Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals Hemichorea-hemiballismus in a patient with hyperglycaemic hyperosmolar state

2020 ◽  
Vol 8 (10) ◽  
pp. 3710
Author(s):  
Rifkatu S. Reng ◽  
Odumodu Kenechukwu ◽  
Shuaibu Ramatu ◽  
Oyakhire Shyngle ◽  
Omonua Special ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Involuntary Movement ◽  
Rare Complication ◽  
Cerebral Atrophy ◽  
Lower Limbs ◽  
High Grade Fever ◽  
Rare Manifestation ◽  
History Of ◽  
Hypertensive Woman ◽  
The Right

Hemichorea-hemiballismus (HCHB) is a rare manifestation of hyperglycaemic hyperosmolar state caused by contralateral lesion in basal ganglia. A 74-year-old, known diabetic and hypertensive woman presented with one-week history of high-grade fever and loss of consciousness associated with involuntary movement of the right upper and lower limbs for 10 hours prior to presentation. Physical examination revealed pyrexia, tachycardia and altered sensorium. Blood glucose was 53.8 mmol/l, hemoglobin A1c (Hb A1c) 9.9% and brain computed tomography (CT) scan showed cerebral atrophy with bilateral basal ganglia hyperdensities. Escherichia coli was cultured from the urine. She did well on treatment with soluble insulin, rehydration and intravenous ceftriaxone. HCHB is a rare complication seen in patients with poorly controlled diabetes mellitus. This report highlights the reversibility of the disease with prompt diagnosis and appropriate insulin treatment. HCHB should be distinguished from other intracranial pathologies.

scholarly journals Herpes Zoster pada Anak – Laporan Kasus

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Thigita A. Pandaleke ◽  
Herry E. J. Pandaleke ◽  
Ratna I. Susanti ◽  
Julieta D. P. Dotulong
Keyword(s):  
Herpes Zoster ◽  
Physical Examination ◽  
Primary Infection ◽  
Giant Cells ◽  
Lumbar Region ◽  
Sensory Ganglia ◽  
Laboratory Findings ◽  
Varicella Zoster ◽  
History Of ◽  
The Right

Abstract: Herpes zoster (HZ) is an acute vesicular eruption caused by latent varicella zoster virus (VVZ) reactivation in sensory ganglia after primary infection. Its incidence increases with age and it is rarely found in children. We reported a case of 10-year-old male with blisters on the right side of his stomach and back 3 days ago. The patient was suffered from fever, common cold, and cough a week before, and had a history of varicella at 5 years old. Dermatologic status showed multiple vesicles on erythematous base at the anterior dan posterior sides of his right lumbar region. The Tzank test showed multinucletaed giant cells. Acyclovir resulted in significant improvement after 7- day therapy. Conclusion: Diagnosis of herpes zoster was based on anamnesis, physical examination, and laboratory findings. Antiviral drugs was aimed to reduce complications and viral shedding.Keywords: Herpes zoster, childAbstrak: Herpes zoster (HZ) merupakan erupsi vesikuler akut yang disebabkan oleh reaktivasi dari virus varisela zoster (VVZ) laten pada ganglia sensoris yang sebelumnya terpajan dengan infeksi primer varisela. Insiden HZ meningkat seiring pertambahan usia dan jarang ditemukan pada anak-anak. Kami melaporkan kasus seorang anak laki-laki, 10 tahun, dengan bintil-bintil berair di perut dan punggung sebelah kanan sejak 3 hari lalu. Riwayat demam, batuk dan pilek 1 minggu sebelum timbul lesi. Riwayat varisela pada usia 5 tahun. Status dermatologis ditemukan vesikel multipel berisi cairan jernih yang tersusun bergerombol di atas kulit yang eritema di regio lumbar dekstra anterior dan posterior. Tes Tzank memperlihatkan sel raksasa berinti banyak. Pasien diterapi dengan asiklovir oral selama 7 hari dan menunjukkan perbaikan yang bermakna. Simpulan: Anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang kasus ini khas untuk herpes zoster. Pemberian obat antiviral bertujuan untuk mengurangi komplikasi dan menurunkan viral shedding.Kata kunci: herpes zoster, anak

scholarly journals Intracranial subdural osteoma

2020 ◽  
Vol 18 ◽  
pp. 205873922092685
Author(s):  
Yunna Yang ◽  
Zheng Gu ◽  
Yinglun Song
Keyword(s):  
Dura Mater ◽  
Histopathological Examination ◽  
Surgical Excision ◽  
Benign Neoplasms ◽  
Resonance Imaging ◽  
Inner Surface ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
T1 Hyperintensity ◽  
The Right

Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater.

scholarly journals Prosthetic joint infection: an extremely rare complication of intravesicular BCG therapy

2019 ◽  
Vol 12 (12) ◽  
pp. e232809 ◽  
Author(s):  
Michael Storandt ◽  
Avish Nagpal
Keyword(s):  
Rare Complication ◽  
Joint Infection ◽  
Acid Fast Bacillus ◽  
Joint Effusion ◽  
Urothelial Bladder Carcinoma ◽  
Prosthetic Joint ◽  
Bcg Therapy ◽  
Urothelial Bladder ◽  
History Of ◽  
The Right

A 66-year-old man was seen in clinic due to concerns of tuberculosis of the right hip. He had a history of urothelial bladder carcinoma, which was treated via transurethral resection followed by intravesicular instillations of Mycobacterium bovis BCG (BCG). A few months later, he developed slowly worsening pain over his prosthetic right hip, and it was recommended he undergo surgical revision. During surgery, joint effusion was noted and synovial fluid was sent for bacterial and mycobacterial cultures, growing an acid-fast bacillus after 3 weeks, identified as Mycobacterium tuberculosis complex via nucleic acid probe. Susceptibility testing revealed resistance to pyrazinamide, which is typically seen in M. bovis. PCR confirmed the diagnosis of BCG infection. The patient was treated with isoniazid, rifampin and ethambutol, which he tolerated well. This case highlights the challenges associated with diagnosis and management of this rare complication of a commonly used therapy.

scholarly journals Thirteen-year follow-up of parasellar intravascular papillary endothelial hyperplasia successfully treated by surgical excision: case report

2015 ◽  
Vol 15 (4) ◽  
pp. 384-391 ◽  
Author(s):  
Sook Young Sim ◽  
Yong Cheol Lim ◽  
Keun Soo Won ◽  
Kyung Gi Cho
Keyword(s):  
Surgical Excision ◽  
Subtotal Resection ◽  
Intravascular Papillary Endothelial Hyperplasia ◽  
Long Term Follow Up ◽  
History Of ◽  
Papillary Endothelial Hyperplasia ◽  
The Right ◽  
Frontal Skull Base

Intracranial intravascular papillary endothelial hyperplasia (IPEH) is very rare, and to our knowledge long-term follow-up results have not been previously published. An 11-year-old boy presented with a 6-month history of progressive visual impairment in the right eye. Magnetic resonance imaging revealed a well-enhanced, large parasellar mass involving the cavernous sinus, right frontal skull base, and ethmoid and sphenoid sinuses. Frontotemporal craniotomy and subtotal resection were performed, and the diagnosis of IPEH was confirmed. The mass increased in size during the following 3 months. A second operation was performed via frontotemporal craniotomy combined with a transsphenoidal approach, and gross-total resection of the tumor was achieved. Adjuvant radiotherapy (5040 cGy) and chemotherapy with interferon were administered. The patient's visual symptoms improved, and there was no recurrence during a 13-year follow-up period. The results of this case indicate that intracranial IPEH can recur with subtotal resection; however, optimal resection with multimodal adjuvant treatment can control the disease for many years, if not permanently.

Sudden Bilateral Sensorineural Hearing Loss Following Speedballing

2008 ◽  
Vol 19 (06) ◽  
pp. 461-464 ◽  
Author(s):  
Cynthia G. Fowler ◽  
Jennifer L. King
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otoacoustic Emissions ◽  
Rare Complication ◽  
Pure Tone Audiometry ◽  
Sensorineural Hearing ◽  
Acoustic Reflexes ◽  
History Of ◽  
Bilateral Sensorineural Hearing Loss ◽  
The Right

Background: Hearing loss is an infrequently-reported consequence of recreational drug abuse. Although there are sporadic reports of hearing loss from heroin and cocaine ingested separately, there are no reports of hearing loss resulting from the combination of both drugs ingested simultaneously in the form of speedballing. Purpose: The purpose of this report is to document a case of bilateral sensorineural hearing loss associated with an episode of speedballing. Research Design: Case Report Data Collection And Analysis: The subject of this report was a 40-year-old man with a 20-year history of substance abuse. Data collected included a case history, pure tone audiometry, tympanometry and acoustic reflexes, and transient evoked otoacoustic emissions. Results: The audiologic evaluation indicated a mild to moderate, relatively flat, bilateral sensorineural hearing loss that was worse in the right ear. Conclusions: A bilateral sensorineural hearing loss involving both cochlear and neural pathology may be a rare complication of cocaine, heroin, or the combination of the two drugs.

Isolated extramedullary plasmacytoma of the true vocal fold

2000 ◽  
Vol 114 (7) ◽  
pp. 540-542 ◽  
Author(s):  
Yoseph Rakover ◽  
Michael Bennett ◽  
Rephael David ◽  
Gabriel Rosen
Keyword(s):  
Vocal Fold ◽  
Plasma Cells ◽  
Surgical Excision ◽  
Extramedullary Plasmacytoma ◽  
Light Chains ◽  
History Of ◽  
Kappa Light Chains ◽  
One Year ◽  
The Right ◽  
Local Surgical Excision

We report a rare case of isolated extramedullary plasmacytoma (EMP) of the right true vocal fold in a 38-year-old male with a one-year history of hoarseness. Immunohistochemical staining of plasma cells in the tumour, showed over 90 per cent of them to be positive for kappa light chains. After two attempts at local surgical excision and recurrence within 10 months, the tumour was irradiated.Only seven reported cases of isolated EMP of the true vocal fold are reported in the literature. The therapeutic options are discussed.

scholarly journals Ectopic intraconal orbital meningioma – A rare case report

2021 ◽  
Vol 12 ◽  
pp. 305
Author(s):  
Anil Kumar Sharma ◽  
Charandeep Singh Gandhoke ◽  
Somen Misra ◽  
Ashik Ravi ◽  
Rakesh Kumar Gupta ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual Outcome ◽  
Surgical Excision ◽  
Histopathological Diagnosis ◽  
Who Grade ◽  
Rare Case Report ◽  
History Of ◽  
The Right ◽  
Orbital Meningioma

Background: Ectopic orbital meningiomas (OM) are a rare subset of OMs which are neither attached to the optic nerve sheath nor to the surrounding bone. Case Description: We report the case of a 65-year-old female who presented with a 1 year history of proptosis followed by visual loss and restricted right eye movements since 3 months. Radiology of the orbits was suggestive of intraorbital, intraconal, and heterogeneous contrast enhancing right eye lesion which was completely excised through supraorbital orbitotomy approach. Intraoperatively, the right optic nerve, though compressed, and displaced inferiorly, was free from the lesion. The final histopathological diagnosis was “Meningioma WHO Grade I.” At 3 months follow-up, patient’s vision in the right eye improved from perception of light positive to 6/12 and there was no evidence of recurrence. Conclusion: Rarity of ectopic OM, total surgical excision with an excellent postoperative visual outcome prompted us to report this case.

scholarly journals Benign cemento-ossifying fibroma: a rare case report

2018 ◽  
Vol 4 (2) ◽  
pp. 585
Author(s):  
Gurbax Singh ◽  
Jasmine Kaur ◽  
Jai Lal Davessar ◽  
Latika Kansal ◽  
Ajay Singh
Keyword(s):  
Sphenoid Sinus ◽  
Rare Case ◽  
Surgical Excision ◽  
Ossifying Fibroma ◽  
Computed Tomography Scan ◽  
Rare Case Report ◽  
History Of ◽  
The Right ◽  
Slow Growing ◽  
Tomography Scan

<p>Cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion commonly seen in the head and neck regions. It is considered as a benign, locally aggressive neoplasm that requires surgical excision. COF has traditionally been considered to be slow growing. We report a case of 11 year-old girl who presented to the ENT Department of our hospital with 7 months history of nasal obstruction, proptosis and headache. Computed Tomography scan images showed a mass in the right nasal cavity. This case is notable because involvement of the sphenoid sinus is rare. </p>

scholarly journals Sacral Tuberculosis: An Atypical Manifestation

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Faisal Amir Si Mirah ◽  
Ahmad Faizal Roslan ◽  
Ed Simor Khan Mor Japar Khan ◽  
Rajandra Kumar Karupiah ◽  
Zamzuri Zakaria @ Mohamad
Keyword(s):  
Correct Diagnosis ◽  
Lower Limbs ◽  
Mantoux Test ◽  
Ct Guided ◽  
Walking Aids ◽  
Grade 5 ◽  
History Of ◽  
Prolapsed Intervertebral Disc ◽  
The Right ◽  
High Index Of Suspicion

Sacral tuberculosis (TB) is extremely rare and its unusual entity might delay the diagnosis and treatment of this treatable disease. A 38-year-old lady presented with a 1 year history of lower back pain with radiculopathy more to right lower limb. The patient was initially treated as Prolapsed Intervertebral Disc (PID), but showed no improvement despite regular physiotherapy and medication. Subsequently, the pain was confined to the right gluteal area and became more severe. Quality of life was impaired in which patient started using walking aids and stopped working. There was a weight loss of 20kg. No other symptom of TB infection or history of contact with TB patient. Bowel and urinary functions were normal. Examination showed localized tenderness at the right gluteal area. Neurological assessment of both lower limbs were MRC grade 5. Blood investigations were normal including the ESR level (17mm/hour). Mantoux test was positive with 18mm induration. MRI revealed a large rim enhancing paravertebral collection at pre-sacral space which extended into bilateral piriformis and gluteal muscles. The patient underwent CT-guided drainage of both gluteals and specimens taken to confirm the diagnosis of TB. Patient showed significant improvement clinically within 1 week after the drainage procedure and initiation of antituberculous chemotherapy. The initial presentation of this patient mimics PID due to irritation of sciatic nerve at piriformis level. However a change in the presentation and failure of conservative treatment should raise a high index of suspicion and necessitates further investigation to establish correct diagnosis hence proper treatment can be initiated.

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