Primary cutaneous ‘ulcerative’ tuberculosis of the scrotum: a rare occurrence

Tuberculosis (TB) is a global disease and if not adequately treated can lead to morbidity and mortality. Though genitourinary TB is common and only next to pulmonary TB, cutaneous ‘ulcerative’ tuberculosis of the scrotum is not reported so far in the literature. We present a 32-year-old man with a non-healing scrotal ulcer and underwent excision. Histopathology was consistent with TB. Antitubercular therapy was given and at the end of a year’s follow-up, there has been no recurrence. TB of the scrotum should be considered in the differential diagnosis of scrotal ulcers. Proper diagnosis and adequate treatment will offer a cure to such patients.

Download Full-text

Case Report: Recurrent Left Posterior Fascicular Ventricular Tachycardia in a Newborn

Frontiers in Pediatrics ◽

10.3389/fped.2021.691146 ◽

2021 ◽

Vol 9 ◽

Author(s):

Lu Zhao ◽

Lin Wu ◽

Qu-ming Zhao ◽

Xue-cun Liang

Keyword(s):

Differential Diagnosis ◽

Ventricular Tachycardia ◽

Case Report ◽

First Year ◽

Age Group ◽

Basic Principles ◽

Left Posterior ◽

Proper Diagnosis ◽

First Year Of Life

Left posterior fascicular ventricular tachycardia (LPFVT) is extremely rare in neonates. We described a 17-day-old girl with LPFVT who was initially misdiagnosed as supraventricular tachycardia (SVT). Eventually, she was successfully treated by amiodarone infusion followed by oral amiodarone with propranolol for 9 months, and LPFVT spontaneously resolved after a 1-year follow-up. This case report illustrated the basic principles and caveats in differential diagnosis of LPFVT in the neonatal age group. With proper diagnosis and therapy, neonatal LPFVT might regress in the first year of life.

Download Full-text

Dental fractures: types, causes, and treatment

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20220004 ◽

2022 ◽

Author(s):

Samar A. Bamofleh ◽

Alanoud F. Alotaibi ◽

Aidel A. Alshahrani ◽

Shoroug M. Alahmadi ◽

Abdulaziz I. AlHumaidan ◽

...

Keyword(s):

Treatment Plan ◽

Diagnostic Procedures ◽

Adequate Treatment ◽

Extensive Evaluation ◽

Carious Lesions ◽

Pulp Exposure ◽

Proper Diagnosis ◽

Root Fractures ◽

Adequate Management

Studies indicate that the management of dental fractures might be challenging because many cases present with minor, hard-to-discover traumas, requiring extensive evaluation and diagnostic procedures. Accordingly, adequate management can only be achieved by establishing a proper diagnosis, drawing an adequate treatment plan, and conducting regular follow-up appointments. We have discussed the different causes, types, and treatments of dental fractures. The commonest causes include impaction by trauma, whether direct or indirect. Many traumatic events were reported in the literature, and age and carious lesions are important factors to consider. Many types of dental fractures were also reported in the literature, including root fractures, crown root fractures, enamel-dentin fractures with and without pulp exposure or crown fractures, enamel infractions, and fractures. Other types include avulsion, intrusion, extrusion, lateral luxation, concussion or subluxation, splinting, and alveolar segment fractures. The treatment should be integrated based on the fracture type, and adequate follow-up should be established to achieve the best predictive outcomes.

Download Full-text

Complete Hydatidiform Mole and Coexisting Fetus With Gastroschisis: A Case Report Highlighting the Importance of Diagnostic Genotyping

Pediatric and Developmental Pathology ◽

10.1177/10935266211024823 ◽

2021 ◽

pp. 109352662110248

Author(s):

Austin McHenry ◽

Urania Magriples ◽

Pei Hui ◽

Raffaella Morotti

Keyword(s):

Differential Diagnosis ◽

Hydatidiform Mole ◽

Gestational Trophoblastic Disease ◽

Diagnostic Process ◽

Rare Occurrence ◽

Complete Hydatidiform Mole ◽

Trophoblastic Disease ◽

Increased Risk ◽

Ancillary Studies

Twin pregnancy with a complete hydatidiform mole and a coexisting fetus (CHMCF) is an extremely rare occurrence, described only by a handful of published series and cases reports. The majority of the literature on CHMCF examines prenatal care and follow-up in relation to the increased risk of gestational trophoblastic neoplasia (GTN). At present, few reports elaborate on the diagnostic process and differential diagnosis, especially in the context of recent molecular advances in risk stratification for GTN. Here, we describe the first known case of a CHMCF with gastroschisis with liveborn delivery at 35 weeks gestation. This report aims to review the pre- and postnatal differential diagnosis and discuss recent updates on the importance of ancillary studies in the diagnosis of gestational trophoblastic disease.

Download Full-text

Prevalence of Asymptomatic Cryptococcal Antigenemia and Association with Follow-up risk of Cryptococcal Meningitis and Mortality among HIV Infected Patients in North West India – A Prospective Cohort Study

Current HIV Research ◽

10.2174/1570162x18666200827113816 ◽

2020 ◽

Vol 18 ◽

Author(s):

Rajendra Bhati ◽

Pramendra Sirohi ◽

Bharat Sejoo ◽

Deepak Kumar ◽

Gopal K Bohra ◽

...

Keyword(s):

Cryptococcal Meningitis ◽

Morbidity And Mortality ◽

People Living With Hiv ◽

Cryptococcal Antigen ◽

North West ◽

Cryptococcal Disease ◽

Increased Risk ◽

Living With Hiv ◽

Inflammatory Syndrome

Objective: Cryptococcal meningitis is an important cause of morbidity and mortality in HIV infected individuals. In the era of universal antiretroviral therapy incidence of immune reconstitution inflammatory syndrome (IRIS) related cryptococcal meningitis has increased. Detection of serum cryptococcal antigen in asymptomatic PLHIV (People Living With HIV) and pre-emptive treatment with fluconazole can decrease the burden of cryptococcal disease. We conducted this study to find the prevalence of asymptomatic cryptococcal antigenemia in India and its correlation with mortality in PLHIV. Method and material: This was a prospective observational study. HIV infected ART naïve patients with age of ≥ 18 years who had CD4 counts ≤ 100 /µL were included and serum cryptococcal antigen test was done. These patients were followed for six months to look for the development of Cryptococcal meningitis and mortality. Results: A total of 116 patients were analysed. Asymptomatic cryptococcal antigenemia was detected in 5.17% patients and it correlated with increased risk of cryptococcal meningitis and mortality on follow-up in PLHIV. Conclusion: Serum cryptococcal positivity is correlated with increased risk of Cryptococcal meningitis and mortality in PLHIV. We recommend the screening of asymptomatic PLHIV with CD4 ≤ 100/µL for serum cryptococcal antigen, so that pre-emptive treatment can be initiated to reduce morbidity and mortality.

Download Full-text

Primary breast tuberculosis: imaging findings of a rare disease

Insights into Imaging ◽

10.1186/s13244-021-00961-3 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Ali H. Baykan ◽

Hakan S. Sayiner ◽

Ibrahim Inan ◽

Elcin Aydin ◽

Sukru M. Erturk

Keyword(s):

Differential Diagnosis ◽

Rare Disease ◽

Extrapulmonary Tuberculosis ◽

Reproductive Age ◽

Malignant Diseases ◽

Imaging Findings ◽

Granulomatous Mastitis ◽

Rare Form ◽

Breast Tuberculosis

AbstractBreast tuberculosis is a rare form of extrapulmonary tuberculosis which tends to affect females of reproductive age, and is much rarer in males, postmenopausal women, and pre-pubescent girls. It is difficult to diagnose because it can mimic benign conditions such as a fibroadenoma, as well as malignant diseases like a carcinoma. It is also particularly difficult to distinguish breast tuberculosis from granulomatous mastitis, so other possible diagnoses should be ruled out first. The diagnosis of breast tuberculosis has three essential pillars: clinical examination, radiological evaluations, and histopathological sampling. Radiological evaluations are not only critical in diagnosis but are also important in the planning of the treatment and during the follow-up. This paper aims to review the imaging findings and the differential diagnosis of breast tuberculosis.

Download Full-text

Excellent Outcome of Acute Necrotizing Encephalopathy in an Adult With Bacterial Infections, Case Report

The Neurohospitalist ◽

10.1177/1941874421991370 ◽

2021 ◽

pp. 194187442199137

Author(s):

Yan Wang ◽

John R. Younce ◽

Joel S. Perlmutter ◽

Soe S. Mar

Keyword(s):

Differential Diagnosis ◽

Bacterial Infections ◽

Vasogenic Edema ◽

Brain Magnetic Resonance Imaging ◽

Acute Necrotizing Encephalopathy ◽

Excellent Outcome ◽

Intravenous Antibiotics ◽

Acute Necrotizing ◽

Supportive Management

Acute necrotizing encephalopathy (ANE) is a rare para-infectious encephalopathy that classically occurs in children. However, ANE should be considered in the differential diagnosis of adults with symmetric brain lesions after a prodromal illness given recent reports of coronavirus disease of 2019 (COVID-19) to presumably cause ANE in adults. We report a case of a 29-year-old male presenting with fever, malaise, and rapid deterioration into coma. Brain magnetic resonance imaging revealed multifocal symmetric areas of diffusion restriction and surrounding vasogenic edema involving bilateral thalami, pons and cerebellar hemispheres with a core of susceptibility artifact, and minimal thalamic contrast enhancement, most consistent with ANE. Extensive infectious workup revealed isolated Escherichia coli and Neisseria gonorrhoeae in his urine. Despite the severe encephalopathy on initial presentation, the patient improved with intravenous antibiotics and supportive management with minimal residual deficits at 9 months follow-up. We aim to provide an overview of the radiological features, differential diagnosis, treatment and prognosis of ANE. Becoming familiarized with this rare but devastating disease will improve detection, treatment, and ultimately prognosis, especially in the era of a new pandemic.

Download Full-text

Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center

Pediatric Neurosurgery ◽

10.1159/000515516 ◽

2021 ◽

pp. 1-11

Author(s):

Hamid Reza Niknejad ◽

Melissa Frederickx ◽

Emiel Salaets ◽

Jurgen Lemiere ◽

Lieven Lagae ◽

...

Keyword(s):

Aqueductal Stenosis ◽

Maximum Diameter ◽

Benign Tumors ◽

Term Outcome ◽

Adequate Treatment ◽

Long Term Outcome ◽

Tectal Plate ◽

The Mean

Introduction: Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients. Methods: We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression. Results: In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (p = 0.031) and the estimated tumor volume with 35% (p = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, U = 3, p < 0.01, z = −2.71), performance (TPG= 100, IAS = 85, U = 7, p = 0.03, z = −2.2), and verbal intelligence (TPG = 122, IAS = 91.5, U = 2, p < 0.00, z = −2.87) as well as working memory (TPG = 109.5, IAS = 77, U = 0.5, p = 0.01, z = −2.46). Conclusion: Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.

Download Full-text

Rapid growth of myxoid leiomyosarcoma of the vulva during pregnancy: a case report

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200401000-00026 ◽

2004 ◽

Vol 14 (1) ◽

pp. 172-175 ◽

Cited By ~ 1

Author(s):

A. R. Di Gilio ◽

G. Cormio ◽

L. Resta ◽

C. Carriero ◽

V. Loizzi ◽

...

Keyword(s):

Differential Diagnosis ◽

Smooth Muscle ◽

Case Report ◽

Lymph Node ◽

Cesarean Section ◽

Recurrent Disease ◽

Node Dissection ◽

Smooth Muscle Tumors ◽

Vulvar Mass

Smooth muscle tumors arising in the vulva are rare. Leiomyosarcoma is the most common variant of vulvar sarcoma, and very few cases have been reported during pregnancy. A 36-year-old woman presented with a progressively enlarging vulvar mass during pregnancy, diagnosed as a Bartholin's gland cyst. The lesion was resected at 38 weeks of gestation during cesarean section and diagnosis of myxoid leiomyosarcoma of the vulva was made. Six weeks later the patients were referred to our center and submitted to wide vulvar excision with groin lymph node dissection that revealed the presence of a small residual focus of leiomyosarcoma. At 30 months of follow-up the patient was well without any sign of recurrent disease. Leiomyosarcoma should be included in the differential diagnosis of vulvar masses; progressively enlarging vulvar lesion should be biopsied even during pregnancy. Leiomyosarcoma should be considered in the differential diagnosis of vulvar mass.

Download Full-text