Bilateral Facial Paralysis: Case Presentation and Discussion of Differential Diagnosis

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.

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Uptake of exogenous estrogen as a differential diagnosis of ovarian-remnant-syndrome in a bitch: a case report

BMC Veterinary Research ◽

10.1186/s12917-021-02923-9 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Sebastian Ganz ◽

Axel Wehrend

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Luteinizing Hormone ◽

Clinical Signs ◽

Menopausal Symptoms ◽

Case Presentation ◽

Estrogen Exposure ◽

Exogenous Estrogen ◽

Endocrine Parameters

Abstract Background Clinical signs of heat in bitches that have been previously spayed are often associated with the presence of ovarian remnant syndrome. The inclusion of exogenous estrogens as a differential diagnosis in this regard is often ignored and may lead to misinterpretation of the case. Case presentation Herein, we report a case of exogenous estrogen exposure over several months to a 6.5-year-old spayed crossbred bitch, weighing 8.4 kg. The bitch presented in the clinic because of suspected ovarian remnant syndrome. Castration was performed within the first 6 months after birth. Important endocrine parameters measured at the first appointment were Anti-Müllerian hormone (< 0.01 ng/mL), progesterone (0.36 ng/mL), estradiol-17ß (20.7 pg/mL), and luteinizing hormone (< 0.1 ng/mL). After an extensive conversation with the owner, it was revealed that she was using an estrogen spray because of severe menopausal symptoms. After the owner stopped using this spray, the symptoms of the bitch disappeared. Conclusion Therefore, the uptake of estrogens should be a differential diagnosis for symptoms of the ovarian remnant syndrome. A detailed anamnesis is crucial to identify the source of estrogen in the environment of the affected bitch.

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Neonate born with ischemic limb to a COVID-19 positive mother: management and review of literature

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2020-0086 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Shahana Perveen ◽

Karmaine A. Millington ◽

Suchitra Acharya ◽

Amit Grag ◽

Vita Boyar

Keyword(s):

Differential Diagnosis ◽

Compartment Syndrome ◽

Upper Extremity ◽

Preterm Neonate ◽

Review Of Literature ◽

Case Presentation ◽

Ischemic Limb ◽

History Of ◽

Hand Amputation ◽

Work Up

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.

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Vici syndrome in an Egyptian infant: case report and differential diagnosis of inherited hypopigmented disorders

Egyptian Journal of Medical Human Genetics ◽

10.1186/s43042-020-00103-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Marwa Abd Elmaksoud ◽

Aya Attya Abeesh ◽

Catarina Pereira ◽

Marwa El-Saeed El-Deeb

Keyword(s):

Differential Diagnosis ◽

Corpus Callosum ◽

Clinical Decision Making ◽

Clinical Decision ◽

Phenotype Correlation ◽

Multisystem Disease ◽

Case Presentation ◽

Correlation Studies ◽

Clinical Description ◽

Infant Case

Abstract Background Vici syndrome is a severe inherited multisystem disease caused by mutations in the EPG5 gene. The diagnosis depends on the constellation of cardinal features of agenesis of the corpus callosum, cataracts, oculocutaneous hypopigmentation, cardiomyopathy, and a combined immunodeficiency followed by confirmation by genetic testing. We report an Egyptian infant with Vici syndrome carrying a homozygous splice site variant (c.1252+1G>T; NM_020964.2) in the EPG5 gene, detailed clinical description, outcome, and differential diagnosis of inherited hypopigmentation disorders associated with neurological manifestations. Case presentation The infant initially presented with oculocutaneous hypopigmentation, agenesis of the corpus callosum, and immunodeficiency. A few months later, a diagnosis of dilated cardiomyopathy was made. Family history revealed 2 deceased siblings phenotypically matching our index infant. He died at the age of 15 months with acute respiratory failure. Conclusion The accurate diagnosis of such rare diseases with genetic confirmation is vital for proper clinical decision-making, genetic counseling of the affected families, and future genotype-phenotype correlation studies.

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Ectopic decidua of the appendix: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01204-9 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Manabu Kaneko ◽

Hiroaki Nozawa ◽

Hirofumi Rokutan ◽

Koji Murono ◽

Tetsuo Ushiku ◽

...

Keyword(s):

Differential Diagnosis ◽

Acute Appendicitis ◽

Rare Entity ◽

Lower Quadrant ◽

Case Presentation ◽

Decidual Tissue ◽

Abdominal Symptoms ◽

History Of ◽

Myxoid Degeneration ◽

Right Lower Quadrant

Abstract Background Ectopic decidua is the presence of decidual tissue outside the uterus. Ectopic decidua of the appendix is a rare entity that can present with abdominal symptoms mimicking appendicitis. We report a case of a 39-year-old female patient at 27 weeks gestational age with a 2-day history of right lower quadrant abdominal pain. Case presentation The patient was referred to our hospital with suspicion of either acute appendicitis or threatened rupture of the uterus, the latter of which was considered unlikely following close examination. Therefore, she underwent emergency appendectomy via laparotomy. Microscopic examination revealed decidual tissue with myxoid degeneration in the subserosal layer of the tip side of the appendix, without endometriosis, which was compatible with ectopic decidua (deciduosis). Conclusions Because it is extremely difficult to distinguish ectopic decidua of the appendix from acute appendicitis, even with various imaging modalities, we should be aware that ectopic decidua of the appendix is a differential diagnosis for acute appendicitis in pregnant women.

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Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion

Case Reports in Dentistry ◽

10.1155/2021/1371329 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Ashwag Yagoub Aloyouny

Keyword(s):

Differential Diagnosis ◽

Clinical Presentation ◽

Surgical Intervention ◽

Fungal Infections ◽

The Body ◽

Palatine Tonsil ◽

Unusual Site ◽

Case Presentation ◽

Lymphoepithelial Cysts ◽

Malignant Lesions

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

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A Rare Case of Coexistence of Pituitary Stalk Interruption Syndrome and Mayer-Rokitansky-Küster-Hauser Syndrome

10.21203/rs.3.rs-91618/v1 ◽

2020 ◽

Author(s):

Wanlu Ma ◽

Xi Wang ◽

jiangfeng mao ◽

Min Nie ◽

Xueyan Wu

Keyword(s):

Computed Tomography ◽

Differential Diagnosis ◽

Rare Case ◽

Hypogonadotropic Hypogonadism ◽

Pituitary Stalk ◽

Primary Amenorrhea ◽

Case Presentation ◽

Mrkh Syndrome ◽

Breech Delivery ◽

Prepubertal Girls

Abstract Background Pituitary stalk interruption syndrome (PSIS) is a rare congenital pituitary anatomical disorder. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is characterized by congenital absence of the uterus, cervix, and part of the vagina in phenotypically normal 46, XX females. Case presentation A young woman was initially diagnosed as MRKH syndrome based on primary amenorrhea, 46, XX karyotype, and absence of uterus or vagina. Further investigation revealed breech delivery, short stature, hypogonadotropic hypogonadism, interrupted pituitary stalk on pituitary MRI, which led to the diagnosis of PSIS. After a 12-month treatment with estradiol, no signs of uterus or vagina were found on pelvic computed tomography.Conclusions We highlight the importance of considering PSIS in the differential diagnosis of suspected MRKH syndrome in prepubertal girls or girls with delayed or absent puberty, when no uterus is visualized on imaging.

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Binswanger's disease: Case presentation and differential diagnosis

Clinical Case Reports ◽

10.1002/ccr3.3459 ◽

2020 ◽

Vol 8 (12) ◽

pp. 3450-3457

Author(s):

Vitalie Văcăraș ◽

Adrian Mihai Cordoș ◽

Imelda Rahovan ◽

Sorina Frunze ◽

Dafin Fior Mureșanu

Keyword(s):

Differential Diagnosis ◽

Case Presentation ◽

Disease Case ◽

Binswanger’S Disease ◽

Binswanger's Disease

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Intraoral Sebaceous Carcinoma: Case Report of a Rare Tumor Emphasizing the Histopathological Differential Diagnosis

Case Reports in Dentistry ◽

10.1155/2018/3054931 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Manveen Kaur Jawanda ◽

R. V. Subramanyam ◽

Harshaminder Grewal ◽

Chitra Anandani ◽

Ravi Narula

Keyword(s):

Differential Diagnosis ◽

Oral Cavity ◽

Sebaceous Carcinoma ◽

Rare Tumor ◽

Radiographic Findings ◽

Case Presentation ◽

Clinical Appearance ◽

Cutaneous Malignancy ◽

The Face ◽

Rare Malignancy

Background. Sebaceous carcinoma (SC) is an uncommon cutaneous malignancy, usually occurring predominantly in the eyelids and only occasionally involving the oral cavity. Sebaceous carcinoma (SC) is a rare malignancy. Only 10 cases of sebaceous carcinoma of the oral cavity have been reported so far. Case Presentation. A 40-year-old female presented with a mass on the left side of the middle third of the face. Radiographic findings were inconclusive. Resection of the mass was consistent with the diagnosis of primary sebaceous carcinoma. Conclusion. Intraoral sebaceous carcinoma is uncommon. Due to its varied clinical appearance and presence of a diverse histopathologic appearance, the diagnosis is quite often confounding and elusive. Hence, it is imperative to familiarize oneself about various aspects of this rare tumor for earlier diagnosis, to improve the chances of patient’s survival.

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Facial Paralysis in Children: Differential Diagnosis

Otolaryngology ◽

10.1177/019459988108900528 ◽

1981 ◽

Vol 89 (5) ◽

pp. 841-848 ◽

Cited By ~ 54

Author(s):

Mark May ◽

Thomas J. Fria ◽

Frank Blumenthal ◽

Hugh Curtin

Keyword(s):

Hearing Loss ◽

Differential Diagnosis ◽

Herpes Zoster ◽

Facial Paralysis ◽

Positive Family History ◽

Pseudobulbar Palsy ◽

Slow Progression ◽

Facial Edema ◽

Physical Findings ◽

Fissured Tongue

The differential diagnosis in 170 patients between birth and 18 years of age is reviewed. There are a number of obvious physical findings and historical features that allow one to make a diagnosis rather quickly. Pain, vesicles, a red pinna, vertigo, and sensorineural hearing loss suggest herpes zoster oticus. Slow progression beyond three weeks, recurrent facial paralysis involving the same side, facial twitching, weakness, or no return of function after six months indicate a neoplasm. Bilateral simultaneous facial paralysis indicates a cause other than Bell's palsy, such as Guillain-Barré syndrome, pseudobulbar palsy, sarcoidosis, and leukemia. Recurrent facial paralysis associated with a fissured tongue, facial edema, and a positive family history should suggest Melkersson-Rosenthal syndrome.

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