scholarly journals Recurrent Encephalopathy with Transverse Myelitis: An Uncommon Presentation of Neurobrucellosis

2019 ◽  
Vol 10 (04) ◽  
pp. 703-706
Author(s):  
Ravi K. Anadure ◽  
Jitesh Goel ◽  
S. Sahu ◽  
Tushar Vidhale
Keyword(s):  
Transverse Myelitis ◽  
Elderly Male ◽  
Diagnostic Dilemma ◽  
Uncommon Presentation ◽  
Increasing Trend ◽  
History Of ◽  
Malta Fever ◽  
Unusual Occurrence ◽  
Cranial Neuropathies ◽  
Abattoir Worker

AbstractBrucellosis (malta fever) is a zoonotic infection caused by a gram-negative coccobacillus which is a facultative intracellular pathogen. It causes a chronic granulomatous infection, similar in histology to tuberculosis. Brucellosis remains a diagnostic dilemma due to misleading, nonspecific manifestations and increasing trend of unusual presentations. In brucellosis, the nervous system involvement occurs in only 5 to 7% of untreated patients, and it may manifest with encephalitis, meningoencephalitis, radiculitis, and peripheral and cranial neuropathies. Transverse myelitis is an unusual occurrence. Here, the authors are reporting an unusual case of neurobrucellosis in an elderly male patient who visited multiple hospitals with recurring febrile encephalopathy and paraparesis. The diagnosis was suspected by his occupational history of working as an abattoir worker and was confirmed by the presence of high titers of Brucella immunoglobulin (Ig) M and IgG antibodies in the serum. The patient was managed with injection gentamicin for 2 weeks along with oral course of doxycycline and rifampicin for 6 weeks. He made a good clinical recovery and went back to work with mild residual deficits.

Left ventricular apical mass after myocardial infarction—not always a thrombus: a diagnostic dilemma

2021 ◽  
Vol 14 (10) ◽  
pp. e245963
Author(s):  
Jayanty Venkata Balasubramaniyan ◽  
Judah Nijas Arul ◽  
Jebaraj Rathinasamy ◽  
Thangavel Periyasamy
Keyword(s):  
Myocardial Infarction ◽  
Systolic Dysfunction ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Prior History ◽  
Surgical Removal ◽  
Diagnostic Dilemma ◽  
Echocardiographic Evaluation ◽  
Lv Mass ◽  
History Of

Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.

Psoas Abscess: Diagnosis and Treatment

2006 ◽  
Vol 5 (1) ◽  
pp. 13-16
Author(s):  
Raj Kandasamy ◽  
◽  
Asha Srikanth ◽  
SM Rutter ◽  
CJ Butcher ◽  
...  
Keyword(s):  
Clinical Features ◽  
Case History ◽  
Diagnostic Tests ◽  
Psoas Abscess ◽  
Diagnosis And Treatment ◽  
Uncommon Presentation ◽  
Appropriate Treatment ◽  
History Of

Psoas abscess is an uncommon presentation on the acute medical take. However recognition and appropriate treatment is essential. This review is designed to highlight the clinical features, microbiology, diagnostic tests and treatment for this condition. In order to illustrate some of the pitfalls and complexities in the management of psoas abscess we have included a case history of a patient who was recently treated in our department.

scholarly journals Tubulocystic renal cell carcinoma: Report of a rare case

2015 ◽  
Vol 9 (9-10) ◽  
pp. 654 ◽  
Author(s):  
Aanchal Kakkar ◽  
Mehar C. Sharma ◽  
Manpreet Uppal ◽  
Sunil Chumber
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Histopathological Examination ◽  
Cystic Neoplasm ◽  
Diagnostic Challenge ◽  
Elderly Male ◽  
Diagnostic Dilemma ◽  
Cystic Neoplasms ◽  
Atypical Cells

Cystic neoplasms of the kidney are rare, and present a unique diagnostic challenge. We report the case of an elderly male who presented with a large cystic neoplasm, which was a diagnostic dilemma clinically and radiologically. Histopathological examination showed a tumour composed of variably sized tubules lined by atypical cells having large round nuclei with prominent nucleoli. Hobnailing was seen at places. Tumour cells were immunopositive for pancytokeratin, vimentin, CD10, CK19 and AMACR, confirming a diagnosis of tubulocystic renal cell carcinoma (TC-RCC).

Rare case of perforated appendicitis presenting as persistent perineal discharge following laparoscopic abdominoperinal excision of rectum (APER)

2021 ◽  
Vol 14 (1) ◽  
pp. e236312
Author(s):  
Tanmoy Mukherjee ◽  
Shantata Jayant Kudchadkar ◽  
Jayesh Sagar ◽  
Shashank Gurjar
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Perforated Appendicitis ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Major Surgery ◽  
Salvage Procedure ◽  
Uncommon Presentation ◽  
Rare Case Report ◽  
History Of

Abdominoperineal excision of rectum (APER) is one of the widely used surgical procedures to treat low rectal cancer, benign conditions like Crohn’s proctitis with anal involvement and as a salvage procedure for anal cancer. Perineal wound infection is a well-recognised complication following such major surgery. Occurrence of appendicitis in a few weeks’ time following such a major surgery is uncommon. However, here we present a rare case report of perforated appendicitis presenting as persistent perineal discharge in an elderly man, following laparoscopic APER for a low rectal tumour. To our knowledge, this is the first time such a rare clinical presentation of appendicitis is reported in the history of medical literature. Through this case report, we aim to highlight the importance of considering such an uncommon presentation in patients with perineal discharge, following APER.

Diagnostic dilemma of isolated fallopian tube torsion

2021 ◽  
Vol 14 (7) ◽  
pp. e242682
Author(s):  
Michael Gerard Baracy Jr ◽  
Janie Hu ◽  
Holly Ouillette ◽  
Muhammad Faisal Aslam
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Differential Diagnoses ◽  
Adnexal Torsion ◽  
Normal Appendix ◽  
Diagnostic Dilemma ◽  
Perimenopausal Women ◽  
Adolescent Patients ◽  
History Of

Paratubal cysts are fluid-filled sacs that grow adjacent to the fallopian tube which can rarely result in torsion. Isolated fallopian tube torsion (IFTT) is a gynaecological emergency that warrants urgent laparoscopic detorsion to salvage the affected tube. IFTT has a proclivity to affect adolescents between the ages of 12 and 15 years and is rarely seen in premenarchal or perimenopausal women. Due to a lack of pathognomonical features, IFTT is difficult to diagnose. Adnexal torsion, including IFTT is a surgical diagnosis and no clinical or imaging criteria is sufficient to diagnose IFTT. Urgent laparoscopy and detorsion are required for preservation of the affected fallopian tube. However, given the diagnostic ambiguity, IFTT diagnosis is often delayed. IFTT should be included in the differential diagnoses for adolescent patients with acute abdomen when imaging demonstrates a normal appendix and ovaries. We report a 15-year-old girl with a 4-day history of abdominopelvic pain and bilateral paratubal cysts resulting in right IFTT.

scholarly journals Pleomorphic Adenoma Presenting as an Atypical Nasal Mass in a 26-Year-Old Female

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Racheal Hapunda ◽  
Chibamba Mumba ◽  
Owen Ngalamika
Keyword(s):  
Nasal Cavity ◽  
Pleomorphic Adenoma ◽  
Salivary Gland Tumor ◽  
Rare Entity ◽  
Gland Tumor ◽  
Diagnostic Dilemma ◽  
Nasal Blockage ◽  
History Of ◽  
The Right ◽  
Radiological Image

Pleomorphic adenoma (PA) is a salivary gland tumor that may rarely occur in the nasal cavity. It can be a clinical diagnostic dilemma in many instances due to many possible differential diagnoses. We report the case of a 26-year-old female who presented with a 3-year history of a right nasal growth associated with ipsilateral nasal blockage, nasal pain, and rhinorrhea. Radiological image showed a mild enhancing lesion in the right nasal cavity. The patient underwent a lateral rhinotomy with wide excision of the mass. Histopathological exam was consistent with PA. Nasal PA is a rare entity and should be suspected as a diagnosis for intranasal tumors.

scholarly journals Metastatic Primary Gastric Squamous Cell Carcinoma: An Uncommon Presentation of a Rare Malignancy

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Michael Beattie ◽  
Ramy Mansour ◽  
Derek Thigpin ◽  
Carolyn Haus
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Upper Endoscopy ◽  
Poor Appetite ◽  
Nicotine Abuse ◽  
Uncommon Presentation ◽  
History Of ◽  
Gastric Mass ◽  
Rare Malignancy

Primary gastric squamous cell carcinoma is a very rare disease. A 53-year-old male with history of hypertension, alcoholism, and nicotine abuse presented to the hospital after a syncopal episode. He complained of bloating abdominal pain, early satiety, and poor appetite. A CT of his abdomen and pelvis revealed a gastric mass with diffuse hepatic metastasis. A gastric mass was seen on upper endoscopy and biopsies revealed gastric squamous cell carcinoma. There was no involvement of the esophagus. This case should add to the limited literature and serve as a reminder that while this is a rare malignancy, it must be considered when evaluating a gastric mass.

scholarly journals Resection of a colonic mass following trauma: a diagnostic dilemma

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Paul Burchard ◽  
Alan A Thomay
Keyword(s):  
Ct Scan ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Symptomatic Improvement ◽  
Diagnostic Dilemma ◽  
Vehicle Accident ◽  
Abdomen Ct ◽  
History Of ◽  
Mitotic Figures ◽  
The Right

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.

scholarly journals Small bowel volvulus versus adhesive small bowel obstruction: a diagnostic dilemma in a 19-year-old woman

2019 ◽  
Vol 12 (6) ◽  
pp. e229157
Author(s):  
Kay Tai Choy ◽  
Nathan Brunott
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Adhesive Small Bowel Obstruction ◽  
Diagnostic Study ◽  
Diagnostic Dilemma ◽  
Small Bowel Volvulus ◽  
Intraabdominal Adhesions ◽  
Preoperative Diagnostic ◽  
History Of

Small bowel volvulus (SBV) is often challenging to diagnose. Research suggests that the clinical presentation of this disease is often very similar to other more common causes of small bowel obstruction (SBO) such as intraabdominal adhesions and no single preoperative diagnostic study is sensitive or specific enough to identify this rare cause of mechanical SBO. This report describes a case of a 19-year-old woman who presented with irretractable vomiting and abdominal pain secondary to SBV. This case is unusual as her history of recurrent adhesive SBO presented a diagnostic dilemma that required a higher degree of clinical suspicion to tease these differential diagnoses apart. She underwent laparoscopy which facilitated successful detorsion and resection of the floppy tongue of jejunum. This report aims to increase the awareness among surgeons.

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