Chasing the culprit in shadow – Sinonasal mucormycosis in an immunocompetent host

2021 ◽  
pp. 004947552199135
Author(s):  
Anup Singh ◽  
Ishan Choudhary ◽  
Aru C Handa
Keyword(s):  
Diabetes Mellitus ◽  
Early Detection ◽  
Orbital Cellulitis ◽  
Immunocompetent Host ◽  
Radiological Findings ◽  
Immunocompetent Adult ◽  
Deep Mycosis ◽  
High Index Of Suspicion ◽  
Delay In Treatment ◽  
Predisposing Conditions

Rhino-orbital mucormycosis is an uncommon, rapidly progressive, fulminant, angio-invasive deep mycosis usually affecting individuals with underlying immunosuppression, the most common being diabetes mellitus. In such, the course may be fatal with dissemination. Early detection with control of underlying predisposing conditions is critical with respect to the prognosis. Rarely, mucormycosis may develop in an immunocompetent host, when its non-specific symptomatology and inconspicuous radiological findings may obscure its diagnosis. Any delay in treatment predisposes to multi-organ morbidity and potential mortality. We present an immunocompetent adult with no underlying predisposing illness who was harbouring invasive sinonasal mucormycosis causing orbital cellulitis. A high index of suspicion is mandatory.

PULMONARY TALCOSIS: A Foreign body granulomatous lung disease

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Olufisayo Otusanya
Keyword(s):  
Foreign Body ◽  
Lung Biopsy ◽  
Granulomatous Disease ◽  
Mycobacterial Disease ◽  
Intravascular Injection ◽  
Radiological Findings ◽  
Atypical Mycobacterium ◽  
Mycobacterium Infection ◽  
Granulomatous Lung Disease ◽  
High Index Of Suspicion

Pulmonary Talcosis is a rare foreign body granulomatous disease that occurs as a result of exposure to talc either by inhalation of talc particles or via intravascular injection of talc containing medications. Pulmonary Talcosis is often misdiagnosed as pulmonary tuberculosis, atypical mycobacterium infection or sarcoidosis as many of their clinical and radiological findings overlap. We report a case of talcosis mimicking mycobacterial disease which was eventually diagnosed via lung biopsy. A detailed history and high index of suspicion is required for timely diagnosis and appropriate management.

Case Report: A Great Mimicker of Neoplasm: Pulmonary Cryptococcosis in an Immunocompetent Host After High-Altitude Descent

2021 ◽  
Author(s):  
Keely Johnson ◽  
Umaima Dhamrah ◽  
Aisha Amin ◽  
Joseph Masci
Keyword(s):  
New York ◽  
High Altitude ◽  
Acid Fast Bacillus ◽  
Chest Imaging ◽  
Immunocompetent Host ◽  
Pleuritic Chest Pain ◽  
Pulmonary Cryptococcosis ◽  
Radiological Findings ◽  
Travel History ◽  
Fluconazole Therapy

Cryptococcus exposure in certain global regions is common and yet virulence in the immunocompetent host remains rare. Radiological findings of pulmonary cryptococcosis may include nonspecific lung nodules or masses indistinguishable from lung cancer or pulmonary tuberculosis. We present a case of an immunocompetent diabetic female who presented with progressively worsening pleuritic chest pain and cough with travel between Tibet and New York 2 months earlier. Chest imaging demonstrated a large lobulated mass, acid-fast bacillus smears were negative, and our patient underwent pulmonary biopsy, which grew rare budding yeast later confirmed by mucicarmine staining as Cryptococcus. Our patient was successfully treated with fluconazole therapy. We hypothesize that the high altitude of Tibet may allow for clinical latency followed by symptomatic reactivation on descent. A raised index of suspicion for pulmonary cryptococcosis with careful attention to travel history is expected to facilitate timely diagnosis.

scholarly journals The result of treadmill test in asymptomatic type 2 diabetes mellitus

2017 ◽  
Vol 3 (6) ◽  
pp. 166 ◽  
Author(s):  
Anil Shrinivasrao Joshi ◽  
Chandrakant Gunaji Lahane ◽  
Akshay Arvind Kashid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Early Detection ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Asymptomatic Patients ◽  
Cardiovascular Morbidity And Mortality

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To study the prevalence of silent myocardial ischaemia in asymptomatic patients with type 2 DM</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was conducted in the Govt. Medical College and Hospital Aurangabad. During December 2012 to November 2014 with 50 patients. It was two year cross sectional study with the patients of asymptomatic type 2 diabetes mellitus without clinical and electrocardiographic evidence of coronary artery disease. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">12 (24%) out of 50 subjects had positive TMT. It correlated with years of duration of diabetes (9 positive TMT cases with duration of diabetes more than 10 years). 5 (25%) out of 20 had serum cholesterol levels &gt;240, Number of positive TMT were higher in patients with LDL &gt;160 [5 (25%) out of 20]</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Diabetic patients are at very high risk for cardiovascular morbidity and mortality. Early detection of IHD is very important so that pharmacological therapy, which may improve outcome, can be established. Tread mill exercise TMT being a non-invasive test with high safety, has an important role in early detection of IHD. It is recommended that TMT should be a part of routine management in asymptomatic patients with type II DM. </span></p>

scholarly journals A young lady with inflammation of unknown origin

2018 ◽  
Vol 18 (2) ◽  
pp. 67-71
Author(s):  
Chiu Sum Chu ◽  
Chi Hung To ◽  
Chi Chiu Mok
Keyword(s):  
Young Women ◽  
Systemic Vasculitis ◽  
Unknown Origin ◽  
Young Lady ◽  
Imaging Studies ◽  
Biochemical Tests ◽  
Vascular Stenosis ◽  
High Index Of Suspicion ◽  
Anemia Of Chronic Inflammation ◽  
Delay In Treatment

Abstract Takayasu’s arteritis (TAK) is a systemic vasculitis mainly affecting the aorta and its first branches. The initial presentation can be very non-specific while its sequelae can be debilitating and fatal. Apart from clinical and biochemical tests, imaging studies remain pivotal for the diagnosis of this rare disease. Delay in treatment may result in vascular stenosis, leading to morbidity and mortality. We report a case of a young woman who presented with anemia with no obvious causes. Subsequently she developed ischemic symptoms and the diagnosis of TAK was established with magnetic resonance angiography (MRA). Our case illustrates the importance of recognition of the possibility of TAK in young women who presented with non-specific systemic upset and anemia of chronic inflammation. A high index of suspicion is needed and imaging studies should be considered early. The treatment of TAK will also be briefly reviewed.

scholarly journals Symmetrical peripheral gangrene in a child following severe malaria with concomitant sepsis

2020 ◽  
Vol 47 (3) ◽  
pp. 280-284
Author(s):  
O.S. Katibi ◽  
B.S. Olorunshola ◽  
O.O. Akintade ◽  
O.S. Folayan
Keyword(s):  
Early Detection ◽  
Severe Malaria ◽  
Severe Anaemia ◽  
Clinical Syndrome ◽  
Ischemic Damage ◽  
Permanent Disability ◽  
Peripheral Gangrene ◽  
Distal Interphalangeal ◽  
Left And Right ◽  
High Index Of Suspicion

Symmetrical peripheral gangrene (SPG) is a welldocumented but rare clinical syndrome characterized by symmetrical distal ischemic damage  leading to gangrene of two or more sites in the absence of large vessel obstruction or vasculitis. The aetiological factors responsible for SPG are vast and it could follow many common diseases such as malaria. This is a report of a 9month old child who developed symmetric peripheral gangrene following severe malaria (severe anaemia) and sepsis. Gangrene involved the 2nd to the 5thdigits and 3rd and 4thdigits of the left and right hands and all the toes. Autoamputation of the affected digits followed several weeks after discharge and was limited to the distal  interphalangeal joints. There is the need for a high index of suspicion, early detection and prompt management of patients with disorders associated with SPG in order to limit the risk of permanent disability in otherwise treatable diseases. Key words: peripheral, gangrene, malaria, child

scholarly journals Prevalence and Risk Factors of Depression in Chinese Patients With Type 2 Diabetes Mellitus: a Protocol of Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Xiaobo LIU ◽  
Chao Dong ◽  
Hong Jiang ◽  
Dongling Zhong ◽  
Yuxi Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Early Detection ◽  
Meta Analysis ◽  
Prevalence Of Depression ◽  
Associated Risk Factors

Abstract Background: The prevalence of type 2 diabetes mellitus (T2DM) is growing in China. Both physical and psychological complications occur along with the development of T2DM. The patients with depression account for a significant proportion of T2DM. Depressive symptoms interfere with blood glucose management, leading to poorer treatment outcome and even relate to the occurrence of other serious complications of T2DM population. Among these T2DM patients with depression, early detection and treatment is essential and effective. Knowledge of the current prevalence of depression in T2DM patients as well as associated risk factors may be meaningful for healthcare planning. Therefore, we plan to conduct a systematic review and meta-analysis to evaluate the Chinese prevalence of depression in T2DM and explore associated risk factors.Methods: We will search literatures recorded in MEDLINE/PubMed, EMBASE, the Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database (Wanfang Data). The grey literatures and reference list will be manually searched. We will include population-based, cross-sectional surveys that investigated the Chinese prevalence of depression in T2DM or/and researched the possible risk factors. Two reviewers will screen studies, extract data and evaluate quality independently. We will assess inter-rater agreement between reviewers for study inclusion, data extraction, and study quality assessment using Kappa statistics. The primary outcome will be the pooled Chinese prevalence of depression in T2DM patients. The secondary outcome will contain the potential risk factors for depression in patients with T2DM. R software (version 3.6.1) and STATA software (version 12) will be used for data analysis.Discussion: This systematic review will provide comprehensive evidence of the Chinese prevalence and risk factors of depression in patients with T2DM. we expect to provide evidence basis for healthcare practitioners and policy makers to pay attention to the mental health of T2DM. Our data will highlight the need and importance of early detection and intervention for depression in patients with T2DM. Systematic review registration: PROSPERO CRD42020182979.

scholarly journals A rare cause of right iliac fossa lump: contained fish bone perforation of caecum

2020 ◽  
Vol 7 (10) ◽  
pp. 3476
Author(s):  
Washim F. Khan ◽  
Sandeep Jain ◽  
Yashwant S. Rathore ◽  
Sunil Chumber
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Iliac Fossa ◽  
Exploratory Laparotomy ◽  
Right Hemicolectomy ◽  
Fish Bone ◽  
Rare Entity ◽  
Radiological Findings ◽  
Generalized Peritonitis ◽  
High Index Of Suspicion

Ingested foreign bodies usually pass uneventfully through the gastrointestinal tract but few of them can cause symptoms. They can get stuck at acute angulations or narrow part of intestine and can perforate leading to localized to generalized peritonitis, collection or abscess formation. We describe a case of 59 year old gentleman who presented with pain in right iliac fossa with fever and a hard, tender lump. Initial investigation revealed a mass in right iliac fossa adherent to anterior abdominal was in right iliac fossa region with a foreign body inside. Patient was managed with exploratory laparotomy, removal of a fish bone from cacecum and limited right hemicolectomy. Fishbone perforation of caecum is a rare entity. Careful corroboration between patient’s presentation and radiological findings with a high index of suspicion is needed for pre-operative diagnosis.

scholarly journals Intracranial suppurations surgically managed at Jos, North Central Nigeria: a nine-years retrospective review

2021 ◽  
Author(s):  
Danaan J. Shilong ◽  
Gyang M. Bot
Keyword(s):  
Positive Culture ◽  
Descriptive Statistics ◽  
University Teaching ◽  
Common Symptom ◽  
Common Site ◽  
Radiological Findings ◽  
North Central ◽  
Common Cause ◽  
High Index Of Suspicion ◽  
Contiguous Spread

Background: Intracranial suppurations are rare but can be fatal entities consisting of pus collection within the intracranial cavity.  The aim of the study was to document the clinical and radiological findings in our patients and the outcome of treatment.Methods: A retrospective analysis of all consecutive patients presenting to the Jos University Teaching Hospital from January 2012 to December 2019. Data of interest were retrieved from their folders and entered into SPSS version 22 and descriptive statistics run on the variables.Results: There were 33 patients within this period, but only 21 had complete records and thus used for the analysis. The median age was 18 years (IQR=29), males accounted for 81% of the patients. The median time to presentation was 14 days (IQR=23). The most common cause of abscess in our series was trauma (surgical and non-surgical) in 38.1%, followed by contiguous spread from the ear or paranasal sinuses (23.8%). The most common symptom was fever occurring in 61.9%, followed by headache 42.8%. In two thirds of the patients, the abscess was intra-axial (the frontal lobe being the most common site). Patients were managed surgically with either a craniotomy (28.6%) or a burr whole (71.4%). A positive culture was obtained in 33.3% of cases.Conclusions: Intracranial suppurations are uncommon, but can occur in the setting of predisposing factors. A high index of suspicion is required to clinch the diagnosis.

Sign in / Sign up

Export Citation Format

Share Document