scholarly journals Organising pneumonia manifesting as a late-phase complication of COVID-19

2021 ◽  
Vol 14 (10) ◽  
pp. e246119
Author(s):  
Boon Hau Ng ◽  
Andrea Yu-Lin Ban ◽  
Nik Nuratiqah Nik Abeed ◽  
Mohamed Faisal
Keyword(s):  
Steroid Therapy ◽  
Late Phase ◽  
Acute Onset ◽  
Pleuritic Chest Pain ◽  
Rare Presentation ◽  
Reverse Transcription Pcr ◽  
First Case ◽  
Late Sequela ◽  
Residual Fatigue ◽  
New Onset

Acute COVID-19 usually lasts 4 weeks from the onset of symptoms. We report two cases of COVID-19-associated organising pneumonia (OP) occurring beyond 4 weeks from the acute onset of symptoms. Both tested positive for SARS reverse transcription–PCR 2 months before presentation with a resolution of respiratory symptoms. The first case presented with residual fatigue and worsening exertional dyspnoea. Chest CT revealed an OP pattern. The second case presented with worsening cough and new-onset pleuritic chest pain with persistent radiological consolidation. A transbronchial lung biopsy confirmed OP. Both patients responded well to 12 weeks of steroid therapy. This case illustrates the rare presentation of OP as a late sequela of COVID-19 and the good response to steroid therapy.

scholarly journals Acute Onset Polymyositis after Prolactinoma Extirpation

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Juan Jakez-Ocampo ◽  
Yemil Atisha-Fregoso ◽  
Luis Llorente
Keyword(s):  
Autoimmune Diseases ◽  
Muscle Biopsy ◽  
Steroid Therapy ◽  
Acute Onset ◽  
Pituitary Macroadenoma ◽  
Inflammatory Infiltration ◽  
Total Recovery ◽  
First Case ◽  
Very High

Hyperprolactinemia has been related to autoimmune diseases. Herein, we describe a case of a female with a prolactin producer pituitary macroadenoma who developed severe polymyositis one month after its removal. The patient had very high levels of CPK and muscle biopsy showed remarkable inflammatory infiltration. Steroid therapy was followed with total recovery. To the best of our knowledge, this is the first case reported of acute polymyositis after pituitary macroadenoma exeresis.

Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden
Keyword(s):  
Airway Obstruction ◽  
Nasal Polyp ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Rare Presentation ◽  
First Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Sinonasal Symptoms ◽  
Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

scholarly journals Successful extracorporeal membrane oxygenation resuscitation of patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 746-751
Author(s):  
Tao Wang ◽  
Qiancheng Xu ◽  
Xiaogan Jiang
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Tumour Size ◽  
Acute Onset ◽  
Left Ventricular ◽  
Vanillylmandelic Acid ◽  
Membrane Oxygenation ◽  
First Case ◽  
Va Ecmo

Abstract A 29-year-old woman presented to the emergency department with the acute onset of palpitations, shortness of breath, and haemoptysis. She reported having an abortion (56 days of pregnancy) 1 week before admission because of hyperthyroidism diagnosis during pregnancy. The first diagnoses considered were cardiomyopathy associated with hyperthyroidism, acute left ventricular failure, and hyperthyroidism crisis. The young woman’s cardiocirculatory system collapsed within several hours. Hence, venoarterial extracorporeal membrane oxygenation (VA ECMO) was performed for this patient. Over the next 3 days after ECMO was established, repeat transthoracic echocardiography showed gradual improvements in biventricular function, and later the patient recovered almost completely. The patient’s blood pressure increased to 230/130 mm Hg when the ECMO catheter was removed, and then the diagnosis of phaeochromocytoma was suspected. Computed tomography showed a left suprarenal tumour. The tumour size was 5.8 cm × 5.7 cm with central necrosis. The vanillylmandelic acid concentration was 63.15 mg/24 h. Post-operation, pathology confirmed phaeochromocytoma. To our knowledge, this is the first case report of a patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism which was successfully resuscitated by VA ECMO.

RADT-04. STEREOTACTIC LASER ABLATION (SLA) FOLLOWED BY CONSOLIDATION STEREOTACTIC RADIOSURGERY (SRS) AS A TREATMENT STRATEGY FOR BRAIN METASTASIS THAT RECURRED LOCALLY AFTER INITIAL RADIOSURGERY (BMRS)

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi41-vi41
Author(s):  
Isabela Pena-Pino ◽  
Jun Ma ◽  
Yusuki Hori ◽  
Elena Fomchenko ◽  
Kathryn Dusenbery ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Steroid Therapy ◽  
Local Control ◽  
Treatment Strategy ◽  
Median Overall Survival ◽  
Systemic Disease ◽  
Wound Complications ◽  
Institutional Experience ◽  
New Onset

Abstract INTRODUCTION In independent clinical trials, ~30% of brain metastases recur locally after radiosurgery (BMRS). For these lesions, treatment with stereotactic laser ablation (SLA, also known as laser interstitial thermal therapy (LITT)) alone achieves a 12-month local control (LC12) of 54-85% while repeat SRS achieved LC12 of 54-79%. Here, we report favorable outcomes for BMRS treated with SLA followed by consolidation radiosurgery (SLA/cSRS). METHODS Clinical outcome of 18 patients with 19 histologically confirmed BMRS treated with SLA followed by consolidation SRS and >3 months follow-up were collected retrospectively across three institutions. Local control was defined as stability or decrease in contrast-enhancing (CE) and FLAIR volume. RESULTS SLA achieved ablation of 73-100% of the BMRS CE volumes. Consolidation hypo-fractionated radiosurgery (5 Gy x 5 or 6 Gy x 5) was carried out 16-40 days post-SLA (median of 26 days). With a median follow-up of 185 days (range: 93-1367 days) and median overall survival (OS) of 185 days (range: 99-1367 days), 100% LC12 was achieved. 13/18 (72%) patients that required steroid therapy prior to SLA/cSRS were successfully weaned off steroid by three months post-SLA/cSRS. Post-SLA, KPS declined for 3/19 (16%) patients and improved for 1/19 (5%) patients. No KPS changes occurred subsequent to consolidation SRS. There were no 30-day mortalities or wound complications. Two patients required re-admission within 30 days of SRS (severe headache that resolved with steroid therapy (n=1) and new-onset seizure (n=1)). Except for two patients who suffered histologically confirmed, local failure at 649 and 899 days, all other patients are either alive (n=6) or died from systemic disease progression (n=10). None of the treated patients developed symptomatic radiation necrosis. CONCLUSIONS This collaborative institutional experience support efficacy and safety of SLA followed by consolidation SRS as a treatment for BMRS. The treatment strategy warrants further investigations.

scholarly journals Septic Pulmonary Embolism: three Case Reports

2016 ◽  
Vol 69 (2) ◽  
Author(s):  
Z. Celebi Sözener ◽  
A. Kaya ◽  
C. Atasoy ◽  
M. Kılıckap ◽  
N. Numanoglu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Case Reports ◽  
Pleuritic Chest Pain ◽  
Radiological Findings ◽  
Wound Culture ◽  
Septic Embolism ◽  
First Case ◽  
Septic Pulmonary Embolism ◽  
Fever Response ◽  
Valve Operation

We present three cases of septic pulmonary embolism which occurred as a result of three different causes. The first case, was a 23 year old woman suffering from cough, sputum, hemopthisis and pleuritic chest pain. She had a right subclavian port. On her thorax computed tomography (CT) scans there were widespread bilateral, irregular parenchymal nodular infiltrates and some of them beginning to cavitate. Meticilin resistant stafilococus aureus (MRSA) was isolated from the blood culture and septic embolism was diagnosed. A month after antibiotic theraphy her parenchymal nodules have considerably decreased in size. The second case was a 40 year old woman admitted to our hospital with the same complaints. Her radiological findings were similar. Meticilin sensitive stafilococus aureus (MSSA) was isolated from the blood cultures and antibiotic theraphy was initiated. To investigate the etiology of the nodules due to septic embolism, echocardiography was performed and infective endocarditis was diagnosed. After the antibiotic theraphy and a tricuspid valve operation her parenchymal nodules disappeared. The final case involved a 51 year old man suffering from fever, fatigue, cough and pain in the left arm for one week. His general status was bad. His radiological findings were also similar to the others. Staphillococcus aureus was isolated from blood and wound culture. Following clinical and radiological findings we thought it was a case of septic pulmonary embolism and antibiotic theraphy was started. Despite the therapy we did not take fever response and he died five days after antibiotic therapy. In conclusion, septic pulmonary embolism should be considered in bilateral cavitary nodular infiltrates and must be managed fast.

scholarly journals Case report: a 5-year-old with new onset nephrotic syndrome in the setting of COVID-19 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelsi M. Morgan ◽  
Peace D. Imani
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Pediatric Patient ◽  
Corticosteroid Therapy ◽  
Clinical Remission ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Third ◽  
First Case ◽  
New Onset

Abstract Background This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. Case presentation This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. Conclusions Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.

NEW ONSET METABOLIC SYNDROME AFTER RENAL TRANSPLANTATION: EFFECTS OF MAINTENANCE STEROID THERAPY AND DIABETES

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 214
Author(s):  
E S. Woodle ◽  
R M. Lee ◽  
A H. Rike ◽  
R R. Alloway ◽  
J J. Everly ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Renal Transplantation ◽  
Steroid Therapy ◽  
New Onset

scholarly journals Post-Malaria Neurological Syndrome - A Case of Bell’s Palsy After Plasmodium Vivax Malaria

2013 ◽  
Vol 33 (1) ◽  
pp. 66-67 ◽  
Author(s):  
AK Singh ◽  
S Chakraborti ◽  
S Subhranag
Keyword(s):  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Clinical Symptoms ◽  
Bell’S Palsy ◽  
Acute Onset ◽  
Blood Film ◽  
Bell's Palsy ◽  
Neurological Syndrome ◽  
First Case ◽  
Plasmodium Vivax Malaria

 Post-malaria neurological syndrome (PMNS) is defined as the acute onset of neurological or neuropsychiatric syndrome in a patient who had recently recovered from malaria and have negative blood film at the time of onset of neurological symptoms. It is relatively rare, with various clinical symptoms. We report first case of Bell’s palsy developing on 10th day of afebrile period after successful treatment of Plasmodium vivax (P.vivax) malaria and which completely recovered in next two weeks. DOI: http://dx.doi.org/10.3126/jnps.v33i1.6893 J Nepal Paediatr Soc. 2013;33(1):66-67

Sweet Syndrome and Pemphigus Vulgaris

2012 ◽  
Vol 16 (2) ◽  
pp. 128-130 ◽  
Author(s):  
Ashley O'toole ◽  
Maureen O'malley
Keyword(s):  
Clinical Presentation ◽  
Pemphigus Vulgaris ◽  
Neutrophilic Dermatosis ◽  
Rare Presentation ◽  
Sweet Syndrome ◽  
Autoimmune Blistering Disease ◽  
Mucous Membranes ◽  
Blistering Disease ◽  
Erythematous Plaques ◽  
New Onset

Background: Pemphigus vulgaris is an autoimmune blistering disease of the skin and mucous membranes. Sweet syndrome is an uncommon reactive neutrophilic dermatosis. Objective: This case report describes the rare presentation of a 58-year-old female patient with newly diagnosed pemphigus vulgaris who later presented with erythematous plaques and leukocytosis highly suggestive of Sweet syndrome. Methods: Review of the literature using the PubMed and Medline databases. Results: The clinical presentation of new-onset Sweet syndrome in a patient with pemphigus has been reported in the literature only on one other occasion. Conclusion: The observation of an association between Sweet syndrome and autoimmune diseases, such as pemphigus vulgaris, may ultimately lead to better understanding of the pathophysiology of this disease.

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