scholarly journals Hard bilateral syphilitic testes with vasculitis: a case report and literature review

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sat Prasad Nepal ◽  
Takehiko Nakasato ◽  
Takashi Fukagai ◽  
Takeshi Shichijo ◽  
Jun Morita ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Rare Case ◽  
Testicular Tumor ◽  
Adrenal Failure ◽  
Steroid Use ◽  
Case Presentation ◽  
Uncontrolled Blood Pressure

Abstract Background We report the case of a patient with syphilitic testicular gumma and vasculitis with adrenal failure due to chronic steroid use. Case presentation A 63-year-old male presented with hard right eye swelling and very firm bilateral testes on palpation, which he had for 2 years. Testicular tumor markers were negative; syphilis test was positive. Radiological examination suggested aortitis and bilateral testicular malignancy. The patient received ampicillin for the infection and prednisolone for vasculitis. Left orchidectomy was performed to confirm the presence of testicular tumor; histological examinations revealed granulomatous orchitis. The prednisolone doses were adjusted because of relapses and adverse effects of steroid use. Unfortunately, the patient died in the intensive care unit because of uncontrolled blood pressure and pneumonia. Conclusions This is a rare case of syphilis with testicular involvement and vasculitis. This report shows the importance of broadening the differential diagnoses of testicular firmness.

scholarly journals Choriocarcinoma with Uterine Rupture in a Patient with Confirmed COVID-19 Infection: A Rare Case Report

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Sedigheh Ghasemian Dizaj Mehr ◽  
Hale Ayatollahi ◽  
Afshin Mohammadi ◽  
Naser Gharebaghi ◽  
Farzaneh Rashidi Fakari ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Uterine Rupture ◽  
Rare Case ◽  
Surgical Intervention ◽  
Emergency Setting ◽  
Case Presentation ◽  
Rare Case Report ◽  
Emergency Hysterectomy

Introduction: Choriocarcinoma is a rare neoplasm, which is commonly treated with chemotherapy. However, in some cases, it is managed by surgical intervention to save the patient’s life. Here, we present a rare case of uterine rupture associated with choriocarcinoma in a patient with COVID-19 infection. Case Presentation: We present the case of a 34-year-old woman with choriocarcinoma, complicated by uterine rupture after the first course of chemotherapy, and concurrent COVID-19 infection. The patient underwent an emergency hysterectomy and survived after transferring to an isolated intensive care unit room. Conclusions: During the COVID-19 pandemic, it is suggested to perform optimal surgery in the emergency setting to prevent further complications.

scholarly journals The Management of a Thirteen Weeks Pregnant Woman Rendered Brain-Dead Following a Ruptured Aneurysm

2019 ◽  
Vol 5 (3) ◽  
pp. 111-114
Author(s):  
Iwona Pikto-Pietkiewicz ◽  
Antoni Okniński ◽  
Rafał Wójtowicz ◽  
Marlena Wójtowicz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Pregnant Woman ◽  
Subject Area ◽  
Detailed Account ◽  
Brain Aneurysm ◽  
Case Presentation ◽  
Brain Functions ◽  
Brain Dead

Abstract Introduction The current lack of clear guidelines on how to manage cases of brain-dead pregnant patients makes this topic controversial and extremely difficult to deal with for both medical and ethical reasons. This report deals with such a situation. Case presentation A twenty-seven years old woman, thirteen weeks pregnant, with a ruptured brain aneurysm was admitted to an Intensive Care Unit. She presented with loss of all brain functions, but somatic support was sustained to enable the delivery of her baby. Conclusion The case report gives a detailed account of the management of the mother before the successful delivery of her baby. It indicates the need for ongoing contributions to the debate on this delicate subject area to establish guidelines on how to manage brain-dead pregnant patients.

Descending Cervical-Sacral Pain after the Administration of Antivenom to the Scorpion Sting Poisoning: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 93-96
Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Case Report ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Scorpion Sting ◽  
Case Presentation ◽  
Sacral Region ◽  
Scorpion Stings

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Phenylketonuria and juvenile idiopathic arthritis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Ting Zhu ◽  
Jin Wu ◽  
Li Yuan Wang ◽  
Xiao Mei Sun
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Autoimmune Diseases ◽  
Hip Joint ◽  
Metabolic Disorder ◽  
Rare Case ◽  
Molecular Data ◽  
Methotrexate Therapy ◽  
Case Presentation

Abstract Background Phenylketonuria (PKU) is a genetic metabolic disorder in which patients have no ability to convert phenylalanine to tyrosine. Several autoimmune diseases have been reported to combine with PKU, co-existent of PKU and Juvenile Idiopathic Arthritis (JIA) has not been presented. Case presentation The girl was diagnosed with PKU at the age of 1 month confirmed by molecular data. At the age of 3.5 years, she presented with pain and swelling of her right ankle, right knee, and right hip joint. After a serial of examinations, she was diagnosed with JIA and treated with a nonsteroidal anti-inflammatory drug. Conclusions We report a rare case of a 4-year-old girl with PKU and JIA, which supports a possible interaction between PKU and JIA. Long-term metabolic disturbance may increase the susceptibility to JIA. Further chronic inflammation could alter the metabolism of tryptophan and tyrosine to increase blood Phe concentration. In addition, corticosteroid and methotrexate therapy for JIA may increase blood Phe concentration.

scholarly journals Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Hongwei Cai ◽  
Huiping Ding ◽  
Xiaoping Xu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Arrest ◽  
Case Report ◽  
Nasal Cavity ◽  
Pituitary Surgery ◽  
Case Presentation ◽  
Clinical Anesthesia ◽  
Vagus Reflex

Abstract Background Trigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation. Case presentation This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support. Conclusion Although the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.

SKULL METASTASES OF FOLLICULAR CARCINOMA THYROID: A RARE CASE REPORT

2021 ◽  
pp. 24-25
Author(s):  
Smriti Kumari ◽  
Manoj Kumar Paswan ◽  
Nishat Ahamad
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Case Report ◽  
Body Temperature ◽  
Thyroid Gland ◽  
Basal Metabolic Rate ◽  
Rare Case ◽  
Follicular Carcinoma ◽  
Rare Case Report ◽  
Follicular Carcinoma Thyroid

The thyroid gland, usually located below and anterior to the larynx, consists of two bulky lateral lobes connected by a relatively thin isthmus. The thyroid is divided by thin brous septae into lobules composed of about 20 to 40 evenly dispersed follicles, lined by a cuboidal to low columnar [1] epithelium, and lled with PAS-positive thyroglobulin. The thyroid secretes hormones that control the heart rate, blood pressure, body temperature and basal metabolic rate

scholarly journals Leptospirosis presenting as severe cardiogenic shock: A case report

2018 ◽  
Vol 19 (4) ◽  
pp. 351-353
Author(s):  
E Forbat ◽  
MJ Rouhani ◽  
C Pavitt ◽  
S Patel ◽  
R Handslip ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiogenic Shock ◽  
Social History ◽  
Rare Case ◽  
Clinical Course ◽  
Unknown Origin ◽  
Case Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Severe Cardiogenic Shock ◽  
Infectious Illness

Background Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.

scholarly journals Topical Ophthalmic Cyclosporine in the Treatment of Toxic Epidermal Necrolysis

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Zafer Onaran ◽  
Gülşah Usta ◽  
Mukadder Koçak ◽  
Kemal Örnek ◽  
Ünase Büyükkoçak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Acute Stage ◽  
Ocular Involvement ◽  
Pathologic Finding ◽  
Ocular Complication ◽  
Case Presentation ◽  
Intravenous Corticosteroid

Aim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine.Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2 mm of symblepharon in the lower fornix as the sole pathologic finding.Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease.

scholarly journals Acute Human Immunodeficiency Virus (HIV) Infection Presenting With Bilateral Interstitial Pneumonia: Case Report and Discussion of Potential HIV-Induced Interstitial Pneumonia

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Anna Maria Peri ◽  
Laura Alagna ◽  
Serena Trovati ◽  
Francesca Sabbatini ◽  
Roberto Rona ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Human Immunodeficiency Virus ◽  
Intensive Care ◽  
Case Report ◽  
Interstitial Pneumonia ◽  
Antiretroviral Treatment ◽  
Pneumonia Case ◽  
Immunodeficiency Virus ◽  
Acute Hiv ◽  
Hiv 1

Abstract A 50-year-old man was admitted to intensive care unit because of acute respiratory failure due interstitial pneumonia; after admission, a diagnosis of acute human immunodeficiency virus (HIV)-1 infection was made. Clinical and radiological improvement was observed only after introduction of antiretroviral treatment. We discuss the hypothesis of interstitial pneumonia induced by the acute HIV-1 infection.

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