scholarly journals Sphenoid sinusitis: a rare cause of ischaemic stroke

2021 ◽  
Vol 14 (10) ◽  
pp. e242943
Author(s):  
Kenneth Stuart Young ◽  
Jian Shen Kiam ◽  
Kneale Metcalf ◽  
Ramez Nassif
Keyword(s):  
Ischaemic Stroke ◽  
Multidisciplinary Approach ◽  
Lateral Wall ◽  
Sphenoid Sinusitis ◽  
Stroke Imaging ◽  
Streptococcus Constellatus ◽  
Accident And Emergency ◽  
Streptococcus Milleri ◽  
Streptococcus Milleri Group ◽  
Accident And Emergency Department

We present the case of a 61-year-old woman who presented to the accident and emergency department with an ischaemic stroke, on a background of receiving intravenous and oral antibiotics to treat chronic left sphenoid sinusitis. Initially presenting with right-sided weakness and aphasia, a diagnosis of acute ischaemic stroke was made. Antibiotics had been commenced 1 month prior to the ischaemic stroke. Imaging at that time showed changes in keeping with chronic sphenoid sinusitis along with a small dehiscence in the lateral wall of the left sphenoid sinus and thrombosis of the left superior ophthalmic vein. During that admission blood cultures grew Streptococcus constellatus, a member of the Streptococcus milleri group. We discuss the unusual aetiology of this stroke, the emerging evidence associating chronic rhinosinusitis with stroke and the complex multidisciplinary approach required for management in this case.

Thrombolysis and its Implications in the Management of Stroke in the Accident and Emergency Department

2002 ◽  
Vol 47 (3) ◽  
pp. 57-59 ◽  
Author(s):  
O. Quaba ◽  
C. E. Robertson
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Great Majority ◽  
Ct Scanning ◽  
Emergency Setting ◽  
Initial Management ◽  
Mean Delay ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department

Objectives: Examination of initial management of stroke patients in the emergency setting to assess feasibility of thrombolysis for acute ischaemic stroke. Methods: Retrospective analysis of all patients presenting with a clinical diagnosis of stroke over a two month period. Exclusion criteria for thrombolysis were applied to assess the number of patients that would potentially have been eligible for thrombolysis. Results: Of 94 patients identified with clinical stroke, only 57 (60.6%) had a CT scan; 23 (24.4%) were confirmed as having had an acute ischaemic stroke. Mean delay in scanning was 2.2 days (range 0–15 days). Even if all patients had presented and been scanned within three hours (as required for thrombolysis), only six (6.4%) patients would have been eligible for thrombolysis. Conclusions: The great majority of patients presenting with clinical stroke do not fulfil the criteria for thrombolysis. Current practice involves significant delays in CT scanning, which has implications for resource structuring should thrombolysis become widely available.

scholarly journals Multiple lung abscesses caused by Streptococcus constellatus

2018 ◽  
Vol 32 (4) ◽  
Author(s):  
Vanina Rognoni ◽  
Annalisa Malara ◽  
Enrico Storti ◽  
Adriano Anesi
Keyword(s):  
Streptococcus Constellatus ◽  
Streptococcus Milleri ◽  
Laboratory Features ◽  
Streptococcus Milleri Group

Despite numerous descriptions of body abscesses produced by Streptococcus milleri group bacteria, lung abscesses caused by this group remain under-reported and the clinical and laboratory features have yet to be fully characterised. We present the case of a patient admitted with lung multiple abscesses produced by Streptococcus constellatus.

scholarly journals Antibiotic Susceptibilities of Genetically Characterized Streptococcus milleri Group Strains

2001 ◽  
Vol 45 (5) ◽  
pp. 1511-1514 ◽  
Author(s):  
Michael Tracy ◽  
Anna Wanahita ◽  
Yevgeny Shuhatovich ◽  
Elizabeth A. Goldsmith ◽  
Jill E. Clarridge ◽  
...  
Keyword(s):  
16S Rrna Gene Sequencing ◽  
Rrna Gene ◽  
Beta Lactam ◽  
Streptococcus Anginosus ◽  
Beta Lactam Antibiotics ◽  
Streptococcus Constellatus ◽  
Antibiotic Susceptibilities ◽  
Streptococcus Milleri ◽  
Streptococcus Milleri Group ◽  
Rrna Gene Sequencing

ABSTRACT Previous studies of the antibiotic susceptibility ofStreptococcus milleri group organisms have distinguished among species by using phenotypic techniques. Using 44 isolates that were speciated by 16S rRNA gene sequencing, we studied the MICs and minimum bactericidal concentrations of penicillin, ampicillin, ceftriaxone, and clindamycin for Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus. None of the organisms was resistant to beta-lactam antibiotics, although a few isolates were intermediately resistant; one strain of S. anginosus was tolerant to ampicillin, and another was tolerant to ceftriaxone. Six isolates were resistant to clindamycin, with representation from each of the three species. Relatively small differences in antibiotic susceptibilities among species of the S. milleri group show that speciation is unlikely to be important in selecting an antibiotic to treat infection caused by one of these isolates.

scholarly journals Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

2021 ◽  
Vol 07 (03) ◽  
pp. e124-e126
Author(s):  
Mark Portelli ◽  
Mark Bugeja ◽  
Charles Cini
Keyword(s):  
Computed Tomography ◽  
Young Adult ◽  
Rare Case ◽  
Surgical Repair ◽  
Bochdalek Hernia ◽  
Case Presentation ◽  
Atypical Case ◽  
Accident And Emergency ◽  
History Of ◽  
Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

Use of an accident and emergency department observation ward in the management of head injury

1993 ◽  
Vol 80 (8) ◽  
pp. 1079-1079 ◽  
Author(s):  
A. F. T. Brown ◽  
G. J. Wilkes ◽  
C. T. Myers ◽  
R. E. Maclaren
Keyword(s):  
Emergency Department ◽  
Head Injury ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

1993 ◽  
Vol 18 (1) ◽  
pp. 115-118 ◽  
Author(s):  
J. STEVENSON ◽  
I. W. R. ANDERSON
Keyword(s):  
Emergency Department ◽  
Complete Resolution ◽  
Wound Care ◽  
Duration Of Treatment ◽  
Mean Delay ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
The Mean ◽  
Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

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