scholarly journals “Unexplained” Delayed Death From Fungal Meningitis After Meningioma Resection

1995 ◽  
Vol 22 (3) ◽  
pp. 239-243
Author(s):  
R. John Hurlbert ◽  
Juan M. Bilbao ◽  
William S. Tucker
Keyword(s):  
Differential Diagnosis ◽  
High Risk ◽  
Patient Care ◽  
Neurological Deterioration ◽  
Extensive Investigation ◽  
Review Of The Literature ◽  
Diagnostic Challenge ◽  
Neurosurgical Procedure ◽  
Fungal Meningitis ◽  
Risk Patients

AbstractBackgroundProgressive deterioration and ensuing death following a neurosurgical procedure often represents a diagnostic challenge to the team responsible for patient care. Many, but not all, causes are treatable if a diagnosis is made early.MethodsA 69-year-old woman who died 6 weeks post-operatively following a meningioma resection is reported. An initial routine post-operative course became complicated by progressive neurological deterioration 3–4 weeks later. Despite extensive investigation she died 6 weeks post-operatively without a diagnosis.ResultsAutopsy demonstrated extensive Candida meningitis. A review of the literature demonstrates this to be a reported complication in high risk patients, difficult to diagnose, but treatable when identified.ConclusionsFungal meningitis should be high in the differential diagnosis in the post-operative patient with delayed, unexplained neurological deterioration, especially when associated with negative CSF cultures.

Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum

2021 ◽  
Vol 14 (3) ◽  
pp. e237669
Author(s):  
Susan Addley ◽  
Moiad Alazzam ◽  
Catherine Johnson ◽  
Hooman Soleymani majd
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
High Risk ◽  
Kinase Inhibitor ◽  
Correct Diagnosis ◽  
Rectovaginal Septum ◽  
Gastrointestinal Stromal Tumours ◽  
Diagnostic Challenge ◽  
High Quality ◽  
Primary Surgery

Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.

Combined modalities in the prevention of venous thromboembolism: A review of the literature

2006 ◽  
Vol 21 (1_suppl) ◽  
pp. 23-28 ◽  
Author(s):  
S K Kakkos ◽  
J A Caprini ◽  
A N Nicolaides ◽  
D Reddy
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Risk Groups ◽  
Intermittent Pneumatic Compression ◽  
Low Molecular Weight ◽  
Review Of The Literature ◽  
Case Control Studies ◽  
Vte Prophylaxis ◽  
Risk Patients ◽  
Elastic Stockings

Objective Despite recent advances in the field of venous thromboembolism (VTE) prophylaxis and adherence to guideline recommendations, VTE remains a serious problem, especially in high-risk groups. The aim of the present review was to summarize the evidence supporting the use of combined modalities, both physical and pharmacological, in VTE prevention. Methods Using Medline, original studies on the value of combined modalities in VTE prevention were identified. Keywords used for physical methods included elastic stockings and intermittent pneumatic compression, and for pharmacological methods included unfractionated and low molecular weight heparin. Relevant articles from their bibliography were also retrieved. Results Combined pharmacological and physical modalities were more effective than each modality alone in a variety of specialties, including orthopaedic, general and cardiac surgery, as shown by 14 of the 18 randomized or case-control studies retrieved. Mean reduction in VTE incidence was 69% (range 16–100%). Conclusion Combined modalities are more effective than single modalities in VTE prophylaxis. These results endorse their use, especially in high-risk patients, and support this otherwise typical recommendation of the consensus documents on VTE prophylaxis.

scholarly journals Fibrolipoma presenting as a posterior nasal septum mass: a report of a unique case and review of the literature

2021 ◽  
pp. 201010582110000
Author(s):  
Nor Rahimah Aini ◽  
Sakinah Mohamad ◽  
Seoparjoo Azmel Mohd Isa ◽  
Baharudin Abdullah
Keyword(s):  
Differential Diagnosis ◽  
Nasal Septum ◽  
Definitive Treatment ◽  
Review Of The Literature ◽  
Diagnostic Challenge ◽  
Unique Case ◽  
Common Presentation ◽  
Sinonasal Mass

Unilateral sinonasal mass presenting as nasal block is a common presentation but poses a diagnostic challenge. The differential diagnosis includes inflammatory polyps, benign and malignant sinonasal neoplasm. Fibrolipoma presenting in the sinonasal area is an uncommon pathology. As it is uncommon, there is potential for a misdiagnosis, unnecessary investigation and delay in the definitive treatment. We report a patient with a fibrolipoma originating from the posterior nasal septum. The diagnostic and surgical features of this unique case are discussed.

scholarly journals Tuberculosis of the patella masquerading as prepatellar bursitis

2013 ◽  
Vol 95 (1) ◽  
pp. e17-e19 ◽  
Author(s):  
S MacLean ◽  
S Kulkarni
Keyword(s):  
Differential Diagnosis ◽  
High Risk ◽  
Western World ◽  
High Risk Patients ◽  
Risk Patients ◽  
Prepatellar Bursitis

Tuberculosis of bone is an uncommon entity in the Western world. We present a case of tuberculosis of the patella mimicking prepatellar bursitis in an otherwise fit and well woman of Bangladeshi origin. We believe tuberculosis of bone should form a differential diagnosis of the swollen knee in high risk patients.

Differential Diagnosis in Hypophysitis: First Report on a Spindle Cell Rhabdomyosarcoma of the Pituitary Gland

2021 ◽  
Author(s):  
Hajrullah Ahmeti ◽  
Eva Jüttner ◽  
Christoph Röcken ◽  
Olav Jansen ◽  
Matthias Laudes ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
High Risk ◽  
Pituitary Gland ◽  
Poor Prognosis ◽  
Rare Case ◽  
Spindle Cell ◽  
Myogenic Differentiation ◽  
Primary Tumors ◽  
Risk Patients ◽  
Pituitary Metastasis

AbstractPituitary gland metastases are very rare. Most patients with pituitary gland metastases are asymptomatic; therefore, most cases of this disease are diagnosed during autopsies. Moreover, the four most common primary tumors that metastasize to the pituitary gland are breast, lung, thyroid, and renal carcinomas. We present a very rare case of pituitary metastasis of spindle cell rhabdomyosarcoma (RMS). Our patient presented with headache, visual disorder, panhypopituitarism, and diabetes insipidus. Due to tumor expansion, resection was not possible, so diagnosis was confirmed by biopsy, and chemotherapy and irradiation were administered. Our patient showed widespread spindle cell RMS, which harbors a mutation of myogenic differentiation 1 (MYOD1) and is associated with a poor prognosis. Even high-risk patients can show a remission after chemotherapy and irradiation. In the cases with indistinct lesions in the sella region, pituitary metastasis should always be considered.

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