scholarly journals Life-Threatening Stridor due to Laryngeal Tuberculosis in the COVID-19 Era: Report of a Case

2022 ◽  
pp. 014556132110708
Author(s):  
Svetlana Valjarevic ◽  
Dejan Radaljac ◽  
Nenad Miladinovic
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Community Hospital ◽  
Complete Regression ◽  
Granulomatous Disease ◽  
Flexible Laryngoscopy ◽  
Life Threatening ◽  
Coronavirus Infection ◽  
Hospital Acquired ◽  
Laryngeal Tuberculosis

Laryngeal tuberculosis is the most frequent granulomatous disease of the larynx and it is prone to be diagnosed as cancer. COVID-19 pandemic caused considerable disruption in tuberculosis service provisions both in the primary care and hospital settings. This report describes a rare case of life-threatening stridor in a patient who presented with an ulceroproliferative laryngeal mass later confirmed as laryngeal tuberculosis. Urgent tracheostomy was performed. The patient’s sputum and the computed tomography of the chest revealed a pulmonary, as well as laryngeal tuberculosis. The patient was commenced on a 24 week course of anti-tuberculous treatment which was interrupted because of a mild course of hospital-acquired coronavirus infection. 3 months after initial treatment for tuberculosis, his sputum cultures became negative. Flexible laryngoscopy was performed at our department 4 months after commencement of treatment, demonstrating complete regression of the lesion and symmetrical laryngeal mobility, hence the patient was successfully decannulated and discharged to be followed up to his community hospital. In the time of COVID-19 pandemic, we should never underestimate other severe infectious diseases.

scholarly journals An Unusually Large Cavernous Hemangioma of Retropharyngeal Space: A Rare Case

2015 ◽  
Vol 100 (5) ◽  
pp. 958-961
Author(s):  
Linli Tian ◽  
Jiarui Zhang ◽  
Yufei Jiao ◽  
Tianyi Liu ◽  
Ming Liu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Rare Case ◽  
Benign Tumors ◽  
Retropharyngeal Space ◽  
Complete Regression ◽  
Resonance Imaging ◽  
Associated Symptoms ◽  
Dense Mass

Hemangiomas rarely occur in the retropharyngeal space with only several cases reported in the current literature. This article reports the hemangiomas of retropharyngeal space. A 55-year-old woman was referred to our institution for dysphagia. Computed tomography and magnetic resonance imaging of the neck and spine revealed a large, well-circumscribed, dense mass that extended from the retropharyngeal space to the sides of the neck. Patient underwent direct excision of the lesion. Complete regression of symptoms was observed after surgery, with no lesions found on routine 24-month follow-up. Although hemangiomas are relatively common in the head and neck, those that originate in the retropharyngeal space are very rarely observed. These benign tumors have the potential to compress adjacent tissues or organs and thereby produce associated symptoms like dysphagia and dyspnea. We present the reported case of larger hemangiomas of the retropharyngeal space and detail their management.

scholarly journals Infected Anastomotic Pseudoaneurysm after Aortic Valve Replacement with Annular Enlargement

2019 ◽  
Vol 22 (3) ◽  
pp. E252-E255
Author(s):  
Runqian Sui ◽  
Jie Zi ◽  
Liangong Sun ◽  
Decai Li ◽  
Anbiao Wang
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Ascending Aorta ◽  
Anastomotic Pseudoaneurysm ◽  
Computed Tomography Scans ◽  
Infected Pseudoaneurysm ◽  
Life Threatening ◽  
Important Means ◽  
Anastomotic Line

Anastomotic pseudoaneurysm remains one of the main life-threatening complications of cardiac and thoracic aorta surgery. We report a rare case of infected pseudoaneurysm at the anastomotic line found during follow-up. Blood culture results suggested Enterococcus faecium infection. Transthoracic echocardiography and computed tomography scans revealed the presence of a pseudoaneurysm of the ascending aorta. The pseudoaneurysm was resected and the ascending aorta was reconstructed with an artificial vascular patch without complications. Reducing the anastomotic tension, with complete hemostasis at the anastomotic incision, is the most important means of preventing the formation of pseudoaneurysm.

scholarly journals A Rare Case of Oropharyngeal Teratoma Diagnosed Antenatally with MRI

2014 ◽  
Vol 4 ◽  
pp. 15 ◽  
Author(s):  
Murali Mohan Manchali ◽  
Chandrahasa Sharabu ◽  
Meher Latha ◽  
Leela Kumar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Rare Case ◽  
Antenatal Diagnosis ◽  
Resonance Imaging ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Plan Management

Oropharyngeal teratomas are extremely rare congenital tumors and have an incidence rate of one in 35,000-200,000 newborn babies/neonates. Oropharyngeal teratomas may cause life threatening airway obstruction to a newborn. Early diagnosis with ultrasound and magnetic resonance imaging (MRI) is essential to plan management. Here, we present a rare case of oropharyngeal true teratoma diagnosed with MRI antenatally in a fetus at 34 weeks of gestation in a 25-year-old female who was being evaluated for polyhydraminos. We found MRI to be more helpful for antenatal diagnosis, counseling, and management than ultrasonography and computed tomography (CT).

Bilateral choanal atresia in an adult: is it compatible with life?

2004 ◽  
Vol 118 (3) ◽  
pp. 244-245 ◽  
Author(s):  
Naresh K. Panda ◽  
Sridhar Simhadri ◽  
Shakuntala Ghosh
Keyword(s):  
Computed Tomography ◽  
Respiratory Distress ◽  
Endoscopic Surgery ◽  
Rare Case ◽  
Choanal Atresia ◽  
Adult Life ◽  
Life Threatening ◽  
First Time ◽  
Rare Report ◽  
Transnasal Endoscopic Surgery

Bilateral choanal atresia is potentially life-threatening. The condition almost always presents in the new born, with alternating phases of respiratory distress and apnoea relieved by crying. We report a rare case of bilateral choanal atresia presenting for the first time at 22 years of age. The patient had no features of cyanosis or apnoea, presenting only with bilateral nasal obstruction, rhinorrhoea and anosmia. His neonatal history was unremarkable. No syndromic association was noted excepting for telecanthus. The presence of bony atresia was confirmed on computed tomography (CT) scan and transnasal endoscopic surgery was used to obtain a patent airway. This case is a rare report of bilateral choanal atresia presenting for the first time in adult life.

scholarly journals Computed Tomography Imaging in Simulated Ongoing Cardiopulmonary Resuscitation: No Need to Switch Off the Chest Compression Device during Image Acquisition

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1122
Author(s):  
Jessica Graef ◽  
Bernd A. Leidel ◽  
Keno K. Bressem ◽  
Janis L. Vahldiek ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Image Acquisition ◽  
Circulatory Arrest ◽  
Motion Artifacts ◽  
Current Standard ◽  
Ct Protocol ◽  
Life Threatening ◽  
Reconstruction Time

Computed tomography (CT) represents the current standard for imaging of patients with acute life-threatening diseases. As some patients present with circulatory arrest, they require cardiopulmonary resuscitation. Automated chest compression devices are used to continue resuscitation during CT examinations, but tend to cause motion artifacts degrading diagnostic evaluation of the chest. The aim was to investigate and evaluate a CT protocol for motion-free imaging of thoracic structures during ongoing mechanical resuscitation. The standard CT trauma protocol and a CT protocol with ECG triggering using a simulated ECG were applied in an experimental setup to examine a compressible thorax phantom during resuscitation with two different compression devices. Twenty-eight phantom examinations were performed, 14 with AutoPulse® and 14 with corpuls cpr®. With each device, seven CT examinations were carried out with ECG triggering and seven without. Image quality improved significantly applying the ECG-triggered protocol (p < 0.001), which allowed almost artifact-free chest evaluation. With the investigated protocol, radiation exposure was 5.09% higher (15.51 mSv vs. 14.76 mSv), and average reconstruction time of CT scans increased from 45 to 76 s. Image acquisition using the proposed CT protocol prevents thoracic motion artifacts and facilitates diagnosis of acute life-threatening conditions during continuous automated chest compression.

scholarly journals Hypothetical COVID-19 protection mechanism: hints from centenarians

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Franca Rosa Guerini ◽  
Matteo Cesari ◽  
Beatrice Arosio
Keyword(s):  
Adaptive Immune Response ◽  
Human Leukocyte ◽  
Human Longevity ◽  
Biological Mechanisms ◽  
Protection Mechanism ◽  
Leukocyte Antigen ◽  
Adaptive Immune ◽  
Life Threatening ◽  
Coronavirus Infection ◽  
Rule Out

AbstractThe risk of serious complications and the fatality rate due to COVID-19 pandemic have proven particularly higher in older persons, putting a further strain in healthcare system as we dramatically observed.COVID-19 is not exclusively gerophile (géro “old” and philia “love”) as young people can be infected, even if older people experience more severe symptoms and mortality due to their greater frailty. Indeed, frailty could complicate the course of COVID-19, much more than the number of years lived. As demonstration, there are centenarians showing remarkable capacity to recover after coronavirus infection.We hypothesize that centenarian’s portfolio could help in identifying protective biological mechanisms underlying the coronavirus infection.The human leukocyte antigen (HLA) is one of the major genetic regions associated with human longevity, due to its central role in the development of adaptive immune response and modulation of the individual’s response to life threatening diseases. The HLA locus seems to be crucial in influencing susceptibility and severity of COVID-19.In this hypothesis, we assume that the biological process in which HLA are involved may explain some aspects of coronavirus infection in centenarians, although we cannot rule out other biological mechanisms that these extraordinary persons are able to adopt to cope with the infection.

scholarly journals A life-threatening spontaneous ascending aortic rupture due to a small penetrating aortic ulcer

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110377
Author(s):  
Yasuhito Nakamura ◽  
Kiyoshi Doi ◽  
Syojiro Yamaguchi ◽  
Etsuji Umeda ◽  
Osamu Sakai ◽  
...  
Keyword(s):  
Rare Case ◽  
Aortic Wall ◽  
Aortic Rupture ◽  
Ascending Aorta ◽  
Bleeding Site ◽  
Penetrating Aortic Ulcer ◽  
Postoperative Course ◽  
Life Threatening ◽  
Aortic Dissections

We reported a rare case of spontaneous frank rupture of a small (4 mm) penetrating aortic ulcer in the ascending aorta resulted in catastrophic bleeding. The ulcer only created a pinhole wound in the adventitia without saccular aneurysms, intramural hematomas, or aortic dissections. Notably, the wound could be directly closed because the aortic wall was intact only 5 mm away from the bleeding site. The postoperative course was uneventful, and the patient was discharged on the 11th postoperative day. After 8 months, follow-up computed tomography showed no abnormality of the aortic wall at the repair site.

scholarly journals 2′FL and LNnT Exert Antipathogenic Effects against C. difficile ATCC 9689 In Vitro, Coinciding with Increased Levels of Bifidobacteriaceae and/or Secondary Bile Acids

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 927
Author(s):  
Louise Kristine Vigsnaes ◽  
Jonas Ghyselinck ◽  
Pieter Van den Van den Abbeele ◽  
Bruce McConnell ◽  
Frédéric Moens ◽  
...  
Keyword(s):  
Antimicrobial Effect ◽  
Secondary Bile Acid ◽  
Clostridioides Difficile ◽  
Life Threatening ◽  
Intermediate Time ◽  
Indigenous Microbiota ◽  
Hospital Acquired ◽  
Gut Microbial Community ◽  
Secondary Bile Acids

Clostridioides difficile (formerly Clostridium difficile) infection (CDI) is one of the most common hospital-acquired infections, which is often triggered by a dysbiosed indigenous gut microbiota (e.g., upon antibiotic therapy). Symptoms can be as severe as life-threatening colitis. The current study assessed the antipathogenic potential of human milk oligosaccharides (HMOs), i.e., 2′-O-fucosyllactose (2′FL), lacto-N-neotetraose (LNnT), and a combination thereof (MIX), against C. difficile ATCC 9689 using in vitro gut models that allowed the evaluation of both direct and, upon microbiota modulation, indirect effects. During a first 48 h fecal batch study, dysbiosis and CDI were induced by dilution of the fecal inoculum. For each of the three donors tested, C. difficile levels strongly decreased (with >4 log CFU/mL) upon treatment with 2′FL, LNnT and MIX versus untreated blanks, coinciding with increased acetate/Bifidobacteriaceae levels. Interindividual differences among donors at an intermediate time point suggested that the antimicrobial effect was microbiota-mediated rather than being a direct effect of the HMOs. During a subsequent 11 week study with the PathogutTM model (specific application of the Simulator of the Human Intestinal Microbial Ecosystem (SHIME®)), dysbiosis and CDI were induced by clindamycin (CLI) treatment. Vancomycin (VNC) treatment cured CDI, but the further dysbiosis of the indigenous microbiota likely contributed to CDI recurrence. Upon co-supplementation with VNC, both 2′FL and MIX boosted microbial activity (acetate and to lesser extent propionate/butyrate). Moreover, 2′FL avoided CDI recurrence, potentially because of increased secondary bile acid production. Overall, while not elucidating the exact antipathogenic mechanisms-of-action, the current study highlights the potential of HMOs to combat CDI recurrence, help the gut microbial community recover after antibiotic treatment, and hence counteract the adverse effects of antibiotic therapies.

scholarly journals Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

2021 ◽  
Vol 07 (03) ◽  
pp. e124-e126
Author(s):  
Mark Portelli ◽  
Mark Bugeja ◽  
Charles Cini
Keyword(s):  
Computed Tomography ◽  
Young Adult ◽  
Rare Case ◽  
Surgical Repair ◽  
Bochdalek Hernia ◽  
Case Presentation ◽  
Atypical Case ◽  
Accident And Emergency ◽  
History Of ◽  
Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

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