scholarly journals A Case of Scabies Presenting as Chronic Urticaria

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1854-e1856
Author(s):  
Imelda Muller ◽  
Alyson Brinker
Keyword(s):  
Delayed Diagnosis ◽  
Sarcoptes Scabiei ◽  
Active Duty ◽  
Military Recruits ◽  
Typical Finding ◽  
Missed Diagnosis ◽  
Communal Living ◽  
The Many ◽  
Dermatologic Manifestations ◽  
Military Barracks

Abstract Scabies outbreaks are relatively common worldwide, particularly in communal living settings such as military barracks. The infestation is caused by the parasite Sarcoptes Scabiei and is easily treated once properly diagnosed. Classic symptoms include pruritus around the waist, wrists, and ankles.1 On physical examination, linear burrows visualized in finger web spaces is a typical finding.1 It is not uncommon, however, for scabies to present with a variety of other dermatologic manifestations, which can lead to a delayed or missed diagnosis. This case highlights a delayed diagnosis of scabies, initially presenting as urticaria in a 26-year-old active duty male living in military barracks where multiple previous outbreaks were identified. Providers should be aware of the oftentimes-elusive diagnosis of scabies and the many nonclassic dermatologic manifestations. A thorough skin examination with skin scrapings and examination of the finger web spaces should be considered in those with ambiguous skin rashes who are particularly at risk for scabies infection, such as military recruits, submariners, and other service members living in communal settings. Timely and accurate diagnosis and treatment is crucial to prevent reinfection and spread of scabies throughout these communal living settings.

Esophageal Atresia and Associated Duodenal Atresia: A Cohort Study and Review of the Literature

2020 ◽  
Author(s):  
Maria Enrica Miscia ◽  
Giuseppe Lauriti ◽  
Dacia Di Renzo ◽  
Angela Riccio ◽  
Gabriele Lisi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Esophageal Atresia ◽  
Primary Repair ◽  
English Literature ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Primary Treatment ◽  
Duodenal Atresia ◽  
Staged Approach ◽  
Missed Diagnosis

Abstract Introduction Esophageal atresia (EA) is associated with duodenal atresia (DA) in 3 to 6% of cases. The management of this association is controversial and literature is scarce on the topic. Materials and Methods We aimed to (1) review the patients with EA + DA treated at our institution and (2) systematically review the English literature, including case series of three or more patients. Results Cohort study: Five of seventy-four patients with EA had an associated DA (6.8%). Four of five cases (80%) underwent primary repair of both atresia, one of them with gastrostomy placement (25%). One of five cases (20%) had a delayed diagnosis of DA. No mortality has occurred. Systematic Review: Six of six-hundred forty-five abstract screened were included (78 patients). Twenty-four of sixty-eight (35.3%) underwent primary correction of EA + DA, and 36/68 (52.9%) underwent staged correction. Nine of thirty-six (25%) had a missed diagnosis of DA. Thirty-six of sixty-eight underwent gastrostomy placement. Complications were observed in 14/36 patients (38.9 ± 8.2%). Overall mortality reported was 41.0 ± 30.1% (32/78 patients), in particular its incidence was 41.7 ± 27.0% after a primary treatment and 37.0 ± 44.1% following a staged approach. Conclusion The management of associated EA and DA remains controversial. It seems that the staged or primary correction does not affect the mortality. Surgeons should not overlook DA when correcting an EA.

scholarly journals Case for diagnosis

2013 ◽  
Vol 88 (5) ◽  
pp. 826-827 ◽  
Author(s):  
Rita Cabral ◽  
Ines Coutinho ◽  
Jose Pedro Reis
Keyword(s):  
Direct Contact ◽  
Delayed Diagnosis ◽  
Daily Practice ◽  
Sarcoptes Scabiei ◽  
Rare Form ◽  
Direct Microscopic Examination ◽  
Visible Hand ◽  
Crusted Scabies ◽  
Prompt Diagnosis ◽  
Pruritic Skin

Human scabies is an intensely pruritic skin infestation caused by Sarcoptes scabiei var. hominis. Crusted scabies (previously known as Norwegian scabies) is a rare form, very contagious and transmitted by direct contact with the skin. Despite being readily treatable, a delayed diagnosis often leads to widespread infestation of contacts, and therefore difficult to restrain. This case concerns a patient where dermoscopy (with scabetic burrows and a visible hand-glider structure), together with direct microscopic examination, allowed a prompt diagnosis, thereby reinforcing the increasing importance of this technique in daily practice.

scholarly journals Missed Diagnosis of Cholangiocarcinoma Presenting with Atypical Symptoms

2021 ◽  
Author(s):  
Ren Kawamura ◽  
Yukinori Harada ◽  
Taro Shimizu
Keyword(s):  
Abdominal Pain ◽  
Distribution Pattern ◽  
Diagnostic Test ◽  
Acute Abdominal Pain ◽  
Delayed Diagnosis ◽  
Referred Pain ◽  
Good Communication ◽  
Atypical Symptoms ◽  
Missed Diagnosis ◽  
Prompt Diagnosis

We report a case of delayed diagnosis of cholangiocarcinoma. A 62-year-old man developed acute abdominal pain in multiple sites. As the distribution pattern of the abdominal pain was not correctly interpreted based on the mechanisms of visceral and referred pain, the patient was not investigated with the best diagnostic test at first presentation. Moreover, miscommunication between physicians in a clinic and separate hospital delayed diagnosis. For prompt diagnosis, physicians should be practice careful reasoning and focus on good communication with physicians outside their hospital.

Giant coronary artery aneurysms in Kawasaki disease: the cost of a missed diagnosis

2013 ◽  
Vol 23 (4) ◽  
pp. 608-609
Author(s):  
Liliana Marta ◽  
Andreia Francisco ◽  
Rui Anjos
Keyword(s):  
Risk Factor ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Delayed Diagnosis ◽  
Severe Complication ◽  
Coronary Artery Aneurysms ◽  
Coronary Aneurysms ◽  
Appropriate Treatment ◽  
Missed Diagnosis ◽  
The Cost

AbstractGiant coronary aneurysms secondary to Kawasaki disease are rare, but a very severe complication. Delayed diagnosis and appropriate treatment of the disease is a well-known risk factor for coronary aneurysms.

scholarly journals Surgical Treatment for Delayed Ulnar Carpometacarpal Fracture–Dislocations

2019 ◽  
Vol 09 (03) ◽  
pp. 235-239
Author(s):  
Jiro Kato ◽  
Masaya Tsujii ◽  
Yukie Kitaura ◽  
Akihiro Sudo
Keyword(s):  
Surgical Treatment ◽  
Grip Strength ◽  
Delayed Diagnosis ◽  
Fracture Dislocation ◽  
Unaffected Side ◽  
Carpometacarpal Joints ◽  
Early Motion ◽  
Hand Grip ◽  
Fracture Dislocations ◽  
Missed Diagnosis

Background Fracture and dislocations of the carpometacarpal (CMC) joints except the thumb are relatively rare. Herein, we report the case of a delayed fracture–dislocation of fourth and fifth carpometacarpal joints. Case Description The patient is a 41-year-old, right-handed male. To improve the complaints, such as decreased motion, reduced grip strength, and cosmetic appearance, surgical treatment surgically performed with resection of scar tissues and fixation using suture button at 11 weeks after injury. Movement began at 2 weeks after the surgery, which resulted in satisfactory appearance and good function of 92 and 101% of the motion of the unaffected side of the fifth CMC joint and grip strength, respectively. Literature Review Missed diagnosis can cause impairment of function including grip strength and range of motion. Nevertheless, a few previous studies reported that patients with delayed diagnosis did not need further treatment because of less functional loss and less improvement. Clinical Relevance The surgical treatment using the implant allowed early motion from 2 weeks after surgery which resulted in good motion of the ulnar CMC joints as well as increased hand grip.

scholarly journals 1103 Understanding the Role of Sleep as a Risk Factor for Suicidal Ideation in Active Duty Service Members

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A419-A420
Author(s):  
M M Paxton Willing ◽  
T C Pickett ◽  
L L Tate ◽  
C Rhodes ◽  
T DeGraba
Keyword(s):  
Heart Rate ◽  
Suicidal Ideation ◽  
Active Duty ◽  
Service Members ◽  
Health Concern ◽  
Sleep Study ◽  
Increased Risk ◽  
The Many ◽  
Subjective Reports

Abstract Introduction Suicide is an important public health concern with many factors contributing to increased risk. Sleep is one such factor that may elevate risk, yet this association is not well understood. By identifying the strongest sleep-related predictors of suicidal ideation (SI), providers may be able to better intervene and reduce risk of suicide. Methods Data were obtained from the clinical database at the National Intrepid Center of Excellence (NICoE). Patients were active duty service members, predominantly male, and with a mean age of 38. As part of standard care, patients receive a polysomnography sleep study and complete a battery of intake measures offering a comprehensive view of sleep. Individual symptoms were analyzed in an effort to understand the role of each sleep symptom within the context of the many other factors that may contribute to SI in service members. Results Of the many data points collected during polysomnography, only rapid eye movement (REM) sleep latency and minimum sleeping heart rate were related to SI. REM latency was associated with increased odds of SI, while minimum sleeping heart rate was related to decreased odds. Subjective reports of bad dreams, trauma-specific bad dreams, sleepiness, and sleep quality were related to increased odds of SI. Notably, subjective reports of sleep were associated with greater odds than objective measures. Traumatic nightmares had the greatest odds, with these patients being much more likely to have SI. Conclusion These results support the importance of considering sleep factors when evaluating SI in service members. Subjective sleep reports, specifically, appear to be particularly important, as they were associated with increased odds of SI. These findings focus on the role of individual sleep factors in increasing the odds of SI and suggest it is important to evaluate sleep in combination with comorbid conditions when conducting risk assessments. Support N/A

scholarly journals IoT-Based Skin Monitoring System

2020 ◽  
Vol 8 (5) ◽  
pp. 4258-4264
Keyword(s):  
Skin Diseases ◽  
Correct Diagnosis ◽  
Delayed Diagnosis ◽  
Environmental Sensors ◽  
Technological Advances ◽  
Common Skin ◽  
Treatment Facilities ◽  
The Many ◽  
The Impact

The numbers of patients with skin diseases reported a dramatic increase which is a major concern and must be dealt with. The method of diagnosis is always based on physician’s observations and experiences. Many common symptoms such as side effects, allergies and even risks of skin cancer can be seen in someone following misdiagnosis, delayed diagnosis and failure to diagnose. The evaluation of skin changes is crucial to the correct diagnosis during follow-up. Through technological advances and partnerships, skin disorders can be identified and predicted and medical diagnosis outside physical limits are made. The article proposed an IoT-based skin surveillance system that facilitates the monitoring of skin patients in remote locations. In a diagnostic device for real-time skin monitoring and analysis, the proposed system architecture can be applied. A sensor fitted medical carriage is proposed in a remote location to treat individuals suffering from a common skin disorder. The system is also designed to research the impact of climate change on the disease through environmental sensors and provide pre-alertfor prevention. This addresses the many problems that people in remote areas without restricted treatment facilities face.

Long Cheng Air

2019 ◽  
pp. 73-97
Author(s):  
Chia Youyee Vang
Keyword(s):  
Active Duty ◽  
Poor Quality ◽  
Military Leaders ◽  
Close Proximity ◽  
The Many ◽  
Secret War

Chapter 4 details Hmong experiences in combat aviation in the Secret War. It examines the dangerous flying conditions they faced in northern Laos, where, in addition to enemy antiaircraft artillery, freak accidents claimed the lives of some pilots. Poor quality aircraft, a hazardous runway, problematic leadership at all levels, and varied skills resulted in low chances for survival for Hmong pilots. Because of their close proximity to enemy territories, pilots on active duty from 1968 to 1972 were forced to participate in combat missions daily. The chapter also presents the many problems that unfolded in the CIA’s secret city, Long Cheng. Whereas American airmen came and went on tours of duty, Hmong pilots flew until they were either killed in action or injured. Either outcome harmed their families. Injured pilots were no longer considered useful, resulting in military leaders cutting them off financially and socially.

Paediatric eosinophilic oesophagitis presenting to the otolaryngologist

2009 ◽  
Vol 124 (1) ◽  
pp. 96-100 ◽  
Author(s):  
R Harris ◽  
S Mitton ◽  
S Chong ◽  
H Daya
Keyword(s):  
Delayed Diagnosis ◽  
Food Impaction ◽  
Food Bolus ◽  
Eosinophilic Oesophagitis ◽  
Oesophageal Stricture ◽  
Pubmed Search ◽  
Missed Diagnosis ◽  
Food Bolus Impaction ◽  
Bolus Impaction ◽  
Paediatric Gastroenterologist

AbstractIntroduction:The prevalence of eosinophilic oesophagitis is increasing. A Pubmed search for ‘eosinophilic oesophagitis’ and ‘eosinophilic esophagitis’ yielded 345 publications since 1976. Only seven were in otolaryngology journals.1–7Patients typically present with dysphagia, vomiting, dyspepsia or food impaction and are therefore usually referred to a paediatric gastroenterologist; otolaryngologists are not usually involved in management. A missed diagnosis may result in oesophageal stricture.Methods:Two patients, aged two and four years, were referred to the paediatric otolaryngology department with intermittent upper oesophageal food impaction. A paediatric gastroenterologist was involved in the investigation. Histological examination of oesophageal biopsies demonstrated changes consistent with eosinophilic oesophagitis.Results:Both patients were expediently diagnosed, investigated and managed.Conclusion:A diagnosis of eosinophilic oesophagitis must be considered in patients presenting with food bolus impaction. Early involvement of a paediatric gastroenterology team in the diagnosis is recommended in children presenting with oesophageal symptoms, in order to avoid delayed diagnosis.

scholarly journals Intraorbital wooden foreign bodies: case series and literature review

2021 ◽  
Vol 14 (10) ◽  
pp. 1619-1627
Author(s):  
Ya-Yan You ◽  
◽  
Xin-Yan Wang ◽  
Jin Chen ◽  
Zheng-Rong Wang ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Case Reports ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Aged People ◽  
Imaging Characteristics ◽  
Close Observation ◽  
Missed Diagnosis ◽  
Magnetic Resonance Imaging Mri

Intraorbital wooden foreign bodies (IOWFBs) constitute a relatively rare ocular trauma, which occupy a special type of intraorbital foreign bodies (IOFBs). Data regarding IOWFBs must be obtained from case reports or small case series due to their rarity. Here, we reported 5 cases of IOWFBs and reviewed the related literatures, which could provide comprehensive information regarding the clinical manifestations, diagnosis, and surgical treatment of IOWFBs. Combined with the published literature, a total of 51 independent cases were counted after we added 5 cases. Among them, the number of male and female patients was 35 and 16 respectively; the mean age was 27.3±18.2 (range 1-66)y. Obviously, the disorder seemed to occur mainly in young and middle-aged people. Because of the diversity in the clinical manifestations and imaging characteristics of IOWFBs, misdiagnosis and missed diagnosis often occur during the initial visit. Delayed diagnosis may lead to a high risk of orbital infection caused by IOWFBs. Surgery is the treatment of choice for most patients; however, the missed diagnosis and residue of foreign bodies after previous surgery cannot be ignored. Therefore, an accurate diagnosis is governed by the detailed trauma history, careful ocular examination, close observation of clinical manifestations, correct imaging diagnosis [e.g., magnetic resonance imaging (MRI) or computerized tomography (CT)], and timely and completely elimination of IOWFBs.

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