scholarly journals Life threatening abscess in the visceral space with penicillin and metronidazole resistant Prevotella Denticola following use of a laryngeal mask airway: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hervé Vanden Eede ◽  
Elizabeth Norris ◽  
Michaël Torfs ◽  
Olivier Vanderveken
Keyword(s):  
Early Recognition ◽  
Laryngeal Mask ◽  
Pharyngeal Wall ◽  
Case Presentation ◽  
Respiratory Problems ◽  
First Case ◽  
Amoxicillin Clavulanate ◽  
Life Threatening ◽  
Single Use ◽  
Day Care Centre

Abstract Background Laryngeal mask airways (LMA) are commonly used for airway management. Complications with this device are rare. However, when they do occur, there is a high risk for respiratory problems, necessitating early diagnosis and treatment. We present the first case of a life-threatening abscess spreading in the visceral space caused by a penicillin and metronidazole resistant Prevotella Denticola after the use of an LMA. Case presentation A female patient was admitted to our day care centre for bunion surgery. A single use LMA size 3 (Solus®, intersurgical, Wokingham, Berkshire, United Kingdom) was successfully inserted. After surgery, the patient complained of a sore throat and amoxicillin was prescribed by the general practitioner. Three days after surgery the patient was admitted to the Intensive Care Unit (ICU) for obstructive breathing, due to an abscess in the visceral space. Retropharyngeal and certainly parapharyngeal abscesses in adults are already rare. This case however, is unique because it is the first case of abscess spreading into the visceral space after the use of an LMA. Amoxicillin/clavulanate and vancomycin were started. The abscess was incised 5 days later and microbiology showed 3 positive cultures of the anaerobe Prevotella denticola, resistant for penicillin and metronidazole, but sensitive for amoxicillin/clavulanate. The patient fully recovered. Conclusion LMA’s are easy to use and are established, safe tools to support ventilation of the airway. In this case, the authors hypothesise a small wound in the lateral pharyngeal wall probably created an opening into the visceral space causing infection with Prevotella denticola, supporting the idea that the pharyngeal mucosal space must be part of the visceral space. Additionally, early recognition and treatment of an LMA induced abscess is necessary to prevent evolution of complications leading to airway obstruction.

Postpartum ovarian vein thrombosis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kelly Ribeiro ◽  
Samir Mahboobani ◽  
Katherine Van Ree ◽  
Katy Clifford ◽  
TG Teoh
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Early Recognition ◽  
Ovarian Vein ◽  
Transabdominal Ultrasound ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Prompt Treatment ◽  
Life Threatening ◽  
Ovarian Vein Thrombosis

Abstract Objectives Postpartum ovarian vein thrombosis (POVT) is a rare pathology that can lead to severe complications such as sepsis, extension of the thrombus leading to organ failure, and pulmonary embolism. It therefore requires early recognition and prompt treatment. Case presentation A patient with right POVT presented four days after delivery with acute right-sided abdominal pain and fever. Appendicitis was initially considered, before an abdominal-pelvic computed tomography raised the suspicion of POVT, subsequently confirmed through transabdominal ultrasound. Antibiotics and anticoagulation were initiated, with rapid clinical improvement and complete resolution of the thrombus three months later. Conclusions Diagnosing POVT is challenging as it clinically mimics other more frequent conditions. It is rare but life-threatening and should be considered in all females presenting with abdominal pain and fever in the postpartum period.

scholarly journals Endoscopic Retrograde Cholangiopancreatography Scope‑induced Duodenojejunal Flexure Perforation: The World’s First Case

2017 ◽  
Vol 08 (03) ◽  
pp. 145-147
Author(s):  
Jignesh A. Gandhi ◽  
Pravin H. Shinde ◽  
Basavaraj K. Nagur ◽  
Rohan D. Digarse
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Primary Closure ◽  
Early Recognition ◽  
Emergency Laparotomy ◽  
Significant Morbidity ◽  
Endoscopic Retrograde ◽  
The Third ◽  
First Case ◽  
Duodenojejunal Flexure ◽  
Life Threatening

ABSTRACTDuodenojejunal (DJ) flexure perforation is very rare. DJ flexure perforation following endoscopic retrograde cholangiopancreatography (ERCP) has not be documented till date. They are associated with significant morbidity and mortality. We present an ERCP‑induced DJ flexure perforation which has been treated with primary closure in two layers at our institution. To the best of our knowledge, this is the world’s first case. Such site of ERCP‑induced perforation has not been reported in literature till date. A 75‑year‑old female patient underwent repeated ERCP for obstructive jaundice. There was perforation during the third ERCP while removing the larger stone. Emergency laparotomy was performed with primary closure of perforation in two layers. ERCP‑induced DJ flexure perforation has not yet been documented. It is potentially life‑threatening. Early recognition may lead to a better prognosis through earlier intervention.

Early recognition and critical management of adult epiglottitis in the emergency department: a case report and review of the literature

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Airway Management ◽  
Early Recognition ◽  
Pediatric Population ◽  
Delayed Diagnosis ◽  
Lateral Neck ◽  
Review Of The Literature ◽  
Acute Epiglottitis ◽  
Case Presentation ◽  
Life Threatening

Background: Acute epiglottitis was considered a disease of the pediatric population. However, it has constantly been a report of a certain number of adult cases. Death by airway obstruction is caused by delayed diagnosis and untimely invasive airway management contributing to the higher mortality rate in adults. Case presentation: We presented a case of a 24-year-old male patient without significant underlying condition, who presented at our emergency department with a progressive sore throat and high-graded fever for one day. After a set of investigations, the patient was diagnosed with acute epiglottitis, and airway management was managed accordingly. His conditions improved after a course of antibiotic treatment during hospital admission. Conclusion: Acute epiglottitis in adults is not frequently encountered in the emergency department. This case underlines the importance of clinical suspicions in cases with consistent symptoms as well as the excellent utility of lateral neck radiography for the diagnosis of this life-threatening entity.

scholarly journals Gangrena Fournier i rekonstrukcija nastalih defekata

2006 ◽  
Vol 53 (3) ◽  
pp. 95-99 ◽  
Author(s):  
N. Sretenovic ◽  
M. Colic ◽  
R. Lazic ◽  
S. Bosic ◽  
N. Stojadinovic
Keyword(s):  
Early Recognition ◽  
Skin Flaps ◽  
Large Defect ◽  
Local Skin ◽  
Anatomical Region ◽  
First Case ◽  
Number Of Patients ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cutaneous Flap

Fournier?s gangrene is remarkably rare but severe, life threatening condition. Thanks to better early recognition of disease in past few years, the percentage of patients which survive this condition is considerable, but consequence of this fact is large number of patients with defects of cutis and subcutis in perineal and scrotal regions. Reconstruction of this defects is complicate and require healthy, well vascularised tissue from another anatomical region which is not involved in gangrenous process. Authors present two cases of reconstruction of defects in perineal and scrotal regions. First case is large defect which is covered by transposition of musculus gracilis musculo-cutaneous flap. Second case is lesser defect which is enclosed by mobilization of local skin flaps. .

scholarly journals Schwannoma of the Posterior Pharyngeal Wall in a Child

2021 ◽  
Author(s):  
peng zhu ◽  
xiao yan li
Keyword(s):  
Radio Frequency ◽  
Rare Case ◽  
Posterior Pharyngeal Wall ◽  
Pharyngeal Wall ◽  
Case Presentation ◽  
First Case ◽  
Severe Difficulty ◽  
First Time

Abstract Background: To our knowledge, There are only 7 cases of posterior pharyngeal wall schwannoma which have been previously reported in the literature, but none of them was associated with a 3-year-old child.Case presentation: We presented a rare case of a schwannoma which is localized on the posterior pharyngeal wall, It caused severe difficulty in swallowing and breathing in a child whose age is three years old. Schwannomas of the posterior pharyngeal wall has been rarely reported in children, The tumor was removed with plasma radio frequency excision via a transoral route, There was not seen any recurrence of tumor by examination of CT or MRI up to two years. as far as we know, It's the first time which a case of posterior pharyngeal wall schwannoma that has been reported to occur in a 3-year-old child, and the first case in which the schwannoma was removed via transoral plasma radio frequency excision.Conclusions: This case illustrates that schwannoma may be found in children ,and it is safe to treat this disease through plasma radio frequency excision via a transoral route.

Clostridium septicum arthroplasty infection: beware of occult aortitis and malignancy

2018 ◽  
Vol 63 (4) ◽  
pp. 132-139 ◽  
Author(s):  
Gareth Turnbull ◽  
Euan Spierits ◽  
David Russell ◽  
Jon Clarke ◽  
Frédéric Picard ◽  
...  
Keyword(s):  
Haematological Malignancy ◽  
Gas Gangrene ◽  
Review Of The Literature ◽  
Clinical Infection ◽  
Clostridium Septicum ◽  
Case Presentation ◽  
First Case ◽  
Underlying Malignancy ◽  
Life Threatening

Introduction The Clostridia species are responsible for life-threatening conditions such as tetanus, botulism and gas gangrene. Clostridium septicum is a rare cause of clinical infection, accounting for less than 1% of blood culture samples that test positive for Clostridia. However, C. septicum bacteraemia is associated with greater than 60% mortality and in over 80% of cases is associated with an underlying malignancy. Case presentation We present a review of the literature and the first case of an acute arthroplasty infection and concurrent infective aortitis caused by this organism in the absence of an identified underlying malignancy. Early diagnosis and multi-disciplinary input resulted in the patient surviving a rare and potentially fatal infective aortitis and septic arthritis. Conclusion This case demonstrates the importance of early systemic investigation to exclude occult infective aortitis in C. septicum infection. The key role of multi-disciplinary input into the management of this often fatal infection is also discussed along with the requirement to exclude occult gastrointestinal and haematological malignancy.

scholarly journals Systemic lupus erythematosus manifestation following COVID-19: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Batool Zamani ◽  
Seyed-Masoud Moeini Taba ◽  
Mohammad Shayestehpour
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Respiratory Disorder ◽  
Viral Agent ◽  
Systemic Lupus ◽  
Rheumatology Clinic ◽  
Case Presentation ◽  
First Case ◽  
Life Threatening ◽  
Hands And Feet

Abstract Background Systemic lupus erythematosus (SLE) is a complex and challenging autoimmune disease. Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a novel viral agent that can cause a life-threatening respiratory disorder named coronavirus disease 2019 (COVID‑19). Association between SARS‑CoV‑2 and SLE is not clear. We reported the first case of SLE manifestation following COVID-19. Case presentation A 39-year-old Iranian/Persian man with complaints of fever, scaling on the palms of the hands and feet, lower extremity edema, and ankle swelling was referred to Kashan Rheumatology Clinic in 2020. He was infected with SARS-CoV-2 2 months ago. The patient had proteinuria and was positive for SLE laboratory tests. After one week of treatment with prednisolone (30 mg daily) and hydroxychloroquine, paresthesia, proteinuria, and edema continued. The patient was treated with pulse methylprednisolone (1000 mg for three consecutive days), gabapentin, and vitamin B (300 mg daily), which reduced paresthesia. Conclusions This is the first case of SLE manifestation following COVID-19. SARS-CoV-2 may produce autoantibodies or develop the clinical features of subclinical SLE.

scholarly journals Immediate post partum macular subretinal bleeding in a highly myopic patient: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karen Bitton ◽  
J.-L. Bacquet ◽  
F. Amoroso ◽  
S. Mrejen ◽  
M. Paques ◽  
...  
Keyword(s):  
Valsalva Maneuver ◽  
Post Partum ◽  
Pathologic Myopia ◽  
Pathological Myopia ◽  
Case Presentation ◽  
Sudden Loss ◽  
Corrected Visual Acuity ◽  
First Case ◽  
History Of ◽  
Macular Hemorrhage

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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