Nodular melanoma presenting as an exophytic subungual mass

2018 ◽  
Vol 63 (1) ◽  
pp. 32-34 ◽  
Author(s):  
B Finlay ◽  
T Ramachandren ◽  
K Hussey ◽  
S Parkyn ◽  
K Meyer ◽  
...  
Keyword(s):  
Delayed Diagnosis ◽  
Interesting Case ◽  
High Index ◽  
Nodular Melanoma ◽  
Diagnostic Pitfall ◽  
One Year ◽  
High Index Of Suspicion ◽  
Subungual Melanoma

Despite being recognised and reported in the literature for decades, subungual melanoma of the foot remains a diagnostic pitfall, with it commonly being mistaken for benign conditions. We present an interesting case of delayed diagnosis of subungual melanoma of the hallux that was misdiagnosed in the community for over one year. With melanoma being the fourth most commonly diagnosed cancer in Australia in 2013, this case serves as a reminder to all clinicians about the importance of maintaining a high index of suspicion for melanoma of the foot.

scholarly journals Aggressive primary urethral malignancy masquerading as stricture urethra: Unusual presentation of a rare malignancy

2021 ◽  
pp. 449-451
Author(s):  
Sridhar Parnandi ◽  
Ravindra G Varma ◽  
Amit Saple
Keyword(s):  
Delayed Diagnosis ◽  
Outlet Obstruction ◽  
High Index ◽  
Elderly Male ◽  
Stricture Urethra ◽  
Urinary Tract Symptoms ◽  
Retrograde Urethrogram ◽  
Diagnostic Modalities ◽  
Rare Malignancy ◽  
High Index Of Suspicion

Bladder outlet obstruction in an elderly male patient is most of the time diagnosed as prostatomegaly or stricture urethra unless there is a high index of suspicion for other differential diagnoses. Rare tumors like urethral malignancy may be misdiagnosed due to their varied and delayed mode of presentation. Here, we present a case of a patient who presented with acute urinary retention and was suspected to be a stricture urethra which ultimately turned out to be an aggressive urethral tumor. Investigations such as retrograde urethrogram, ultrasound, or cystoscopy which are the most common diagnostic modalities in a patient with lower urinary tract symptoms may not diagnose urethral tumors. Delayed diagnosis is common in these tumors resulting in a lesser chance for curative treatment. A high index of suspicion with a lesser threshold for investigations like MRI is pivotal for early diagnosis in these patients.

scholarly journals Pernicious Anemia and Vitiligo in an HIV Patient: An Unfamiliar Case Presentation

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Katongo Mutengo ◽  
Francis Mupeta ◽  
Owen Ngalamika
Keyword(s):  
Pernicious Anemia ◽  
High Index ◽  
Differential Diagnoses ◽  
Hiv Positive ◽  
Autoimmune Process ◽  
Case Presentation ◽  
Infected Population ◽  
History Of ◽  
One Year ◽  
High Index Of Suspicion

Pernicious anemia (PA) is a rarely considered cause of anemia in HIV-infected population and is seldom on the list of differential diagnoses. However, PA can have serious consequences if misdiagnosed or left untreated. We present the case of a 38-year-old HIV-positive man who was diagnosed with PA, which was preceded by a one-year history of vitiligo. Our case is a reminder for clinicians to have a high index of suspicion for an autoimmune process as a potential cause of anemia in HIV-infected individuals.

Lead encephalopathy secondary to petrol inhalation

1999 ◽  
Vol 16 (4) ◽  
pp. 149-150
Author(s):  
Maria Morgan ◽  
John Owens ◽  
Prega Pillay
Keyword(s):  
Environmental Exposure ◽  
Chelating Agents ◽  
Medical Condition ◽  
Delayed Diagnosis ◽  
High Index ◽  
Lead Encephalopathy ◽  
High Index Of Suspicion

AbstractLead encephalopathy is a relatively rare medical condition. It can present with multiple seizures, delirium, blindness, aphasia and dementia. Usually it is due to environmental exposure. This paper describes a case of delayed diagnosis of lead encephalopathy secondary to petrol sniffing which responded to chelating agents therapy. A high index of suspicion must be maintained to diagnose this treatable cause of encephalopathy.

scholarly journals Tubercular Osteomyelitis of the Clavicle: A Report of Four Cases

2009 ◽  
Vol 17 (1) ◽  
pp. 123-126 ◽  
Author(s):  
AN Aggarwal ◽  
IK Dhammi ◽  
AP Singh ◽  
S Kumar ◽  
MK Goyal
Keyword(s):  
Drug Therapy ◽  
High Index ◽  
Surgical Debridement ◽  
Antitubercular Drug ◽  
Healing Ulcer ◽  
Patients Âgés ◽  
Radiological Features ◽  
Osteoarticular Tuberculosis ◽  
One Year ◽  
High Index Of Suspicion

We report the clinicoradiological features of tuberculosis in the clavicle in 4 patients. The patients' ages ranged from 9 months to 29 years. All patients were managed with antitubercular drug therapy for one year and one underwent surgical debridement and curettage as well. Clinicians should be aware of the varied presentation (pain, non-healing ulcer, abscess, multifocal osteoarticular tuberculosis) of this condition. With the worldwide resurgence of turberculosis, clinicians should maintain a high index of suspicion. The diagnosis of osteoarticular tuberculosis is usually made on clinico-radiological features.

scholarly journals An interesting case of vesical fistula complicating urogenital tuberculosis

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
P. Ashwin Shekar ◽  
Hardik Patel ◽  
Ganesh Gopalakrishnan
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Interesting Case ◽  
High Index ◽  
Bladder Rupture ◽  
Major Public Health Problem ◽  
Urogenital Tuberculosis ◽  
High Index Of Suspicion

Abstract Background The genitourinary tract is one of the commonest regions that can be affected by extrapulmonary tuberculosis where the diagnosis can be quite difficult. A high index of suspicion and an awareness of the atypical clinical manifestations of urogenital tuberculosis (UGTB) are important, especially in patients from regions where tuberculosis continues to be a major public health problem. Case presentation Herein, we report a 33-year-old male who presented with a non-healing fistula at the site of suprapubic catheter following an emergency repair of traumatic bladder rupture. Further evaluation revealed a scarred, small capacity bladder with urinary fistulae along with a poorly functioning kidney which was suspicious of a tuberculous etiology. Urinary isolation of Mycobacterium tuberculosis and a positive bladder biopsy confirmed our suspicions that the findings were indeed part of the spectrum of UGTB. The patient was started on anti-tubercular chemotherapy and underwent a nephrectomy along with an ileal conduit and is doing well at 1-year follow-up. Conclusion To conclude, urogenital tuberculosis always has to be kept in mind especially when dealing with patients with non-healing urinary fistula, especially in endemic countries. A high index of suspicion along with careful and methodical workup of patients with atypical complications following common surgeries can lead to identification of this morbid condition and thereby avoid mismanagement and progression to chronic kidney disease.

Neurobrucellosis associated with feral swine hunting in the southern United States

2020 ◽  
Vol 13 (12) ◽  
pp. e238216
Author(s):  
Harry Ross Powers ◽  
Jared R Nelson ◽  
Salvador Alvarez ◽  
Julio C Mendez
Keyword(s):  
United States ◽  
At Risk ◽  
High Index ◽  
Southern United States ◽  
Endemic Country ◽  
Feral Swine ◽  
Neurological Sequelae ◽  
Initial Symptoms ◽  
The Usa ◽  
High Index Of Suspicion

Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.

Mycobacterium Fortuitum Infections of the Hand

1992 ◽  
Vol 17 (6) ◽  
pp. 675-677 ◽  
Author(s):  
F. K. IP ◽  
S. P. CHOW
Keyword(s):  
Correct Diagnosis ◽  
High Index ◽  
Mycobacterium Fortuitum ◽  
High Index Of Suspicion

Five cases are reported of infection due to Mycobactenum fortuitum involving the hand following contaminated injection or traumatic wounds. Synovectomy, debridement, or amputation together with prolonged chemotherapy using kanamycin or amikacin were required. Doxycycline and sulphamethoxasole also seemed to be the effective antibiotics for this organism. A high index of suspicion is important in order to obtain the correct diagnosis.

scholarly journals Acute permethrin neurotoxicity: Variable presentations, high index of suspicion

2014 ◽  
Vol 1 ◽  
pp. 1026-1028 ◽  
Author(s):  
Bonny Drago ◽  
Namrata S. Shah ◽  
Samir H. Shah
Keyword(s):  
High Index ◽  
High Index Of Suspicion

Benign ano-rectal disorders

2017 ◽  
Vol 10 (5) ◽  
pp. 253-261
Author(s):  
James Kynaston
Keyword(s):  
Primary Care ◽  
High Index ◽  
Diagnosis And Management ◽  
High Index Of Suspicion ◽  
Adult Presentation ◽  
Surgical Referral

Benign ano-rectal disorders are a common adult presentation to primary care; they also generate a significant number of secondary referrals. The exact prevalence of these conditions is difficult to determine, due to under-reporting of symptoms, which patients can find embarrassing and difficult to disclose. It can be challenging to distinguish between different ano-rectal disorders which present with similar symptoms. A high index of suspicion is required to detect serious malignant pathology. The aim of this article is to outline the epidemiology, pathophysiology, diagnosis and management of common benign ano-rectal disorders in primary care. The indications for surgical referral and important cancer referral guidelines are included.

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