scholarly journals Unexpected source of Proteus mirabilis bacteraemia

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-226744
Author(s):  
Sureshkumar Nagiah ◽  
Rassam Badbess
Keyword(s):  
Proteus Mirabilis ◽  
Elderly Woman ◽  
High Morbidity ◽  
Vascular Risk ◽  
Infected Aneurysm ◽  
Gram Negative ◽  
Delay In Diagnosis ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening

Mycotic (infected) aneurysm involving the thoracic aorta is an exceedingly rare and life-threatening condition that is associated with high morbidity and mortality. We report an unusual source of Proteus mirabilis bacteraemia thought to be due to an infected aneurysm in the thoracic aortic arch in an elderly woman. Source of gram-negative bacteraemia is usually isolated to an intra-abdominal or a pelvic source. Proteus bacteraemia from an intrathoracic pathology is very uncommon, and in this case led to a delay in diagnosis. Although an infected aneurysm is a rare source of gram-negative bacteraemia, it must always be considered when common causes of bacteraemia have been ruled out especially in patients with vascular risk factors.

scholarly journals Acute Fatty Liver of Pregnancy: A Life Threatening Condition

2020 ◽  
Vol 15 (1) ◽  
pp. 79-80
Author(s):  
Sarita Sitaula ◽  
Ajay Agrawal ◽  
Achala Thakur ◽  
Tara Manandhar ◽  
Babauram Dixit Thapa ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
High Morbidity ◽  
Third Trimester ◽  
Delay In Diagnosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Acute Fatty Liver ◽  
Catastrophic Disease

Acute Fatty Liver of Pregnancy (AFLP) is a rare but catastrophic disease affecting women in pregnancy. It usually occurs in the third trimester or post-partum period. Delay in diagnosis is associated with morbid complications with high morbidity and mortality. We report a case of 24 years old female at 38 weeks period of gestation who presented with jaundice, vomiting for 3 days and deranged liver function test. She was diagnosed as acute fatty liver of pregnancy and was delivered by instrumental delivery but required cesarean hysterectomy due to postpartum hemorrhage. She started improving with supportive care and discharged after 4 weeks of hospital stay. Key words: AFLP, Hysterectomy, Postpartum hemorrhage

scholarly journals Neonatal Purpura Fulminans

2014 ◽  
Vol 34 (1) ◽  
pp. 80
Author(s):  
D Sharma ◽  
J Yadav
Keyword(s):  
Purpura Fulminans ◽  
Severe Infection ◽  
High Morbidity ◽  
S Deficiency ◽  
Rapid Spread ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gram Negative Organisms

Neonatal purpura fulminans is a rare, life-threatening condition of dermal microvascular thrombosis associated with DIC and perivascular hemorrhage in the newborn period associated with high morbidity and mortality [1]. Gram negative organisms and Staphylococcus species are the most common causes of the acute infectious type [2]. It may be congenital, as a result of protein C and S deficiency, or acquired due to severe infection. It is characterized by the rapid spread of symmetrical, bluish-black hemorrhages into the skin, affecting mainly the extensor surfaces of the extremities and showing a tendency to deep necrosis and the formation of sero-sanguineous bullae. The haemorrhagic areas are well defined and are surrounded by oedema. These lesions are accompanied by a high fever and intense systemic symptoms.DOI: http://dx.doi.org/10.3126/jnps.v34i1.8975 J Nepal Paediatr Soc 2014;34(1):80

Anaphylaxis in the OR—Causes, Recognition, and Treatment

2018 ◽  
pp. 199-206
Author(s):  
Surangama Sharma ◽  
Lovkesh Arora
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Cholecystectomy ◽  
Operating Room ◽  
Clinical Manifestations ◽  
Preventative Measures ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Elective Laparoscopic Cholecystectomy

Anaphylaxis in the operating room is a life-threatening condition that can evolve rapidly. As an anesthesiologist, it is important to understand the pathophysiology, diagnose the condition, recognize the inciting agent/agents, and manage it appropriately. It is equally important to confirm the diagnosis for preventing a catastrophic event from happening in future. This chapter defines anaphylaxis, discusses the clinical manifestations and most common causes, and describes ways it can be diagnosed. It also considers treatment and preventative measures. The chapter uses a case study of a 55-year-old female, weighing 85 kg and a body mass index of 36 with no other known comorbidities, who is scheduled to undergo elective laparoscopic cholecystectomy.

Sudden death due to ruptured oesophageal varices – autopsy-based case report

2020 ◽  
Vol 88 (4) ◽  
pp. 189-191
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar ◽  
Anil Kohli ◽  
Kalyan Kumar Banerjee
Keyword(s):  
Chronic Alcoholism ◽  
Medical Emergency ◽  
Oesophageal Varices ◽  
High Morbidity ◽  
Forensic Pathologist ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cirrhotic Patients ◽  
Acute Haemorrhage

Acute haemorrhage from ruptured oesophageal varices is a serious consequence of portal hypertension in cirrhotic patients. It represents a medical emergency with a high morbidity and mortality rate. Studies over the years have shown a direct link with chronic alcoholism in the development of such complications. Although the gastrointestinal system accounts for a few numbers of sudden deaths, bleeding through ruptured varices represent a life-threatening condition. The role of forensic pathologist is vital in dealing with sudden deaths. Here, we report a case of a 46-year-old man who died suddenly following the rupture of oesophageal varices.

scholarly journals TEVAR for ruptured descending thoracic aortic aneurysm: case report

2016 ◽  
Vol 15 (4) ◽  
pp. 322-327 ◽  
Author(s):  
Sthefano Atique Gabriel ◽  
Enrico Rinaldi ◽  
Marco Leopardi ◽  
Germano Melissano ◽  
Roberto Chiesa
Keyword(s):  
Case Report ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Thoracic Endovascular Aortic Repair ◽  
High Morbidity ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Descending Thoracic Aortic Aneurysm ◽  
Threatening Condition ◽  
Life Threatening

Abstract A ruptured descending thoracic aortic aneurysm (rDTAA) is a life-threatening condition associated with high morbidity and mortality. Endovascular treatment for rDTAA promotes effective aneurysm exclusion with a minimally invasive approach. The authors report a case of a 76-year-old man with hemodynamically unstable 9-cm-diameter rDTAA treated with emergency thoracic endovascular aortic repair (TEVAR).

scholarly journals Foreign bodies in aero-digestive tract in children: spectrum of presentation and management

2017 ◽  
Vol 4 (6) ◽  
pp. 1889
Author(s):  
Rajashekhar T. Patil ◽  
Advait Prakash
Keyword(s):  
Foreign Body ◽  
Digestive Tract ◽  
Bronchial Tree ◽  
Anatomical Location ◽  
High Morbidity ◽  
Radiographic Findings ◽  
Delay In Diagnosis ◽  
Threatening Condition ◽  
High Index Of Suspicion ◽  
A Prospective Study

Background: Foreign body (FB) ingestion and aspiration is quite common in children. It can be a life-threatening condition. Early diagnosis of foreign body aspiration is essential as delay in its recognition and treatment results in high morbidity and mortality. Symptoms seem to mostly depend on the anatomical location. The absence of specific symptoms indicating the occurrence of FB injury can lead to delay in diagnosis, thereby increasing the risk of complications.Methods: This is a prospective study which comprised of 50 patients with between 8 months and 4.5 years. FB involving different parts of the aero-digestive tract were included in the study. The site, side, symptoms and radiographic findings were recorded for each patient. Different procedures were used for retrieval of various FB at different locations. Majority of these procedures were performed under anaesthesia.Results: Most of the FB were organic in nature. Right side bronchus was more commonly involved. A combination of different procedures was used according to the site involved. All the FB were removed successfully and smoothly. There was minimum morbidity with no mortality and the overall outcome was excellent. Hospital stay varied according to the site of involvement.Conclusions: The symptoms of FB change with the site involved and many patients are even asymptomatic. A differential diagnosis of foreign body should always be made in an acute or chronic presentation of respiratory cases. Aspiration of foreign body should be suspected in all cases of broncho-pulmonary infection with atypical course. High index of suspicion is the cornerstone of diagnosis. Bronchoscopy is the best diagnostic and therapeutic method in all suspicions of foreign body of tracheo-bronchial tree. Proper and timely intervention optimizes the outcome.

Surgical management of esophageal perforation: role of primary closure

2019 ◽  
Vol 27 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Vu Huu Vinh ◽  
Nguyen Viet Dang Quang ◽  
Nguyen Van Khoi
Keyword(s):  
Hospital Admission ◽  
Esophageal Perforation ◽  
Primary Closure ◽  
Primary Repair ◽  
Time Interval ◽  
Mortality And Morbidity ◽  
Thoracic Level ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening

Objective Esophageal perforation is a life-threatening condition associated with high mortality and morbidity. Ambiguous clinical presentation is one of the most common causes of delayed and difficult diagnosis of esophageal perforation. In this retrospective single-center study, we reviewed the outcome of primary closure in patients with esophageal perforation between 2009 and 2017. Methods The data of 65 patients attending our department of thoracic surgery (from 2009 to 2017) for esophageal perforation were reviewed. Primary repair was attempted in 63 patients irrespective of the site of perforation and time interval between injury and hospital admission. In intrathoracic lesions, continuous mediastinal and pleural irrigation was undertaken, whereas in cervical perforations, gauze packing and local irrigation were performed. Jejunotomy was carried out in patients with inadequate healing. Results Of the 65 patients, 63 underwent primary closure and 2 were left to heal spontaneously. The majority of patients ( n = 44) had an esophageal perforation at the thoracic level, and only one was admitted early (<24 h after injury). Among the 63 patients managed with primary closure, 55 had satisfactory healing with one surgery. Healing was delayed in the other 10 patients. No mortality was reported. Conclusions Esophageal perforation can be well managed by primary closure, irrespective of the time interval between injury and hospital admission and the site of perforation. Conservative management might lead to an increased rate of complications such as empyema or necrotizing mediastinitis, and increased morbidity and mortality.

Vascular calcifications and calciphylaxis in a patient on concurrent haemodialysis and Coumadin therapy

2021 ◽  
Vol 14 (3) ◽  
pp. e240310
Author(s):  
Jack Schnur ◽  
Hadeer Sinawe ◽  
Athina Lidia Yoham ◽  
Damian Casadesus
Keyword(s):  
Pulmonary Oedema ◽  
Wound Care ◽  
Sodium Thiosulfate ◽  
High Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Haemodialysis Treatment

Calciphylaxis is a rare life-threatening condition, with calcification of small and medium-sized vessels leading to skin necrosis. It has a high morbidity and mortality, and most of the patients die from wound superinfection and sepsis. A 48-year-old man with a history of end-stage renal disease on haemodialysis and Coumadin therapy for venous thromboembolism presented with pulmonary oedema after missing two haemodialysis treatment. At examination, he had bilateral lower extremity dark brown, possibly necrotic, painful ulcers. He was diagnosed with calciphylaxis and treated with sevelamer hydrochloride, low calcium dialysate and sodium thiosulfate with haemodialysis. He received daily wound care with topical collagenase. After daily wound care treatment for 4 months, the patient’s ulcers completely healed. The patient had been followed for 8 months, which included 29 additional readmissions, 3 admissions related to bacteraemia and 26 admissions with the diagnosis of pulmonary oedema and hyperkalaemia requiring haemodialysis.

Endovascular Embolization of Gastroduodenal Artery in its Pancreatogenous Arrosia: a Clinical Case

2019 ◽  
Vol 64 (6) ◽  
pp. 88-90
Author(s):  
M. Popov ◽  
S. Voskanyan ◽  
A. Dunaev ◽  
A. Bashkov ◽  
M. Aronov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Pancreatic Pseudocyst ◽  
Pancreatic Head ◽  
Endovascular Embolization ◽  
Gastroduodenal Artery ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Vascular Structures

Arrosion of the peripancreatic vascular structures is a rare, but life-threatening condition and requires surgical treatment. One of the most common causes of arrosia is the presence of pancreatic pseudocyst. Imaging methods play a crucial role not only in terms of identifying the described pathology, but also in planning the tactics of surgical treatment. We present a clinical case of a patient, a 44-year-old male, with pseudocyst in the pancreatic head in the presence of chronic pancreatitis, complicated by bleeding into its cavity as a result of an arrosion of the gastroduodenal artery, which required endovascular embolization and drainage of the pseudocyst. This clinical case shows the possibility of endovascular embolization of the injured gastroduodenal artery with microspirals.

Painless type A aortic dissection

2020 ◽  
Vol 13 (5) ◽  
pp. e234831
Author(s):  
Victor G Becerra-Gonzales ◽  
Marian Calfa ◽  
Rhea Sancassani
Keyword(s):  
Aortic Dissection ◽  
Asymptomatic Patient ◽  
Type A ◽  
Clinical Findings ◽  
Acute Onset ◽  
Type A Aortic Dissection ◽  
Delay In Diagnosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Electrocardiogram Ecg

Aortic dissection is an uncommon diagnosis that typically presents with acute onset of severe pain. It rarely presents with minimal to no symptoms, which carries a higher mortality risk given the delay in diagnosis. An adequate interpretation of risk factors, clinical findings and auxiliary tests constitutes a greater value for clinicians to detect this life-threatening condition. This report describes a case of type A aortic dissection in an asymptomatic patient presenting with an abnormal electrocardiogram (ECG).

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