudhir; Jhobta, Anupam; Sood, Ram Gopal

    2016-01-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation. PMID:27606018

  10. Schistosomiasis Presenting as a Case of Acute Appendicitis with Chronic Mesenteric Thrombosis

    PubMed Central

    Chan, Wilson W.; Morava-Protzner, Izabella; Kuhn, Susan M.

    2016-01-01

    The manifestations of schistosomiasis typically result from the host inflammatory response to parasitic eggs that are deposited in the mucosa of either the gastrointestinal tract or bladder. We present here a case of a 50-year-old gentleman with a rare gastrointestinal presentation of both schistosomal appendicitis and mesenteric thrombosis. PMID:27366174

  11. Atypical Presentation of Capillary Hemangioma in Oral Cavity- A Case Report

    PubMed Central

    Vallabhan, Chitra Girija; Geetha, Seema; Nair, Manoj S; Jacob, Tharun Varghese

    2015-01-01

    Capillary Haemangioma is a benign vascular tumour characterized by proliferation of blood vessels that are primarily reported to be a developmental hamartomatous lesion of infancy and childhood. Pyogenic granuloma is a non-neoplastic benign lesion found in the oral cavity having a striking predilection for occurrence in the gingiva. The present case report is an atypical presentation of capillary haemangioma on gingiva which is considered to be extremely rare. The lesion in this case was clinically diagnosed as pyogenic granuloma but histopathologically as capillary haemangioma. These lesions present as a diagnostic dilemma to the clinician and can lead to serious complications if not carefully managed. PMID:26557632

  12. The Earliest Presenting Umbilical Port Site Hernia Following Laparoscopic Cholecystectomy: A Case Report

    PubMed Central

    Sharma, Rajeev; Goyal, Manav; Gupta, Sanjay

    2016-01-01

    Port site hernia after laparoscopic surgery is a rare complication. Here we present a case of a 55-year-old female, diagnosed with an anterior abdominal wall hernia through the 10mm umbilical port, just two days after her laparoscopic cholecystectomy. The uniqueness of this case is its extremely early presentation. Patient presented with features of acute intestinal obstruction and due to prompt diagnosis and timely intervention, she underwent a successful reduction of hernia and an anatomical repair of the fascial and peritoneal defect through the midline laparotomy incision.

  13. Gastrointestinal stromal tumors presenting as pelvic masses: report of two cases.

    PubMed

    Erkanli, S; Kayaselcuk, F; Törer, N; Bolat, F; Tarim, E; Simsek, E; Kuscu, E

    2006-01-01

    We present two cases of gastrointestinal stromal tumors (GISTs) that presented as pelvic masses. These tumors can present diagnostic problems and they may be difficult to discover preoperatively. GISTs are neoplasms that can be diagnosed utilizing immunohistochemistry, especially detecting CD117 (c-kit) reactivity along with associated histological features. GISTs, should be considered in the differential diagnosis of ovarian tumors especially when imaging studies and rectovaginal examination findings are inconclusive and vague. Histologic diagnosis of these tumors are important considering the efficacy of tyrosine kinase inhibitor therapy after surgery in such cases. PMID:16550984

  14. Cemento-ossifying mandibular fibroma: a presentation of two cases and review of the literature.

    PubMed

    Sanchis, José María; Peñarrocha, Miguel; Balaguer, José M; Camacho, Fabio

    2004-01-01

    We present two clinical cases of radiolucent mandibular lesions in young women that simulated chronic periapical infectious pathology. The detection of both cases was fortuitous since they were totally asymptomatic. Diagnosis was reached in one case (upon periapical surgery and anatomo-pathologic study) after endodontic treatment and after verifying non-resolution of affected periapical area. The other case was an extensive lesion, which involved the periapices of the four inferior incisors in which surgery was directly performed upon verifying pulp vitality of these teeth. After surgery endodontic treatment was performed on the teeth that had lost their vitality. In both cases the histopathologic tests revealed the presence of a cemento-ossifying fibroma, the initial clinical and radiographic diagnosis of which could easily be overlooked. PMID:14704620

  15. Tubercular Uveitis with Ocular Manifestation as the First Presentation of Tuberculosis: A Case Series.

    PubMed

    Shah, Jayashree S; Shetty, Niharika; Shah, Sharath Kumar D; Shah, Neelesh Kumar S

    2016-03-01

    Tuberculosis is very common disease in India. It is one of the most common causes of Granulomatous Uveitis in our Country even today. So the strongest suspicion in our mind when we are treating a case of Uveitis, should be TB. We reviewed all the cases of clinically suspected ocular tuberculosis attending the Ophthalmology OPD of Sri Siddhartha Medical College between December 2012 and December 2014 who were refractory to routine uveitis management and later on responded to anti-Tubercular treatment. History of TB contact, Ocular manifestation, Demographic Profile of the patients, Diagnostic test, Treatment regime were looked into. Here by we present a case series of 15 cases of refractory uveitis that later were detected to be of tuberculous origin. We studied the characteristic features, complications and correlation of mantoux test, ESR and Koch's contact with these cases. PMID:27134908

  16. Endometrial Cholesterol Granuloma Associated with Prolapsed Uterus- A Rare Case Report with Unusual Clinical Presentation

    PubMed Central

    2016-01-01

    Cholesterol granuloma is a chronic inflammatory reaction to cholesterol deposition. It may develop in variety of sites including middle ear, mastoid process, para nasal sinuses, mediastinum, breast, testis and kidney. But endometrial cholesterol granuloma is a rarely reported case and is usually presented clinically as pyometra. This article reports a case of cholesterol granuloma in the endometrium associated with prolapsed uterus. In this case the patient clinically presented with urinary retention and overflow incontinence of urine. The reason of acute urinary retention in this case was pelvic fibrosis and adhesion secondary to this chronic inflammatory reaction. This was supported by the presence of pus like yellowish material over the uterine surface and pelvic adhesion, noted during surgery. Endometrial biopsy revealed cholesterol granuloma that confirmed the source of chronic inflammatory reaction and pelvic fibrosis. PMID:27134881

  17. Endometrial Cholesterol Granuloma Associated with Prolapsed Uterus- A Rare Case Report with Unusual Clinical Presentation.

    PubMed

    Sumathi, S

    2016-03-01

    Cholesterol granuloma is a chronic inflammatory reaction to cholesterol deposition. It may develop in variety of sites including middle ear, mastoid process, para nasal sinuses, mediastinum, breast, testis and kidney. But endometrial cholesterol granuloma is a rarely reported case and is usually presented clinically as pyometra. This article reports a case of cholesterol granuloma in the endometrium associated with prolapsed uterus. In this case the patient clinically presented with urinary retention and overflow incontinence of urine. The reason of acute urinary retention in this case was pelvic fibrosis and adhesion secondary to this chronic inflammatory reaction. This was supported by the presence of pus like yellowish material over the uterine surface and pelvic adhesion, noted during surgery. Endometrial biopsy revealed cholesterol granuloma that confirmed the source of chronic inflammatory reaction and pelvic fibrosis. PMID:27134881

  18. Ancient Schwannoma of superficial peroneal nerve presenting as intermittent leg pain: A case report

    PubMed Central

    Nascimento, Germano; Nomi, Thaís; Marques, Raquel; Leiria, João; Silva, Carmen; Periquito, Jorge

    2014-01-01

    INTRODUCTION Schwannomas are benign, encapsulated, slow-growing and usually solitary tumors originating from Schwann cells of the peripheral nerve sheath. Schwannomas of the superficial peroneal nerves are very rare, and therefore scarcely documented in the literature. The authors report a case of a diagnosed superficial fibular nerve sheath tumor with an unreported clinical presentation. PRESENTATION OF CASE A 52-year-old Caucasian female arrived to our Orthopedics Department complaining of pain and numbness of the lateral aspect of her left leg. These symptoms were present for a year and were more evident at the end of the day, or after a long time in the orthostatic position. No evidence of other medical illnesses was found. There was no record of prior traumatic events related to that limb. Diagnosis of a benign peripheral nerve tumor was achieved and the patient was treated by surgical excision of the lesion. DISCUSSION The intermittent symptomatology presentation on this case suggest a mechanical compression etiology, allied to classical pain and paresthesia often exhibited by this kind of the tumor. An intracompartimental pressure elevation could explain why the symptoms disclosed an episodic pattern, due to a constricted, inclosed nerve. CONCLUSION We describe a rare case of a patient with an unusual superficial peroneal nerve Schwannoma clinical presentation. Literature on this topic is scarce and, therefore, this case report intends to add further data about this kind of lesion. PMID:25506844

  19. Large ileocecal submucosal lipoma presenting as hematochezia, a case report and review of literature

    PubMed Central

    Chehade, Hiba Hassan El Hage; Zbibo, Riad Hassan; Nasreddine, Walid; Abtar, Houssam Khodor

    2015-01-01

    Introduction Colonic lipomas are rare subepithelial benign tumors affecting mainly middle-aged women. They are usually asymptomatic and, hence, are discovered incidentally on autopsy, surgery, or colonoscopy. There is a wide range of presentations like abdominal pain, bleeding per rectum, intussusception, etc. The latter picture constitutes the usual presentation of an ileocecal lipoma. Only few cases of ileocecal lipomas presenting as lower GI bleeding have been reported in the literature. Presentation of case We present a case of an adult female patient who was admitted to our institution complaining of hematochezia and right lower quadrant pain. She was found to have chronic anemia. She was investigated by CT scan of the abdomen & pelvis and by colonoscopy which showed a fungating, submucosal mass with ulcerated base near the ileocecal valve. She underwent a colonic resection. The pathology came out as a submucosal benign pedunculated ileocecal lipoma. Discussion Colonic lipomas represent 4% of benign lesions of the gastrointestinal tract. They are usually asymptomatic hence are often discovered incidentally on colonoscopy, surgery or autopsy. The definitive diagnosis is made by pathological evaluation. Colonic lipomas are usually treated if they are symptomatic or there is any suspicion of malignancy. The treatment modalities include endoscopic and surgical resection. Conclusion We, hereby, describe a case of benign ileocecal lipoma that presented with hematochezia which is an unusual presentation. Also, there is a great controversy regarding the treatment of colonic lipomas. In this article, we tried to answer several questions concerning the management of ileocecal lipomas. PMID:25770697

  20. A case of cutaneous larva migrans presenting in a pregnant patient.

    PubMed

    Kudrewicz, Kasie; Crittenden, Kylee N; Himes, Alison

    2014-01-01

    Cutaneous larva migrans (CLM) is a pruritic dermatitis caused by migration of the animal hookworm larvae into the epidermis. We present a case of CLM in a 31-year-old pregnant woman. The treatment of CLM relies on antihelminthic agents, such as thiabendazole, albendazole, and ivermectin. This case was interesting in that the standard treatment options previously mentioned were contraindicated owing to the patient's pregnancy. Cryotherapy with liquid nitrogen resulted in complete resolution of her lesion and symptoms. PMID:25526012

  1. A case of cutaneous larva migrans presenting in a pregnant patient.

    PubMed

    Kudrewicz, Kasie; Crittenden, Kylee N; Himes, Alison

    2015-01-01

    Cutaneous larva migrans (CLM) is a pruritic dermatitis caused by migration of animal hookworm larvae into the skin. We present a case of CLM in a 31-year-old pregnant woman. The treatment of CLM relies on antihelminthic agents, such as thiabendazole, albendazole, and ivermectin. This case was interesting in that the standard treatment options previously mentioned were contraindicated owing to the patient's pregnancy. Cryotherapy with liquid nitrogen resulted in complete resolution of her lesion and symptoms. PMID:25612130

  2. A Case of Migrating "Saf-T-Coil" Presenting With a Vesicovaginal Fistula and Vesicovaginal Calculus.

    PubMed

    Madden, Aideen; Aslam, Asadullah; Nusrat, Nadeem B

    2016-07-01

    Intrauterine devices (IUDs) are reliable method for contraception. Although, they are generally regarded as safe, serious consequences may occur in case of uterine perforation or intravesical migration. We present a rare case of a 74 year old lady with a forgotten IUD for 42 years resulting in intravesical migration, formation of vesicovaginal fistula (VVF) without uterine perforation, complete urinary incontinence, recurrent urinary tract infections (UTIs) and a large vesicovaginal calculus. PMID:27335782

  3. Lyme Disease Presenting with Multiple Cranial Nerve Deficits: Report of a Case

    PubMed Central

    Chaturvedi, Abhishek; Baker, Keith; Jeanmonod, Donald

    2016-01-01

    Lyme disease is a tick-transmitted multisystem inflammatory disease caused by the spirochete Borrelia burgdorferi. With more than 25,000 CDC reported cases annually, it has become the most common vector-borne disease in the United States. We report a case of 38-year-old man with Lyme disease presenting with simultaneous palsy of 3rd, 5th, 7th, 9th, and 10th cranial nerves.

  4. Sinistral Portal Hypertension: Presentation, Radiological Findings, and Treatment Options - A Case Report

    PubMed Central

    Kokabi, Nima; Lee, Edward; Echevarria, Carlos; Loh, Christopher; Kee, Stephen

    2010-01-01

    Sinistral portal hypertension occurs when a pathological process causes occlusion of the splenic vein. The resultant elevated splenic bed venous pressure causes formation of gastric varices which can lead to hematemesis as a common presentation for this disease process. We present a case of sinistral portal hypertension in a patient with acute hematemesis as the primary presentation. Despite the challenging diagnosis process, the patient underwent splenectomy and was managed appropriately according to previously published literature. PMID:22470692

  5. Large Osteoarthritic Cyst Presenting as Soft Tissue Tumour – A Case Report

    PubMed Central

    Kosuge, DD; Park, DH; Cannon, SR; Briggs, TW; Pollock, RC; Skinner, JA

    2007-01-01

    Large osteoarthritic cysts can sometimes be difficult to distinguish from primary osseous and soft tissue tumours. We present such a case involving a cyst arising from the hip joint and eroding the acetabulum which presented as a soft tissue malignancy referred to a tertiary bone and soft tissue tumour centre. We discuss the diagnostic problems it may pose, and present a literature review of the subject. PMID:17535605

  6. Unusual Presentations of Actinomycosis; Anterior Abdominal Wall and Appendix: Report of Three Cases

    PubMed Central

    Karateke, Faruk; Özyazıcı, Sefa; Menekşe, Ebru; Daş, Koray; Özdoğan, Mehmet

    2013-01-01

    Background: Primary actinomycosis of the anterior abdominal wall and appendix are very rare clinical entities. An accurate diagnosis is generally obtained by histological examination, and treatment often requires surgical resection. Case Report: In this study we presented two cases of primary actinomycosis involving the anterior abdominal wall and a third one located in the appendix. Conclusion: Actinomyces Israelii can involve all anatomic structures of the abdomen. Although preoperative diagnosis is difficult, the combination of surgery and antibiotic treatment results in complete treatment in the majority of cases. PMID:25207127

  7. Headache—A Rare Presenting Symptom in Multiple Myeloma: A Case Report

    PubMed Central

    Khaleeli, Moyeen; Giorgio, Anthony J.

    1979-01-01

    Headache is a rare symptom in multiple myeloma (MM). A 34-year-old black female presented with severe headache and investigation subsequently led to the diagnosis of non-secretory MM. Non-secretory MM is seen in less than one percent of MM cases. Further-more, less than two percent of MM cases are seen under the age of 40 years. An increasing number of cases of MM are being described in young adults. Attention is drawn to entertaining a diagnosis of MM even in those under age 40 years who may manifest unusual features of the disease. ImagesFigure 1Figure 2 PMID:490671

  8. Bladder Endometriosis and Endocervicosis: Presentation of 2 Cases with Endoscopic Management and Review of Literature

    PubMed Central

    Fuentes Pastor, Javier; Ballestero Diego, Roberto; Correas Gómez, Miguel Ángel; Torres Díez, Eduardo; Fernández Flórez, Alejandro; Ballesteros Olmos, Gerardo; Gutierrez Baños, Jose Luis

    2014-01-01

    Urinary tract endometriosis and endocervicosis are an uncommon pathologic finding, with a common embryological origin. We present 2 cases of female patients with bladder mass. The first one was a finding of a nodular formation in the bladder during study of a nonviable foetus and the second was an incidental finding of a neoformation in the fundus of the bladder during the realization of an ultrasound. In both cases, we performed a surgical management with transurethral resection. Histopathological examination revealed a bladder endometrioma in the first case and endocervicosis with associated endometriosis in the second. PMID:25184072

  9. Extragonadal germ cell tumor presenting in a woman with systemic lupus erythematosus: a case report

    PubMed Central

    2010-01-01

    Introduction Germ cell tumor of the pituitary gland is a very rare occurrence. Case presentation We describe the case of a 28-year-old Malaysian Malay woman with lupus nephritis who complained of a three month headache and blurring of vision. She was found to have a pituitary mass, which was later proven to be a germ cell tumor. As of writing this case report, her disease is in remission. Conclusion The disruption of the pituitary gonad axis could affect the disease activity by reducing immunoregulatory control. PMID:20338049

  10. An unusual presentation of an intraosseous epidermoid cyst of the anterior maxilla: a case report

    PubMed Central

    2014-01-01

    Introduction Intraosseous epidermoid inclusion cysts are rare benign epithelial inclusion cysts in the bone. They are usually found in the cranium and hand phalanges. They are slow growing lesions, and it is difficult to differentiate them from other inflammatory and cystic lesions. Only a few cases of epidermoid inclusion cyst in the jaw have been reported in the literature. This is the fourth case reported as intraosseous epidermoid cyst of the maxilla in the English literature. Case presentation An asymptomatic 59-year-old Caucasian man was referred to our Oral and Maxillofacial Surgery clinic for a unilocular radiolucent area at his anterior maxilla shown on an orthopantomograph. He was scheduled for surgery and underwent cyst extraction surgery. A pathological examination revealed epidermoid cyst. The diagnostic dilemma in this case report in opposition to the presented intraosseous epidermoid cysts in the literature is that there was no trauma history to his upper jaw. Treatment for this cyst is conservative surgical excision and recurrence is uncommon. Conclusions This report presents an unusual case of an intraosseous epidermoid cyst that occurred with no trauma history to the upper jaw. Although only three cases of epidermoid inclusion cyst have been reported in the maxilla, epidermoid inclusion cyst should be considered in the differential diagnosis of radiolucent lesions of the jaws. PMID:25070270

  11. Late onset radioiodine-induced hypothyroidism presenting with psychosis 14 years after treatment: a rare case.

    PubMed

    Er, Chaozer; Sule, Ashish Anil

    2016-04-01

    Radioiodine treatment-induced hypothyroid psychosis is uncommon. Our literature search shows only three cases of hypothyroid psychosis developed within 3 months after the radioiodine treatment. Our case represents the first case of radioiodine-induced hypothyroidism presenting as psychosis much later (14 years) after the radioiodine treatment. A 60-year-old Chinese lady, with long-standing primary hypothyroidism due to the radioiodine treatment performed 14 years ago, presented with a 1-week history of hallucination, delusion and agitation. She was not on thyroid replacement. Thyroid function test done 14 years ago and again upon her admission to our facility was consistent with primary hypothyroidism. General blood tests and brain imaging were unremarkable. Her psychotic features resolved within 1 week with thyroid replacement and 9 days of antipsychotics. No further relapse of psychosis was noted. This emphasizes that radioiodine-induced hypothyroidism can go unnoticed for many years and present much later solely as psychosis. PMID:27099771

  12. A rare pediatric case of grossly dilated ureter presenting as abdominal mass.

    PubMed

    Srivastava, Madhur Kumar; Govindarajan, Krishna Kumar; Chakkalakkoombil, Sunitha Vellathussery; Halanaik, Dhanapathi

    2016-01-01

    Renal masses account for 55% of cases presenting as palpable abdominal mass in children.[1] An eight year male presented with palpable abdominal mass and pain. The patient underwent renal dynamic scan, which raised possibility of left duplex kidney with non-functioning moiety, as the size of left kidney was smaller than seen on Ultrasonography (USG). Magnetic resonance (MR)urography confirmed the findings with patient undergoing left hemi-nephrectomy and is doing well. In case of discrepancy in size of kidney on USG and renal scan, duplex kidney should be considered as differential, other causes being, renal cyst, benign/malignant mass and renal calculi. Gross hydro-ureter presenting as palpable abdominal mass is very rare with few reported cases.[234]. PMID:26917905

  13. Late onset radioiodine-induced hypothyroidism presenting with psychosis 14 years after treatment: a rare case

    PubMed Central

    Er, Chaozer; Sule, Ashish Anil

    2016-01-01

    Radioiodine treatment-induced hypothyroid psychosis is uncommon. Our literature search shows only three cases of hypothyroid psychosis developed within 3 months after the radioiodine treatment. Our case represents the first case of radioiodine-induced hypothyroidism presenting as psychosis much later (14 years) after the radioiodine treatment. A 60-year-old Chinese lady, with long-standing primary hypothyroidism due to the radioiodine treatment performed 14 years ago, presented with a 1-week history of hallucination, delusion and agitation. She was not on thyroid replacement. Thyroid function test done 14 years ago and again upon her admission to our facility was consistent with primary hypothyroidism. General blood tests and brain imaging were unremarkable. Her psychotic features resolved within 1 week with thyroid replacement and 9 days of antipsychotics. No further relapse of psychosis was noted. This emphasizes that radioiodine-induced hypothyroidism can go unnoticed for many years and present much later solely as psychosis. PMID:27099771

  14. Primary adenocarcinoma of the small intestine presenting as superior mesenteric artery syndrome: A case report

    PubMed Central

    SUN, KE-KANG; WU, XIAOYANG; LIU, GANG; QIAN, HAIXIN; SHEN, XIAOJUN

    2016-01-01

    Superior mesenteric artery syndrome (SMAS) is an uncommon cause of vomiting and weight loss due to compression of the third part of the duodenum by the superior mesenteric artery. Small bowel adenocarcinoma is an uncommon tumor, which is frequently delayed in diagnosis as its symptoms and signs are non-specific. The present study describes a case of SMAS occurring in a 51-year-old man, caused by intestinal obstruction secondary to a primary adenocarcinoma of the duodenal-jejunal junction. To the best of our knowledge, the present case is the first report of small bowel adenocarcinoma masquerading as SMAS. The present case highlights the importance of considering the possibility of SMAS in patients with upper bowel obstruction caused by intestinal carcinoma. PMID:26998097

  15. Unusual presentation of basilar artery stroke secondary to patent foramen ovale: a case report

    PubMed Central

    Salam, Abdul; Sanmuganathan, Phil; Pycock, Chris

    2008-01-01

    Introduction We report a case of a patient presenting with neuropsychiatric manifestations secondary to paradoxical embolism Case presentation Unexplained rapid onset of confusion with amnesia and minimal neurological deficits can be a manifestation of various systemic causes of which stroke, either ischemic or hemorrhagic, is one. Thorough and systematic evaluation of these patients can be highly rewarding in terms of optimizing patient outcome. We report the case of a 45-year-old woman whose initial presentation was with acute onset of confusion, memory loss with personality change and headaches. A differential diagnosis of systemic illness and cerebral pathology was entertained. She was empirically treated for neurological infection. Brain imaging revealed bilateral thalamic and cerebellar infarction. Further evaluation with an aim to define the etiology, revealed the diagnosis of Patent Foramen Ovale with paradoxical embolism. The differential diagnosis of unexplained rapid onset of confusion, amnesia with minimal motor neurological deficits and relevant appropriate investigations are discussed in this case report. Conclusion This case highlights the importance of recognising the atypical manifestations of posterior fossa stroke. In young patients presenting with non-focal neuropsychiatric manifestations, paradoxical embolism, secondary to patent foramen ovale is a possible cause. PMID:18328096

  16. Polysomnographic and long-term video electroencephalographic evaluation of cases presenting with parasomnias.

    PubMed

    Yiş, Uluç; Kurul, Semra Hiz; Öztura, Ibrahim; Ecevit, Mustafa Cenk; Dirik, Eray

    2013-09-01

    The aim of this study is to evaluate the clinical, electroencephalographic and polysomnographic features of patients presenting with parasomnias. Cases who were admitted for differentiating parasomnias from epilepsy were included in the study. Clinical features of cases were recorded and routine sleep electroencephalography was obtained from all cases. Cases whose symptoms strongly suggested nocturnal seizure underwent all night video electroencephalography monitoring. Polysomnography was obtained to evaluate the quality of breathing from patients whose symptoms suggested obstructive sleep apnea. Twenty-three patients with no neurological disorder were included in the study. The mean age of the patients was 11.7 ± 2.8 [7-17] years. Twelve patients (52 %) presented with sleep terrors and 11 patients (48 %) presented with sleep walking. All of the patients underwent a routine sleep electroencephalographic study and 15 patients (65 %) whose symptoms strongly suggested nocturnal epilepsy underwent long-term video electroencephalographic evaluation. Ten patients (43 %) underwent polysomnographic study. Three patients (20 %) who underwent long-term video electroencephalographic evaluation were diagnosed to have nocturnal frontal lobe epilepsy and two patients (20 %) who underwent polysomnography had pathological sleep apnea. Eleven patients (48 %) had a psychiatric disorder like major depression, anxiety disorder, hyperactivity disorder and obsessive-compulsive disorder. Childhood cases presenting with parasomnias should be searched for nocturnal epileptic disorders, sleep disordered breathing and psychiatric disorders. PMID:23135782

  17. Metastatic Renal Cell Carcinoma Presenting as Nasal Mass: Case Report and Review of Literature.

    PubMed

    Mahajan, Ritesh; Mayappa, Nagaraj; Prashanth, V

    2016-09-01

    Sinonasal neoplasms are rare and exceptional site for metastatic tumours and comprising <3 % of all malignant aerodigestive tumours and <1 % of all malignancies. Renal cell carcinoma is known to metastasise to the most unusual sites, the sinonasal region being one of them. We here by present a case of 60 year old male patient who presented with epistaxis and nasal obstruction. Clinical examination and CT scan revealed a tumour in the right nasal cavity and maxillary sinus. The presence of primary renal cell carcinoma was recognized only after surgical removal of metastatic tumour. Very few reports have been presented in literature of metastatic renal cell carcinoma in the sinonasal region. We present this case to document its occurrence; highlight the rarity, presentation and difficulties in diagnosis and treatment along with review of literature. PMID:27508143

  18. [Neuromyelitis optica spectrum disorders as initial presentation of Sjögren's syndrome: A case report].

    PubMed

    Alva Díaz, Carlos; Andamayo Villalba, Luis; Mori, Nicanor; Ventura Chilón, Jésica Janet; Romero, Roberto

    2016-01-01

    Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare systemic autoimmune disease which is sometimes found in association with other autoimmune disorders including Sjogren's syndrome. Neurological manifestations occur in 20% to 25% of diagnosed cases of Sjögren's syndrome; however, less than 5% of patients with Sjögren's syndrome have neurological manifestations as the initial presenting feature of Sjögren's syndrome. We report the case of an elderly female with longitudinal myelitis as a presenting feature who had positive antibody to aquaporin-4 (NMO-IgG) and Sjögren's syndrome. PMID:26938585

  19. A Case of Congenital Disorder of Glycosylation Ia Presented with Recurrent Pericardial Effusion

    PubMed Central

    Işıkay, Sedat; Başpınar, Osman; Yılmaz, Kutluhan

    2014-01-01

    Background: Inherited deficiency of phosophomannomutase (PMM2) causes a human glycosylation disorder known as Congenital Disorder of Glycosylation Ia. Case Presentation: Herein, we describe a case of congenital disorder of glycosylation Ia, presented with recurrent pericardial effusion and unusual findings of inverted nipples, fat pads, reduced deep-tendon reflexes and multisystem involvement. Conclusion: Congenital Disorder of Glycosylation Ia should be considered in children with developmental delay, those with multi-system disease involving neurologic, gastrointestinal, ophthalmologic, cardiac or endocrine systems. On the other hand, severe cardiac involvement may also be a feature of Congenital Disorder of Glycosylation Ia and diagnosed patients should also be evaluated in this respect. PMID:25793077

  20. Acute appendicitis presenting as thigh abscess in a child: a case report.

    PubMed

    Sharma, S B; Gupta, Vipul; Sharma, S C

    2005-04-01

    A case of retrocecal appendicitis is described in a 6-year-old male child who presented with thigh abscess. The presence of a positive psoas stretch test, feculent discharge, an enteric growth on bacteriological examination, and intraabdominal fluid collection on abdominal ultrasound provided clues to the presence of an intraabdominal source of sepsis. Laparotomy revealed a perforated retrocecal appendix with surrounding collection communicating into the thigh. Appendectomy with drainage of retroperitoneal and thigh collections under adequate antibiotic coverage resulted in a satisfactory recovery. We describe our experience with the present case and discuss the pertinent literature. PMID:15756560

  1. An uncommon initial presentation of snake bite-subarachnoid hemorrhage: A case report with literature review

    PubMed Central

    Roy, Manoj Kumar; Dutta, Joydip; Chatterjee, Apratim; Sarkar, Anup; Roy, Koushik; Agarwal, Rakhesh; Lahiri, Durjoy; Biswas, Amrito; Mondal, Anupam; Maity, Pranab; Mukhopadhyay, Jotideb

    2015-01-01

    Snake bites are very common in India, particularly in West Bengal. Snake bite can cause various hematological, neuromyopathical complications. It can be very fatal if not detected and treated early. Timely intervention can save the patient. We are reporting a case of hematotoxic Russell viper snake bite presented with subarachnoid hemorrhage. Patient was successfully treated with antivenom serum (AVS) along with other conservative management. Subarachnoid hemorrhage as an initial presentation in viper bite is very rare and we discuss the case with proper literature review. PMID:26425018

  2. Digital Acrometastasis as Initial Presentation in Carcinoma of Lung A Case Report and Review of Literature

    PubMed Central

    Sahoo, Tapan Kumar; Das, Saroj Kumar; Majumdar, Saroj Kumar Das; Senapati, Surendra Nath

    2016-01-01

    Bony metastases develop in 30% of all the cancers, but out of which only 1% to 3% occurs in the hand. Lung is the most common site for acrometastasis, followed by breast and renal cell cancer. Metastases to the digits are with non-specific presentation. We reported a case of 79-year-old male patient with initial presentation of swelling over left index finger, which was found to be squamous cell carcinoma of finger on histopathological examination. He was subsequently diagnosed as a case of squamous cell carcinoma of lung with acrometastasis. PMID:27504389

  3. Digital Acrometastasis as Initial Presentation in Carcinoma of Lung A Case Report and Review of Literature.

    PubMed

    Sahoo, Tapan Kumar; Das, Saroj Kumar; Majumdar, Saroj Kumar Das; Senapati, Surendra Nath; Parida, Dillip Kumar

    2016-06-01

    Bony metastases develop in 30% of all the cancers, but out of which only 1% to 3% occurs in the hand. Lung is the most common site for acrometastasis, followed by breast and renal cell cancer. Metastases to the digits are with non-specific presentation. We reported a case of 79-year-old male patient with initial presentation of swelling over left index finger, which was found to be squamous cell carcinoma of finger on histopathological examination. He was subsequently diagnosed as a case of squamous cell carcinoma of lung with acrometastasis. PMID:27504389

  4. Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations

    PubMed Central

    Ventolini, Gary; Patel, Ravi; Vasquez, Robert

    2015-01-01

    Objective Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. PMID:26056492

  5. Use of spinal manipulation in a rheumatoid patient presenting with acute thoracic pain: a case report

    PubMed Central

    Chung, Chadwick L. R.; Mior, Silvano A.

    2015-01-01

    Background: There is limited research related to spinal manipulation of uncomplicated thoracic spine pain and even less when pain is associated with comorbid conditions such as rheumatoid arthritis. In the absence of trial evidence, clinical experience and appropriate selection of the type of intervention is important to informing the appropriate management of these cases. Case presentation: We present a case of a patient with long standing rheumatoid arthritis who presented with acute thoracic pain. The patient was diagnosed with costovertebral joint dysfunction and a myofascial strain of the surrounding musculature. The patient was unresponsive to treatment involving a generalized manipulative technique; however, improved following the administration of a specific applied manipulation with modified forces. The patient was deemed recovered and discharged with ergonomic and home care recommendations. Discussion: This case demonstrates a clinical situation where there is a paucity of research to guide management, thus clinicians must rely on experience and patient preferences in the selection of an appropriate and safe therapeutic intervention. The case highlights the need to contextualize the apparent contraindication of manipulation in patients with rheumatoid arthritis and calls for further research. Finally the paper advances evidence based decision making that balances the available research, clinical experience, as well as patient preferences. PMID:26136606

  6. Fournier gangrene presenting in a patient with undiagnosed rectal adenocarcinoma: a case report

    PubMed Central

    2009-01-01

    Introduction Fournier gangrene is a rare necrotising fascitis of the perineum and genitals caused by a mixture of aerobic and anaerobic microorganisms. The first case was described by Baurienne in 1764 but the condition was named by Fournier in 1883 who reported the cases of five men with the condition with no apparent etiology. Infection most commonly arises from the skin, urethra, or rectal regions. Despite appropriate therapy, mortality in this disease is still high. We report a case of a low rectal malignancy presenting as Fournier gangrene. This case report serves to highlight an extremely unusual presentation of rectal cancer, a common surgical pathology. Case presentation The patient is a 48 years old Afghanian male that admitted with Fournier gangrene. In the course of medical and surgical treatment the presence of extensive rectal adenocarcinoma was discovered. After partial recovery, standard loop colostomy was inserted. Skin grafting of necrotic areas was performed and systemic rectal cancer chemotherapy initiated after full stabilization. Conclusion Fournier gangrene is an uncommon but life threatening condition with high associated mortality and morbidity. Usually there is an underlying cause for the development of Fournier gangrene, that if addressed correctly, can lead to a good outcome. Early diagnosis and treatment decrease the morbidity and mortality of this life threatening condition. Good management is based on aggressive debridement, broad spectrum antibiotics and intensive supportive care. PMID:20062653

  7. Serotonin syndrome presenting as surgical emergency: A report of two cases.

    PubMed

    Prakash, Sanjay; Rathore, Chaturbhuj

    2016-02-01

    Serotonin syndrome (SS) is an iatrogenic, drug-induced clinical syndrome caused by serotoninergic hyperstimulation. The diagnosis of SS is easily overlooked as most physicians (up to 85%) are unaware of this syndrome as a clinical entity. Diagnosis is also difficult due to its protean manifestations which can mimic a variety of medical conditions. Herein, we describe two cases of SS, who initially presented to the Surgical Department as surgical emergencies. The first case developed urinary retention after the administration of sertraline. The second case developed features mimicking acute intestinal obstruction. Both cases responded to the removal of offending agents and administration of cyproheptadine. There is a need to increase the awareness of SS among physicians because of the widespread use of serotonergic agents all around the world. PMID:27076715

  8. Serotonin syndrome presenting as surgical emergency: A report of two cases

    PubMed Central

    Prakash, Sanjay; Rathore, Chaturbhuj

    2016-01-01

    Serotonin syndrome (SS) is an iatrogenic, drug-induced clinical syndrome caused by serotoninergic hyperstimulation. The diagnosis of SS is easily overlooked as most physicians (up to 85%) are unaware of this syndrome as a clinical entity. Diagnosis is also difficult due to its protean manifestations which can mimic a variety of medical conditions. Herein, we describe two cases of SS, who initially presented to the Surgical Department as surgical emergencies. The first case developed urinary retention after the administration of sertraline. The second case developed features mimicking acute intestinal obstruction. Both cases responded to the removal of offending agents and administration of cyproheptadine. There is a need to increase the awareness of SS among physicians because of the widespread use of serotonergic agents all around the world. PMID:27076715

  9. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature.

    PubMed

    Acevedo, Francisco; Baudrand, Rene; Letelier, Luz M; Gaete, Pablo

    2008-07-01

    Actinomycosis is a rare, chronic disease caused by a group of anaerobic Gram-positive bacteria that normally colonize the mouth, colon, and urogenital tract. Infection involving the cervicofacial area is the most common clinical presentation, followed by pelvic region and thoracic involvement. Due to its propensity to mimic many other diseases and its wide variety of symptoms, clinicians should be aware of its multiple presentations and its ability to be a 'great pretender'. We describe herein three cases of unusual presentation: an inferior caval vein syndrome, an acute cholecystitis, and an acute cardiac tamponade. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment, and prognosis. PMID:18164641

  10. Painful Bladder Syndrome: An Unusual Presentation in a Case of Upper Tract Fungus Balls

    PubMed Central

    Bajic, Petar; Wetterlin, Jessica; Bresler, Larissa

    2016-01-01

    Urinary tract fungus balls are a rare pathologic entity which may be asymptomatic or have variable presentations. To date, there have been no documented cases of fungus balls presenting as painful bladder syndrome. Painful bladder syndrome is a constellation of symptoms which may include pelvic pain, urgency and frequency not explained by other causes. Here, we present the first case of these two entities concurrently. Our patient had a longstanding history of diabetes, nephrolithiasis and recurrent urinary tract infections. He presented with symptoms of painful bladder syndrome and work-up revealed filling defects within the renal collecting system concerning for malignancy. Subsequent ureteroscopy revealed dense white debris consistent with candida fungus balls. Following clearance of the debris and antifungal therapy, our patient has remained asymptomatic. PMID:27390583

  11. An interesting case of systemic lupus erythematosus presenting with hypercalcemia: A diagnostic dilemma

    PubMed Central

    Abdul Gafor, Abdul Halim; Cader, Rizna Abdul; Das, Srijit; Masir, Noraidah; Wahid, Fadilah Abdul

    2013-01-01

    Background Hypercalcemia is common in primary hyperparathyroidism malignancies and even in tuberculosis. Interestingly, systemic lupus erythematosus (SLE) rarely presents with hypercalcemia. Case Report: We describe an interesting case of SLE in a patient who was otherwise thought to have either tuberculosis or a malignancy. The patient initially presented with feeling unwell, with generalized lymphadenopathy, bilateral pleural effusion, and bilateral corneal calcium deposits secondary to severe hypercalcemia. The diagnosis of SLE was made based on positivity of antinuclear antibodies (ANA) and anti-dsDNA, the presence of serositis, lymphadenopathy, autoimmune hemolytic anemia, and constitutional symptoms. She was treated with steroids, with tremendous improvement in her general well-being, resolution of lymphadenopathy and pleural effusion, and normalization of her hemoglobin and serum calcium. The atypical presentation of SLE with hypercalcemia with pleural effusion is discussed. Conclusions: SLE should be one of the differential diagnoses in patients presenting with severe hypercalcemia. PMID:23569551

  12. Cavernous hemangioma of the skull presenting with subdural hematoma. Case report.

    PubMed

    Gottfried, Oren N; Gluf, Wayne M; Schmidt, Meic H

    2004-10-15

    Cavernous hemangioma of the calvaria is a very rare disease, and patients usually present with headaches or a visible skull deformity. Few reports of patients presenting with intradiploic or epidural hemorrhages are found in the literature. No case of an intradural hemorrhage from a cavernous hemangioma of the skull has been reported to date. The authors present the case of a 50-year-old man in whom a symptomatic subdural hematoma (SDH) resulting from a cavernous hemangioma of the calvaria had hemorrhaged and eroded through the inner table of the skull and dura mater. The patient underwent surgery for evacuation of the SDH and resection of the calvarial lesion. Postoperatively, the patient experienced immediate relief of his symptoms and had no clinical or radiological recurrence. Calvarial cavernous hemangiomas should be considered in the differential diagnosis of nontraumatic SDHs. Additionally, skull lesions that present with intracranial hemorrhages must be identified and resected at the time of hematoma evacuation to prevent recurrences. PMID:15633993

  13. A case of late-onset allgrove syndrome presenting with predominant autonomic dysfunction

    PubMed Central

    Sanyal, Debmalya; Bhattacharjee, Shakya

    2013-01-01

    Allgrove Syndrome or triple A syndrome is a rare familial multisystem disorder characterized by achalasia, alacrima and adrenal insufficiency. The objective was to describe a case of 4A syndrome where autonomic dysfunction was the presenting feature. A 22-year-old male presented with erectile dysfunction and loss of spontaneous morning erections for six months. He was having nocturnal diarrhea and recurrent postural dizziness for three months. He was found to have hyperpigmentation at pressure points, postural hypotension and other features of autonomic dysfunction. Laboratory investigations and imaging studies revealed hypoadrenalism, achalasia, alacrima and peripheral neuropathy. Autonomic neuropathy-related features persisted even after correction of hypoadrenalism. Based on clinical features and investigation he was diagnosed as a case of 4A syndrome presenting with autonomic dysfunction. Allgrove or 4A syndrome should be considered as a rare differential diagnosis of someone presenting with features of autonomic neuropathy. PMID:23956580

  14. An Unusual Presentation of Disseminated Histoplasmosis: Case Report and Review of Pediatric Immunocompetent Patients from India.

    PubMed

    Agarwal, Poojan; Capoor, Malini R; Singh, Mukul; Gupta, Arpita; Chhakchhuak, Arini; Debatta, Pradeep

    2015-12-01

    Histoplasmosis is a progressive disease caused by dimorphic intracellular fungi and can prove fatal. Usually, it is present in immunocompromised individuals and immunocompetent individuals in the endemic zones. We report an unusual presentation of progressive disseminated histoplasmosis. The patient in the present case report was immunocompetent child and had fever, bone pains, gradual weight loss, lymphadenopathy and hepatosplenomegaly. Disseminated histoplasmosis (DH) was diagnosed on microscopic examination and fungal culture of bone marrow, blood, skin biopsy and lymph node aspirate. The patient died on seventh day of amphotericin B. In the absence of predisposing factors and classical clinical presentation of febrile neutropenia, lung, adrenal and oropharyngeal lesions, the disease posed a diagnostic challenge. Progressive disseminated histoplasmosis in children can be fatal despite timely diagnosis and therapy. In India, disseminated histoplasmosis is seen in immunocompetent hosts. All the pediatrics immunocompetent cases from India are also reviewed. PMID:26126955

  15. Supraventricular tachycardia presenting in labour: A case report achieving vaginal birth and review of the literature.

    PubMed

    Bircher, C W; Farrakh, S; Gada, R

    2016-06-01

    Arrhythmias are one of the most common forms of cardiac disease presenting in pregnancy. Women with underlying arrhythmias may only present to health care professionals when they are pregnant. The most common type of sustained arrhythmia presenting in pregnancy is a supraventricular tachycardia (SVT). This can be difficult to diagnose, as symptoms such as palpitations, dizziness and shortness of breath are also common symptoms of pregnancy. We present the management of a woman who developed intrapartum SVT. Her case highlights the importance of considering the diagnosis in the antenatal period, the use of antiarrhythmic drugs, as well as the fact that achieving vaginal delivery is possible in correctly selected cases while the mother and baby remain stable. PMID:27512502

  16. Painful Bladder Syndrome: An Unusual Presentation in a Case of Upper Tract Fungus Balls.

    PubMed

    Bajic, Petar; Wetterlin, Jessica; Bresler, Larissa

    2016-05-01

    Urinary tract fungus balls are a rare pathologic entity which may be asymptomatic or have variable presentations. To date, there have been no documented cases of fungus balls presenting as painful bladder syndrome. Painful bladder syndrome is a constellation of symptoms which may include pelvic pain, urgency and frequency not explained by other causes. Here, we present the first case of these two entities concurrently. Our patient had a longstanding history of diabetes, nephrolithiasis and recurrent urinary tract infections. He presented with symptoms of painful bladder syndrome and work-up revealed filling defects within the renal collecting system concerning for malignancy. Subsequent ureteroscopy revealed dense white debris consistent with candida fungus balls. Following clearance of the debris and antifungal therapy, our patient has remained asymptomatic. PMID:27390583

  17. Idiopathic Tumoral Calcinosis with Unusual Presentation-Case Report with Review of Literature

    PubMed Central

    Banshelkikar, Santosh Nagnath; Argekar, Harshad; Bhoir, Asit

    2014-01-01

    Introduction: Tumoral calcinosis is an uncommon disorder characterised by the deposition of calcium phosphate in periarticular tissues. The deposits are usually around large joints; but rarely can be found around small joints of hand and feet. Case Report: We present the case of 13 year old female with three years history of spontaneous, progressively increasing, painful swellings along right middle finger and right heel. She was otherwise well and had normal serum calcium but elevated phosphate levels. Plain radiography demonstrated a dense lobulated cluster of calcific nodules within soft tissues consistent with a diagnosis of tumoral calcinosis. This diagnosis was confirmed on the basis of histopathological examination following surgical excision. Conclusion: As such tumoral calcinosis is a rare entity and with such unusual presentations like in our case, it may lead to diagnostic confusion. Tumoral calcinosis should be considered in the differential diagnosis of painful swellings developing in the vicinity of small joints of hand and feet. PMID:27298986

  18. Castleman's disease presenting in the lungs: A report of two cases

    PubMed Central

    CAO, WEIJUN; LIANG, SHUO; LIU, JINMING; BAI, JIUWU; LI, HUIPING

    2015-01-01

    Castleman's disease (CD) is a rare disease that most commonly occurs in the mediastinum. The lung is a rare site in which CD may occur. The current study reported 2 cases of CD localized in the lungs. Computed tomography imaging identified a high-density mass in the lungs of the two patients. Biopsy and pathological examinations indicated that one case presented features of two CD types (hyaline-vascular and plasma cell types), while the other case suffered from multicentric CD. The present study highlighted the typical clinical features of CD in the lungs. In addition, it is proposed that a diagnosis of CD should be considered for certain patients with masses in the lungs, and a biopsy should be performed to facilitate diagnosis and treatment. PMID:26622622

  19. Ehlers-Danlos syndrome (classic type): report of a case presenting with an unusual dental anomaly.

    PubMed

    Cho, Shiu-Yin

    2011-10-01

    Ehlers-Danlos syndrome (EDS) comprises a group of generalised connective tissue disorders. Deficiency or alteration of the collagen present in the tissues results in some classic signs such as skin hyper extensibility, joint hypermobility, and vascular fragility. Multiple supernumerary teeth, congenitally missing teeth, and odontogenic keratocysts have been reported in some patients with EDS. To the author's knowledge, transposition of permanent canines has not previously been reported in any case of EDS. This case report presents the dental findings of a sporadic case of classic-type EDS in a 14-year-old Chinese male who had transposition of a permanent maxillary canine as well as the presence of two supernumerary premolars in the mandible. PMID:21968044

  20. Endometrial Osseous Metaplasia—A Rare Presentation of Polymenorrhagia: A Case Report

    PubMed Central

    Yadav, Yogesh Kumar; Hakim, Seema

    2015-01-01

    Endometrial ossification is a rare entity in which bones are found in the uterus. Exact aetiopathogenesis is not known but the most accepted theory is metaplasia of stromal cells into osteoblast cells result in the formation of bones. The possibility of malignant mixed mullerian tumour should be in the mind of clinician and pathologist while making diagnosis. We hereby report an extremely rare case, which is among very few reported cases in the world, in which endometrial ossification presented in a perimenopausal female with polymenorrhagia. A 41-year-old multiparous patient presented with irregular bleeding per vaginum for the past two years. She was found to be a case of endometrial calcification with osseous metaplasia with presence of bones varying from 7mm – 1.5 cms size in the uterine cavity. She was successfully managed by total abdominal hysterectomy. PMID:26023606

  1. A Case of Wegener's Granulomatosis Presenting with Unilateral Facial Nerve Palsy

    PubMed Central

    Ujjawal, Roy; Koushik, Pan; Ajay, Panwar; Subrata, Chakrabarti

    2016-01-01

    Wegener's granulomatosis or granulomatosis with polyangiitis is a necrotizing vasculitis affecting both arterioles and venules. The disease is characterized by the classical triad involving acute inflammation of the upper and lower respiratory tracts with renal involvement. However, the disease pathology can affect any organ system. This case presents Wegener's granulomatosis presenting with facial nerve palsy as the first manifestation of the disease, which is rarely reported in medical literature. PMID:27110249

  2. Systemic Lupus Erythematosus Presenting with Massive Ascites: A Case of Pseudo-Pseudo Meigs Syndrome

    PubMed Central

    Song, J.; Abrudescu-Opran, A.

    2016-01-01

    The case presented is consistent with the phenomenon known as Pseudo-Pseudo Meigs Syndrome (PPMS). In it, we describe a young woman with newly diagnosed Systemic Lupus Erythematosus presenting with ascites, pleural effusions, and an elevated CA-125 level. Although rare, and of uncertain etiology, PPMS is becoming increasingly recognized in the literature. It should be considered as a differential diagnosis in such patients, along with the search for malignancy. PMID:27366341

  3. Papular granuloma annulare of palms and soles: case report of a rare presentation.

    PubMed Central

    Sonthalia, Sidharth

    2014-01-01

    We report the case of a 44-year-old Indian male patient who presented with mildly tender isolated papular lesions confined to the palms of the hands and soles of the feet. The histopathology was characteristic of granuloma annulare. There was an excellent response with 4-week treatment with a potent topical steroid ointment and no recurrence was reported at the follow-up one year later. This report is interesting because of the rare presentation of a common disease. PMID:24627801

  4. Unusual Presentation of Melioidosis in a Case of Pseudoaneurysm of Descending Thoracic Aorta: Review of Two Case Reports

    PubMed Central

    Padmaja, Kanne; Lakshmi, Vemu; Sudhaharan, Sukanya; Venkata Surya Malladi, Subbalaxmi; Gopal, Palanki; Venkata Ravinuthala, Kumar

    2015-01-01

    Introduction: Melioidosis is a rapidly fatal infectious disease caused by Burkholderia pseudomallei, an agent of potential biothreat, endemic in several parts of India. Most melioidosis-induced infected aneurysms are located in the abdominal or thoracic aorta. Case Presentation: We reported two unusual cases of melioidosis resulting in pseudoaneurysm of the descending thoracic aorta. In both cases, blood cultures yielded B. pseudomallei. The first patient was managed with resection of aneurysm and reconstruction with Dacron graft followed by medical treatment and was discharged uneventfully. The second patient died within one week of admission before the infecting etiological agent was identified and aneurysmal repair was planned. Conclusions: A high clinical index of suspicion, especially in areas of endemicity is essential for timely management of intracavitary infected pseudoaneurysms caused by B. pseudomallei and use of rapid microbiological techniques, such as bact/alert 3D system, which enables rapid and early recovery of the etiological agent. PMID:26380820

  5. Huntington Disease: A Case Study of Early Onset Presenting as Depression

    ERIC Educational Resources Information Center

    Duesterhus, Pia; Schimmelmann, Benno Graf; Wittkugel, Oliver; Schulte-Markwort, Michael

    2004-01-01

    Huntington disease is a dominantly inherited, neurodegenerative disease characterized by choreiform movement disturbances and dementia, usually with adult onset. The rare juvenile-onset Huntington disease differs from the adult phenotype. A case presenting twice, at age 10 with all the signs of a major depression and age 14 with mutism and…

  6. Guillain-Barré syndrome. Review and presentation of a case with pedal manifestations.

    PubMed

    Viegas, G V

    1997-05-01

    Guillan-Barré syndrome is an acute, symmetrical polyneuropathy with distinctive features. The early clinical course involves painful paresthesia that is usually followed by proximal motor weakness. Albuminocytologic dissociation in the cerebrospinal fluid is considered diagnostically important. Therapy ranges from supportive measures including physical therapy to surgical intervention for residual deformities. A case with pedal manifestations is presented. PMID:9158314

  7. Vasculitis as a Presenting Manifestation of Chronic Hepatitis B Virus Infection: A Case Report

    PubMed Central

    Singh, Harpreet; Sukhija, Gagandeep; Kaur, Parminder; Govil, Nikhil

    2016-01-01

    Hepatitis B virus is responsible for causing hepatic complications like acute and chronic hepatitis, cirrhosis and hepatocellular carcinoma along with some uncommon immune mediated extrahepatic manifestations. Vasculitis remains an uncommon extrahepatic complication of hepatitis B virus infection. Herein we report a case of hepatitis B infection that presented with leucocytoclastic vasculitis as an initial manifestation and managed successfully with entacavir therapy. PMID:27042512

  8. Student Presentations of Case Studies to Illustrate Core Concepts in Soil Biogeochemistry

    ERIC Educational Resources Information Center

    Duckworth, Owen W.; Harrington, James M.

    2012-01-01

    Soil biogeochemistry, a discipline that explores the chemical speciation and transformations of elements in soils and the relationships between soils and global biogeochemical cycles, is becoming a popular course offering because it unites themes from a number of other courses. In this article, we present a set of case studies that have been used…

  9. Sacral perineural cyst presenting as chronic perineal pain: a case report.

    PubMed

    Jain, S K; Chopra, S; Bagaria, H; Mathur, P P S

    2002-12-01

    We present an interesting case of sacral perineural cyst which caused chronic perineal pain. Perineural cyst is relatively rare, especially the sacral region. Chronic perineural pain is an often encountered problem that is difficult to evaluate and sacral perineural cyst may be the etiology of chronic perineal pain in many instances. PMID:12577111

  10. Local Music Collections: Strategies for Digital Access, Presentation, and Preservation--A Case Study

    ERIC Educational Resources Information Center

    Doi, Carolyn

    2015-01-01

    The Saskatchewan Music Collection (SMC) is a local music collection held at the University of Saskatchewan. This case study examines a project to digitize and present this unique special collection in the online environment. The project aims to facilitate access to the collection, preserve the collection and promote scholarship and interest in the…