scholarly journals Isolated Torticollis May Present as an Atypical Presentation of Meningitis

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Roger Chirurgi ◽  
Samrina Kahlon
Keyword(s):  
Case Report ◽  
Bacterial Meningitis ◽  
Adult Patient ◽  
Lumbar Puncture ◽  
Immunocompromised Patient ◽  
Medical Emergency ◽  
Atypical Presentation ◽  
Immunocompromised Patients ◽  
Nuchal Rigidity ◽  
Life Threatening

Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare.Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient.Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis.Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

scholarly journals Rapid Fatal Outcome of Cryptococcal Meningoencephalitis in a Non-HIV Immunocompromised Patient with a Low Fluconazole Susceptibility Isolate: A Case Report from Madagascar

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mihaja Raberahona ◽  
Rivonirina A. Rakotoarivelo ◽  
Njary Randriamampionona ◽  
Angelot F. Rakotomalala ◽  
Tiana Razafinambinintsoa ◽  
...  
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Adult Patient ◽  
Immunocompromised Patient ◽  
Fatal Outcome ◽  
Accurate Diagnosis ◽  
Immunocompromised Patients ◽  
Cryptococcal Meningoencephalitis ◽  
Detailed Case ◽  
Hiv Negative

Cryptococcal meningoencephalitis is considered rare in HIV-negative individuals. In Madagascar, the epidemiology of cryptococcosis has not yet been well described, neither in immunocompetent nor in immunocompromised patients. We report here the first Malagasy detailed case of cryptococcal meningoencephalitis in a non-HIV immunocompromised adult patient carrying a low fluconazole susceptibility isolate. We emphasize the importance of early and accurate diagnosis to meet the challenges of managing cryptococcosis in developing countries.

scholarly journals Osteomyelitis Infection ofMycobacterium marinum: A Case Report and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hao H. Nguyen ◽  
Nada Fadul ◽  
Muhammad S. Ashraf ◽  
Dawd S. Siraj
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Immunocompromised Patient ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Deep Soft Tissue ◽  
Invasive Infections

Mycobacterium marinum(M. marinum) is a ubiquitous waterborne organism that grows optimally at temperatures around 30°C. It is a nontuberculousMycobacteriumfound in nonchlorinated water with worldwide prevalence. It is the most common atypicalMycobacteriumthat causes opportunistic infection in humans.M. marinumcan cause superficial infections and localized invasive infections in humans, with the hands being the sites most frequently affected. It can cause skin lesions, which are either single, papulonodular lesions, confined to an extremity, or may resemble cutaneous sporotrichosis. This infection can also cause deeper infections including tenosynovitis, bursitis, arthritis, and osteomyelitis. Disseminated infections and visceral involvements have been reported in immunocompromised patients. We here report a case of severe deep soft tissue infection with necrotizing fasciitis and osteomyelitis of the left upper extremity (LUE) caused byM. marinumin an immunocompromised patient.

scholarly journals Coagulopathy secondary to chicken pox: a case report

2017 ◽  
Vol 4 (6) ◽  
pp. 1706
Author(s):  
Harharpreet Kaur ◽  
Gurinder Mohan ◽  
Harsehaj Singh ◽  
Gurraj Singh ◽  
Anusha .
Keyword(s):  
Case Report ◽  
Healthy Adult ◽  
Clinical Course ◽  
Hemorrhagic Disease ◽  
Immunocompromised Patients ◽  
Varicella Infection ◽  
Immunocompetent Adult ◽  
Chicken Pox ◽  
Healthy Adult Male ◽  
Life Threatening

Chickenpox often produces a self-limiting disease in children and adolescents. The clinical course is usually mild and complications are rare. The complications that are known to be associated with it are pneumonia, meningitis, myocarditis and nephritis. Severe and disseminated varicella infection with organ dysfunction can also be seen amongst diabetics and immunocompromised patients. However, it is not commonly known that varicella can be life threatening even in immunocompetent adult patients. We present a case of a healthy adult male in which this infection progressed to malignant hemorrhagic disease associated with coagulopathy.

Can Seizures Be the Sole Manifestation of Meningitis in Febrile Children?

PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 527-534
Author(s):  
Steven M. Green ◽  
Steven G. Rothrock ◽  
Kathleen J. Clem ◽  
Raymond F. Zurcher ◽  
Laura Mellick
Keyword(s):  
Bacterial Meningitis ◽  
Lumbar Puncture ◽  
Decision Rules ◽  
Case Series ◽  
Signs And Symptoms ◽  
Viral Meningitis ◽  
Retrospective Case ◽  
Nuchal Rigidity ◽  
Referral Hospitals ◽  
Meningitis In Children

Objective. It is frequently taught that lumbar puncture is a mandatory procedure in many or all children who have fever and a seizure, because the convulsion may represent the sole manifestation of bacterial meningitis. We attempted to determine the incidence of this occult manifestation of meningitis. Design. Retrospective case series. Setting and patients. 503 consecutive cases of meningitis in children aged 2 months to 15 years seen at two referral hospitals during a 20-year period. Main outcome measures. Signs and symptoms of meningitis in patients having associated seizures. Results. Meningitis was associated with seizures in 115 cases (23%), and 105 of these children were either obtunded or comatose at their first visit with a physician after the seizure. The remaining 10 had relatively normal levels of consciousness and either were believed to have viral meningitis (2) or possessed straightforward indications for lumbar puncture: nuchal rigidity (6), prolonged focal seizure (1), or multiple seizures and a petechial rash (1). No cases of occult bacterial meningitis were found. Conclusion. In our review of 503 consecutive children with meningitis, none were noted to have bacterial meningitis manifesting solely as a simple seizure. We suspect that this previously described entity is either extremely rare or nonexistent. Commonly taught decision rules requiring lumbar puncture in children with fever and a seizure appear to be unnecessarily restrictive.

scholarly journals COVID-19 Associated Rhino-Orbital Mucormycosis Complicated by Gangrenous and Bone Necrosis—A Case Report from Honduras

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 826
Author(s):  
Elsa Yolanda Palou ◽  
María Auxiliadora Ramos ◽  
Emec Cherenfant ◽  
Adoni Duarte ◽  
Itzel Carolina Fuentes-Barahona ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Early Diagnosis ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Immunocompromised Patients ◽  
Bone Necrosis ◽  
Inappropriate Use ◽  
Prompt Treatment ◽  
Life Threatening

Background: Mucormycosis is a life-threatening invasive fungal infection most commonly observed in immunocompromised patients. Throughout the COVID-19 pandemic, a growing number of Mucorales associated infections, now termed COVID-19 associated mucormycosis (CAM), have been reported. Despite an increase in fatality reports, no cases of rhino-orbital CAM complicated with gangrenous bone necrosis have been described in the literature to date. Case: A 56-year-old male with a recent COVID-19 diagnosis developed rhino-orbital mucormycosis after 22 days of treatment with dexamethasone. Cultures and histopathological assessment of tissue biopsy confirmed the diagnosis. The patient survived after treatment with amphotericin B. Conclusions: Mucormycosis is an invasive fungal infection affecting mostly immunocompromised patients. Along with the COVID-19 pandemic, the inappropriate use of steroids, in addition to concurrent risk factors, such as diabetes, has led to an increase in the occurrence of these devastating mycoses, leading to the development of severe presentations and complications, as observed in many cases. Early diagnosis and prompt treatment are crucial in order to avoid dissemination and fatal outcomes.

scholarly journals Tooth as a foreign body in trachea mimicking asthma in an adult patient

2020 ◽  
Vol 6 (2) ◽  
pp. 403
Author(s):  
Ankur Batra ◽  
Megha Goyal
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Adult Patient ◽  
Early Recognition ◽  
Foreign Body Aspiration ◽  
Progressive Dyspnoea ◽  
Radiological Findings ◽  
Tracheobronchial Foreign Body ◽  
Life Threatening

<p class="abstract">Tracheobronchial foreign body aspiration is a life threatening emergency that requires prompt removal, but sometimes it may remain undetected because of atypical history, or misleading clinical and radiological findings. We present a case report of a 32 years old female who presented with progressive dyspnoea, misdiagnosed as asthma, not responding to bronchodilators and finally diagnosed as foreign body in trachea. The inclusion of foreign body aspiration in the differential for such patients allows for early recognition and appropriate management.</p>

scholarly journals Herpes Vegetans, an atypical herpes lesion in HIV patient: a case report

2021 ◽  
Author(s):  
Sondang P. Sirait ◽  
Wresti Indriatmi
Keyword(s):  
Case Report ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Differential Diagnoses ◽  
Atypical Presentation ◽  
Immunocompromised Patients ◽  
Rare Form ◽  
Herpes Infection ◽  
Genital Area ◽  
Simplex Virus

Herpes vegetans is a rare form of Herpes simplex virus (HSV) infection in immunocompromised patients that clinically presents as a verrucous and hypertrophic lesion. In this case, we present a 36- year-old man with exophytic verrucous masses in the genital area that was initially suspected as a malignancy. Difficulty to properly diagnose the patient resulted in a few failed attempts at treating the lesion. After excluding other differential diagnoses, the atypical lesion proved to be caused by vegetative herpes infection due to a good response to HSV therapy. Reevaluation of biopsy also showed signs of HSV etiology. Atypical presentation of herpes simplex in immunocompromised patients still proves to be a challenge to diagnose and treat. Proper clinical identification and workup are needed to diagnose and to choose proper regiments

scholarly journals An uncommon side effect from the ‘king of fruit’: A case report on life-threatening hyperkalaemia after eating durian fruit

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110631
Author(s):  
Alvin Oliver Payus ◽  
Fatimah Ahmedy ◽  
Syed Sharizman Syed Abdul Rahim ◽  
Doreen Sumpat
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Potassium Level ◽  
Treatment Initiation ◽  
Kidney Injury ◽  
Medical Emergency ◽  
Rare Occurrence ◽  
Severe Condition ◽  
Life Threatening ◽  
Prompt Diagnosis

Hyperkalaemia is a condition of excess potassium level that occurs as a result of increased intake, or reduced renal clearance, or both. In a severe condition, hyperkalaemia is a medical emergency that can be life-threatening especially if recognised late and left untreated. There are many causes of hyperkalaemia. However, eating durian fruit in the background of impaired kidney function is a very rare occurrence. In this article, we report a case of an elderly lady who presented with a life-threatening hyperkalaemia as a result of eating large amount of durian fruit while having multiple diarrhoeal episodes due to acute gastroenteritis that led to acute kidney injury. She was successfully treated and was discharged well. The objective of this case report is to share the rare cause of a life-threatening hyperkalaemia where prompt diagnosis and treatment initiation are crucial to prevent mortality.

scholarly journals Atypical Presentation of Systemic Arthritis in a Toddler with Down Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Emily Worley ◽  
Weijie Li ◽  
Jordan T. Jones
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Broad Spectrum ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Chronic Inflammatory Disease ◽  
Atypical Presentation ◽  
Increased Risk ◽  
Macular Rash ◽  
Life Threatening ◽  
Atypical Presentations

Systemic juvenile idiopathic arthritis (sJIA) is a chronic, inflammatory disease of childhood, which is characterized by the combination of arthritis, serositis, daily, high-spiking fevers, and evanescent macular rash and can present with the life-threatening complication of macrophage activation syndrome (MAS). Children with Down syndrome (DS) have complex medical challenges related to abnormalities in their immune system, which can cause a broad spectrum of disease manifestations, which can occur atypically. Children with DS are at increased risk for arthritis and interstitial lung disease (ILD) associated with sJIA that has high mortality. This case report outlines an atypical presentation of sJIA in a 21-month-old male with DS in which fever was not part of the initial presentation of sJIA and then later developed MAS and ILD. Due to broad spectrum of disease and atypical presentation in children with DS, this case report was created to increase awareness of atypical presentations of rheumatic disease in children with DS.

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