scholarly journals Case of Mycotic Pseudoaneurysm of the Common Carotid Artery due to Salmonella typhi Bacteremia

2022 ◽  
pp. 263394472110610
Author(s):  
Sruti P. Nair ◽  
Aravind Reghukumar ◽  
Athul Gurudas ◽  
Kiran Kumar V. Sasidharan ◽  
Sreekumar Sivadasan
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Past History ◽  
Fatal Outcome ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
High Dose ◽  
Uncontrolled Diabetes ◽  
Life Threatening ◽  
History Of

Aneurysm of the extracranial carotid artery is a rare disease, mycotic pseudoaneurysms being even less common. They are a life-threatening complication of systemic infection and atherosclerosis. Immunocompromised people, including patients with HIV, uncontrolled diabetes melltus, those on immunosuppressants like high-dose steroids, and chemotherapy, are at a higher risk for development of mycotic pseudoaneurysms. Due to the high risk of potential complications like rupture and thromboembolic events, mycotic aneurysms always require surgical management. Early detection followed by restoration of blood flow is critical to minimize a fatal outcome. Here we report the case of a 52-year-old man with a past history of hypertension and dyslipidemia who presented with a pulsatile painful neck swelling. On evaluation, the patient was diagnosed to have Salmonella typhi bacteremia, HIV infection, and a mycotic aneurysm of the left common carotid artery.

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.

scholarly journals A Case Report on Scleroderma: A Diagnostic Dilema

2021 ◽  
pp. 251-255
Author(s):  
Ch. K. V. L. S. N. Anjana Male ◽  
Hari Chandana Varikallu ◽  
Tirumalasetty Sai Swapna ◽  
N. Dileep ◽  
S. Hemanth Durga Prasad ◽  
...  
Keyword(s):  
Past History ◽  
Immunosuppressive Agents ◽  
Localized Scleroderma ◽  
Visceral Organ ◽  
Tight Skin ◽  
Heterogenous Group ◽  
Life Threatening ◽  
History Of ◽  
Organ Fibrosis

Scleroderma is a rare heterogenous group of autoimmune fibrosing disorder that mainly exists in two forms; localized scleroderma (LS) and systemic sclerosis (SSc). It involves thickening of the skin at fingers region extending from proximal to metacarpophalangeal joints. The diagnostic criteria of scleroderma include past history of patient, symptoms of patient, serology, and skin biopsy. The morbidity and mortality are much worse for SSc with the patients are at risk for life threatening lung, heart and other visceral organ fibrosis and vasculopathy. There is no drug that can cure or stop scleroderma over fibrosis, but certain drugs regulate the symptoms associated with it and boost the patient's quality of life, particularly steroidal creams that help alleviate swelling, joint pain, loosen tight skin; blood pressure drugs that dilate blood vessels; immunosuppressive agents. If the disease is severe amputation is necessary.

scholarly journals Endovascular Internal Trapping by Low-Concentration N-butyl-2-Cyanoacrylate for a Ruptured Giant Common Carotid Artery Pseudoaneurysm

2020 ◽  
Vol 55 (1) ◽  
pp. 81-85
Author(s):  
Tomoaki Harada ◽  
Atsushi Fujita ◽  
Junichi Sakata ◽  
Masaaki Kohta ◽  
Eiji Kohmura
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Parent Artery ◽  
Artery Pseudoaneurysm ◽  
Low Concentration ◽  
Complete Obliteration ◽  
Minimum Number ◽  
History Of ◽  
Giant Pseudoaneurysm

Treating carotid blowout syndrome following rupture of giant pseudoaneurysms is difficult because the destroyed parent artery precludes conventional treatment. We present a patient with a ruptured giant pseudoaneurysm that we occluded using a modified internal trapping technique with low-concentration N-butyl-2-cyanoacrylate (NBCA) and a minimum number of coils. An 80-year-old man with a history of chemoradiation therapy for oropharyngeal cancer presented with several episodes of active bleeding from the subsequent tracheostomy site. Radiological examination revealed a giant right common carotid artery (CCA) pseudoaneurysm. Endovascular internal trapping was performed using both NBCA and coils under proximal flow control. We slowly injected 9 ml of low-concentration NBCA, which subsequently filled the entire pseudoaneurysm. We then injected an additional 2 ml of NBCA into the proximal CCA to achieve complete obliteration. No re-bleeding was observed during the 6-month follow-up. Endovascular internal trapping using low-concentration NBCA was feasible to treat a giant CCA pseudoaneurysm. The injected low-concentration NBCA filled the entire pseudoaneurysm without the risk of catheter entrapment.

scholarly journals High Dose Methylprednisolone: Effective in Pregnancy Associated Post-splenectomy Refractory Chronic Immune Thrombocytopenic Purpura

2014 ◽  
Vol 9 (1) ◽  
pp. 64-66
Author(s):  
A Singh ◽  
A Solanki
Keyword(s):  
Past History ◽  
Oral Steroid ◽  
High Dose ◽  
Third Trimester ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Male Baby ◽  
High Dose Methylprednisolone ◽  
History Of ◽  
Acute Crisis

We present a case of 23 years multigravid woman (G2P0+1) with chronic idiopathic thrombocytopenic purpura (ITP), refractory to treatment in forms of oral steroid, dapsone, azathioprine and splenectomy. She presented to the hospital in third trimester of pregnancy, with reduced platelet counts and purpuric rashes over abdomen and both upper extremeties. There was a past history of spontaneous abortion at 18 weeks. The patient responded to intravenous high dose methylprednisolone (HDMP) infusion leading to delivery of full term male baby. The baby also required treatment for thrombocytopenia with intravenous immunoglobulin (IVIG). This case lays down the importance of HDMP in form of using it effectively in managing acute crisis of low platelet counts in pregnant patients with ITP refractory to splenectomy. DOI: http://dx.doi.org/10.3126/njog.v9i1.11192 NJOG 2014 Jan-Jun; 2(1):64-66

Change in common carotid artery diameter, distensibility and compliance in subjects with a recent history of impaired glucose tolerance

2000 ◽  
Vol 18 (3) ◽  
pp. 293-300 ◽  
Author(s):  
Robert A.J.M. van Dijk ◽  
Giel Nijpels ◽  
Jos W.R. Twisk ◽  
Mieke Steyn ◽  
Jacqueline M. Dekker ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Common Carotid Artery ◽  
Recent History ◽  
History Of

Common carotid artery pseudoaneurysm formation following foreign body ingestion

2009 ◽  
Vol 124 (6) ◽  
pp. 684-686 ◽  
Author(s):  
N N Mathur ◽  
R R Joshi ◽  
A Nepal ◽  
R K Rauniyar
Keyword(s):  
Foreign Body ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
World Literature ◽  
Radiological Investigation ◽  
Artery Pseudoaneurysm ◽  
Pseudoaneurysm Formation ◽  
History Of ◽  
The Common ◽  
Lower Neck

AbstractObjective:To report an unusual case of pseudoaneurysm formation following ingestion of a thin wire.Method:Case report, including management, and review of the world literature concerning pseudoaneurysm and its management.Results:A 15-year-old boy presented as an emergency with a two-week history of painful swallowing, and a one-week history of a progressively enlarging, right-sided swelling of the lower neck. A foreign body had been ingested two weeks previously. Radiological investigation showed a pseudoaneurysm of the right common carotid artery. The neck was explored, the foreign body removed and the common carotid artery repaired. The patient was discharged on the 10th post-operative day without neurovascular complication.Conclusion:This is an unusual presentation of pseudoaneurysm of the common carotid artery following accidental ingestion of a foreign body, reported for its rarity and management.

scholarly journals Efficacy of High-Dose and Low-Dose Simvastatin on Vascular Oxidative Stress and Neurological Outcomes in Patient with Acute Ischemic Stroke: A Randomized, Double-Blind, Parallel, Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Nattaphol Uransilp ◽  
Pannawat Chaiyawatthanananthn ◽  
Sombat Muengtaweepongsa
Keyword(s):  
Oxidative Stress ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Barthel Index ◽  
Low Dose ◽  
Past History ◽  
High Dose ◽  
Neurological Outcomes ◽  
History Of ◽  
Vascular Oxidative Stress

Backgrounds. Stroke is the leading cause of death and long-term disability. Oxidative stress is elevated during occurrence of acute ischemic stroke (AIS). Soluble LOX-1 (sLOX-1) and NO are used as biomarkers for vascular oxidative stress that can reflect stabilization of atherosclerotic plaque. Previous study showed that simvastatin can reduce oxidative stress and LOX-1 expression. Objectives. To evaluate neurological outcomes and serum sLOX-1 and NO levels in patients with AIS treatment with low dose 10 mg/day and high dose 40 mg/day of simvastatin. Methods. 65 patients with AIS within 24 hours after onset were randomized to treatment with simvastatin 10 mg/day or 40 mg/day for 90 days. Personal data and past history of all patients were recorded at baseline. The blood chemistries were measured by standard laboratory techniques. Serum sLOX-1 and NO levels and neurological outcomes including NIHSS, mRS, and Barthel index were tested at baseline and Day 90 after simvastatin therapy. Results. Baseline characteristics were not significantly different in both groups except history of hypertension. Serum sLOX-1 and NO levels significantly reduce in both groups (sLOX-1 = 1.19±0.47 and 0.98±0.37 ng/ml; NO = 49.28±7.21 and 46.59±9.36 μmol/l) in 10 mg/day and 40 mg/day simvastatin groups, respectively. Neurological outcomes including NIHSS, mRS, and Barthel index significantly improve in both groups. However, no difference in NO level and neurological outcomes was found at 90 days after treatment as compared between low dose 10 mg/day and high dose 40 mg/day of simvastatin. Conclusion. High-dose simvastatin might be helpful to reduce serum sLOX-1. But no difference in clinical outcomes was found between high- and low-dose simvastatin. Further more intensive clinical trial is needed to confirm the appropriate dosage of simvastatin in patients with acute ischemic stroke. This trial is registered with ClinicalTrials.gov ID: NCT03402204.

Lethal toxicities after capecitabine intake in a previously 5-FU-treated patient: why dose matters with dihydropryimidine dehydrogenase deficiency

2019 ◽  
Vol 20 (13) ◽  
pp. 931-938 ◽  
Author(s):  
Crescent C Gbeto ◽  
Sylvie Quaranta ◽  
Roxane Mari ◽  
Raphaelle Fanciullino ◽  
Catherine Roche ◽  
...  
Keyword(s):  
Cytidine Deaminase ◽  
Treated Patient ◽  
Fatal Outcome ◽  
Metastatic Breast ◽  
Warning Signal ◽  
Symptomatic Treatment ◽  
Deficiency Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Grade 3

Dihydropryimidine dehydrogenase (DPD) deficiency is a pharmacogenetic syndrome associated with severe or lethal toxicities with oral capecitabine. Usually, patients with history of 5-FU-based therapy with no signs for life-threatening toxicities are considered as not DPD-deficient individuals who can be safely treated next with capecitabine if required. Here we describe the case of a woman originally treated with standard FEC100 protocol for metastatic breast cancer with little severe toxicities but grade-3 mucosities that were quickly resolved by symptomatic treatment. When switched to capecitabine + vinorelbine combo, extremely severe toxicities with fatal outcome were unexpectedly observed. Pharmacogenetic investigations were performed on cytidine deaminase and DPYD, and showed that this patient was heterozygous for the 2846A>T mutation on the DPYD gene. DPD phenotyping (i.e., uracil plasma levels >250 ng/ml, dihydrouracil/uracil ratio <0.5) confirmed that this patient was profoundly DPD deficient. Differences in fluoropyrimidine dosing between FEC100 (i.e., 500 mg/m2 5-FU) and capecitabine (i.e., 2250 mg daily) could explain why initial 5-FU-based protocol did not lead to life-threatening toxicities, whereas capecitabine rapidly triggered toxic death. Overall, this case report suggests that any toxicity, even when not life threatening, should be considered as a warning signal for possible underlying profound DPD deficiency syndrome, especially with low-dose protocols.

scholarly journals Parotid swelling due to external carotid artery thrombus—a rare manifestation in antiphospholipid syndrome

2019 ◽  
Vol 2019 (6) ◽  
Author(s):  
Rajdeep Basu ◽  
Omkarr De Hazra ◽  
Sumantro Mondal ◽  
Srabani Ghosh ◽  
Soumitra Ghosh
Keyword(s):  
Carotid Artery ◽  
Antiphospholipid Syndrome ◽  
Past History ◽  
Vascular Complications ◽  
Arterial Occlusion ◽  
External Carotid Artery ◽  
External Carotid ◽  
Rare Manifestation ◽  
Parotid Swelling ◽  
History Of

Abstract Vascular complications in forms of venous and arterial thrombi are common scenario in antiphospholipid syndrome with raised titer of antibodies. Here we describe an 18 years old female who was admitted with right parotid swelling due to external carotid artery thrombi within gland parenchyma in antiphospholipid syndrome, with past history of right lower leg arterial occlusion and digital gangrene.

Homograft patch repair in carotid artery rupture

VASA ◽  
2007 ◽  
Vol 36 (4) ◽  
pp. 279-281 ◽  
Author(s):  
Teebken ◽  
Pichlmaier ◽  
Leinung ◽  
Lenarz ◽  
Haverich
Keyword(s):  
Drug Abuse ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Intravenous Drug ◽  
Patch Repair ◽  
Intravenous Drug Abuse ◽  
Autologous Vein ◽  
Vein Segment ◽  
History Of ◽  
Carotid Bulb

The case of a 24-year-old man with a rupture of the left common carotid artery and history of intravenous drug abuse is presented. Due to absence of a suitable autologous vein segment the carotid bulb was repaired with a human allograft patch.

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