scholarly journals Spontaneous Gastric Necrosis: A Rare Presentation of Invasive Mucormycosis in an Immunocompetent Adult

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tariq Hameed ◽  
Sudhir Kumar Jain ◽  
Faiz Manzar Ansari ◽  
Adiba Nizam ◽  
Amrita Dua
Keyword(s):  
Surgical Excision ◽  
Young Female ◽  
Immunocompetent Adult ◽  
Rare Presentation ◽  
Ulcer Disease ◽  
Pain Abdomen ◽  
Life Threatening ◽  
History Of ◽  
Intravenous Amphotericin ◽  
Immunocompetent Adults

Spontaneous gastric perforations are usually seen in patients with untreated peptic ulcer disease. Mucormycosis, an uncommon, opportunistic, life-threatening fungal infection, rarely causes gastric perforation in immunocompetent adults. Here, we present a case of young female who was admitted to hospital for acute pain abdomen and distension with 5 days history of fever. She was operated and was found to have multiple perforations in the stomach with transmural necrosis. Despite adequate surgical excision and intravenous amphotericin B, patient succumbed to sequelae of infection.

Stridor: a rare presentation of motor neuron disease

2021 ◽  
Vol 14 (7) ◽  
pp. e241923
Author(s):  
Brian Gordon ◽  
Eimear Joyce ◽  
Timothy J Counihan
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Vocal Cord ◽  
Poor Response ◽  
Vocal Cord Palsy ◽  
Pharmacological Therapy ◽  
Rare Presentation ◽  
Emergency Tracheostomy ◽  
Life Threatening ◽  
History Of

A 74-year-old farmer presented to the emergency department with a subacute history of progressive dyspnoea, wheeze and dysphonia. He was treated for an exacerbation of asthma with poor response to pharmacological therapy. Investigation of dysphonia via laryngoscopy identified a bilateral vocal cord palsy. Subsequently, the patient developed an episode of life-threatening stridor and hypercapnic respiratory failure requiring an emergency tracheostomy. Neurology input identified evidence of widespread muscle fasciculations on clinical examination. MRI of the brain and cervical spine were unremarkable. Electromyogram testing identified changes of acute denervation in several limbs consistent with a diagnosis of motor neuron disease (MND). Bilateral vocal cord palsy has been rarely reported in the literature as the heralding symptom resulting in the diagnosis of MND. In patients with a subacute onset of dysphonia, dyspnoea and stridor, MND should be a differential diagnosis.

scholarly journals Sporadic Intra-Abdominal Desmoid: A Rare Presentation as a Hepatic Mass

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shahana Gupta ◽  
Udipta Ray ◽  
Souvik Chatterjee ◽  
Sanjeev Kumar ◽  
Ayusman Satapathy ◽  
...  
Keyword(s):  
Young Female ◽  
Unusual Presentation ◽  
Desmoid Tumour ◽  
History Of Surgery ◽  
Rare Presentation ◽  
Hepatic Mass ◽  
Intraoperative Evaluation ◽  
History Of ◽  
Fibroblastic Cells

We report an unusual presentation of a sporadic intra-abdominal desmoid tumour, possibly arising from the diaphragm, masquerading as a hepatic mass in a young female without any history of surgery or trauma. Histopathology ruled out a hepatic origin of the tumour as was inferred from pre- and intraoperative evaluation. Immunohistochemistry showed positivity of lesional fibroblastic cells forβ-catenin and negativity for CD34, CD117, EMA, SMA, desmin, vimentin, cytokeratin, and ALK1 thereby confirming the diagnosis of a desmoid tumour. There exist only a few reports in the literature on desmoids related to the diaphragm, but only one on a diaphragmatic desmoid that is possibly primary.

scholarly journals Pneumomediastinum following spontaneous vaginal delivery: report of a rare phenomenon

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Dania Badran ◽  
Safiyah Ismail ◽  
James Ashcroft
Keyword(s):  
Medical History ◽  
Vaginal Delivery ◽  
Esophageal Perforation ◽  
Young Female ◽  
Past Medical History ◽  
Rare Presentation ◽  
Spontaneous Vaginal Delivery ◽  
Spontaneous Pneumomediastinum ◽  
Life Threatening ◽  
Clinical Considerations

Abstract Pneumomediastinum is the presence of mediastinal air, which raises concern for life-threatening conditions such as esophageal perforation and mediastinitis. Here, we described the case of a young female with no previous past medical history, who developed spontaneous pneumomediastinum following uncomplicated spontaneous vaginal delivery (SVD) giving birth to a healthy newborn at full term. The incidence of benign pneumomediastinum following SVD is estimated at 1 in 100 000 deliveries. This case explores the etiology of this rare presentation, recommends essential investigations and advises on pertinent clinical considerations.

scholarly journals Coexistence of myasthenia gravis with hypokalemic periodic paralysis: a rare presentation

2019 ◽  
Vol 12 (10) ◽  
pp. e231241 ◽  
Author(s):  
Farah Gul Khan ◽  
Sidra Namran
Keyword(s):  
Myasthenia Gravis ◽  
Young Female ◽  
Periodic Paralysis ◽  
Acute Onset ◽  
Hypokalemic Periodic Paralysis ◽  
Rare Presentation ◽  
Limb Weakness ◽  
Oral Steroids ◽  
Life Threatening ◽  
Neurological Illnesses

Bilateral symmetrical weakness of acute onset is not very uncommon and the differential varies widely from life-threatening neurological illnesses to metabolic and electrolyte derangements. We report the case of a young female with severe muscle weakness, respiratory distress and hypokalemia who required immediate intubation on arrival to emergency department. During hospital course, even after normalisation of serum potassium and some improvement in limb weakness, patient failed multiple attempts of extubation because of type II respiratory failure. Subsequently, acetyl cholinesterase antibodies were checked which came out positive, and diagnosis of myasthenia gravis and hypokalemic periodic paralysis was made. She was successfully extubated after intravenous pulse steroids, pyridostigmine and plasmapheresis. Patient was finally discharged home on oral steroids, pyridostigmine and azathioprine. In a patient presenting with hypokalemic weakness, the suspicion of a second disorder should be very high if weakness fails to resolve following correction of hypokalemia.

Persistent Vulvar Hemorrhage Secondary to Vaginal Hemangioma in Dogs

2008 ◽  
Vol 44 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Jonathan M. Miller ◽  
Nicolaas E. Lambrechts ◽  
Robert A. Martin ◽  
D. P. Sponenberg ◽  
Molly Subasic
Keyword(s):  
Vaginal Bleeding ◽  
Surgical Excision ◽  
Young Female ◽  
History Of

Two young female dogs were presented with a chronic history of persistent vulvar hemorrhage. Vaginoscopy was ultimately used to locate bleeding vaginal masses near the urethral papilla. In both cases, episiotomy was performed to resect the mass, and hemangioma was diagnosed histologically. These tumors caused persistent vaginal bleeding; they were difficult to diagnose without vaginoscopy and lavage; and surgical excision was curative in at least one case.

scholarly journals Renal Abscess Caused by Salmonella Typhi

2015 ◽  
Vol 7 (02) ◽  
pp. 121-123 ◽  
Author(s):  
Amarjeet Kaur ◽  
Smita Sarma ◽  
Navin Kumar ◽  
Sharmila Sengupta
Keyword(s):  
Enteric Fever ◽  
Renal Involvement ◽  
Hepatic Abscess ◽  
Clinical History ◽  
Salmonella Typhi ◽  
The Body ◽  
Renal Abscess ◽  
Rare Presentation ◽  
Life Threatening ◽  
History Of

ABSTRACT Salmonella typhi is a true pathogen, which is capable of causing both intestinal and extraintestinal infections. Unusual presentations of Salmonella should always be kept in mind as this organism can cause disease in almost any organ of the body. S. typhi has been reported to cause the life-threatening infections such as meningitis, endocarditis, myocarditis, empyema, and hepatic abscess. Renal involvement by S. typhi is a relatively rare presentation. We report a case of renal abscess caused by S. typhi in an afebrile, 10-year-old child who did not have any clinical history of enteric fever. To our knowledge, this is the first reported case of isolation of S. typhi from the renal abscess, and interestingly this isolate was found to be resistant to quinolones.

Chronic Inversion of Uterus Following Spontaneous Abortion: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 41-43
Author(s):  
Tara Manandhar ◽  
Deepa Shah ◽  
Pappu Rijal
Keyword(s):  
Coming Out ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Trimester Abortion ◽  
Uterine Inversion ◽  
Pain Abdomen ◽  
Threatening Condition ◽  
Lower Pain ◽  
Life Threatening ◽  
History Of

Uterine inversion is a rare entity but poses a serious threat if not diagnosed and managed timely. Here we present a case of chronic uterine inversion in a 30-year-old lady who presented in emergency with a mass coming out per vagina, blood mixed vaginal discharge, and lower pain abdomen for the last 15 days. She underwent laparotomy and was found to have uterine inversion. The patient was attempted for repositioning of uterus with the Huntington’s approach, but it was unsuccessful, hence Haultain’s operation was done with a total abdominal hysterectomy and bilateral salpingectomy with right-sided ovarian cystectomy for a dermoid cyst. Our case emphasizes the importance of keeping chronic uterine inversion as a differential diagnosis in women presenting with pain abdomen, mass, and bleeding per vagina, and with a recent history of second-trimester abortion. Timely recognition, especially in chronic inversion, will decrease the morbidity and mortality associated with this rare but life-threatening condition.

Disseminated genitourinary histoplasmosis in a patient with AIDS with negative urine antigen testing

2021 ◽  
Vol 14 (11) ◽  
pp. e243375
Author(s):  
Candice Theodora Joseph ◽  
Michael Feely ◽  
Nicole Iovine
Keyword(s):  
Histoplasma Capsulatum ◽  
Surgical Pathology ◽  
Rare Presentation ◽  
Persons Living With Hiv ◽  
Pathological Evaluation ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Living With Hiv

Disseminated histoplasmosis is a life-threatening condition in immunocompromised patients. The majority of healthy persons have benign disease not requiring treatment. However, in persons living with HIV, mortality is high and accurate diagnosis is paramount. We present a case of a 48-year-old HIV-positive woman who presented with haematuria and flank pain. She had a history of recurrent urinary tract infection and nephrolithiasis with obstructive hydronephrosis. During cystoscopy, a bladder lesion was found. Pathological evaluation demonstrated abundant intracellular organisms with apparent budding. Subsequent urine histoplasma antigen was negative. Given the high index of suspicion for histoplasmosis based on the surgical pathology findings and epidemiological history, the patient was started immediately on antifungal therapy. One week later, PCR results of the bladder lesion confirmed the presence of Histoplasma capsulatum. This case highlights a rare presentation of genitourinary histoplasmosis and the utility of surgical pathology evaluation and PCR for diagnosis.

scholarly journals Rapunzel Syndrome: A Rare Presentation with Giant Gastric Ulcer

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Antonios Athanasiou ◽  
Adamantios Michalinos ◽  
Demetrios Moris ◽  
Eleftherios Spartalis ◽  
Nikolaos Dimitrokallis ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Ulcer ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Young Female ◽  
Rare Form ◽  
Rare Presentation ◽  
Rapunzel Syndrome ◽  
History Of ◽  
Small Intestines

The Rapunzel syndrome refers to an uncommon and rare form of trichobezoar that extends past the stomach into the small intestines. The Rapunzel syndrome is usually found in young female patients with a history of psychiatric disorders, mainly trichotillomania and trichophagia. We describe a case of Rapunzel syndrome in a 15-year-old girl who presented with abdominal pain, vomiting, and weight loss. We performed a surgical laparotomy and successfully removed a huge trichobezoar extending into the small intestine.

scholarly journals Occult Leydig Cell Tumour Presenting as Bilateral Gynaecomastia. Case Report and Literature Review

2005 ◽  
Vol 5 ◽  
pp. 884-887
Author(s):  
A. B. Patel ◽  
L. Wilson ◽  
A. Rane
Keyword(s):  
Leydig Cell ◽  
Surgical Excision ◽  
Cell Tumour ◽  
Left Testis ◽  
Threatening Condition ◽  
Leydig Cell Tumour ◽  
Life Threatening ◽  
Hypoechoic Mass ◽  
History Of ◽  
Secondary Hypogonadism

Gynaecomastia is the most common benign breast disorder in men. Among the various causes, testicular malignancies are an uncommon, life-threatening condition requiring prompt diagnosis and treatment. The case of a 28-year-old man is discussed, who presented with a 6-month history of painful bilateral gynaecomastia with no abnormality on clinical or biochemical examination. The patient's symptoms spontaneously resolved within 4 weeks. He then represented 10 years later with similar symptoms and an associated secondary hypogonadism. Ultrasound imaging revealed a clinically occult, hypoechoic mass in the left testis (Leydig cell tumour on histology). Clinical and hormonal findings normalized following surgical excision. This report underlines the importance in clinical practice of ultrasonographic evaluation of the testis, in all patients with gynaecomastia, despite unremarkable findings on physical examination.

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