Delayed complication of tracheocutaneous fistula closure with severe compromising subcutaneous emphysema

We report a significant complication after tracheocutaneous fistula (TCF) excision with closure by secondary intention in a 4-year-old boy who had been tracheostomy dependent since infancy. He had a persistent 3 mm TCF one year after decannulation. On postoperative day 2 the patient developed profound subcutaneous emphysema and pneumomediastinum. He was extubated after 2 days and discharged from the hospital on postoperative day 7. At follow up he had complete resolution of subcutaneous emphysema and complete closure of the TCF. The main methods of TCF closure and management of subcutaneous emphysema are discussed along with the lessons learned from this case.

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Non-surgical management of an extraoral cutaneous sinus tract of odontogenic origin

BMJ Case Reports ◽

10.1136/bcr-2020-234699 ◽

2020 ◽

Vol 13 (7) ◽

pp. e234699

Author(s):

Lynn Lilly Varghese ◽

Auric Bhattacharya ◽

Praveena Sharma ◽

Abhishek Apratim

Keyword(s):

Case Report ◽

Surgical Management ◽

Dental Pulp ◽

Complete Resolution ◽

Sinus Tract ◽

Odontogenic Origin ◽

One Year ◽

Minimal Scar ◽

Cutaneous Sinus

Chronic apical periodontitis associated with dental pulp necrosis is the main cause of odontogenic extraoral cutaneous sinus openings. These tracts are often initially misdiagnosed unless the treating clinician considers a dental aetiology. This case report of a 19-year-old woman describes the diagnosis and treatment of an extraoral cutaneous sinus tract of odontogenic origin. Non-surgical conservative endodontic therapy was opted as the involved teeth were restorable. One month after the completion of obturation, there was closure of the sinus tract. One year follow-up showed complete resolution of the sinus tract with minimal scar formation.

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Combined atypical primary hypoadrenocorticism and primary hypothyroidism in a dog

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v85i6.16310 ◽

2016 ◽

Vol 85 (6) ◽

pp. 355-364

Author(s):

B. Vanmal ◽

V. Martlé ◽

D. Binst ◽

P. Smets ◽

S. Daminet ◽

...

Keyword(s):

Complete Resolution ◽

Low Dose ◽

Primary Hypothyroidism ◽

Abdominal Ultrasonography ◽

Maintenance Rate ◽

Blood Examination ◽

Total Thyroxine ◽

One Year ◽

Schmidt’S Syndrome

A dog with combined atypical primary hypoadrenocorticism and primary hypothyroidism is described. The dog presented with waxing and waning, vague complaints since more than a year and had been treated with several drugs without complete resolution of signs. Based on the abnormalities on physical examination, blood examination and abdominal ultrasonography, atypical primary hypoadrenocorticism and primary hypothyroidism were diagnosed. Glucocorticoid supplementation was started and gradually tapered to maintenance rate because of polydipsia. Ten days later, levothyroxine supplementation was started at a very low dose and was gradually increased based on serum total thyroxine concentrations. The dog rapidly improved and recovered completely. Follow-up over a one-year period did not reveal new abnormalities. The presence of combined primary hypoadrenocorticism and primary hypothyroidism has been infrequently described in dogs and may resemble the Schmidt’s syndrome in humans.

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Efficacy of endonasal dacryocystorhinostomy, using ‘cold steel’ instruments without stenting, in treatment of distal nasolacrimal duct obstruction

The Journal of Laryngology & Otology ◽

10.1017/s002221511100017x ◽

2011 ◽

Vol 125 (6) ◽

pp. 590-594 ◽

Cited By ~ 6

Author(s):

L Ananth ◽

P Hosamani ◽

G Chary

Keyword(s):

Complete Resolution ◽

Cost Effective ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Success Rates ◽

Duct Obstruction ◽

Lacrimal System ◽

Reliable Procedure ◽

One Year

AbstractObjective:To assess the efficacy of an endonasal dacryocystorhinostomy technique using conventional instruments, without the use of any adjunctive techniques.Study design:Prospective, non-randomised, cohort study.Methods:Patients diagnosed with nasolacrimal duct obstruction between January 2006 and December 2008 were included in the study. Seventy-eight endonasal dacryocystorhinostomies (primary or revision) were performed with conventional ‘cold steel’ instruments. The technique involved complete exposure and marsupialisation of the lacrimal sac. No adjunctive procedures were used. Success was defined as complete resolution of epiphora and a patent lacrimal system, evaluated by lacrimal irrigation and endoscopy, one year post-operatively.Results:Seventy-four of the 78 cases were symptom-free after a minimum follow up of 12 months, giving an overall success rate of 94.9 per cent. The success rates for primary and revision cases were 95.5 and 90.9 per cent, respectively.Conclusion:Meticulous surgical technique can ensure high success rates with the use of conventional cold steel instruments, without the use of adjunctive procedures, making endonasal dacryocystorhinostomy a cost-effective, reliable procedure.

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Generalised myoclonus associated with COVID-19 infection

BMJ Case Reports ◽

10.1136/bcr-2021-243780 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243780

Author(s):

Aatma Ram ◽

Hafiz Jeelani ◽

Dilpat Kumar ◽

Heeren Patel

Keyword(s):

Critically Ill ◽

Complete Resolution ◽

Respiratory Symptoms ◽

Bacterial Infections ◽

Case Reports ◽

The Past ◽

Short Course ◽

Delayed Complication

Postinfectious generalised myoclonus has been reported after many viral and bacterial infections in the past. Recently, some case reports have described it in the context of COVID-19 infection. Most patients described in these case reports are either critically ill and intubated or have concurrent respiratory symptoms. Herein, we present a case of a 79-year-old man, who was recovering from a recent COVID-19 infection, presented with isolated generalised myoclonus. The patient was treated with levetiracetam, a short course (10 days) of dexamethasone, and required extensive rehabilitation. Outpatient follow-up at 2 months suggested complete resolution of symptoms and levetiracetam was subsequently discontinued. This case highlights that generalised myoclonus can occur as a delayed complication of COVID-19 infection.

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Self-reported smell and taste recovery in COVID-19 patients: a one-year prospective study

10.1101/2021.03.18.21253862 ◽

2021 ◽

Author(s):

Paolo Boscolo-Rizzo ◽

Francesco Guida ◽

Jerry Polesel ◽

Alberto Vito Marcuzzo ◽

Paolo Antonucci ◽

...

Keyword(s):

Prospective Study ◽

Recovery Rate ◽

Complete Resolution ◽

Substantial Proportion ◽

Sense Of Smell ◽

One Year ◽

The One ◽

Snot 22 ◽

New Onset

Purpose. The aim of the present study was to estimate the one-year prevalence and recovery rate of self-reported chemosensory dysfunction in a series of subjects with previous mild-to-moderate symptomatic COVID-19. Methods Prospective study based on the SNOT-22 (item sense of smell or taste) and additional outcomes. Results 268/315 patients (85.1%) completing the survey at baseline also completed the follow-up interview. The 12-months prevalence of self-reported COVID-19 associated chemosensory dysfunction was 21.3% (95% CI: 16.5-26.7%). Of the 187 patients who complained of COVID-19 associated chemosensory dysfunction at baseline, 130 (69.5%; 95% CI 62.4-76.0%) reported complete resolution of smell or taste impairment, 41 (21.9%) reported a decrease in the severity, and 16 (8.6%) reported the symptom was unchanged or worse one year after onset. The risk of persistence was higher for patients reporting a baseline SNOT-22 score > o = 4 (OR=3.32; 95% CI: 1.32-8.36) as well as for those requiring > o = 22 days for a negative swab (OR=2.18; 95% CI: 1.12-4.27). Conclusion A substantial proportion of patients with previous mild-to-moderate symptomatic COVID-19 characterized by new onset of chemosensory dysfunction still complained on altered sense of smell or taste one-year after the onset.

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Plasma cell mucositis with exclusive involvement of the perianal region

Journal of Dermatology & Cosmetology ◽

10.15406/jdc.2020.04.00144 ◽

2020 ◽

Vol 4 (1) ◽

pp. 23-24

Author(s):

Ramirez Bellver JL

Keyword(s):

Plasma Cell ◽

Complete Resolution ◽

Perianal Region ◽

Topical Treatments ◽

One Year ◽

Perianal Ulcers

We present the case of a woman who has had perianal ulcers for several years. Since no improvement was achieved with topical treatments, a biopsy was performed, showing a dense lymphoplasmocellular infiltrate. After ruling out other differentials, a diagnosis of plasma cell mucositis was made and intralesional betametasone was attempted, with almost complete resolution of the lesions in a few days and no recurrence in one-year follow-up.

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