scholarly journals 346. Head to Toe Imaging of Complications and Sequelae of COVID- 19 and COVID-19 Vaccination

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S277-S278
Author(s):  
Deepti H Vijayakumar ◽  
Deepali Saxena ◽  
Rajesh V Helavar ◽  
Raghavendra Tirupathi
Keyword(s):  
Neurological Complications ◽  
Hypercoagulable State ◽  
Ground Glass ◽  
Arterial Phase ◽  
Cardiac Complications ◽  
Fungal Sinusitis ◽  
Gastrointestinal Complications ◽  
Secondary Infections ◽  
The Right ◽  
Lung Window

Abstract Background COVID 19 is associated with a hypercoagulable state with cytokine storm syndrome and thrombocytopenia leading to complications across various systems. COVID-19 infection, its treatment, resultant immunosuppression, and pre-existing comorbidities have made patients vulnerable to secondary infections Methods We systematically reviewed COVID-19 cases between Jan to May 2021 for pulmonary and extrapulmonary complications. Patients with recent COVID-19 vaccination and neurological symptoms were also included. Figure 1. “Black turbinate” sign of mucormycosis Contrast enhanced coronal T1 FS images of paranasal sinuses shows necrotic non-enhancing right superior and middle turbinates (*) with extension into the right orbital fat. FIGURE 2 - A composite image of Coronal CT of upper abdomen in arterial phase and lung bases in lung window showing wedge showing right renal infarcts (line arrow) due to inferior polar artery thrombosis and ground glass opacities (solid arrow) in lung bases. Results Neurological complications: Neurological complications include ischemic and haemorrhagic strokes. Other complications are encephalopathy, encephalitis, Guillain-Barré syndrome, acute hemorrhagic necrotizing encephalopathy. Demyelination and radiculopathies are seen as post vaccination complications. Mucormycosis: Unprecedented high rate of invasive fungal sinusitis in association with COVID -19 is reported from the Indian subcontinent. This has a propensity for intra orbital and intracranial extension. COVID -19 associated coagulopathy: COVID -19 is a pro-inflammatory hypercoagulable state. Pulmonary thromboembolism, deep venous thrombosis and catheter related thrombosis are well documented. Cardiac complications: Cardiac manifestations include Myocardial Injury with non-obstructed coronary arteries (MINOCA), myocarditis, myocardial ischemia, cardiomyopathy. Pulmonary complications and sequelae of COVID -19: Progression of lung injury to ARDS during the initial phase and fibrosis of parenchyma in the recovery phase. Spontaneous pneumomediastinum, pneumatoceles and pneumothorax and secondary infections are identified in our study. COVID- 19 associated gastrointestinal complications: Patients evaluated for renal colic, pancreatitis, cholecystitis showed, ground glass opacities or subpleural bands in typical Covid-19 distribution. COVID-19 may lead of acute kidney and bowel injury due to arterial thrombosis. COVID - 19 associated myonecrosis: Ischemia of the small caliber vessels may result in myonecrosis. FIGURE 3 - Coronal STIR image shows thickened and hyperintense trunks and divisions of the right brachial plexus suggestive of plexopathy in a COVID -19 patient with H/O recent COVID-19 vaccination. Figure 4. Axial CT chest section in lung window showing pneumothorax (white arrow) and pneumatocele ( grey arrow) with peripheral ground glass opacities and consolidations in both lungs. Conclusion Awareness of these unusual manifestations will facilitate an early diagnosis, improve management and help reduce morbidity and mortality Disclosures All Authors: No reported disclosures

scholarly journals Primary Gastrointestinal Stromal Tumor of the Liver with Cystic Changes

2019 ◽  
Vol 13 (1) ◽  
pp. 58-65
Author(s):  
Takashi Tashiro ◽  
Fumihiro Uwamori ◽  
Yukiomi Nakade ◽  
Tadahisa Inoue ◽  
Yuji Kobayashi ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Past History ◽  
Brain Infarction ◽  
Arterial Phase ◽  
First Case ◽  
Positron Emission ◽  
Cystic Changes ◽  
Multiple Bone Metastases ◽  
The Right ◽  
Cells Of Cajal

Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the internal tumor sites. Both liver tumors had cystic changes. Gastrointestinal examinations using endoscopy revealed no other gastrointestinal tumors, and [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed multiple bone metastases in addition to the liver tumors. The liver tumor specimens were composed of spindle cells, and the immunohistochemical staining for c-Kit and for DOG1, as discovered on GIST, was positive. The patient was diagnosed with primary hepatic GIST with cystic changes.

1. Fatal Acute Hepatitis in Infectious Mononucleosis in a Forensic Setting

2005 ◽  
Vol 45 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Anny Sauvageau ◽  
Stéphanie Racette
Keyword(s):  
Acute Hepatitis ◽  
Infectious Mononucleosis ◽  
Splenic Rupture ◽  
Upper Airway ◽  
Neurological Complications ◽  
Bleeding Complications ◽  
Respiratory Obstruction ◽  
First Case ◽  
Secondary Infections ◽  
Forensic Setting

Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.

scholarly journals Neurological complications after H1N1 influenza vaccination: magnetic resonance imaging findings

2014 ◽  
Vol 72 (7) ◽  
pp. 496-499 ◽  
Author(s):  
Ronaldo Lessa ◽  
Maurício Castillo ◽  
Renata Azevedo ◽  
Fernanda Azevedo ◽  
Hildo Azevedo
Keyword(s):  
Facial Palsy ◽  
H1n1 Virus ◽  
Altered Mental Status ◽  
H1n1 Influenza ◽  
Neurological Complications ◽  
Abrupt Onset ◽  
Resonance Imaging ◽  
Post Vaccination ◽  
Peripheral Facial Palsy ◽  
The Right

Objective: To report 4 different neurological complications of H1N1 virus vaccination. Method: Four patients (9, 16, 37 and 69 years of age) had neurological symptoms (intracranial hypertension, ataxia, left peripheral facial palsy of abrupt onset, altered mental status, myelitis) starting 4-15 days after H1N1 vaccination. MRI was obtained during the acute period. Results: One patient with high T2 signal in the cerebellum interpreted as acute cerebellitis; another, with left facial palsy, showed contrast enhancement within both internal auditory canals was present, however it was more important in the right side; one patient showed gyriform hyperintensities on FLAIR with sulcal effacement in the right fronto-parietal region; and the last one showed findings compatible with thoracic myelitis. Conclusion: H1N1 vaccination can result in important neurological complications probably secondary to post-vaccination inflammation. MRI detected abnormalities in all patients.

scholarly journals Neurological Complications of Middle East Respiratory Syndrome Coronavirus: A Report of Two Cases and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Hussein Algahtani ◽  
Ahmad Subahi ◽  
Bader Shirah
Keyword(s):  
Middle East ◽  
Neurological Complications ◽  
Critical Illness Polyneuropathy ◽  
Asymptomatic Infection ◽  
Middle East Respiratory Syndrome ◽  
Systemic Complications ◽  
Gastrointestinal Complications ◽  
Icu Stay ◽  
Pathological Mechanism ◽  
Respiratory Tract Illness

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first discovered in September 2012 in Saudi Arabia. Since then, it caused more than 1600 laboratory-confirmed cases and more than 580 deaths among them. The clinical course of the disease ranges from asymptomatic infection to severe lower respiratory tract illness with multiorgan involvement and death. The disease can cause pulmonary, renal, hematological, and gastrointestinal complications. In this paper, we report neurological complications of MERS-CoV in two adult patients, and we hypothesize the pathophysiology. The first patient had an intracerebral hemorrhage as a result of thrombocytopenia, disseminated intravascular coagulation, and platelet dysfunction. The second case was a case of critical illness polyneuropathy complicating a long ICU stay. In these cases, the neurological complications were secondary to systemic complications and long ICU stay. Autopsy studies are needed to further understand the pathological mechanism.

scholarly journals Rare Cardiac Mass Assessed by Cardiac Magnetic Resonance

2019 ◽  
Vol 16 (6) ◽  
pp. 77-79
Author(s):  
Sebastian Militaru ◽  
Bernhard Gerber
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Involvement ◽  
Specific Treatment ◽  
Cardiac Mass ◽  
Cardiac Complications ◽  
Erdheim Chester Disease ◽  
The Right ◽  
Erdheim Chester ◽  
Chester Disease

AbstractA 43 year old male was referred to our center for assessment of the cardiac involvement in Erdheim-Chester disease (EHD) by cardiac magnetic resonance (CMR). The patient presented with a history of bone involvement as well as retroperitoneal mass, demonstrated to consist fibrosis as well as histiocyte infiltration.The CMR examination included cine (SSFP – steady state free procession), T1 weighted (T1w) and T2 weighted (T2w) sequences, as well as late enhancement images 10 minutes after gadolinium based contrast injection (0.2 mmol/kg). The acquired images showed normal dimensions and function for both right and left cardiac chambers. However, a cardiac mass was revealed in the free wall of the right atrium and the junction with the right ventricle, with clear borders and a diameter of 2.5 cm (Image 1). The tissue was best viewed on axial sequences and was isointense on cine, T1w and T2w images and was mildly enhanced on LGE images. Consequently, the diagnosis of cardiac involvement in EHD was confirmed. The patient was started on specific treatment for EHD and 3-year CMR follow-up showed regression of cardiac involvement.Erdheim-Chester disease is a rare disorder most frequently characterized by non-Langerhans histiocytic multifocal osteosclerotic lesions, with multisystemic granulomatosis and widespread manifestations, as well as highly variable severity(1). ECD affects the cardiovascular system in 75% of patients with infiltration of the pericardium and the right atrioventricular septum being the most common presentation. Typically the mass appears isointense on T1 and T2 weighted images and has low contrast enhancement, as was the case in our patient. In approximately 60% of cases death occurs because of cardiac complications, like pericardial tamponade, myocardial infarction, cardiomyopathy or arrhythmias(2). Patients may sometimes be successfully treated with biologic therapy, interferon alpha or radiotherapy.

Pneumatosis Intestinalis In Childhood Dermatomyositis

PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 711-712
Author(s):  
Miguel A. Oliveros ◽  
John J. Herbst ◽  
Patrick D. Lester ◽  
Fred A. Ziter
Keyword(s):  
Abdominal Pain ◽  
Muscle Wasting ◽  
Progressive Systemic Sclerosis ◽  
Pneumatosis Intestinalis ◽  
Gastrointestinal Complications ◽  
Benign Condition ◽  
History Of ◽  
The Right ◽  
Subcutaneous Calcification ◽  
Childhood Dermatomyositis

The gastrointestinal complications of dermatomyositis are well known. Reviews, however, do not mention pneumatosis intestinalis in this disorder).1-3 Although noted in progressive systemic sclerosis,4-7 its association with dermatomyositis has been documented in only one case,5 unreported in the pediatric literature. It is important to distinguish this apparently benign condition from pneumoperitoneum secondary to intestinal perforation, which is a grave complication of dermatomyositis.1 CASE REPORT W. W., an 8-8/12-year-old girl with a three-year history of dermatomyositis with prominent skin rash, disseminated subcutaneous calcification, muscle wasting and induration, also complained of occasional abdominal pain, recently localized to the right hypochondriurn and right shoulder. Inspite of continuous prednisone treatment and intermittent trials of azathioprine, methotrexate, and cyclophosphamide the patient's disease failed to remit.

Case 17.10

2014 ◽  
pp. 811-812
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Equilibrium Phase ◽  
Arterial Phase ◽  
Hepatic Lobe ◽  
The Right

54-year-old man with cirrhosis Axial precontrast 3D SPGR image (Figure 17.10.1A) demonstrates a nodular hepatic contour and moderate splenomegaly. Postgadolinium arterial (Figure 17.10.1B), portal venous (Figure 17.10.1C), and equilibrium phase (Figure 17.10.1D) images reveal a finger superimposing the left side of the abdomen (and pointing toward 2 arterial phase enhancing nodules in the periphery of the right hepatic lobe). Axial 2D SPGR image (...

Case 12.21

2014 ◽  
pp. 604-605
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Signal Intensity ◽  
Posterior Margin ◽  
Positive Margin ◽  
Robotic Prostatectomy ◽  
Arterial Phase ◽  
The Past ◽  
Endorectal Coil ◽  
The Right ◽  
P 53

53-year-old man who underwent robotic prostatectomy 4 years ago with a small positive margin in the right apex; PSA was initially zero postoperatively, but it has been slowly increasing in the past year Axial (Figure 12.21.1) and sagittal (Figure 12.21.2) T2-weighted FRFSE images obtained with an endorectal coil demonstrate a lobulated mass with mildly increased signal intensity along the right posterior margin of the bladder outlet extending inferiorly into the prostatectomy bed. Axial arterial phase postgadolinium 3D SPGR images (...

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