scholarly journals Transcalvarial and Transdural Involvement of Skull Actinomycosis with Recurrence

2019 ◽  
Vol 08 (03) ◽  
pp. 185-187
Author(s):  
Kramadhari Harshith ◽  
Krishnan Nagarajan ◽  
Andi Sadayandi Ramesh ◽  
Debasis Gochhait
Keyword(s):  
Immune System ◽  
Human Body ◽  
Sudden Onset ◽  
Diabetic Woman ◽  
Gram Positive Bacteria ◽  
Malignant Lesions ◽  
Histopathologic Analysis ◽  
Prompt Diagnosis

AbstractActinomycosis is caused by anaerobic gram-positive bacteria of Actinomyces genus, generally found as commensals in the human body and infection occurs when the immune system is compromised. We present the case of a 35-year-old diabetic woman, who presented with headache and sudden onset of left-sided weakness apart from scalp swelling, which on imaging showed transcalvarial transdural involvement, and subsequent surgical debridement and histopathologic analysis confirmed actinomycosis. Follow-up showed recurrence of the lesion at the same site following a period of remission. Calvarial involvement of actinomycosis is rare and can mimic even neoplastic or malignant lesions, hence requiring prompt diagnosis, treatment with surgery, and long-term antibiotic treatment to prevent complications.

Evaluation of Strength Recovery after Traumatic Acute Compartment Syndrome of the Thigh. A Case Study

2017 ◽  
Vol 19 (4) ◽  
pp. 0-0
Author(s):  
Alban Fouasson-Chailloux ◽  
Pierre Menu ◽  
Marc Dauty
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Intramuscular Pressure ◽  
Rehabilitation Care ◽  
Fracture Reduction And Fixation ◽  
Strength Recovery ◽  
Prompt Diagnosis

Acute compartment syndrome of the thigh is an underestimated serious pathology which can cause long term morbidities. The management, recovery and follow-up of the case of a 20-year-old Caucasian man, who presented an acute compartment syndrome of the thigh, are described. After femoral fracture reduction and fixation by nail, intramuscular pressure measurements confirmed the diagnosis before treatment by fasciotomies. 12-months’ follow-up showed the presence of neurological femoral complications and physical impairment in spite of rehabilitation care. Because compartment syndrome of the thigh after a trauma is rare but potentially devastating, prompt diagnosis is required for performing early fasciotomies.

scholarly journals Clinical features and outcomes of bowel perforation in primary pediatric gastrointestinal lymphoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiayu Yan ◽  
Yanlong Duan ◽  
Tingting Liu ◽  
Jianlin Guo ◽  
Chunhui Peng ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Bowel Perforation ◽  
Outpatient Department ◽  
Gastrointestinal Lymphoma ◽  
Long Term Follow Up ◽  
The Mean ◽  
Mean Time ◽  
Prompt Diagnosis

Abstract Background Whether surgery can improve the prognosis of patients with primary pediatric gastrointestinal lymphoma (PPGL) who experienced bowel perforation remains controversial. This study aimed to evaluate the prognosis of such patients. Methods Nine patients pathologically diagnosed with PPGL who experienced perforation at our center between January 2010 and December 2020 were enrolled and divided into two groups: those with perforation during (n = 4) and before (n = 5) chemotherapy. Their medical records were reviewed, and long-term follow-up was conducted by telephone in February 2021. Results All patients with perforation during chemotherapy were diagnosed with PPGL in the outpatient department. The mean time from outpatient visit to chemotherapy was 17.3 ± 6.1 days. Two patients experienced perforation during the first chemotherapy regimen and received conservative treatment, while the others developed perforation after multiple chemotherapy regimens and underwent surgery. All of the patients received regular chemotherapy and survived for a mean follow-up time of 3.8 ± 1.9 years. No patient with perforation before chemotherapy had a definite diagnosis in the outpatient department. Among these patients, 4 experienced perforation and underwent surgery, of whom 3 developed perforation-related complications and died; the other recurred after chemotherapy. Only the patient who received conservative treatment was diagnosed with PPGL before chemotherapy, received regular chemotherapy, and survived without a recurrence for 1.0 year. Conclusion Prompt diagnosis and chemotherapy improve the prognosis of PPGL. Surgery does not affect the prognosis of patients with perforation during chemotherapy but may accelerate disease progression in patients with perforation before chemotherapy.

Tumours of the eye and orbit

2016 ◽  
pp. 904-917
Author(s):  
Daniel G. Ezra ◽  
Geoffrey E. Rose ◽  
Jacob Pe’er ◽  
Sarah E. Coupland ◽  
Stefan Seregard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Imaging Procedures ◽  
Treatment Assessment ◽  
Long Term Follow Up ◽  
Malignant Lesions ◽  
Symptoms And Signs ◽  
Intraocular Tumours

This chapter provides information about the tumours of the eye and orbit, including benign and malignant lesions of the conjunctiva and ocular adnexa as well as intraocular tumours, such as uveal melanoma, vascular tumours, and lymphoma of the retina and CNS. The chapter also provides information on the symptoms and signs of such lesions, the recommended examination and imaging procedures, the principles of management and treatment, assessment of quality of life, as well as on prognosis, histopathology, differential diagnoses, and molecular biology. Each section discusses not only optimal potentially curative management, but also long-term follow-up and maintenance of vision.

Complications of Plantar Fascia Rupture Associated with Corticosteroid Injection

1998 ◽  
Vol 19 (2) ◽  
pp. 91-97 ◽  
Author(s):  
Jorge I. Acevedo ◽  
James L. Beskin
Keyword(s):  
Corticosteroid Injection ◽  
Plantar Fascia ◽  
Sudden Onset ◽  
Lateral Plantar Nerve ◽  
Gradual Onset ◽  
Significant Difference ◽  
Cross Training ◽  
Fair Poor

From 1992 to 1995, 765 patients with a clinical diagnosis of plantar fasciitis were evaluated by one of the authors. Fifty-one patients were diagnosed with plantar fascia rupture, and 44 of these ruptures were associated with corticosteroid injection. The authors injected 122 of the 765 patients, resulting in 12 of the 44 plantar fascia ruptures. Subjective and objective evaluations were conducted through chart and radiographic review. Thirty-nine of these patients were evaluated at an average 27-month follow-up. Thirty patients (68%) reported a sudden onset of tearing at the heel, and 14 (32%) had a gradual onset of symptoms. In most cases the original heel pain was relieved by rupture. However, these patients subsequently developed new problems including longitudinal arch strain, lateral and dorsal midfoot strain, lateral plantar nerve dysfunction, stress fracture, hammertoe deformity, swelling, and/or antalgia. All patients exhibited diminished tension of the plantar fascia upon examination by the stretch test. Comparison of calcaneal pitch angles in the affected and uninvolved foot showed a statistically significant difference of 3.7° ( P = 0.0001). Treatment included NSAIDs, rest or cross-training, stretching, orthotics, and boot-brace immobilization. At an average 27-month follow-up, 50% had good/excellent scores and 50% had fair/poor scores. Recovery time was varied. Ten feet were asymptomatic by 6 months post rupture, four feet by 12 months post rupture, and 26 feet remained symptomatic 1 year post rupture. Our findings demonstrate that plantar fascia rupture after corticosteroid injection may result in long-term sequelae that are difficult to resolve.

Long term follow-up and effect of immunosuppression in acute zonal occult outer retinopathy

2020 ◽  
pp. 112067212098187
Author(s):  
Andrea Guijarro ◽  
Nelida Muñoz ◽  
Nicolas Alejandre ◽  
Sheila Recuero ◽  
Olga Sanchez-Pernaute ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Young Women ◽  
Immunosuppressive Treatment ◽  
Intravenous Immunoglobulins ◽  
Sudden Onset ◽  
Electrophysiological Tests ◽  
Long Term Follow Up

Acute zonal occult outer retinopathy (AZOOR) is a rare syndrome characterized by sudden onset of photopsia, scotomas, and abnormal electrophysiological tests, predominantly affecting young women. Although its pathogenesis remains unknown, auto-reactivity to retinal components is thought to mediate tissue damage. A 42-year-old woman presented with symptoms and examination consistent with the diagnosis of AZOOR. She was treated with azathioprine for 5 years. In spite of the immunosuppressive treatment, clear progression in the visual field, autofluorescence, electrophysiological tests and optical coherence tomography was observed. Treatment with intravenous immunoglobulins (IVIg) and subcutaneous Abatacept was subsequently started with little efficacy. Hereby, we present a case of progressive AZOOR despite aggressive immunosuppression with 10-year follow up. Currently, there is no consensus regarding management of AZOOR, and the convenience of administering aggressive immunosuppression remains uncertain.

Tibial tuberosity fracture as a complication of tibial tuberosity advancement

2014 ◽  
Vol 27 (02) ◽  
pp. 148-154 ◽  
Author(s):  
J. Aisa ◽  
D. Chase ◽  
P. Garcia-Fernandez ◽  
F. San Roman ◽  
D. Bennett ◽  
...  
Keyword(s):  
Medical Records ◽  
Incidental Finding ◽  
Weight Bearing ◽  
Sudden Onset ◽  
Tibial Tuberosity ◽  
Tibial Tuberosity Fracture ◽  
Long Term Follow Up ◽  
Surgical Group

SummaryTo retrospectively compare two clinical subsets of dogs suffering tibial tuberosity (TT) fracture (incidental finding or sudden onset severe lameness) as a complication of tibial tuberosity advancement (TTA) and to report the surgical management and outcome of TT fracture as a complication of TTA.The medical records of 10 dogs with eleven TT fractures or crest fractures after TTA were reviewed. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between six and 12 weeks postoperatively. Owners were contacted by phone for long-term follow-up at least six months after the last examination.Four dogs required surgical stabilization and six dogs had conservative management. In the surgical group, every case experienced a sudden non-weight-bearing lameness after the initial TTA surgery. In three of the four cases an attempt was made to stabilize the TT and crest fracture while maintaining the TT advancement. Postoperative complications were encountered in three of the four surgically treated cases. Functional outcome was considered excellent in seven cases and good in the other three.Tibial tuberosity fracture is a complication of TTA that seems to have a favourable prognosis, although it can result in significant morbidity and in some cases revision surgery may be required.

scholarly journals Upper limb phlegmasia cerulea dolens treated with single-session suction thrombectomy: a case report

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Paul Ghaly ◽  
Glen Schlaphoff ◽  
John Crozier ◽  
Mehtab Ahmad
Keyword(s):  
Upper Limb ◽  
Rare Condition ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Single Session ◽  
Vessel Patency ◽  
Clinical Triad ◽  
Phlegmasia Cerulea Dolens

Abstract Phlegmasia cerulea dolens (PCD) of the lower limbs is a rare condition. PCD of the upper limbs is extremely uncommon, with only a select few cases documented in the literature. A complication of severe deep venous thrombosis, PCD, is characterized by the clinical triad of oedema, pain and limb cyanosis. Delays in treatment are associated with high rates of morbidity and mortality. We present a case of sudden-onset upper limb PCD in a 68-year-old man following haemodialysis through a long-term arteriovenous fistula. Prompt diagnosis and rapid initiation of intravenous anticoagulation followed by urgent single-session suction thrombectomy resulted in the successful restoration of vessel patency without any significant adverse sequelae on 3-month follow-up.

scholarly journals Intramedullary spinal cavernoma: clinical presentation, microsurgical approach, and long-term outcome in a cohort of 48 patients

2015 ◽  
Vol 39 (2) ◽  
pp. E19 ◽  
Author(s):  
Matthias Reitz ◽  
Till Burkhardt ◽  
Eik Vettorazzi ◽  
Frank Raimund ◽  
Erik Fritzsche ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Sudden Onset ◽  
Neurological Function ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Progressive Decline ◽  
Spinal Cavernoma ◽  
Long Term Follow Up

OBJECT Intramedullary spinal cavernoma (ISC) is a rare entity and accounts for approximately 5%−12% of all spinal vascular pathologies. The purpose of the present study was to examine the influence of clinical presentation, localization, and different surgical approaches on long-term outcome in patients treated for ISC. METHODS The authors performed a retrospective single-center study of 48 cases of ISC treated microsurgically over the past 28 years. Analyzed factors included preoperative clinical history, microsurgical strategies, neurological outcome (American Spinal Injury Association [ASIA] grade, Epstein and Cooper grade), and the occurrence of postoperative spinal ataxia. Univariate analysis was performed to identify factors influencing long-term outcome. RESULTS Preoperatively, 18.8% of all patients experienced a slow, progressive decline in neurological function and 33.3% suffered repetitive episodes of acute neurological deterioration over a time frame of months to years. Moreover, 16.7% noted the sudden onset of a severe neurological deficit, whereas 25% experienced the sudden onset of symptoms with a subsequent gradually progressive decline in neurological function. On long-term follow-up after treatment (mean ± SD, 79.3 ± 35.2 months), 70.8% of patients showed no change in neurological function, 6.3% suffered from a decline, and 22.9% improved neurologically. Thoracolumbar localization (p = 0.043), low preoperative Epstein and Cooper grade for the lower extremities (p < 0.001), and a low preoperative ASIA grade (p < 0.001) were identified as factors associated with an unfavorable outcome (ASIA Grade A-C). The rate of spinal ataxia related to surgical approach was 16.7%. CONCLUSION Postoperative neurological function in ISC patients is determined by the preoperative neurological status. On long-term follow-up after microsurgical treatment, 93.7% of patients presented with a stable or improved condition (ASIA grade); thus, definite microsurgical treatment should be considered as long as patients present with only mild symptoms after the diagnosis of symptomatic ISC.

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