Ocular Toxoplasmosis: No Stranger to the Masquerade Ball

2021 ◽  
pp. 247412642110567
Author(s):  
Alexander B. Dillon ◽  
Greg Budoff ◽  
Colin A. McCannel ◽  
Edmund Tsui ◽  
Sheeja T. Pullarkat ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
The Body ◽  
Ocular Toxoplasmosis ◽  
Acute Retinal Necrosis ◽  
Pertinent Literature ◽  
Diagnosis And Management ◽  
Vitreoretinal Lymphoma ◽  
Atypical Manifestations ◽  
Life Threatening ◽  
Case Presentations

Purpose: This article illustrates multiple atypical manifestations of ocular toxoplasmosis masquerading as acute retinal necrosis and vitreoretinal lymphoma. Methods: Two case presentations are discussed, and the body of pertinent literature is reviewed and discussed. Results: In these cases, an extensive workup and attention to history lead to the correct diagnosis and management. Conclusions: Aggressive cases of ocular toxoplasmosis may present in a variety of phenotypes that may mimic other vision- and potentially life-threatening conditions, particularly in a milieu of inadequate endogenous and exogenous antimicrobial defenses.

scholarly journals Hereditary angioedema: an update on causes, manifestations and treatment

2019 ◽  
Vol 80 (7) ◽  
pp. 391-398 ◽  
Author(s):  
Hilary J Longhurst ◽  
Konrad Bork
Keyword(s):  
Quality Of Life ◽  
Hereditary Angioedema ◽  
Genetic Disorder ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Self Administration ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Short And Long Term

Hereditary angioedema is a rare genetic disorder caused by deficiency of C1 esterase inhibitor (C1-INH) and characterized by recurrent episodes of severe swelling that affect the limbs, face, intestinal tract and airway. Since laryngeal oedema can be life-threatening as a result of asphyxiation, correct diagnosis and management of hereditary angioedema is vital. Hereditary angioedema attacks are mediated by bradykinin, the production of which is regulated by C1-INH. Hereditary angioedema therapy relies on treatment of acute attacks, and short- and long-term prophylaxis. Acute treatment options include C1-INH concentrate, icatibant and ecallantide. Self-administration of treatment is recommended and is associated with increased quality of life of patients with hereditary angioedema. Advances in diagnosis and management have improved the outcomes and quality of life of patients with hereditary angioedema.

scholarly journals Multiphasic CT and MR Imaging Findings of an Isolated Transverse Colon Hemangioma

2021 ◽  
Vol 5 (1) ◽  
pp. 67-71
Author(s):  
Bohyun Kim
Keyword(s):  
Mr Imaging ◽  
Ct Scan ◽  
Transverse Colon ◽  
Correct Diagnosis ◽  
Imaging Findings ◽  
Mesenchymal Tumors ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Pathognomonic Sign

Colonic hemangiomas are rare benign mesenchymal tumors but can potentially cause a life-threatening bleeding. Although phlebolith on simple radiography or CT scan is a pathognomonic sign of colonic hemangioma, it may not be always present. With wider use of cross-sectional images, it is necessary to know the imaging findings of the colonic hemangiomas on multiphasic scan and MRI for the correct diagnosis and management of the disease.

EXPRESSION OF SOME IMMUNOLOGIC MARKERS FOR THE DIAGNOSIS OF SUSPECTED LYMPHOID LESIONS OF LYMPHOMA

2018 ◽  
Vol 8 (4) ◽  
pp. 28-33
Author(s):  
Mao Nguyen Van ◽  
Thao Le Thi Thu
Keyword(s):  
Correct Diagnosis ◽  
Tumour Cells ◽  
The Body ◽  
The Other ◽  
Cervical Region ◽  
Cross Sectional ◽  
Immunologic Markers ◽  
Microscopic Features ◽  
Poor Differentiation ◽  
Benign Tumours

Background: In practice it was difficult or impossible to have a correct diagnosis for the lymphoid proliferation lesions based on only H.E standard histopathology. In addition to histopathology, the application of immunohistochemistry was indispensable for the definitive diagnosis of the malignant or benign tumours and the origin of the tumour cells as well. Objectives: 1. To describe the gross and microscopic features of the suspected lesions of lymphoma; 2. To asses the expression of some immunologic markers for the diagnosis and classification of the suspected lesions of lymphoma. Materials and Method: Cross-sectional research on 81 patients diagnosed by histopathology as lymphomas or suspected lesions of lymphoma, following with immunohistopathology staining of 6 main markers including LCA, CD3, CD20, Bcl2, CD30 and AE1/3. Results: The most site was lymph node 58.1% which appeared at cervical region 72.3%, then the stomach 14.9% and small intestine 12.4%. The other sites in the body were met with lower frequency. Histopathologically, the most type of the lesions was atypical hyperplasia of the lymphoid tissue suspecting the lymphomas 49.4%, lymphomas 34.5%, the other diagnoses were lower including inflammation, poor differentiation carcinoam not excluding the lymphomas, lymphomas differentiating with poor differentiation carcinomas. Immunohistochemistry showed that, LCA, CD3, CD20, Bcl2, CD30 and AE1/3 were all positive depending on such type of tumours. The real lymphomas were 48/81 cases (59.3%), benign ones 35.8% and poor differentiated carcinomas 4.9%. Conclusion: Immunohistochemistry with 6 markers could help to diagnose correctly as benign or malignant lesions, classify and determine the origin of the tumour cells as lymphocytes or epithelial cells diagnosed by histopathology as lymphomas or suspected lesions of lymphomas. Key words: histopathology, immunohistochemistry, lymphomas, poor differentiated carcinomas, hyperplasia, atypicality

Ultrasound diagnosis of dissecting thoracic aortic aneurysms: procedure with a handheld device and a video-illustrated case

2021 ◽  
Vol 51 (1) ◽  
pp. 10-15
Author(s):  
Kenneth V Iserson ◽  
Sri Devi Jagjit ◽  
Balram Doodnauth
Keyword(s):  
Aortic Dissection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Handheld Device ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Handheld Ultrasound

Acute thoracic aortic dissection is an uncommon, although not rare, life-threatening condition. With protean signs and symptoms that often suggest more common cardiac or pulmonary conditions, it can be difficult to diagnose. Ultrasound has proven useful in making the correct diagnosis. This case demonstrates that training gained using standard ultrasound machines can be easily and successfully adapted to newer handheld ultrasound devices. The examination technique using the handheld device is illustrated with photos and a video.

scholarly journals Congenital Craniofacial Plexiform Neurofibroma in Neurofibromatosis Type 1

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 218
Author(s):  
Antonella Cacchione ◽  
Alessia Carboni ◽  
Mariachiara Lodi ◽  
Rita De Vito ◽  
Andrea Carai ◽  
...  
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Correct Diagnosis ◽  
Plexiform Neurofibroma ◽  
Neurofibromatosis Type ◽  
Detection Techniques ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Diagnostic Work ◽  
Radiological Methods

We present a case demonstrating the performance of different radiographical imaging modalities in the diagnostic work-up of a patient with neurofibromatosis type 1 (NF1) and plexiform neurofibroma (PN). The newborn boy showed an expansive-infiltrative cervical and facial mass presented with macrocrania, craniofacial disfigurement, exophthalmos and glaucoma. A computer tomography (CT) and a magnetic resonance imaging (MRI) were performed. The CT was fundamental to evaluate the bone dysmorphisms and the MRI was crucial to estimate the mass extension. The biopsy of the lesion confirmed the suspicion of PN, thus allowing the diagnosis of NF1. PN is a variant of neurofibromas, a peripheral nerves sheath tumor typically associated with NF1. Even through currently available improved detection techniques, NF1 diagnosis at birth remains a challenge due to a lack of pathognomonic signs; therefore congenital PN are recognized in 20% of cases. This case highlights the importance of using different radiological methods both for the correct diagnosis and the follow-up of the patient with PN. Thanks to MRI evaluation, it was possible to identify earlier the progressive increasing size of the PN and the possible life threatening evolution in order to perform a tracheostomy to avoid airways compression.

From strongyloidiasis to disseminated mucormycosis: the story of an HTLV-1-infected migrant

2020 ◽  
Author(s):  
Brice Autier ◽  
Adélaïde Chesnay ◽  
Claire Mayence ◽  
Stéphanie Houcke ◽  
Hélène Guégan ◽  
...  
Keyword(s):  
Immune Deficiency ◽  
Strongyloides Stercoralis ◽  
The Body ◽  
Life Threatening ◽  
Disseminated Strongyloidiasis ◽  
Disseminated Mucormycosis

Strongyloidiasis manifestations range from asymptomatic cases to the life-threatening disseminated strongyloidiasis in case of immune deficiency: larvae migrate throughout the body, disseminating germs from the digestive flora to various organs. Here, we described a case of disseminated mucormycosis consecutive to Strongyloides stercoralis hyperinfestation in a Surinamese migrant infected with HTLV-1.

scholarly journals Preparedness of pre-intern medical graduates of three universities in Sri Lanka to diagnose and manage anaphylaxis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Medical Graduates ◽  
Self Confidence ◽  
Case Diagnosis

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.

scholarly journals Concussion Knowledge among Medical Students and Neurology/Neurosurgery Residents

2012 ◽  
Vol 39 (3) ◽  
pp. 361-368 ◽  
Author(s):  
Miranda Boggild ◽  
Charles H. Tator
Keyword(s):  
Medical Students ◽  
Chronic Traumatic Encephalopathy ◽  
Sample Population ◽  
Diagnosis And Management ◽  
University Of Toronto ◽  
Concussion Management ◽  
Life Threatening ◽  
Concussion History ◽  
The University ◽  
Impact Syndrome

Background and Objectives:Concussion is a prevalent brain injury in the community. While primary prevention strategies need to be enhanced, it is also important to diagnose and treat concussions expertly and expeditiously to prevent serious complications that may be life-threatening or long lasting. Therefore, physicians should be knowledgeable about the diagnosis and management of concussions. The present study assesses Ontario medical students’ and residents’ knowledge of concussion management.Methods:A survey to assess the knowledge and awareness of the diagnosis and treatment of concussions was developed and administered to graduating medical students (n= 222) and neurology and neurosurgery residents (n = 80) at the University of Toronto.Results:Residents answered correctly significantly more of the questions regarding the diagnosis and management of concussions than the medical students (mean = 5.8 vs 4.1, t= 4.48, p<0.01). Gender, participation in sports, and personal concussion history were not predictive of the number of questions answered correctly. Several knowledge gaps were identified in the sample population as a whole. Approximately half of the medical students and residents did not recognize chronic traumatic encephalopathy (n = 36) or the second impact syndrome (n = 44) as possible consequences of repetitive concussions. Twenty-four percent of the medical students (n = 18) did not think that “every concussed individual should see a physician” as part of management.Conclusions:A significant number of medical students and residents have incomplete knowledge about concussion diagnosis and management. This should be addressed by targeting this population during undergraduate medical education.

Lumps and Bumps in Children

1992 ◽  
Vol 13 (10) ◽  
pp. 371-378
Author(s):  
Thomas C. Putnam
Keyword(s):  
The Body ◽  
Clear Cut ◽  
Life Threatening ◽  
Subcutaneous Tissues

Many lesions involving the skin or subcutaneous tissues alarm parents and, often fearing cancer, they bring their child to a physician. Most lesions are benign and rarely life-threatening. The physician faces the problem of determining which characteristics suggest only observation of a lesion and which make biopsy necessary. Because many lesions have a predilection for certain areas of the body, this is a useful form of categorization (Table 1). On first inspection of a superficial lesion, several questions must be asked, including the known duration, change in size, presence of pain or other signs of inflammation, and any noted multiplicity. The examination includes an accurate measurement of the size and, most importantly, a determination of the level of the lesion. This will help establish the diagnosis and help to determine whether the possibility of malignancy exists. Essentially all lesions originating in the skin of children are benign. Some are obvious, such as a wart, while others may not be so clear-cut, especially if the epidermis is not altered in appearance. Upon palpation of a cutaneous mass, the skin does not move over the surface and puckers when the adjacent skin and tissues are compressed and elevated. If the skin moves freely over the mass, the nature of the lesion is not so readily apparent.

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