DELAYED DIAGNOSIS OF CONVULSIVE SYNCOPE FROM PACEMAKER LEAD FRACTURE IN A PATIENT WITH HISTORY OF SEIZURE DISORDER

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

Posterior Fossa Arachnoid Cyst Masking a Delayed Diagnosis of Hyperparathyroidism in a Child

Case Reports in Endocrinology ◽

10.1155/2012/931371 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4

Author(s):

B. Dhamija ◽

D. Kombogiorgas ◽

I. Hussain ◽

G. A. Solanki

Keyword(s):

Differential Diagnosis ◽

Primary Hyperparathyroidism ◽

Posterior Fossa ◽

Arachnoid Cyst ◽

Hospital Admissions ◽

Delayed Diagnosis ◽

Visual Disturbance ◽

Organ Damage ◽

Presenting Symptoms ◽

History Of

Background. Primary hyperparathyroidism in childhood is a very rare entity, often being diagnosed late after the onset of its presenting symptoms. It most commonly affects patients in their fourth decade of life and beyond. The inclusion of primary hyperparathyroidism in the differential diagnosis is necessary when evaluating patients presenting with nonspecific symptoms such as polyuria, fatigue, weight loss, abdominal pain, nausea, and vomiting.Methods. We report the case of an eleven-year-old girl presenting with three years history of headaches, visual disturbance, along with episodes of emotional lability. Neuroimaging confirmed a large posterior fossa arachnoid cyst. It was decided to manage this lesion conservatively with surveillance. Only after further hospital admissions with recurrent loss of consciousness, dizziness, and nausea to add to her already existing symptoms, a full biochemical and endocrine assessment was performed to look for more specific causes for her presentation. These pointed to a diagnosis of primary hyperparathyroidism.Conclusions. The inclusion of primary hyperparathyroidism in the differential diagnosis should be considered when evaluating paediatric patients presenting with nonspecific (neurological, gastrointestinal, and renal) symptoms in order to establish a prompt diagnosis of the disorder and to avoid severe complications of prolonged hypercalcaemia and end-organ damage.

Case of second primary breast cancer in ectopic breast tissue and review of the literature

BMJ Case Reports ◽

10.1136/bcr-2020-241361 ◽

2021 ◽

Vol 14 (4) ◽

pp. e241361

Author(s):

Jamin Kweku Addae ◽

Thomas Genuit ◽

Joseph Colletta ◽

Kathy Schilling

Keyword(s):

Breast Cancer ◽

Primary Breast Cancer ◽

Breast Tissue ◽

Delayed Diagnosis ◽

Left Breast ◽

Second Primary ◽

Female Population ◽

Accessory Breast ◽

History Of ◽

High Index Of Suspicion

Accessory breast tissue (ABT) is found in approximately 2%–6% of the female population and are subject to most of the physiological and pathological changes that occur in pectoral breast. Primary breast cancer occurring in ABT is a rare occurrence and a second primary breast cancer occurring in an accessory breast has never been reported. We report the case of a 60-year-old woman with a history of mastectomy for left breast cancer 5 years prior to presentation, who presented with an enlarging right axilla mass found to be a second primary breast cancer in an accessory tissue on biopsy. Many physicians are unfamiliar with the clinical presentation of accessory breast cancer due to the rarity of the condition and this ultimately results in delayed diagnosis and advanced disease at presentation. It is therefore prudent that physicians have a high index of suspicion when patients present with axillary masses.

The great deceiver: the role of convulsive syncope in the history of epilepsy

Journal of Clinical Neuroscience ◽

10.1016/s0967-5868(96)90032-6 ◽

1996 ◽

Vol 3 (4) ◽

pp. 354-357 ◽

Cited By ~ 1

Author(s):

Peter F Bladin

Keyword(s):

History Of ◽

History Of Epilepsy ◽

Convulsive Syncope

Delayed diagnosis of bilateral subdural effusions complicating intracranial hypotension in a patient presenting with post lumbar puncture headache

BMJ Case Reports ◽

10.1136/bcr-2020-239559 ◽

2021 ◽

Vol 14 (2) ◽

pp. e239559

Author(s):

Saleheen Huq ◽

Menaka G Iyer ◽

Samson O Oyibo

Keyword(s):

Lumbar Puncture ◽

Delayed Diagnosis ◽

Bed Rest ◽

Viral Meningitis ◽

Magnetic Imaging ◽

Intracranial Complications ◽

Life Threatening ◽

History Of ◽

Discharge From Hospital ◽

Subdural Effusions

A 34-year-old woman presented with an unrelenting headache which had been ongoing since discharge from hospital 4 days before. She initially presented 2 weeks earlier with a 7 days history of severe headache, for which she had a CT scan, lumbar puncture and treatment for possible viral meningitis. The headache got worse 4 days after the lumbar puncture. Despite analgesics and bed rest, the headache persisted. A subsequent magnetic imaging scan demonstrated bilateral subdural effusions. She was given supportive treatment, which included advice concerning strict bed rest and analgesia. The headache took several months to abate. A third of patients suffer from post lumbar puncture headaches and this should be explained during informed consenting and post procedure. Not all post lumbar puncture headaches are simple headaches. A post lumbar puncture headache continuing for more than 7–14 days after the procedure requires further investigation to exclude life-threatening intracranial complications.

Growing Skull Fracture of Temporal Bone in Adults: A Case Report and Literature Review

Ear Nose & Throat Journal ◽

10.1177/0145561320914774 ◽

2020 ◽

Vol 99 (10) ◽

pp. 654-657

Author(s):

Xiao-hong Yan ◽

Ke Qiu ◽

Yan Gao ◽

Jianjun Ren ◽

Danni Cheng ◽

...

Keyword(s):

Literature Review ◽

Head Trauma ◽

Skull Fracture ◽

Delayed Diagnosis ◽

Postoperative Recovery ◽

Mastoid Cavity ◽

Growing Skull Fracture ◽

Computed Tomographic ◽

Uneventful Postoperative Recovery ◽

History Of

Growing skull fracture (GSF) is an uncommon post-traumatic complication, which accounts for approximately 0.05% to 1% of all skull fractures. Delayed diagnosis of GSF in adulthood is rare and often involved with a variety of neurological symptoms. Here, we reported an adult patient, with an interval of 17 years from initial head trauma to first diagnosis of GSF. The patient complained of short periods of fainting and bilateral visual hallucinations, with a hard palpable bulge around his right occipitomastoid suture region. Computed tomographic imaging demonstrated an arachnoid cyst extending into right mastoid cavity. Consequently, the delayed diagnosis of GSF was confirmed, and the patient was managed with duroplasty and cranioplasty. At the 8-month follow-up, the patient showed an uneventful postoperative recovery. A comprehensive literature review was also conducted, and a total of 70 GSF cases were identified and summarized. According to the literature review, patients with GSF generally have a history of head trauma in their childhood, and delayed diagnosis is a common situation. Diagnosis of GSF should include complete retrospective medical history, physical, and imaging examinations. Once the diagnosis is confirmed, cranioplasty accompanied with duroplasty might be the most effective way to relieve symptoms and prevent further damage.

Regional Blockade in Patients with a History of a Seizure Disorder

Anesthesia & Analgesia ◽

10.1213/ane.0b013e3181a832da ◽

2009 ◽

Vol 109 (1) ◽

pp. 272-278 ◽

Cited By ~ 21

Author(s):

Sandra L. Kopp ◽

Kimberly P. Wynd ◽

Terese T. Horlocker ◽

James R. Hebl ◽

Jack L. Wilson

Keyword(s):

Seizure Disorder ◽

History Of

Delayed Diagnosis of Ewing's Sarcoma of the Right Humerus Initially Treated as Chronic Osteomyelitis: A Case Report

Journal of Orthopaedic Surgery ◽

10.1177/230949900501300117 ◽

2005 ◽

Vol 13 (1) ◽

pp. 88-92 ◽

Cited By ~ 10

Author(s):

BPB Tow ◽

MH Tan

Keyword(s):

Case Report ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Chronic Osteomyelitis ◽

Delayed Diagnosis ◽

Delay In Diagnosis ◽

Limited Stage ◽

History Of ◽

Anti Inflammatory ◽

The Right

We report a case of limited stage Ewing's sarcoma which was initially treated as chronic osteomyelitis for 3 years. A 24-year-old man presented with a one-week history of pain in the right arm and fever, with histology suggestive of osteomyelitis of the affected humerus. He developed multiple relapses of pain and fever; each episode responded to antibiotic treatment. A second biopsy was performed 3 years later and confirmed a diagnosis of Ewing's sarcoma. Despite a 3-year delay in diagnosis, the disease remained localised. This case report highlights an atypical facet of the natural history of Ewing's sarcoma: a response to antibiotic and anti-inflammatory agents, and the limited stage of the disease despite a misdiagnosis of 3 years. This suggests the possibility that anti-inflammatory agents exert an inhibitory effect on the tumour growth. We also highlight the newer histologic and immunologic staining used in the diagnosis of Ewing's sarcoma.

Complete pacemaker lead fracture potentially due to intra-cardiac mass

EP Europace ◽

10.1093/europace/euq406 ◽

2010 ◽

Vol 13 (4) ◽

pp. 593-595 ◽

Cited By ~ 3

Author(s):

B. Godin ◽

A. Savoure ◽

F. Bauer ◽

F. Anselme

Keyword(s):

Cardiac Mass ◽

Pacemaker Lead ◽

Lead Fracture

Report of a rare case of hand-foot-mouth disease in a adult woman with systemic arthritis

Brazilian Dental Science ◽

10.14295/bds.2016.v19i4.1261 ◽

2016 ◽

Vol 19 (4) ◽

pp. 125

Author(s):

Luciana Eloísa Da Silva Castro Nóbrega ◽

Viviane Alves De Oliveira ◽

Patrícia Teixeira De Oliveira ◽

Éricka Janine Dantas Da Silveira ◽

Ana Myriam Costa De Medeiros

Keyword(s):

Infectious Disease ◽

Rare Case ◽

Correct Diagnosis ◽

Delayed Diagnosis ◽

Mouth Disease ◽

Intestinal Infection ◽

Mouth Diseases ◽

Hand Foot Mouth Disease ◽

History Of ◽

Systemic Arthritis

Hand-foot-mouth disease (HFMD) is a highly infectious disease, rare in adults which usually presents a painfull stomatitis. We describe a rare case of HFMD in a 34-year-old woman with medical history of recent intestinal infection and systemic arthritis with only oral and hands involvement. Additionally, we discuss diagnosis and treatment of this disease and reinforce the importance of the correct diagnosis because delayed diagnosis can cause spread of the disease.Keywords: Adult; Arthritis; Mouth diseases.