scholarly journals Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Richard Jesse Durrance ◽  
Alice Kyungsun Min ◽  
Marilyn Fabbri ◽  
Terrence McGarry
Keyword(s):  
Bacterial Pneumonia ◽  
Clinical Case ◽  
Cell Mediated Immunity ◽  
Cd4 Counts ◽  
Legionella Pneumonia ◽  
Aged Woman ◽  
Appropriate Treatment ◽  
Middle Aged Woman ◽  
Hiv Aids

Introduction. Legionella is a frequent cause of bacterial pneumonia in patients with AIDS. While multiple organisms have been associated with cavitary pneumonia in this population, Legionella has not. Clinical Case. A middle-aged woman with HIV-AIDS and severely depressed CD-4 count presented with one month of progressively worsening productive cough and dyspnea. Serial imaging showed focal consolidations which multiplied and cavitated over the subsequent days. Legionella urine antigen was positive, and appropriate treatment was continued for 3 weeks total. The patient recovered quickly, and follow-up imaging 8 weeks later showed near-resolution of all lesions. Discussion. Cavitary pneumonia secondary to Legionella has been seldom described, traditionally in the context of immunosuppressive therapy. Patients with AIDS and severely depressed CD4 counts have significantly compromised cell-mediated immunity. This case highlights the importance of consideration for legionellosis in rapidly progressing cavitary pneumonia, especially in patients with severely compromised cell-mediated immunity, including those with HIV-AIDS.

A case of statin-induced liver injury with positive rechallenge with a second statin. Is there a class effect?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giovanna Onfiani ◽  
Fabio Nascimbeni ◽  
Francesca Carubbi
Keyword(s):  
Liver Injury ◽  
Clinical Symptoms ◽  
High Risk Population ◽  
Drug Induced ◽  
Case Presentation ◽  
Drug Induced Liver Injury ◽  
Aged Woman ◽  
Cardiovascular Morbidity And Mortality ◽  
Middle Aged Woman

Abstract Objectives Statins have proved to reduce cardiovascular morbidity and mortality in high-risk population and are generally well tolerated, although adverse events can occur. Up to 3% of patients develop aminotransferases elevation, which usually normalizes with continued treatment and hardly is associated with clinical symptoms. Serious statin-related liver injury is exceedingly rare. Furthermore, literature regarding rechallenge with a second statin is extremely poor. Some authors caution that re-exposure to these drugs is associated with a more serious liver injury but safe switching to a second statin after drug-induced liver injury (DILI) is also reported. Case presentation We describe a case of a middle-aged woman who developed hepatocellular liver injury after simvastatin dose escalation; a rechallenge with low dose rosuvastatin caused rapid recurrence of DILI. Conclusions In our opinion, clinicians should be very cautious upon rechallenge and closely follow-up patients who experienced statin-induced liver injury when trying re-exposure to another statin.

scholarly journals Clitorial inclusion cyst in an adult: a rare presentation

2019 ◽  
Vol 8 (8) ◽  
pp. 3374
Author(s):  
Tanweerul Huda ◽  
Tarun Sutrave ◽  
Bharati Pandya
Keyword(s):  
Postoperative Recovery ◽  
Cystic Mass ◽  
The Body ◽  
Inclusion Cyst ◽  
Rare Presentation ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Rare Site ◽  
Local Examination

Dermoid cysts are benign lesions that grow slowly and can occur anywhere in the body. Clitoris is an extremely rare site for dermoids cysts. We present a case of inclusion cyst of clitoris in a middle aged woman, who had it for 10 years before presenting for relief from her symptoms. Local examination revealed a 3 cm X 4 cm size cystic mass at the clitoris giving it an appearance of clitoromegaly. She underwent an excision of the cyst at our hospital with the histopathology report suggesting the lesion to be a dermoid cyst. Postoperative recovery was uneventful with no evidence of recurrence on follow up.

Gastroesophageal Junction Tumors Does Location Determine Treatment?

2017 ◽  
Author(s):  
Emily L. Siegel ◽  
Miguel Burch
Keyword(s):  
Study Design ◽  
Clinical Case ◽  
Classification Scheme ◽  
Treatment Approach ◽  
Gastroesophageal Junction ◽  
Design Study ◽  
Appropriate Treatment ◽  
Study Intervention ◽  
Landmark Study

This chapter summarizes a landmark study in treatment of gastroesophageal (GE) junction tumors. Should an anatomically based classification scheme of GE tumors define the appropriate treatment approach for these tumors? Starting with that question, it describes the basis of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving possible gastrectomy and esophagectomy.

scholarly journals Renal Tuberculosis in a Middle Aged Woman Presenting with Asymptomatic Microscopic Haematuria and Erythema Nodosum

1970 ◽  
Vol 10 (2) ◽  
pp. 132-134
Author(s):  
Abdul Wadud Chowdhury ◽  
Muhammad Rafiqul Alam ◽  
Amitav Saha ◽  
Mohammad Mahbub Jamil
Keyword(s):  
Erythema Nodosum ◽  
Urine Analysis ◽  
Aged Woman ◽  
Urogenital Tuberculosis ◽  
Renal Tuberculosis ◽  
Middle Aged Woman ◽  
Primary Origin ◽  
Pulmonary Focus ◽  
Common Association

Erythema nodosum is a common association of tuberculosis (TB), especially in this part of the world. Urogenital TB, although less common than other form of tuberculosis, may be associated with erythema nodosum along with other urinary complaints. Here we present a case of an old lady who presented with erythema nodosum with painless haematuria (microscopic) which was later found to be of tuberculous aetiology. Urine analysis yielded no acid-fast bacilli but culture on special media showed growth of Mycobacterium tuberculosis. Though erythema nodosum is usually associated with primary TB, our case revealed it can be found in cases where pulmonary focus is not the primary origin. The patient responded well to anti-tubercular drugs and is doing well on follow-up. Keywords: Erythema nodosum, Renal Tuberculosis, Urogenital Tuberculosis.   doi: 10.3329/jom.v10i2.2831   J MEDICINE 2009; 10 : 132-134

scholarly journals A Case of Coronary Cameral Fistula: When and How to Intervene?

2021 ◽  
Author(s):  
Mehdi Peighambari ◽  
Marziyeh Pakbaz ◽  
Azin Alizadehasl ◽  
Saeid Hosseini ◽  
Hamidreza Pouraliakbar
Keyword(s):  
Coronary Artery ◽  
Unusual Case ◽  
Coronary Artery Fistula ◽  
Circumflex Coronary Artery ◽  
Aged Woman ◽  
Complex Anatomy ◽  
Coronary Artery Fistulas ◽  
Middle Aged Woman ◽  
The Right

Coronary artery fistulas constitute a rare anomaly defined as an abnormal communication between a coronary artery and a great vessel or any cardiac chamber. The majority of these fistulas arise from the right coronary artery and the left anterior descending coronary artery; the circumflex coronary artery is rarely involved. We present an unusual case of a coronary artery fistula in a middle-aged woman who presented with symptoms of heart failure and abnormal auscultation. Echocardiography and conventional and computed tomography angiography showed that the coronary fistula originated from the left circumflex coronary artery and drained majorly into the right ventricle. Given the complex anatomy of the fistula, we managed it surgically rather than percutaneously. There were no complications early after surgery and at 1 year’s follow-up.

scholarly journals ‘Transvenous’ pleurocentesis

2019 ◽  
Vol 27 (5) ◽  
pp. 313-315
Author(s):  
Kelvin Shenq Woei Siew ◽  
Huynh Quoc Hieu ◽  
Alexander Loch
Keyword(s):  
Central Venous Catheter ◽  
Fluid Resuscitation ◽  
Venous Catheter ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
X Ray ◽  
Aged Woman ◽  
Appropriate Treatment ◽  
Middle Aged Woman ◽  
Chest X Ray

A middle-aged woman had a central venous catheter insertion for fluid resuscitation presented with tachypnea and oxygen desaturation 6 h later. Diagnosis was made based on the chest X-ray performed 6 h after the catheter placement. Thereafter, the patient received appropriate treatment.

The Use of Hypnosis for Airplane Phobia With an Obsessive Character

2012 ◽  
Vol 11 (2) ◽  
pp. 89-103
Author(s):  
Erin G. Volpe ◽  
Michael R. Nash
Keyword(s):  
Simulation Modeling ◽  
Single Case ◽  
Self Report ◽  
Anxiety Management ◽  
Level Change ◽  
Aged Woman ◽  
Modeling Analysis ◽  
Middle Aged Woman

This is a single-case study of a middle-aged woman with specific phobia and panic symptoms associated with airplanes. Treatment was brief and supportive in nature, using hypnosis for both exposure purposes and as a self-regulatory tool for anxiety management. The patient’s identified target symptom (readiness to fly) was tracked using daily subjective, self-report measures over the 12-session treatment. Simulation modeling analysis for time-series was used to evaluate the level change across baseline, treatment, and follow-up phases. The patient’s self-assessed readiness to fly increased significantly over the course of treatment, and she successfully engaged in a “practice flight” toward the end of her treatment. However, this patient required a drastic shift in treatment modality, after which progress was made. Theoretical rationale for this shift and ultimate success is discussed.

Wallerian degeneration as a mimic of recurrence of myelitis

2021 ◽  
pp. practneurol-2020-002911
Author(s):  
Arpan Patel ◽  
Prateeka Koul ◽  
Asaff Harel
Keyword(s):  
Cervical Spine ◽  
Wallerian Degeneration ◽  
Middle Aged ◽  
Corticospinal Tracts ◽  
Aged Woman ◽  
Dorsal Columns ◽  
Middle Aged Woman

A middle-aged woman with idiopathic longitudinally extensive myelitis underwent repeat MR scan of cervical spine at 5-month follow-up, which showed new non-enhancing T2 hyperintensities, initially reported as myelitis recurrence. However, the hyperintensities involved both lateral corticospinal tracts caudal to the initial lesion and both dorsal columns rostral to the initial lesion and were therefore compatible with Wallerian degeneration. This radiological mimic should be considered in the differential of recurrence of myelitis.

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