Anomalous Extratemporal Facial Nerve in Oculoauriculovertebral Spectrum

2018 ◽  
Vol 55 (5) ◽  
pp. 769-772
Author(s):  
Linden K. Head ◽  
Lisa Xuan ◽  
Kirsty U. Boyd ◽  
Daniel A. Peters
Keyword(s):  
Facial Nerve ◽  
Subcutaneous Tissue ◽  
Nerve Repair ◽  
High Index ◽  
Pes Anserinus ◽  
Oculoauriculovertebral Spectrum ◽  
Facial Nerve Anatomy ◽  
Nerve Dysfunction ◽  
High Index Of Suspicion

Facial nerve dysfunction is common in oculoauriculovertebral spectrum (OAVS). However, the course of the nerve has rarely been described. A 23-year-old woman with OAVS underwent excision of microtic ear remnants in preparation for an osseointegrated prosthesis and suffered iatrogenic transection of the facial nerve—the pes anserinus was within the subcutaneous tissue 15 mm posterior and 15 mm cephalad to the external acoustic meatus. The patient underwent primary nerve repair and regained nearly complete preoperative function. When considering reconstruction for OAVS patients, clinicians should have a high index of suspicion for anomalous facial nerve anatomy.

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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