scholarly journals Disseminated Cryptococcosis in a Non-HIV Patient in Singapore

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Jonathan See ◽  
Kok Choon Raymond Fong ◽  
Humaira Shafi
Keyword(s):  
Lupus Erythematosus ◽  
Pulmonary Involvement ◽  
Tertiary Hospital ◽  
Mortality And Morbidity ◽  
Therapeutic Modalities ◽  
Appropriate Treatment ◽  
Improved Outcomes ◽  
Atypical Clinical Presentation ◽  
Threatening Condition ◽  
Life Threatening

We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition.

Pyriform sinus rupture caused by blunt trauma

2020 ◽  
pp. 197140092097516
Author(s):  
Emil Jernstedt Barkovich ◽  
M Reza Taheri
Keyword(s):  
Blunt Trauma ◽  
Pyriform Sinus ◽  
Significant Heterogeneity ◽  
Cervical Trauma ◽  
Specific Location ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Pharyngeal Perforation ◽  
Life Threatening ◽  
Foreign Body Impaction

Hypopharyngeal perforation (HP) is a potentially life-threatening condition most associated with iatrogenic injury and foreign body impaction. Additionally, a number of cases of posterior HP have been reported following blunt cervical trauma. We present a case of a construction accident causing lateral hypopharyngeal rupture. Visceral perforation was initially diagnosed on computed tomography (CT) imaging and managed conservatively. We speculate this region may be particularly vulnerable to injury due to an anatomic transition in adjacent fascial support. A review of 29 prior cases suggests that this may be the first reported case of blunt trauma causing rupture of the pyriform sinus. However, significant heterogeneity exists in diagnostic approach. Radiography and CT are rapid, sensitive modalities for suggesting pharyngeal perforation, while fluoroscopy and endoscopy can better assess injury size and location and monitor resolution. Early radiologic recognition of hypopharyngeal injury is essential to initiate appropriate treatment. In certain cases, including our own, both the presence and specific location of perforation may be identified on initial CT images.

scholarly journals Spontaneous liver rupture in a pregnant woman associated with HELLP syndrome

2019 ◽  
Vol 24 (3) ◽  
pp. 132-138
Author(s):  
T. M. Bunyatov ◽  
I. A. Kozlov ◽  
B. N. Gurmikov ◽  
Yu. A. Stepanova ◽  
V. S. Shirokov ◽  
...  
Keyword(s):  
Hellp Syndrome ◽  
Similar Case ◽  
Case Reports ◽  
Endovascular Embolization ◽  
Syndrome Patient ◽  
Liver Rupture ◽  
Right Hepatic Artery ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous liver rupture is rare and highly dangerous, life-threatening condition occurring in 1–2% of pregnant women with preeclampsia and eclampsia. There are more than 100 similar case reports in the literature. It is believed that liver rupture is caused by HELLP syndrome as one of the signs of preeclampsia. The results of surgical treatment is still unsatisfactory. Appropriate treatment strategy is absent because of rareness of this condition. It is presented case report of a woman with spontaneous liver rupture associated with HELLP syndrome. Patient underwent perihepatic tamponade, endovascular embolization of right hepatic artery followed by right-sided hemihepatectomy.

Life-threatening complications of Ludwig’s angina: a series of cases in a developed country

2021 ◽  
Vol 14 (4) ◽  
pp. e240429
Author(s):  
Catarina Mendes Silva ◽  
Joana Paixão ◽  
Pedro Neves Tavares ◽  
João Pedro Baptista
Keyword(s):  
Developed Countries ◽  
Developed Country ◽  
Mortality And Morbidity ◽  
Space Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ludwig’S Angina ◽  
Reduction Of Mortality ◽  
Modern Era ◽  
Ludwig's Angina

Ludwig’s angina is a deep neck space infection defined as a rapidly progressive bilateral cellulitis of the submandibular space. In spite of being an uncommon entity in developed countries and the reduction of mortality and morbidity due to modern era of antibiotics, improved imaging and airway management, it is still an important and potentially life-threatening condition. The authors present 3 cases of Ludwig’s angina that occurred in a developed country, and that required admission in intensive care unit and extensive surgical and medical treatment.

scholarly journals An uncommon cause of diffuse alveolar hemorrhage in a young male

2019 ◽  
Vol 89 (2) ◽  
Author(s):  
Anshul Mittal ◽  
Jagdish Chander Suri ◽  
Shibdas Chakrabarti ◽  
Pranav Ish
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Young Male ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Systemic Lupus ◽  
Threatening Condition ◽  
Life Threatening

It is uncommon for Systemic lupus erythematosus (SLE) to present with diffuse alveolar hemorrhage (DAH) as the initial presentation. To diagnose this in a young male with no renal involvement is further uncommon. We report a case of a 16-year-old boy, who presented with hemoptysis and was eventually diagnosed as DAH with underlying SLE. Treatment with steroids and immunosuppressant helped in rapid recovery from this potentially life-threatening condition. This case highlights the need of defining diagnostic criteria for SLE in patients presenting as DAH and formulating guidelines for treatment of the same, especially in absence of co-existing lupus nephritis.

Managing laryngotracheal trauma: 3 year experience at a tertiary hospital in North India

2020 ◽  
Vol 6 (3) ◽  
pp. 459
Author(s):  
Manish Munjal ◽  
Japneet Kaur ◽  
Porshia Rishi ◽  
Harjinder Singh ◽  
Nitika Tuli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Hospital ◽  
Aerodigestive Tract ◽  
North India ◽  
Common Finding ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Emergency Procedures ◽  
Acute Injuries ◽  
Life Threatening

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Laryngotracheal trauma includes life threatening injuries that are encountered by emergency care physicians, trauma surgeons and ENT surgeons. These injuries can occur in the most remote areas or in the busiest metropolitan setting. Earlier intervention is vital in order to reduce the mortality and morbidity associated with insult to the aerodigestive tract and surrounding structures.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This is a retrospective study of 21 patients who presented to the emergency department of Dayanand Medical College and Hospital, Ludhiana, for management of injuries to aerodigestive tract over a period of 3 years from January 2016 to December 2019.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>Twenty-one patients were seen with acute injuries to the airway in the emergency department. There were 12 males and 9 female patients out of which there were 10 men and 5 women, 3 girls and 2 boys ranging in age from 9 to 60 years. Although most of these injuries occurred as a result of blunt trauma, 6 were due to penetrating injuries out of which 2 were due to homicidal assault. Stridor was the most common finding followed by surgical emphysema. Twelve patients were in acute respiratory distress requiring emergency procedures to secure the airway. All patients underwent successful repair of the injuries. All patients except 1 had a good airway.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Laryngotracheal injury is rare but very crucial and life-threatening surgical emergency. Timely intervention is crucial in the management of laryngotracheal trauma in order to prevent complications.</p>

scholarly journals Maternal and foetal outcome of eclampsia in a referral hospital

2017 ◽  
Vol 6 (3) ◽  
pp. 1021
Author(s):  
Mousumi Das Ghosh ◽  
Vinita Singh ◽  
Alokananda Ray
Keyword(s):  
Antenatal Care ◽  
Early Recognition ◽  
Mode Of Delivery ◽  
Ventilatory Support ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Foetal Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Foetal Outcome

Background: Eclampsia is a life-threatening condition, common in developing countries with high fatality rate. It is a cause of maternal and foetal mortality and morbidity. The aim of the study is to determine the maternal and foetal outcome in Tata Main Hospital, Jamshedpur, Jharkhand, India.Methods: All cases of eclampsia were analysed from January 2012 to December 2014 from admission to discharge or death of the patient.  Age, parity, antenatal care, interval between attack and admission, blood pressure on admission, gestational age and mode of delivery were  taken into account. There were 135 cases of eclampsia out of 14572 deliveries. Only singleton pregnancies were analysed.Results: The incidence of antepartum eclampsia was 84.4%, intrapartum 3% and postpartum 12.5 %. 83% patients were primigravida, 33% less than 20 yrs,42% had no antenatal checkup and 45% had < 4 visits. Only 15% patients received magnesium sulphate before referral to the hospital. There were four maternal deaths and twenty-one perinatal deaths. Eleven patients needed ventilatory support, four developed pulmonary oedema,  two patients had respiratory depression and three patients had renal failure.Conclusions: Hypertensive disease in pregnancy requires proper antenatal care, early recognition and referral, adequate treatment and timely delivery.

Surgical management of esophageal perforation: role of primary closure

2019 ◽  
Vol 27 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Vu Huu Vinh ◽  
Nguyen Viet Dang Quang ◽  
Nguyen Van Khoi
Keyword(s):  
Hospital Admission ◽  
Esophageal Perforation ◽  
Primary Closure ◽  
Primary Repair ◽  
Time Interval ◽  
Mortality And Morbidity ◽  
Thoracic Level ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening

Objective Esophageal perforation is a life-threatening condition associated with high mortality and morbidity. Ambiguous clinical presentation is one of the most common causes of delayed and difficult diagnosis of esophageal perforation. In this retrospective single-center study, we reviewed the outcome of primary closure in patients with esophageal perforation between 2009 and 2017. Methods The data of 65 patients attending our department of thoracic surgery (from 2009 to 2017) for esophageal perforation were reviewed. Primary repair was attempted in 63 patients irrespective of the site of perforation and time interval between injury and hospital admission. In intrathoracic lesions, continuous mediastinal and pleural irrigation was undertaken, whereas in cervical perforations, gauze packing and local irrigation were performed. Jejunotomy was carried out in patients with inadequate healing. Results Of the 65 patients, 63 underwent primary closure and 2 were left to heal spontaneously. The majority of patients ( n = 44) had an esophageal perforation at the thoracic level, and only one was admitted early (<24 h after injury). Among the 63 patients managed with primary closure, 55 had satisfactory healing with one surgery. Healing was delayed in the other 10 patients. No mortality was reported. Conclusions Esophageal perforation can be well managed by primary closure, irrespective of the time interval between injury and hospital admission and the site of perforation. Conservative management might lead to an increased rate of complications such as empyema or necrotizing mediastinitis, and increased morbidity and mortality.

Cavernous sinus thrombophlebitis caused by a dental infection: A case report

2021 ◽  
Vol 7 (04) ◽  
pp. 01-04
Author(s):  
Chantal Ngoune
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Motor Nerve ◽  
Case Series ◽  
Dental Infection ◽  
Mortality And Morbidity ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Enhanced Computed Tomography

Septic cavernous sinus thrombosis (CST) is a rare, life-threatening complication of infections of any of the tissues drained by the cavernous sinus such as the mid-face, orbit and sinuses. With the introduction of antibiotics, the mortality and morbidity rates have significantly reduced although they remain high. The necessity of an early diagnosis and appropriate treatment is therefore of great importance. Clinical presentation includes proptosis, chemosis, ocular motor nerve palsy, and sensitive disorders. Imaging investigations, such as contrast enhanced computed tomography (CT) and magnetic resonance imaging (MRI) have had a significant impact on the diagnosis. This condition is rare and after literature review, we found very few case series and some cases reports. We herein share a case of cavernous sinus thrombophlebitis caused by a dental infection.

scholarly journals Diabetic ketoacidosis in pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2945
Author(s):  
Rosália S. Coutada ◽  
Soraia S. Cunha ◽  
Elisabete S. Gonçalves ◽  
Ana P. Gama ◽  
João P. Silva ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pregnant Woman ◽  
Diabetic Ketoacidosis ◽  
Perinatal Mortality ◽  
Aggressive Treatment ◽  
Mortality And Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
In Pregnancy

Diabetic ketoacidosis in pregnancy is a rare but potential life-threatening condition for the mother and the fetus. It tends to occur latter in pregnancy and is more common in patients with pregestational diabetes. Obstetricians should be aware of the events that can trigger diabetic ketoacidosis in pregnancy. Prompt recognition and aggressive treatment of this condition are essential in order to reduce perinatal mortality and morbidity. The authors present a case of a pregnant woman with type 1 diabetes with a poor surveillance of pregnancy and noncompliance to treatment that develops severe diabetic ketoacidosis at 34 weeks of gestation.

scholarly journals Successful completion of pregnancy in a woman with chronic granulomatous disease

2011 ◽  
Vol 4 (4) ◽  
pp. 174-176 ◽  
Author(s):  
Michi Hisano ◽  
Shinichi Kobayashi ◽  
Naoko Arata ◽  
Atsuko Murashima ◽  
Koushi Yamaguchi
Keyword(s):  
Chronic Granulomatous Disease ◽  
Antimicrobial Prophylaxis ◽  
Granulomatous Disease ◽  
Successful Completion ◽  
Mortality And Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fatal Illness

Chronic granulomatous disease (CGD) used to be a fatal illness of childhood and patients rarely survived past the first decade. Although antimicrobial prophylaxis has dramatically reduced mortality and morbidity in recent years, CGD remains a life-threatening condition. We present the successful obstetric course of a patient with CGD.

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