scholarly journals Rare crystalline nephropathy leading to acute graft dysfunction: a case report

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sahil Bagai ◽  
Dinesh Khullar ◽  
Bhavna Bansal
Keyword(s):  
Correct Diagnosis ◽  
Kidney Injury ◽  
Graft Dysfunction ◽  
Case Presentation ◽  
Therapeutic Implications ◽  
High Index Of Suspicion ◽  
Indian Male ◽  
Aprt Deficiency ◽  
Genetic Form ◽  
Acute Graft

Abstract Background Adenine phosphoribosyl transferase (APRT) deficiency is a rare genetic form of kidney stones and/or kidney failure characterized by intratubular precipitation of 2,8 dihydroxyadenine crystals. Early diagnosis and prompt management can completely reverse the kidney injury. Case presentation 44 year old Indian male, renal transplant recipient got admitted with acute graft dysfunction. Graft biopsy showed light brown refractile intratubular crystals with surrounding giant cell reaction, consistent with APRT deficiency. Patient improved after receiving allopurinol and hydration. Conclusion APRT forms a reversible cause of crystalline nephropathy. High index of suspicion is required for the correct diagnosis as timely diagnosis has therapeutic implications.

scholarly journals Vulval Elephantiasis: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Harsh Mohan ◽  
Bhumika Bisht ◽  
Poonam Goel ◽  
Geeta Garg
Keyword(s):  
Diagnostic Tests ◽  
Correct Diagnosis ◽  
Young Female ◽  
Filarial Infection ◽  
Case Presentation ◽  
Tissue Sections ◽  
Filarial Antigen ◽  
High Index Of Suspicion ◽  
Conclusive Diagnosis ◽  
Microscopic Findings

Introduction. Elephantiasis is a chronic manifestation of filariasis; it commonly affects limbs, scrotum, and trunk. Females have lower incidence of filarial infection. Vulval elephantiasis due to filariasis is still rarer. It is difficult to make the diagnosis on histopathology alone, more so in view of the fact that the parasite is usually not identified in tissue sections. Identification of microfilariae in night samples of peripheral blood or seropositivity for filarial antigen is requisite for the correct diagnosis.Case Presentation. A young female presented with progressively increasing vulval swelling over a period of two years. The swelling was soft and measured5×6 cm. Other possible differential diagnoses were excluded, and ancillary tests were performed to reach a conclusive diagnosis of vulval elephantiasis on histopathology.Conclusion. Vulval elephantiasis due to filariasis is rare. Its diagnosis on histopathology is more often by exclusion. High index of suspicion on microscopic findings and corelation with relevant diagnostic tests are required to reach the correct diagnosis.

scholarly journals Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Julio Poveda ◽  
Farah El-Sharkawy ◽  
Leopoldo R. Arosemena ◽  
Monica T. Garcia-Buitrago ◽  
Claudia P. Rojas
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Correct Diagnosis ◽  
Strongyloides Stercoralis ◽  
Aminosalicylic Acid ◽  
Therapeutic Implications ◽  
Pathologic Features ◽  
History Of ◽  
Inflammatory Bowel ◽  
High Index Of Suspicion

Autoinfection caused by Strongyloides stercoralis frequently becomes a life-long disease unless it is effectively treated. There is overlapping histomorphology between Strongyloides colitis and inflammatory bowel disease; a low index of suspicion can lead to misdiagnosis and fatal consequences. We present a case of Strongyloides colitis mimicking the clinical and pathologic features of inflammatory bowel disease. A 64-year-old female presented to the emergency department with a four-day history of abdominal pain, diarrhea, and hematochezia. Colonoscopy revealed diffuse inflammation suggestive of inflammatory bowel disease, which led to initiation of 5-aminosalicylic acid and intravenous methylprednisolone. Biopsies of the colon revealed increased lymphoplasmacytic infiltrate of the lamina propria with eosinophilic microabscesses and presence of larvae, consistent with Strongyloides stercoralis. Immunosuppressive medication was halted. The patient ultimately died a few days later. This case emphasizes the importance of identifying the overlapping clinical and pathologic features of Strongyloides colitis and inflammatory bowel disease. A high index of suspicion and recognition of particular histological findings, including eosinophilic microabscesses, aid in the correct diagnosis. Definitive diagnosis is crucial as each disease carries distinct therapeutic implications and outcome.

scholarly journals Chlorhexidine – a commonly used but often neglected culprit of dialysis associated anaphylactic reactions (case report)

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Jia Neng TAN ◽  
Yi ◽  
Sabrina HAROON ◽  
Titus LAU
Keyword(s):  
Dialysis Patient ◽  
Kidney Injury ◽  
Healthcare Setting ◽  
Dialysis Treatment ◽  
Case Presentation ◽  
Fluid Removal ◽  
Life Saving ◽  
End Stage ◽  
High Index Of Suspicion ◽  
Time Of Presentation

Abstract Background Hemodialysis-associated anaphylactic reactions are rare and frequently complex in nature due to the sheer number of possible culprit agents. Unfortunately, dialysis is often unavoidable or strictly essential for life-saving solute clearance or fluid removal in patients with end stage kidney failure and those with severe acute kidney injury. It is of utmost importance that the culprit agent is identified and avoided to allow continuation of dialysis treatment as needed. Case presentation We present 2 cases of hemodialysis-associated anaphylactic reactions. These patients developed anaphylactic reactions peri-dialysis and were initially suspected to have dialyser reactions. They were investigated in a controlled healthcare setting and possible culprit agents were systemically identified and eliminated. They both underwent allergy testing and were diagnosed with chlorhexidine allergy. Of note, Case 1 was an incident dialysis patient at the time of presentation and Case 2 was a prevalent dialysis patient. This suggests that the time from initial sensitization to reaction may not always be helpful in determining if a particular agent is the culprit of an anaphylactic reaction. In both cases, the patients were dialysed through a tunnelled dialysis catheter. We postulate that the presence of an exit site, which represents a compromise to the integrity of the skin’s epidermal barrier, may have a significant role in the development of these reactions. As chlorhexidine is a widely used disinfectant in hemodialysis, it is imperative that we consider it as a possible culprit agent when these reactions arise. To our knowledge, there are no other reported cases of anaphylaxis secondary to chlorhexidine use in dialysis patients other than a previous report in 2017. Our report also highlights the possibility of these reactions occurring more frequently in patients with damaged epidermal barriers and in patients exposed to higher environmental concentrations of chlorhexidine. These are novel concepts that can be explored with further research. Conclusion Chlorhexidine associated anaphylactic reactions can occur in the peri-dialysis setting and a high index of suspicion is paramount to diagnosis.

scholarly journals SARS-CoV-2 infection in an infant with non-respiratory manifestations: a case report

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Muhammad Adel ◽  
Ahmed Magdy
Keyword(s):  
Computed Tomography ◽  
Aplastic Anemia ◽  
Rt Pcr ◽  
Positive Real ◽  
Case Presentation ◽  
Chest Computed Tomography ◽  
High Incidence ◽  
Laboratory Investigations ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Abstract Background Coronavirus disease (COVID-19) presents in children usually with less severe manifestations than in adults. Although fever and cough were reported as the most common symptoms, children can have non-specific symptoms. We describe an infant with aplastic anemia as the main manifestation. Case presentation We describe a case of SARS-CoV-2 infection in an infant without any respiratory symptoms or signs while manifesting principally with pallor and purpura. Pancytopenia with reticulocytopenia was the predominant feature in the initial laboratory investigations, pointing to aplastic anemia. Chest computed tomography surprisingly showed typical findings suggestive of SARS-CoV-2 infection. Infection was later confirmed by positive real-time reverse transcription polymerase chain reaction assay (RT-PCR) for SARS-CoV-2. Conclusions Infants with COVID-19 can have non-specific manifestations and a high index of suspicion should be kept in mind especially in regions with a high incidence of the disease. Chest computed tomography (CT) and testing for SARS-CoV-2 infection by RT-PCR may be considered even in the absence of respiratory manifestations.

Thrombosed Urethral Prolapse: a case series and review of the literature

2021 ◽  
pp. 205141582110328
Author(s):  
Abisola Oliyide ◽  
Ijeoma Chibuzo ◽  
Magda Kujawa
Keyword(s):  
Clinical Condition ◽  
Correct Diagnosis ◽  
Age Distribution ◽  
Case Series ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Case Presentation ◽  
Urethral Prolapse ◽  
Evidence Level

Thrombosed urethral prolapse is a rare clinical condition. In this context, we describe our experience and compare our findings with the literature, following presentation of five consecutive cases over 2 years. This will hopefully improve awareness and appropriateness of specialty referrals as a correct diagnosis is rarely established prior to the patient being seen by a urologist. We also wish to highlight a case presentation of thrombosed urethral prolapse outside the bimodal age distribution which has been recorded in the literature. Level of Evidence: Level 4

scholarly journals Type Va extrahepatic bile duct duplication: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Bharat Mani Banjade ◽  
Ashish Rajbhandari ◽  
Rabin Koirala ◽  
Tuhin Shah ◽  
Chitra Lal Bhattachan
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Correct Diagnosis ◽  
Diagnostic Techniques ◽  
Case Presentation ◽  
Double Common Bile Duct ◽  
Unusual Variant ◽  
Rural Nepal ◽  
Calculous Cholecystitis

Abstract Background Extrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist. There are five different types of this anomaly and we present an unusual variant of duplication of an extrahepatic biliary system of type Va variety. Case presentation This case report describes a 63-year-old women from rural Nepal who presented with type Va of duplicated extrahepatic bile duct, with chronic calculous cholecystitis and choledocholithiasis. She was managed with cholecystectomy with hepatic ductoplasty and hepaticojejunostomy. Conclusion A rare case of double common bile duct (type Va) complicated by choledocholithiasis, cholangitis, and chronic cholecystitis is reported here. Rare cases are sometimes overlooked by modern diagnostic techniques. Correct diagnosis helps appropriate surgical intervention.

Mycobacterium Fortuitum Infections of the Hand

1992 ◽  
Vol 17 (6) ◽  
pp. 675-677 ◽  
Author(s):  
F. K. IP ◽  
S. P. CHOW
Keyword(s):  
Correct Diagnosis ◽  
High Index ◽  
Mycobacterium Fortuitum ◽  
High Index Of Suspicion

Five cases are reported of infection due to Mycobactenum fortuitum involving the hand following contaminated injection or traumatic wounds. Synovectomy, debridement, or amputation together with prolonged chemotherapy using kanamycin or amikacin were required. Doxycycline and sulphamethoxasole also seemed to be the effective antibiotics for this organism. A high index of suspicion is important in order to obtain the correct diagnosis.

scholarly journals Concomitant hepatic tuberculosis and hepatocellular carcinoma: a case report and review of the literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hind S. Alsaif ◽  
Ali Hassan ◽  
Osamah Refai ◽  
Khaled Awary ◽  
Haitham Kussaibi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Malignancy ◽  
Ct Guided ◽  
Case Presentation ◽  
Hepatic Tuberculosis ◽  
Ct Guided Biopsy ◽  
History Of ◽  
Abdominal Examination ◽  
Peripheral Arterial ◽  
High Index Of Suspicion

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary liver malignancy that is strongly associated with chronic liver disease. Isolated hepatic tuberculosis is an uncommon type of tuberculosis. Concomitant occurrence of both conditions is extremely rare. Case presentation We report the case of a 47-year-old man who presented with fever and abdominal pain for 3 months prior to presentation. He reported a history of anorexia and significant weight loss. Abdominal examination revealed a tender, enlarged liver. Abdominal computed tomography (CT) demonstrated a solid heterogeneous hepatic mass with peripheral arterial enhancement, but no venous washout, conferring a radiological impression of suspected cholangiocarcinoma. However, a CT-guided biopsy of the lesion resulted in the diagnosis of concomitant HCC and isolated hepatic tuberculosis. Conclusion A rapid increase in tumor size should draw attention to the possibility of a concomitant infectious process. Clinicians must have a high index of suspicion for tuberculosis, especially in patients from endemic areas, in order to initiate early and proper treatment.

Metastatische pulmonale calcificaties als zeldzame oorzaak van matglasopaciteiten op een CT-scan

2021 ◽  
Author(s):  
I. CARPENTIER ◽  
E. PEETERS ◽  
B. VANZIELEGHEM
Keyword(s):  
Correct Diagnosis ◽  
Kidney Injury ◽  
Lung Damage ◽  
Ground Glass ◽  
Literature Overview ◽  
Chronic Kidney Injury ◽  
Patient’S History ◽  
Pulmonary Calcifications ◽  
Metastatic Pulmonary Calcification

Metastatic pulmonary calcification: a case report and literature overview Ground-glass opacities have a broad differential diagnosis, including infectious, metabolic, inflammatory and malignant causes. This case presents an underdiagnosed entity of dense ground-glass opacities, namely metastatic pulmonary calcifications (MPC). This is a benign metabolic disease characterised by the deposition of calcium in the lungs, mostly described in patients with chronic kidney injury and secondary hyperparathyroidism. The majority of the patients require no treatment, but in some cases it may lead to irreversible lung damage. Clinical and radiological features, as well as the patient’s history, are crucial to make a correct diagnosis since MPC has a relatively specific appearance on imaging. This case study discusses the medical history and imaging appearance of a 44-year-old woman with MPC, followed by a literature overview.

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