Management of pleural empyema in a 12-year-old obese patient with COVID-19: a pediatric case report

Abstract Background With the ongoing coronavirus disease (COVID-19) pandemic, along with the development of new mutations of the virus and an increase in the number of cases among pediatrics, physicians should be aware and alerted on the atypical presentations of the disease, especially in less expected individuals. Case presentation Here we present a 12-year-old obese boy (BMI = 37.5 kg/m2) who presented with empyema, which was following SARS-CoV-2 infection. The patient had no history of fever. Due to the onset of dyspnea, a chest tube was inserted for him which was later altered to a pleural drainage needle catheter. Conclusion Our case is the first report of COVID-19 presenting as empyema among pediatrics. Pleural empyema should be considered as a rare complication of COVID-19. Since there is still no guideline in the management of empyema in the context of COVID-19, delay in diagnosis and intervention may cause morbidity and mortality in children.

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Leptomeningeal Cyst in the Adult: Case Report and Review of the Literature

Surgical Case Reports ◽

10.31487/j.scr.2021.02.05 ◽

2021 ◽

pp. 1-3

Author(s):

Paula Pilar Morales Cejas ◽

Yanire Sánchez Medina ◽

Marta García Berrocal ◽

Luis Francisco Gómez Perals

Keyword(s):

Case Report ◽

Rare Complication ◽

Review Of The Literature ◽

Adult Case ◽

Leptomeningeal Cyst ◽

Case Presentation ◽

Affected Area ◽

Previous Trauma ◽

History Of ◽

Childhood Fractures

Background: Leptomeningeal cysts are a rare complication of childhood fractures, being very rare in adulthood and usually related to previous trauma generated in children. Case Presentation: We present a case of “growing fracture” in a 70-year-old woman with a history of head injury in childhood, who clinically debuted with paresthesia-dysesthesia in the left hemicranium and hypersensitivity and pain in the affected area, and who was treated with surgical treatment. Conclusion: We review the pathogenesis, diagnosis and treatment of this injury today.

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Reduction en masse of inguinal hernia after self-reduction: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02845-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Khosrow Najjari ◽

Hossein zabihi Mahmoudabadi ◽

Seyed Zeynab Seyedjavadeyn ◽

Reza Hajebi

Keyword(s):

Case Report ◽

Inguinal Hernia ◽

Ct Scan ◽

Lower Quadrant ◽

Case Presentation ◽

Delay In Diagnosis ◽

Patient Reported ◽

History Of ◽

Old Persian ◽

The Right

Abstract Background Reduction en mass (REM) is one of the rare complications of inguinal hernia reduction. Although REM can be detected on the basis of specific computed tomography (CT) scan findings, many radiologists are not familiar with its radiological appearance because of the scarcity of this complication, which may cause a delay in diagnosis. Case presentation The patient reported in this article was a 50-year-old Persian man with a history of inguinal hernia, who had been referred with the periumbilical pain that radiated to the right lower quadrant and developed following hernia replacement by the patient himself. REM diagnosis was based on clinical examination and CT scan findings, and surgical treatment was performed by the Lichtenstein repair and mesh implantation. Conclusions Although REM usually occurs after reduction with compression in the inguinal hernia, this unique case report highlighted the possibility of REM after self-reduction. Surgeons and radiologists should consider REM in patients with a history of inguinal hernia presenting with intestinal obstruction symptoms, even without any apparent signs of hernia in the physical examination.

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Colonic Metastasis of Renal Cell Carcinoma Two Years After Therapeutic Radical Nephrectomy a Case Report

10.21203/rs.3.rs-844954/v1 ◽

2021 ◽

Author(s):

Dina Alnabwani ◽

Frederick Acquah ◽

Anish Kumar Kanukuntla ◽

Priyaranjan Kata ◽

Pramil Cheriyath

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Renal Cell ◽

Colonic Metastasis ◽

Case Presentation ◽

Metastatic Lesions ◽

History Of ◽

Atypical Presentations ◽

Intestinal Metastasis

Abstract Background: Renal Cell carcinoma usually presents metastasis at the diagnosis and the most common sites include lung, bones, liver, and brain in decreasing order. Metastasis to the large intestine is very uncommon and few cases are reported in the literature. Case Presentation: We present a case of post nephrectomy renal cell carcinoma who presented to our institution with signs of anemia and on further investigations found to be having metastatic lesions of renal cell carcinoma in the intestine, peritoneum, and abdominal wall. Conclusion: We hypothesize that due to recent advances in the treatment of renal cell carcinoma, the patient's survival rate increased and this leads to atypical presentations of the known diseases. Through this case report, we stress the importance of vigilant evaluation for intestinal metastasis when the patient presents with gastrointestinal bleeding and a history of renal cell carcinoma regardless of the time since nephrectomy.

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Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

Iranian Journal of Neurosurgery ◽

10.32598/irjns.5.3.9 ◽

2020 ◽

Vol 5 (3 And 4) ◽

pp. 155-160

Author(s):

Mohsen Aghapoor ◽

◽

Babak Alijani Alijani ◽

Mahsa Pakseresht-Mogharab ◽

◽

...

Keyword(s):

Antifungal Drugs ◽

The Body ◽

Lower Limbs ◽

Lumbar Pain ◽

Case Presentation ◽

Delay In Diagnosis ◽

Death Case ◽

Therapeutic Results ◽

History Of ◽

Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

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An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

10.31487/j.gscr.2020.01.03 ◽

2020 ◽

pp. 1-5

Author(s):

Anton Stift ◽

Kerstin Wimmer ◽

Felix Harpain ◽

Katharina Wöran ◽

Thomas Mang ◽

...

Keyword(s):

Case Report ◽

Sigmoid Colon ◽

Immunohistochemical Staining ◽

Late Onset ◽

Hirschsprung Disease ◽

Endoscopic Examination ◽

Case Presentation ◽

Idiopathic Megacolon ◽

History Of ◽

Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

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The spontaneous resolution of a vortex vein varix: case report

BMC Ophthalmology ◽

10.1186/s12886-021-01861-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara L Weidmayer ◽

Hakan Demirci

Keyword(s):

Case Report ◽

Natural History ◽

Extended Period ◽

Spontaneous Resolution ◽

Case Presentation ◽

Clinical Resolution ◽

History Of ◽

Vortex Vein ◽

Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

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Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

The Journal of Critical Care Medicine ◽

10.1515/jccm-2017-0013 ◽

2017 ◽

Vol 3 (2) ◽

pp. 84-88

Author(s):

Thomas-Michael Schneider ◽

Friederike Klenner ◽

Franz Brettner

Keyword(s):

Case Report ◽

Extracorporeal Membrane Oxygenation ◽

Therapeutic Option ◽

High Dose ◽

Great Success ◽

Case Presentation ◽

Computed Tomographic ◽

Rehabilitation Hospital ◽

Membrane Oxygenation ◽

History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

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Subcutaneous Emphysema Secondary to Tonsillectomy

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1194 ◽

2015 ◽

Vol 7 (2) ◽

pp. 78-80

Author(s):

Vivek Sasindran ◽

Vijay Stephen ◽

Lakshana Deve

Keyword(s):

Case Report ◽

Surgical Procedures ◽

Subcutaneous Emphysema ◽

Subcutaneous Tissue ◽

Rare Complication ◽

Tension Pneumothorax ◽

Tonsillar Fossa ◽

Superior Constrictor ◽

History Of ◽

Fatal Complications

ABSTRACT Background Tonsillectomy is one of the most common surgical procedures performed worldwide. However, it can potentially be associated with several complications. One of the very rare complications post-tonsillectomy in adults is subcutaneous emphysema, as in our case here. Although, most reported cases are resolved spontaneously, it may lead to fatal complications, like tension pneumothorax. Case report Tonsillectomy was performed on an adult patient with history of frequent tonsillitis. The patient developed facial subcutaneous emphysema 48 hours after the surgery (evident by clinical and radiological examination) that resolved within 2 days without further complications. Conclusion Tonsil should be removed along with tonsilar capsule. If tonsillectomy causes deeper than usual mucosal tear up to the level of the muscles, then air might pass into the subcutaneous tissue through the tonsillar fossa and superior constrictor muscle into fascial layers of neck. Emphysema can then spread to parapharyngeal, retropharyngeal spaces and mediastinum with its related morbidity. Though a rare complication, all otorhinolaryngologists must be aware of this complication and its management. How to cite this article Abraham SS, Stephen V, Deve L, Kurien M. Subcutaneous Emphysema Secondary to Tonsillectomy. Int J Otorhinolaryngol Clin 2015;7(2):78-80.

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Spine Metastasis of Thymic Carcinoma in a Pediatric Patient: A Case Report and Comprehensive Literature Review

Pediatric Neurosurgery ◽

10.1159/000510471 ◽

2020 ◽

Vol 55 (5) ◽

pp. 289-294

Author(s):

Kadir Oktay ◽

Ebru Guzel ◽

Okay Baykara ◽

Mevlana Akbaba ◽

Ibrahim Sari ◽

...

Keyword(s):

Pediatric Patients ◽

Thymic Carcinoma ◽

Tumor Resection ◽

Treatment Protocol ◽

Spinal Column ◽

Spinal Instability ◽

Pediatric Case ◽

Case Presentation ◽

Intrathoracic Tumor ◽

History Of

Introduction: Thymic carcinoma metastases of the spinal column are very rare, especially in pediatric patients. To our knowledge, this is the first such pediatric case in the literature. Case Presentation: We report the case of a 14-year-old male patient with T12 and L1 metastases of thymic carcinoma. He had history of thymectomy and intrathoracic tumor resection 7 months previously. The patient’s neurological condition deteriorated; therefore, tumor resection and decompression of the spinal canal were performed. He underwent instrumentation and fusion procedures to prevent spinal instability. Conclusion: The main purpose of the treatment is gross total resection of the thymic carcinoma. However, adjuvant methods such as radiotherapy and chemotherapy should be added to the treatment protocol in patients who have higher stage diseases or those in whom total tumor resection cannot be achieved.

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An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽

10.1186/s12893-019-0601-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yi Zhao ◽

Zhichao Lai ◽

Xiaojun Song ◽

Rong Zeng ◽

Changwei Liu ◽

...

Keyword(s):

Prostate Cancer ◽

Case Report ◽

Carotid Endarterectomy ◽

Early Stage ◽

Prostatic Hyperplasia ◽

Surgical Patients ◽

Blood Products ◽

Case Presentation ◽

Life Threatening ◽

History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

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