Skin endometriosis between the breasts of a young girl: A case study and literature review

2019 ◽  
Vol 11 (4) ◽  
pp. 207-209
Author(s):  
Mohammad Reza Taghavi ◽  
Samaneh Mollazadeh ◽  
Mohammad Bagheri Mansoori ◽  
Mehdi Asadi
Keyword(s):  
Uterine Cavity ◽  
Diagnostic Procedures ◽  
Excision Biopsy ◽  
Common Complication ◽  
Rare Presentation ◽  
Young Females ◽  
Periodic Discharges ◽  
History Of

Objective: Endometriosis is defined as the presence of functional endometrial glands and stroma outside the uterine cavity. Skin involvement is a rare presentation of this common complication. The purpose of this study is to introduce a markedly atypical case of the skin endometriosis with periodic pains located between the breasts of the 24-year-old girl. Care report: In this case, the patient with unknown periodic discharges and painful lesion presented in different consulting diagnostics centers for her complaint. After various diagnostic procedures and treatments, she underwent an excision biopsy to evaluate endometriosis. The history of periodic fluid findings of this case aid to indicate endometriosis. This case also emphasizes the significance of suspecting not only the atypical locations of endometriosis but also presentations of endometriosis. Follow-up tests indicated that she was risk-free of endometriosis relapsing status. Conclusion: The atypical endometriosis sites can present with varied ranges of symptoms, especially ones occurred periodically with menses in young females.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

scholarly journals Overt Lower Gastrointestinal Bleeding and Pseudotumor: A Rare Presentation of Cytomegalovirus Infection

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Akanksha Agrawal ◽  
Deepanshu Jain ◽  
Sameer Siddique
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
The Body ◽  
Cmv Infection ◽  
Rare Presentation ◽  
Multiple Organs ◽  
Highly Active ◽  
History Of ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Cytomegalovirus (CMV) is a ubiquitous organism which can infect multiple organs of the body. In an immunocompromised patient, it can have a myriad of gastrointestinal manifestations. We report a case of recurrent hematochezia and concomitant pseudotumor in an AIDS (acquired immunodeficiency syndrome) patient attributable to CMV infection. A 62-year-old man with a history of AIDS, noncompliant with highly active antiretroviral therapy (HAART), presented with bright red blood per rectum. Index colonoscopy showed presence of multiple ulcers, colonic stenosis, and mass-like appearing lesion. Biopsy confirmed CMV infection and ruled out malignancy. Cessation of dual antiplatelet therapy and compliance with HAART lead to clinical cessation of bleeding and endoscopic healing of ulcers with complete resolution of colon mass on follow-up colonoscopy.

Refugee and Asylum-Seeking Children in Mae Sot and Bangkok: An Analysis of Unmet Needs and Risks

2020 ◽  
Author(s):  
Paradee Thoresen ◽  
Sue Gillieatt ◽  
Angela Fielding
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Unmet Needs ◽  
Psychological Development ◽  
Longitudinal Case Study ◽  
Children’S Perspectives ◽  
Rights Of The Child ◽  
History Of

Abstract This article reports on a longitudinal case study, which included site visits in Thailand from 2014 to 2015, and participant follow-up to mid-2018. It documents the lived experience of children from Syria, Sri Lanka, Pakistan, Vietnam, and Myanmar in two different locations in Thailand: Bangkok and Mae Sot (a district close to Thailand-Myanmar border with a long history of economic migrants and refugees from Myanmar). It documents perspectives of children and the adults in their lives while in exile. It presents an analysis of the children’s perspectives on needs and how unmet needs for safety, basic materials, health care, and education put them at risk of arrest, detention, abuse, and exploitation, and impact their psychological development. Contextual factors such as available services, existing policies and laws are also discussed in relation to the Convention on the Rights of the Child (CRC).

Reduction of Hemifacial Spasm and Dysarthria Following EMG Biofeedback

1984 ◽  
Vol 49 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Rick T. Rubow ◽  
John C. Rosenbek ◽  
Michael J. Collins ◽  
Gastone G. Celesia
Keyword(s):  
Hemifacial Spasm ◽  
Relaxation Training ◽  
Speech Therapy ◽  
Emg Biofeedback ◽  
Feedback Training ◽  
Facial Spasm ◽  
History Of ◽  
Carry Over

In this case study, a geriatric patient who had an 18-year history of hemifacial spasm was given EMG-biofeedback-assisted relaxation training. No formal speech therapy was provided. Our results confirmed two hypotheses: (a) The patient would learn to reduce frontalis EMG and facial spasm with and then without biofeedback, and (b) as a result, speech would be markedly improved. At both the 1-month and 15-month follow-up the patient retained the ability to relax his facial muscles with similar carry-over to speech. Possible neurophysiologic mechanisms of action mediating the feedback training are discussed.

scholarly journals Unrecognized tuberculosis in a patient with COVID-19

2021 ◽  
pp. 6-6
Author(s):  
Mihailo Stjepanovic ◽  
Slobodan Belic ◽  
Ivana Buha ◽  
Nikola Maric ◽  
Marko Baralic ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Chronic Illnesses ◽  
Immune Systems ◽  
Indicator Tube ◽  
Global Pandemic ◽  
Severe Clinical Presentation ◽  
History Of ◽  
Growth Indicator

Introduction. COVID-19 is responsible for the current global pandemic. Globally, over 15 million people are currently infected, and just over 600,000 have died due to being infected. It is known that people with chronic illnesses and compromised immune systems can develop more severe clinical presentation. Tuberculosis is still one of the biggest epidemiological problems worldwide. Both of these diseases can be misdiagnosed and can manifest in a similar way. We will present a case study of a patient who was initially treated as a COVID-19 infection, with Tuberculosis being diagnosed later on. The recovery began only after being treated for both diseases simultaneously. Case report. The patient is a 27-year-old male, non-smoker, with no history of any significant diseases. He presented with fever, fatigue and hemoptysis. Computed tomography pulmoangiography had shown massive consolidations and excavations, which could be caused by COVID-19. Despite being treated for COVID-19, there was no clinical improvement. On the follow-up chest X-radiograohy, beside signs of COVID-19, there were also changes that could indicate Tuberculosis. Tuberculosis was detected in sputum, using PCR and Mycobacteria Growth Indicator Tube, and only after being treated for both diseases did his condition improve. Conclusion. There are a few reported cases of COVID-19 and Tuberculosis coinfections, and we believe that there are many more patients with this coinfection being unrecognized.

scholarly journals A 45-year-old Female with an Atypical Presentation of Pharyngitis

2020 ◽  
Vol 4 (2) ◽  
pp. 234-240
Author(s):  
Artur Schander ◽  
Andrew Glickman ◽  
Nancy Weber ◽  
Brian Rodgers ◽  
Michael Carney
Keyword(s):  
Sore Throat ◽  
Complete Blood Count ◽  
Differential Diagnoses ◽  
Prescription Medications ◽  
Over The Counter ◽  
Case Presentation ◽  
Common Causes ◽  
History Of

Introduction: Emergency physicians are trained to treat a variety of ailments in the emergency department (ED), some of which are emergent, while others are not. A common complaint seen in the ED is a sore throat. While most sore throats are easily diagnosed and treated, less common causes are often not considered in the differential diagnoses. Therefore, the purpose of this case study was to present an atypical case of sore throat and discuss differential diagnoses. Case Presentation: The patient was a 45-year-old female who presented to the ED with a three-day history of sore throat that was exacerbated by eating and drinking. The patient was not on any prescription medications, but tried over-the-counter medications for the sore throat without any improvement in symptoms. Review of systems was positive for sore throat, fevers, and chills. Physical examination of her oropharynx revealed mildly dry mucous membranes with confluent plaques and white patchy ulcerative appearance involving the tongue, tonsils, hard palate, and soft palate. Rapid streptococcal antigen, mononucleosis spot test, and KOH test were performed and found to be negative. Discussion: After initial testing was negative, a follow-up complete blood count with differential and complete metabolic profile were ordered. The patient was found to have decreased lymphocytes and platelets. Based upon those results, a diagnosis was made in the ED, the patient was started on medication, and further laboratory workup was ordered to confirm the diagnosis. ED providers should consider non-infectious as well as infectious causes for a sore throat, as this might lead to a diagnosis of an underlying condition.

Recurrent cervical stitch sinus arising from the deep neck space after thyroidectomy: case study and review

2021 ◽  
Vol 30 (8) ◽  
pp. 612-616
Author(s):  
Hsing-Fu Chen ◽  
Marios Papadakis ◽  
Seng-Feng Jeng
Keyword(s):  
Past History ◽  
Muscle Flap ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Single Centre Study ◽  
History Of ◽  
Surgical Cure

Objective: We describe a one-stage surgical technique for the management of recurrent cervical stitch sinus after thyroidectomy. Method: A retrospective, single-centre study of all patients who were operated on because of cervical neck sinus after thyroidectomy. We provide a detailed description of our surgical approach, based on guided sinus removal after prior tract staining with methylene blue and subsequent obliteration using local strap muscle flap. Results: A total of seven patients with a mean age of 46 years were included in the study. All patients had a past history of thyroidectomy because of goitre (n=5) or thyroid cancer (n=2) which had previously been unsuccessfully debrided two or three times. Surgical sinus removal was successful in all cases and no recurrence was observed during the follow-up time. Conclusions: We conclude that a comprehensive en bloc resection down to the suture granuloma is essential in order to provide surgical cure and prevent recurrence.

scholarly journals Myxedema Psychosis: Neuropsychiatric Manifestations and Rhabdomyolysis Unmasking Hypothyroidism

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Sundus Sardar ◽  
Mhd-Baraa Habib ◽  
Aseel Sukik ◽  
Bashar Tanous ◽  
Sara Mohamed ◽  
...  
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Prior History ◽  
Psychomotor Slowing ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Endocrine Disorder ◽  
Psychiatric Illnesses ◽  
Neuropsychiatric Manifestations ◽  
History Of

Background. Hypothyroidism is a prevalent endocrine disorder, often presenting with a spectrum of symptoms reflecting a hypothyroid state. It is also generally linked to causing mood swings, psychomotor slowing, and fatigue; however, in rare instances, it may lead to or induce acute psychosis, a condition referred to as myxedema psychosis (MP). We report a case of myxedema psychosis and present a literature review discussing its presentation, diagnosis, management, and prognosis. Case Presentation. A 36-year-old lady presented with one-week history of persecutory and paranoid delusions, along with visual and auditory hallucinations. She had no prior history of psychiatric illnesses. She underwent total thyroidectomy three years before the current presentation due to papillary thyroid cancer. She was not on regular follow-up, nor any specific therapy. On examination, she was agitated and violent. There were no signs of myxedema, and the physical exam was unremarkable. The initial workup showed a mild elevation in serum creatinine. Additional investigations revealed a high thyroid-stimulating hormone (TSH) of 56.6 mIU/L, low free T4<0.5 pmol/L, elevated creatine kinase of 3601 U/L, and urine dipstick positive for blood, suggestive of myoglobinuria. MRI of the head was unremarkable. We diagnosed her as a case of myxedema psychosis and mild rhabdomyolysis. She was started on oral thyroxine 100 mcg/day, fluoxetine 20 mg daily, and as-needed haloperidol. She was closely followed and later transferred to the Psychiatry Hospital for further management. Within one week, her symptoms improved completely, and she was discharged off antipsychotics with additional scheduled follow-ups to monitor TFTs and observe for any recurrence. Discussion and Conclusion. Myxedema psychosis is a rare presentation of hypothyroidism—a common endocrine disorder. Scarce data are describing this entity; hence, there is currently a lack of awareness amongst clinicians regarding proper identification and management. Moreover, the atypical nature of presentations occasionally adds to a diagnostic dilemma. Thus, any patient with new-onset psychosis should be screened for hypothyroidism, and awareness of this entity must be emphasized amongst clinicians and guideline makers.

scholarly journals Two Individuals with Rare Blocked Antigen Phenomenon and Coinciding Warm Autoantibody Mimicking Alloanti-Jk3 Resolved with JK Analysis

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S162-S162
Author(s):  
J G Zinni ◽  
D Mullins ◽  
P J DeChristopher ◽  
G Ramsey ◽  
B Vission ◽  
...  
Keyword(s):  
Uterine Cancer ◽  
False Negative ◽  
Complement C3 ◽  
Normocytic Normochromic Anemia ◽  
High Prevalence ◽  
History Of ◽  
Normochromic Anemia

Abstract Introduction/Objective Kidd antigens can bind complement (C3) as well as Kidd specific warm autoantibodies (WAAb). An 838G&gt;A single nucleotide variant (SNV) defines JK*01 and JK*02 which codes the antithetical Jka and Jk b, respectively. Both alleles translate the high prevalence (&gt;99%) Jk3 (JK3). The 130G&gt;A is associated with weak Jka and weak Jkb expression. In vivo binding of non-agglutinating globulins can cause false-negative phenotypes by means of the blocked antigen phenomenon (BAP). Methods/Case Report Transfusions were requested for a 74-year-old Caucasian (CA) female with Evan’s Syndrome, and an 85-year-old African American (AA) female with metastatic uterine cancer. Both had a history of nonspecific WAAb. Direct antiglobulin testing (DAT) detected moderate in vivo sensitization of IgG and C3. They phenotyped Jk(a- b-) with untreated and EDTA glycine-acid (EGA) treated IgG DAT-negative cells. Their serum contained anti-Jk3 reactivity, while a panreactive WAAb in the eluate reacted with Jk3- donor and EGA treated DAT-negative autologous cells. Weak anti-Jka and anti-Jkb reactivity remained in the alloadsorbed serum of the antithetical adsorbing cells. Genetic testing of the CA revealed JK*01W.01(130A)/02 alleles, while cDNA confirmed the alleles would be transcribed into mRNA. Sequencing of the AA detected 130G/A, and 838G/A as well as other silent mutations predicting either a Jk(a+wb+) or Jk(a+b+w) phenotype. The CA received one compatible JK:-3 transfusion, and both individuals benefited from multiple least incompatible transfusions of Jk a+ and/or Jk b+ donors with expected hemoglobin increases (1 g/dL per transfusion). The CA serologically phenotyped Jk(a-b+) 132 days later following prolonged immunosuppressive therapy while a normocytic normochromic anemia and the WAAb persisted. No follow up evaluations of the AA are available. Results (if a Case Study enter NA) NA Conclusion Unexpected BAP can confound immunohematology testing and lead WAAbs mimicking alloanti-Jk3 to be mischaracterized as allogeneic. By predicting phenotypes, genetic analysis can aid serological techniques in antibody characterization and help circumvent complications searching for rare JK:-3 donors.

scholarly journals Empty Sella Syndrome with Typical Facies: A Case Report

2021 ◽  
Author(s):  
Megha Mukundan ◽  
Prativa Sethi ◽  
Prasan Kumar Panda
Keyword(s):  
Empty Sella ◽  
Total Testosterone ◽  
Ataxic Gait ◽  
Rare Presentation ◽  
Empty Sella Syndrome ◽  
History Of ◽  
Loss Of Libido ◽  
Magnetic Resonance Imaging Mri ◽  
Work Up

Empty Sella syndrome with typical facies is a rare presentation of panhypopituitarism. Here, authors presented a case of 45-year- old male with a history of altered behaviour such as low mood, passivity, talkativeness with low-hoarse voice and spells of cries for three months. He also had headache, vomiting, abdominal pain, ataxic gait, and loss of libido. He had meningitis 10 years back since then he had multiple similar episodes. He had sparse thinned out hair, male pattern temporal balding, madarosis, brownish pigmentation of face and chest and dry coarse skin. Patient had hypotension but without hypoperfusion. Hormone levels including thyroid hormones, Follicle Stimulating Hormone (FSH), Luteinizing hormone (LH), total testosterone cortisol, and plasma Adrenocorticotropic Hormone (ACTH) were less than normal. Magnetic Resonance Imaging (MRI) brain suggested streak pituitary gland (empty sella). He was supplemented with required hormones. On follow-up, he improved significantly. Trio composite hypothyroidism, hypocortisolism, and hypogonadism have characteristic facies. This unique presentation of patient with blank look facies gives a hint of empty sella, thus leading the clinician to diagnose the disease through timely evaluation and work-up.

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