scholarly journals Scarlet fever in an adult patient: A challenging diagnosis in an airway emergency

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110499
Author(s):  
Luísa Conceição Martins Ferreira ◽  
Ana Oliveira ◽  
Cláudia Pereira ◽  
Alexandra Guedes ◽  
José Pedro Assunção
Keyword(s):  
Early Diagnosis ◽  
Adult Patient ◽  
Scarlet Fever ◽  
Orotracheal Intubation ◽  
Childhood Disease ◽  
Airway Emergency ◽  
Life Threatening ◽  
Emergency Room Setting ◽  
Spread Of Infection ◽  
High Degree

Scarlet fever is essentially a childhood disease, although it may occur in all ages. Early diagnosis and treatment are essential in preventing the spread of infection and progression to life-threatening complications. The case presented describes the clinical difficulty in the diagnosis of scarlet fever in an adult patient with acute involvement of the airway (oedematous laryngitis) and the need for emergent orotracheal intubation and eventually tracheotomy. A high degree of suspicion related to the airway involvement is of utmost importance in an emergency room setting.

929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Oyende ◽  
J Jackman
Keyword(s):  
White Cell Count ◽  
General Surgeon ◽  
High Dose ◽  
General Anaesthetic ◽  
Microbiological Analysis ◽  
Reactive Protein ◽  
Affected Tissue ◽  
Life Threatening ◽  
History Of ◽  
High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

POTT’S PUFFY TUMOR: A CASE REPORT

2020 ◽  
Vol 18 (Suppl.1) ◽  
pp. 93-96
Author(s):  
V. Stoyanov ◽  
D. Petkov ◽  
P. Bozdukova
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Rare Complication ◽  
Frontal Bone ◽  
Frontal Sinusitis ◽  
Subperiosteal Abscess ◽  
Prompt Treatment ◽  
Pott’S Puffy Tumor ◽  
Intracranial Complications ◽  
Life Threatening

Pott’s puffy tumor (PPT) is a rare complication of sinusitis characterized by osteomyelitis of the frontal bone with subperiosteal abscess presenting as frontal swelling. It was first described by Sir Percival Pott in 1768 in relation to frontal head trauma. Later, it was established that this entity is more common in relation to frontal sinusitis (1). In this article we report a case of PPT in a 17-year-old boy. CT scan confirmed subperiosteal abscess. At surgery, the subperiosteal abscess was drained and sequestrectomy of the affected frontal bone was done. Broad-spectrum antibiotics were given for 4 weeks. The patient recovered without residual problems and has remained well. PPT is now relatively uncommon and early diagnosis and prompt treatment is necessary to avoid further intracranial complications, which can be life-threatening.

Look at the whole X-ray, not just the bones

2006 ◽  
Vol 92 (3) ◽  
pp. 118-120
Author(s):  
S. Warwick ◽  
J. E. Smith ◽  
I. Higginson
Keyword(s):  
Early Diagnosis ◽  
Incidental Finding ◽  
X Rays ◽  
X Ray ◽  
Life Threatening

AbstractA case is presented where an incidental finding on a trauma radiograph led to early diagnosis of a potentially life-threatening tumour, highlighting the need to be vigilant when interpreting X-rays.

The readiness of teachers in primary schools to deal with cardiac arrest situation

2021 ◽  
Vol 9 (1) ◽  
pp. 6-11
Author(s):  
Sami M. Fawzy ◽  
Tarek M. Esmael ◽  
Hany Hosny ◽  
Abdulmajeed Al Amri ◽  
Khalid Al Malki ◽  
...  
Keyword(s):  
Primary Schools ◽  
Personal Information ◽  
Training Session ◽  
Personal Data ◽  
Population Characteristics ◽  
Student Conduct ◽  
Head Teachers ◽  
Survey Questions ◽  
Life Threatening ◽  
High Degree

Progress in deciding the opinion of head-teachers on the instructional and logistical characteristics needed for a fundamental cardiopulmonary resuscitation (b-CPR) program for adolescents in secondary school. The purpose of the thesis is to explore the level of educators' preparation to cope with life-threatening circumstances. This paper aims to determine the connection between the score of the instructor to the questions drawn up and their knowledge of BSL. And we have studied the participants' student conduct without any impact on their behaviour. Teachers from chosen primary schools are the partners. There will also be a record of population characteristics. There will be registered personal data and documents. Some of the information involves the compilation of gender, gender, degree of education and weight data using survey questions. A high degree of secrecy would be ensured through this study. In addition, all information from the participants will be collected voluntarily. The educators would be allowed to have an answer to all the questions. The primary aim of the research is to raise awareness of the importance of critical support for life in schools. At the beginning of each academic year, this study is proposed to create a compulsory training session for teachers, and the outcome is gathered using survey questions to produce using personal information and data such as sex, gender, level of education and weight details.

scholarly journals Similarly Lethal Strains of Extraintestinal Pathogenic Escherichia coli Trigger Markedly Diverse Host Responses in a Zebrafish Model of Sepsis

mSphere ◽  
2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Amelia E. Barber ◽  
Brittany A. Fleming ◽  
Matthew A. Mulvey
Keyword(s):  
The United States ◽  
Host Responses ◽  
Inflammatory Condition ◽  
Therapeutic Approaches ◽  
Zebrafish Model ◽  
Life Threatening ◽  
High Degree ◽  
Care Costs ◽  
Variable Impact ◽  
Degree Of Heterogeneity

ABSTRACT Sepsis is a life-threatening systemic inflammatory condition that is initiated by the presence of microorganisms in the bloodstream. In the United States, sepsis due to ExPEC and other pathogens kills well over a quarter of a million people each year and is associated with tremendous health care costs. A high degree of heterogeneity in the signs and symptomology of sepsis makes this disease notoriously difficult to effectively diagnose and manage. Here, using a zebrafish model of sepsis, we find that similarly lethal but genetically distinct ExPEC isolates can elicit notably disparate host responses. These variances are in part due to differences in the levels and types of flagellin that are expressed by the infecting ExPEC strains. A better understanding of the variable impact that bacterial factors like flagellin have on host responses during sepsis could lead to improved diagnostic and therapeutic approaches to these often deadly infections. In individuals with sepsis, the infecting microbes are commonly viewed as generic inducers of inflammation while the host background is considered the primary variable affecting disease progression and outcome. To study the effects of bacterial strain differences on the maladaptive immune responses that are induced during sepsis, we employed a novel zebrafish embryo infection model using extraintestinal pathogenic Escherichia coli (ExPEC) isolates. These genetically diverse pathogens are a leading cause of sepsis and are becoming increasingly dangerous because of the rise of multidrug-resistant strains. Zebrafish infected with ExPEC isolates exhibit many of the pathophysiological features seen in septic human patients, including dysregulated inflammatory responses (cytokine storms), tachycardia, endothelial leakage, and progressive edema. However, only a limited subset of ExPEC isolates can trigger a sepsis-like state and death of the host when introduced into the bloodstream. Mirroring the situation in human patients, antibiotic therapy reduced ExPEC titers and improved host survival rates but was only effective within limited time frames that varied, depending on the infecting pathogen. Intriguingly, we find that phylogenetically distant but similarly lethal ExPEC isolates can stimulate markedly different host transcriptional responses, including disparate levels of inflammatory mediators. These differences correlate with the amounts of bacterial flagellin expression during infection, as well as differential activation of Toll-like receptor 5 by discrete flagellar serotypes. Altogether, this work establishes zebrafish as a relevant model of key aspects of human sepsis and highlights the ability of genetically distinct ExPEC isolates to induce divergent host responses independently of baseline host attributes. IMPORTANCE Sepsis is a life-threatening systemic inflammatory condition that is initiated by the presence of microorganisms in the bloodstream. In the United States, sepsis due to ExPEC and other pathogens kills well over a quarter of a million people each year and is associated with tremendous health care costs. A high degree of heterogeneity in the signs and symptomology of sepsis makes this disease notoriously difficult to effectively diagnose and manage. Here, using a zebrafish model of sepsis, we find that similarly lethal but genetically distinct ExPEC isolates can elicit notably disparate host responses. These variances are in part due to differences in the levels and types of flagellin that are expressed by the infecting ExPEC strains. A better understanding of the variable impact that bacterial factors like flagellin have on host responses during sepsis could lead to improved diagnostic and therapeutic approaches to these often deadly infections. Podcast: A podcast concerning this article is available.

Clinical presentation and treatment of melioidosis in the head and neck region

2018 ◽  
Vol 132 (9) ◽  
pp. 827-831 ◽  
Author(s):  
K Mahawerawat ◽  
P Kasemsiri
Keyword(s):  
Early Diagnosis ◽  
Confidence Interval ◽  
Head And Neck ◽  
Clinical Presentation ◽  
Neck Region ◽  
Oral Antibiotic ◽  
Head And Neck Region ◽  
Indirect Haemagglutination ◽  
Appropriate Treatment ◽  
Life Threatening

AbstractBackgroundAlthough melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.ObjectivesTo report the clinical presentation and management of melioidosis in the head and neck.MethodA retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.ResultsMedical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35–88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47–98.80).ConclusionCareful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.

Wounds, Fractures, Orthopaedics

2011 ◽  
Author(s):  
Pawan Gupta
Keyword(s):  
Physical Examination ◽  
Soft Tissue Injuries ◽  
Basic Knowledge ◽  
X Rays ◽  
Number Of Patients ◽  
Before And After ◽  
Life Threatening ◽  
Minor Injuries ◽  
High Degree ◽  
Type Of Injury

A significant number of patients attending the ED are those who are often referred to as ‘minors’, ‘streamers’, ‘walking wounded’, etc. These include patients with minor injuries, wounds, fractures or other soft tissue injuries. Therefore, a basic knowledge of anatomy and its application in various circumstances is mandatory. The injuries mentioned above are rarely life-threatening, but they may be limb-threatening and severely disabling. So it is extremely important to avoid errors in diagnosis and management, and to know when to ask for help at the appropriate time. By following the key principles listed below, you will be able to avoid many problems with such patients: • In the history, a detailed description of the mechanism of injury and the patient’s complaint will help in predicting the type of injury sustained. • A careful and thorough physical examination can point to the site and type of injury, on the basis of which appropriate radiological images can then be requested. • A neurovascular examination must be completed and documented in every limb injury, before and after any reductions, and before and after immobilization. • Appropriate radiological imaging, accompanied by a thorough physical examination, can pick up injuries with a high degree of accuracy. Inadequate radiographic films should not be accepted. • Immobilize the patient if a fracture is clinically suspected even if the X-rays are negative. • In cases of dislocations or subluxations, X-rays should be done before and after reductions, except when a delay could be potentially harmful to the patient (for example, when a severe traumatic deformity of a joint threatens to jeopardize the viability of the overlying skin). • The patient should be able to mobilize safely before being discharged from the ED. • Patients should be given proper aftercare instructions before leaving the ED, including how to look after themselves and to recognize limb-threatening features, the follow-up arrangement, and to return if things go wrong. • Ask for senior help if you are not sure about an injury or its management.

scholarly journals Use of lung ultrasound for diagnosis and monitoring of coronavirus disease 2019 pneumonia: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095891
Author(s):  
Debo Yun ◽  
Yan Cui ◽  
Yuan Geng ◽  
Yujiao Yang
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Early Diagnosis ◽  
Lung Ultrasound ◽  
Nasopharyngeal Swab ◽  
Ultrasound Images ◽  
Healthcare Settings ◽  
Pleural Line ◽  
Ultrasound Findings ◽  
Spread Of Infection

Knowledge of lung ultrasound characteristics of coronavirus disease 2019 pneumonia might be useful for early diagnosis and clinical monitoring of patients, and lung ultrasound can help to control the spread of infection in healthcare settings. In this case report, a 36-year-old man with severe acute respiratory syndrome coronavirus 2 infection was diagnosed by reverse transcription-polymerase chain reaction testing of a nasopharyngeal swab. The lung ultrasound findings for this patient were the interstitial-alveolar damage showing bilateral, diffuse pleural line abnormalities, subpleural consolidations, white lung areas and thick, irregular vertical artifacts. When the patient recovered from the severe acute respiratory syndrome coronavirus 2 infection, lung ultrasound images showed a normal pleural line with A-lines regularly reverberating. Performing lung ultrasound at the bedside minimizes the need to move the patient, thus reducing the risk of spreading infection among healthcare staff. Lung ultrasound is useful for early diagnosis and evaluation of the severity of coronavirus disease 2019 pneumonia and for monitoring its progress over the course of the disease.

Life‐threatening ventricular arrhythmia as first presentation of Tuberculosis—Early diagnosis and successful treatment: A case series

2020 ◽  
Vol 43 (4) ◽  
pp. 418-422
Author(s):  
Mohan Nair ◽  
Pranav Bhagirath ◽  
Rajesh Gothi ◽  
Gautum Singal ◽  
Pritam Kitey ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Ventricular Arrhythmia ◽  
Successful Treatment ◽  
Case Series ◽  
Life Threatening

Endocrine emergencies

2020 ◽  
Vol 13 (3) ◽  
pp. 165-172
Author(s):  
Apurva Mishra ◽  
Marc Quinn
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Adrenal Insufficiency ◽  
Small Group ◽  
Diabetic Ketoacidosis ◽  
Hospital Setting ◽  
Thyroid Storm ◽  
Relative Lack ◽  
Common Presentation ◽  
High Degree

Endocrine emergencies represent a small group of conditions, where the presentation is related to either a relative lack or excess of hormones. They may present with non-specific features, which can make them difficult to diagnose. Endocrine emergencies are commonly treated in a hospital setting. Having a high degree of suspicion and awareness of the presentation can lead to early diagnosis and prompt management. This article focuses on the epidemiology, common presentation, risk factors, investigation and management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, thyroid storm, myxoedema crisis, adrenal insufficiency, hypercalcaemia, phaeochromocytoma and acute pituitary failure.

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