scholarly journals P.031 A Rare Canadian Case of Cervical Pyomyosistis Presenting as Occipital Neuralgia

2021 ◽  
Vol 48 (s3) ◽  
pp. S29-S29
Author(s):  
H Girgis ◽  
M Ziller
Keyword(s):  
Source Control ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Tropical Regions ◽  
Lower Limb Muscles ◽  
Nuchal Rigidity ◽  
Intravenous Antibiotics ◽  
Local Destruction ◽  
Immunocompromised Hosts ◽  
Tomography Scan

Background: Pyomyositis is an infectious disease usually encountered in tropical regions. It typically occurs in immunocompromised hosts and most commonly affects lower limb muscles. Our patient was a healthy Canadian with an atypical presentation of cervical pyomyositis. Methods: We report a case of a healthy 22-year old woman presenting to the emergency department with unprovoked severe bilateral cervico-occipital pain and nuchal rigidity. She remained afebrile. Review of the literature was conducted to search for similar presentations. Results: A Computed Tomography scan of the head and neck demonstrated the presence of a ring enhancing lesion in the semispinalis capitis muscle extending from the occiput to the C4 level. The abscess was surgically drained and cultures grew staphylococcus aureus. The patient rapidly improved on intravenous antibiotics. Literature review revealed this to be the first Canadian case of cervical pyomyositis. Conclusions: Cervical pyomyositis can be complicated by local destruction of the vertebrae, septic shock, endocarditis, septic emboli, brain abscess or rhabdomyolysis. Early diagnosis and source control is necessary to reduce the risk of morbidity. Therefore, it is important to consider this rare disease in the differential diagnosis of cervicalgia even in healthy immunocompetent patients.

scholarly journals Fulminant amoebic colitis in the era of computed tomography scan: A case report and review of the literature

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Suman Mewa Kinoo ◽  
Vikesh V. Ramkelawon ◽  
Jaynund Maharajh ◽  
Bugwan Singh
Keyword(s):  
Computed Tomography ◽  
Bowel Wall ◽  
Abdominal Distension ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Fulminant Colitis ◽  
Bowel Necrosis ◽  
Amoebic Colitis ◽  
History Of ◽  
Tomography Scan

Amoebic colitis, caused by ingestion of water or food contaminated with the protozoan Entamoeba histolytica, can progress to a fulminant colitis. Computed tomography (CT) findings reported in the literature on this type of colitis are sparse. We present a 59-year-old male patient with a one-week history of progressive abdominal pain, abdominal distension and associated watery and bloody diarrhoea. A CT scan revealed deep ulcerations with submucosal and intramural tracking of contrast. Colonoscopy and biopsy confirmed a diagnosis of Amoebic colitis. The patient required a laparotomy and demised. Deep ulcerations with submucosal and intramural tracking of contrast on CT are diagnostic of fulminant amoebic colitis. Although not demonstrated at CT in this case, discontinuous bowel necrosis, omental wrapping (seen at laparotomy in our case) and neovascularisation of the bowel wall may be other features to look out for.

scholarly journals TP10.2.13Outcome of Acute appendicitis management during COVID-19 pandemic in a tertiary hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Su Kwan Lim
Keyword(s):  
Acute Appendicitis ◽  
Readmission Rate ◽  
Best Practice ◽  
Tertiary Hospital ◽  
Inclusion Criteria ◽  
Computed Tomography Scan ◽  
Intravenous Antibiotics ◽  
The Uk ◽  
Surgical Unit ◽  
Tomography Scan

Abstract Aim Coronavirus (COVID) has influenced the management of acute appendicitis. The Royal Colleges of Surgeons recommend best practice depending on local circumstances. The aim of this project is to assess the 30-day outcome of patients managed operatively and conservatively for acute appendicitis during the first wave of the pandemic in the UK. Method Patient data were collected prospectively at the end of March 2020, when Covid-19 became prevalent in the UK and lockdown started. Data was collected for patients admitted to the acute surgical unit for the admission dates of 20/03/2020 to 15/05/2020. At 30 days after admission, a search was done on the electronic clinical portal to check if the patient was readmitted for operation. The inclusion criteria are any patients above 16-year-old admitted through acute surgical unit with a clinical diagnosis of acute appendicitis or computed tomography scan findings of proven acute appendicitis. Result A total of 34 patients (median age, 33; range, 17-74) were identified from March 2020 to May 2020. All patients have covid-19 status as negative and were given intravenous antibiotics at point of admission. All patients received a course of seven-day of antibiotic. 17 patients underwent operation and 17 patients were managed conservatively. Only one patient who was treated conservatively for acute appendicitis, was re-admitted within 30 days of admission date. Discussion The readmission rate of patients treated conservatively for acute appendicitis after 30 days were low during the first wave of the pandemic.

scholarly journals Metastatic renal cell carcinoma to the testis: A case report and review of the literature

2014 ◽  
Vol 8 (11-12) ◽  
pp. 924 ◽  
Author(s):  
Karim Marzouk ◽  
Fahad Alyami ◽  
Jennifer Merrimen ◽  
Scott Bagnell
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Metastatic Lesion ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Cytoreductive Nephrectomy ◽  
Tomography Scan

This is a case of a 68-year-old male who presented with a chief compliant of a testicular mass, which was discovered to be a metastatic lesion of undiagnosed renal cell carcinoma. A computed tomography scan revealed a large right renal mass and multiple pulmonary metastasis. Shortly after diagnosis, the patient was initiated on systemic therapy and received a cytoreductive nephrectomy. We discuss the details of this case as well as a pertinent review of metastatic renal cell carcinoma to the testes.

Laryngolith

2009 ◽  
Vol 123 (2) ◽  
Author(s):  
A H Hegab
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Interesting Case ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Unique Case ◽  
The Past ◽  
Tomography Scan ◽  
Biochemical Examination

AbstractObjective:To report an extremely rare and interesting case of a woman who developed a laryngeal stone.Case report:A 44-year-old woman was referred to our ENT clinic complaining of dyspnoea and stridor. She had been treated for chest problems for approximately 30 years. On examination, she had a large, spiky, subglottic lesion compromising the airway. A laryngeal computed tomography scan and histopathological and biochemical examination showed the lesion to be a calcium phosphate stone. Review of the literature from the past 50 years, using several search engines, revealed no similar cases.Conclusion:To the author's knowledge, this is a unique case of a stone that developed in the subglottis. This rare entity was the cause of long-standing chest problems unresponsive to medical treatment. The patient recovered completely from all her symptoms after removal of the laryngolith.

scholarly journals Postpulmonary Embolism Pericarditis: A Case Report and Review of the Literature

1996 ◽  
Vol 3 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Finlay A McAlister ◽  
Mohammed Al-Jahlan ◽  
Bruce Fisher
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Features ◽  
Systemic Corticosteroid ◽  
Oral Prednisone ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Retrosternal Pain ◽  
Perfusion Defects ◽  
Tomography Scan ◽  
Systemic Corticosteroid Therapy

Pericarditis developing as a sequela of pulmonary embolism has been rarely described. A 44-year-old male presented with acute dyspnea and pleuritic pain; V/Q scan showed multiple perfusion defects, and he was treated with heparin. Three days later retrosternal pain was accompanied by a pericardial friction rub. There was a rapid response to systemic corticosteroid therapy; anticoagulation was continued. Steroids were discontinued after four weeks, and anticoagulation (warfarin) was continued. Two months later he presented with clinical features of pulmonary embolus and new perfusion defects on scan. He was treated with heparin and warfarin; three weeks later clinical features of pericarditis recurred, and he was again treated successfully with four weeks' oral prednisone. Three months later pericarditis recurred without signs of pulmonary embolism; computed tomography scan showed thickening of the pericardium. The patient was asymptomatic for five months on indomethacin. A literature search showed 11 cases of pericarditis associated with emboli, all responding promptly to steroids. Continuation of anticoagulation does not appear to increase the risk (or magnitude) of hemorrhagic pericardial effusion.

scholarly journals The importance of early management of severe biliary infection: current concepts

2021 ◽  
Author(s):  
Mireia Amillo-Zaragueta ◽  
Esther Nve ◽  
Daniel Casanova ◽  
Pau Garro ◽  
Josep M Badia
Keyword(s):  
Clinical Presentation ◽  
Multidrug Resistant ◽  
Progressive Increase ◽  
Source Control ◽  
Control Treatment ◽  
Resistant Bacteria ◽  
Review Of The Literature ◽  
Early Management ◽  
Emergency Admissions ◽  
Intravenous Antibiotics

Background. The incidence of biliary infections is rising worldwide and has become one of the main reasons for emergency admissions. Methods. Narrative review of the literature emphasizing news concepts related to the early management of biliary diseases.  Results. The bacteriology is frequently polymicrobial, with a progressive increase of multidrug resistant bacteria. The form of presentation is variable, and the mortality rate may reach 20%. When cholecystitis or cholangitis is suspected, ultrasound is the gold standard imaging test. Depending on the severity of presentation, local resistances and risk factors for multi-resistant organisms, the most appropriate empirical antibiotic treatment must be initiated. In acute cholecystitis, cholecystectomy plays the main therapeutic role. In patients not suitable for surgery, percutaneous cholecystostomy is a valid alternative for source control. Treatment of severe cholangitis is based on the drainage of the bile duct and antibiotic therapy. Conclusions. Biliary infections are serious conditions which can lead to sepsis and death. The introduction of new internationally accepted guidelines, based on clinical presentation, laboratory tests and imaging, provides a platform for their timely diagnosis and management. Early severity assessment, initiation of intravenous antibiotics and source control are fundamental to improving morbidity and mortality.

scholarly journals Pierce the ear and stab the spleen

2020 ◽  
Vol 14 (2) ◽  
pp. 95-99
Author(s):  
Thomas Matteazzi ◽  
Italo Balzani ◽  
Michele Alberghini ◽  
Federica Beretta ◽  
Claudia Bon ◽  
...  
Keyword(s):  
Splenic Abscess ◽  
Invasive Procedure ◽  
Computed Tomography Scan ◽  
Unique Case ◽  
Ear Piercing ◽  
Left Hypochondrium ◽  
Intravenous Antibiotics ◽  
Focus Of Infection ◽  
Dangerous Condition ◽  
Tomography Scan

Splenic abscess is a rare but extremely dangerous condition generally spreading from a local, or systemic, focus of infection. We present the case of a young immunocompetent female admitted with sepsis and multiple splenic abscesses. The patient had a recent left ear piercing on the tragus complicated by an ear infection. The presence of a solitary parotid abscess, the absence of other infectious foci on computed tomography scan, the negativity of blood cultures and the absence of endocarditis vegetations led us to think that the most likely culprit was a hematogenous dissemination from the left tragus. The patient was successfully treated with intravenous antibiotics. There had been no need of splenectomy or any other procedure. This rather unique case underscores that splenic abscess should be suspected when a long-lasting fever and pain in the left hypochondrium are present, even when an apparently innocuous invasive procedure, such as a body piercing, is performed.

scholarly journals Osteoma of the Medial Wall of the Maxillary Sinus: A Primary Cause of Nasolacrimal Duct Obstruction and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Athanasios Saratziotis ◽  
Enzo Emanuelli
Keyword(s):  
Maxillary Sinus ◽  
Nasolacrimal Duct ◽  
Medial Wall ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Duct Obstruction ◽  
Chronic Dacryocystitis ◽  
History Of ◽  
Left Maxillary Sinus ◽  
Tomography Scan

A 74-year-old male patient presented to the outpatient department with left-sided epiphora and chronic dacryocystitis, without any history of head trauma or previous nasal or paranasal sinuses surgery. No abnormalities were noted at the time with the use of nasal endoscopy. The computed tomography scan however revealed an osteoma of the medial wall of the left maxillary sinus. An endonasal endoscopic dacryocystorhinostomy (DCR) with osteoma removal by using a drill with temporary silicone stenting of the nasolacrimal duct system was performed. Due to a granuloma formation at the DCR-window site 2 months postoperatively a revision-DCR was performed and the new window remained patent at control 6 months after surgery.

Gastroduodenal intussusception and pylorus obstruction induced by a c-KIT-negative gastric gastrointestinal stromal tumor: case report and review of the literature

2018 ◽  
Vol 56 (04) ◽  
pp. 374-379 ◽  
Author(s):  
Yong Zhou ◽  
Xu-Dong Wu ◽  
Quan Shi ◽  
Chuan-hai Xu ◽  
Jing Jia
Keyword(s):  
English Language ◽  
Acute Abdominal Pain ◽  
Wedge Resection ◽  
Endoscopic Examination ◽  
Gastric Gist ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Case Presentation ◽  
Gastroduodenal Intussusception ◽  
Tomography Scan

Abstract Introduction Gastrointestinal stromal tumors (GISTs) are infrequently reported to cause gastroduodenal intussusception, especially in the cases with complete pylorus obstruction. GISTs comprise only 1 – 3 % of all gastrointestinal tract tumors, and most of them strongly express the c-KIT protein. Approximately 5 % of GISTs show negative staining of c-KIT. Case presentation A 69-year-old man complained of acute abdominal pain accompanied with nausea and vomiting for 6 hours. Emergency endoscopic examination, upper gastroenterography, and computed tomography scan suggested gastroduodenal intussusception and pylorus obstruction induced by a gastric GIST. Laparoscopic exploration and wedge resection of the tumor were performed in the patient. Postoperative histological examination showed a gastric GIST with c-KIT-negative expression. Conclusion Herein, we report the unique findings of a c-KIT-negative gastric GIST presenting with gastroduodenal intussusception and pylorus obstruction. We also reviewed the English language literature of gastroduodenal intussusception induced by GISTs and put our case in the context of the previously reported cases.

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