Adult residual rectourethral fistula and diverticulum presenting decades after imperforate anus repair: a case report

Abstract Background This report describes a rare surgical case of an intraabdominal mass in a middle-aged patient 40 years after imperforate anus repair. Case presentation A 44-year-old Latino male with history of repaired anorectal malformation presented with recurrent urinary tract infections and rectal prolapse with bothersome bleeding and fecal incontinence. During his preoperative evaluation, he was initially diagnosed with a prostatic utricle cyst on the basis of magnetic resonance imaging findings, which demonstrated a cystic, thick-walled mass with low signal contents that extended inferiorly to insert into the distal prostatic urethra. However, at the time of surgical resection, the thick-walled structure contained an old, firm fecaloma. The final pathology report described findings consistent with colonic tissue, suggesting a retained remnant of the original fistula and diverticulum. Conclusions Although rare, persistent rectourethral fistula tracts and rectal diverticula after imperforate anus repair can cause symptoms decades later, requiring surgical intervention. This is an important diagnostic consideration for any adult patient with history of imperforate anus.

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A Rare Benign Tumor in a 14-Year-Old Girl

Case Reports in Nephrology ◽

10.1155/2018/1548283 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Meral Hassan Abualjadayel ◽

Osama Y. Safdar ◽

Maysaa Adnan Banjari ◽

Sherif El Desoky ◽

Ghadeer A. Mokhtar ◽

...

Keyword(s):

Benign Tumor ◽

Renal Oncocytoma ◽

Pathology Report ◽

Renal Neoplasm ◽

Case Presentation ◽

Renal Oncocytomas ◽

Rare Benign Tumor ◽

History Of ◽

Tract Infections ◽

Left Flank Pain

Background. Oncocytomas are the second most common benign renal neoplasm but, unfortunately, they are difficult to differentiate from renal cell carcinoma. Renal oncocytomas are rare and have mostly been reported in adults. To our knowledge, this is only the sixth pediatric reported case of renal oncocytoma worldwide. Case Presentation. A 14-year-old Yemeni girl with a recurrent history of urinary tract infections came to our clinic complaining of left flank pain with a frontal headache. Ultrasound showed a 3 cm, well-defined echogenic lesion with mild vascularity. This lesion increased in size on her subsequent follow-ups. Computed tomography showed no intralesional fat, vessels invasion, or enlarged lymph nodes. The patient underwent laparoscopic radical nephrectomy, and a pathology report confirmed the diagnosis of renal oncocytoma. Conclusion and Recommendations. We present the rare occurrence of renal oncocytoma in a pediatric patient and highlight the importance of considering oncocytomas in the diagnosis of a renal mass.

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Haemoptysis in a toddler: An uncommon presentation of unusual foreign body ingestion

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907920944056 ◽

2020 ◽

pp. 102490792094405

Author(s):

Sadesvaran Muniandy ◽

Mohd Faiz Mohd Shukri ◽

Nur Izzah Ghazali ◽

Mohd Saiful Adli Ishak ◽

Irfan Mohamad ◽

...

Keyword(s):

Foreign Body ◽

Foreign Body Ingestion ◽

Case Presentation ◽

Unusual Foreign Body ◽

Uncommon Presentation ◽

Common Causes ◽

History Of ◽

The Common ◽

Tract Infections ◽

High Index Of Suspicion

Introduction: Haemoptysis is uncommon in toddler. Lower respiratory tract infections and foreign body are among the common causes. Case Presentation: We are reporting a case of a child presented to emergency department with complaint of mild haemoptysis, whom was later found to have a piece of broken satay skewer at the tonsillar region. The foreign body was removed during the procedure without any complication. Discussion: Foreign body ingestion, particularly a piece of broken satay skewer, is difficult to suspect without a proper history and eyewitness. Therefore, parent’s supervision is important. Emergency residents should have a high index of suspicion of foreign body ingestion in a child with vague symptoms. Conclusion: Foreign body is among the commonest cause of haemoptysis in an afebrile toddler. Acute haemoptysis in otherwise healthy toddler should alert the emergency residents about foreign body ingestion. History of food intake should be more thorough even if trivial.

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Acute Respiratory Infection in Co-Infection Form of Bacteria and Virus, Human Bocavirus with Streptococcus pneumoniae: A Case Report

International Journal of Infection ◽

10.5812/iji.106476 ◽

2020 ◽

Vol 7 (3) ◽

Author(s):

Mehrdad Mohammadi

Keyword(s):

Respiratory Infection ◽

Respiratory Infections ◽

Causative Organism ◽

Human Bocavirus ◽

Gastrointestinal Infections ◽

Case Presentation ◽

Microbiological Methods ◽

Life Threatening ◽

History Of ◽

Tract Infections

Introduction: Human bocavirus (HBoV) belongs to the Parvoviridae family, which has been revealed to be associated with respiratory and gastrointestinal infections in children. There are many reports worldwide on respiratory infection or gastroenteritis caused by this virus. Case Presentation: In a twin case (a girl and a boy), we demonstrated that HBoV infection in combination with Streptococcus pneumonia as co-infection caused the death of a 14-month-old girl with a history of high fever and wheezing. A week later, her brother presented with almost the same symptoms, but only HBoV was found in a nasopharyngeal aspirate sample. Discussion: This case suggests that lower respiratory tract infections due to HBoV may cause severe and life-threatening diseases, resulting in death in combination with a bacterial infection, such as S. pneumonia. The study suggests replacing multiplex PCR as a fast and meticulous method instead of conventional and time-consuming microbiological methods for determining the causative organism for respiratory infections.

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Retroperitoneal ganglioneuroma with nodal involvement in an adult patient with human immunodeficiency virus: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-021-03134-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Elliott Lebby ◽

Daniel Kwan ◽

Thanh-Lan Bui ◽

Ryan O’Connell ◽

Mani Seetharaman ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Involvement ◽

Case Presentation ◽

Immunodeficiency Virus ◽

Node Involvement ◽

Neuroblastic Tumors ◽

History Of ◽

Latino Male

Abstract Background Ganglioneuromas are a benign tumor originating from neural crest cells. As one of the neuroblastic tumors, ganglioneuromas are most common in children, with a mean age at presentation of 7 years. Ganglioneuromas are typically singular in nature, but rarely can present with lymph node involvement and distant metastasis. We present a rare case of a retroperitoneal ganglioneuroma found in a human immunodeficiency virus positive adult, which was complicated by lymph node involvement. This case is notable not only in regard to the age of the patient, but also because of his human immunodeficiency virus positive status and the extension of tumor to lymph nodes. Case presentation A 27-year-old Latino male with history of human immunodeficiency virus presented with a 6-month history of left upper quadrant and epigastric abdominal pain with associated nausea and vomiting. The patient had a computed tomography scan showing a retroperitoneal mass encasing the aorta, celiac axis, and superior mesenteric artery. Core needle biopsy revealed ganglioneuroma. Owing to obstructive symptoms, resection of the mass along with partial gastric resection, partial pancreatic resection, and splenectomy was performed by a multidisciplinary group of surgeons. Pathology results revealed metastatic spread of ganglioneuroma to surrounding lymph nodes. Conclusions Ganglioneuromas are most common in children and very rarely occur in adults. However, it is still important to consider this entity in the differential for patients presenting with suspicious symptoms. While rare, it is essential to consider metastasis in this generally benign disease.

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The prostatic utricle cyst with huge calculus and hypospadias: A case report and a review of the literature

Canadian Urological Association Journal ◽

10.5489/cuaj.2381 ◽

2015 ◽

Vol 9 (5-6) ◽

pp. 345 ◽

Cited By ~ 4

Author(s):

Weigang Wang ◽

Yuantao Wang ◽

Dezhun Zhu ◽

Pengfei Yan ◽

Biao Dong ◽

...

Keyword(s):

Computed Tomography ◽

Cystic Lesion ◽

Low Density ◽

Review Of The Literature ◽

Prostatic Utricle ◽

History Of ◽

Posterior Urethra ◽

Frequent Micturition ◽

Prostatic Utricle Cyst ◽

Penoscrotal Hypospadias

Prostatic utricle cysts with calculus and hypospadias are rare in clinical practice. According to our literature review, only few cases have been reported. Recently, we experienced a case of prostatic utricle cyst with huge calculus in a 25-year-old male patient. He had a history of left cryptorchidism and surgery for penoscrotal hypospadias in his infancy. He was referred for frequent micturition, urgency of urination, urine pain, terminal hematuria and dysuria. Computed tomography (CT) revealed a retrovesical cystic lesion of low density, in which a 5×5 cm calcification was shown. Retrograde urethrocystography showed a 5×5 cm high-density shadow in the posterior urethra. The cyst was incised by transperineal approach and the stone was clearly observed and removed. Urethral stricture repair was performed simultaneously. The patient recovered smoothly after operation.

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Abstract 16207: An Uncommon Pathogen Causing Endocarditis and Valve Abscess: Aerococcus Sanguinicola

Circulation ◽

10.1161/circ.142.suppl_3.16207 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Aditi Shankar ◽

James P Macnamara ◽

Andrew D Assaf ◽

Robert Brockie ◽

Carter A King

Keyword(s):

Mitral Regurgitation ◽

Valve Replacement ◽

Leukocyte Count ◽

Severe Case ◽

Transesophageal Echocardiogram ◽

Case Presentation ◽

History Of ◽

Tract Infections ◽

Gram Positive Cocci

Introduction: Aerococcus Sanguinicola is a rare pathogen associated with urinary tract infections (UTI). Widespread use of MALDI-TOF can better differentiate Aerococcus species and has led to the identification of A. Sanguinicola as a source of endocarditis. Case Presentation: A 55-year-old male with a history of diabetes mellitus and recent cystitis presented to the hospital with confusion, back pain, fever, chills and myalgias. The patient was tachycardic and hypotensive on exam. Leukocyte count was at 16 k/ul with elevated inflammatory markers. Blood cultures were obtained and empiric vancomycin and cefepime were initiated. Transthoracic echocardiogram revealed mild mitral regurgitation. On hospital day 3, gram stain demonstrated gram positive cocci in clusters, and physical exam revealed a new 3/6 holosystolic murmur in the left 6th intercoastal space. Transesophageal echocardiogram demonstrated acute severe mitral regurgitation and multiple large vegetations with abscess on the anterior leaflet (Figure). Gentamycin was added to treat presumed Staphylococcus Aureus endocarditis. Subsequent species identification revealed A. Sanguinicola as the blood-based pathogen. He underwent bioprosthetic mitral valve replacement due to acute heart failure. Anatomic pathology of the valve confirmed A. Sanguinicola infection. He completed a 6-week course of antibiotics. On his follow up visit at 3 months, the patient had recovered. Conclusion: This case demonstrates a severe case of A. Sanguinicola endocarditis requiring urgent valve replacement. A. Sanguinicola is known to generate biofilms, which are activated by plasma which contrasts with S. Aureus, for which A. Sanguinicola can be mistaken. Additionally, known case of A. Sanguinicola infection demonstrate B-lactams sensitivity. While the organism has the potential to form abscesses, we present the first reported case of valvular abscess that was successfully cured with antibiotics and surgery.

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Facklamia Hominis Pyelonephritis in a Pediatric Patient: First Case Report and Review of the Literature

10.21203/rs.3.rs-776631/v1 ◽

2021 ◽

Author(s):

Samantha Perez Cavazos ◽

Daniela Cisneros Saldaña ◽

Fernando Espinosa Villaseñor ◽

José Iván Castillo Bejarano ◽

Denisse Natalie Vaquera Aparicio ◽

...

Keyword(s):

Pediatric Patient ◽

Urine Culture ◽

Current Treatment ◽

Intermittent Fever ◽

Case Presentation ◽

Gram Positive Bacteria ◽

First Case ◽

History Of ◽

Gram Negative Organisms ◽

Tract Infections

Abstract Background Pyelonephritis is one of the most serious bacterial illnesses during childhood. Gram-negative organisms account for up to 90% of the cases. Gram-positive bacteria are uncommon causes of urinary tract infections, and only a few cases caused by Facklamia hominis have been reported in the literature. Case presentation: A five-year-old girl with tracheostomy and gastrostomy and past medical history of congenital lymphangioma presented with a two-week history of with intermittent fever, frequent urination, and vesical tenesmus. Diagnosis of pyelonephritis was made. Urine culture reported colonies with alpha-hemolysis in blood agar at 48-hours of incubation and Facklamia hominis was identified by MALDI-TOF. The patient was successfully treated with gentamicin. Conclusions This is the first reported case of pyelonephritis by Facklamia hominis in a child, and the second involving infection in a pediatric patient. Although this pathogen is uncommon, current treatment of F. hominis is a challenge for physicians. This case illustrates the requirement to standardize identification and treatment of care to avoid treatment failure and antimicrobial resistance.

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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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Pulmonary Rehabilitation After Lobectomy On Pulmonary Aspergilloma: Case Report

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/2019.ikfr.07(2).05 ◽

2019 ◽

pp. 35-41

Author(s):

Andwi Setiawan Kokok ◽

Selly Christina Anggoro ◽

Siti Chandra Widjanantie

Keyword(s):

Pulmonary Rehabilitation ◽

Peak Flow ◽

Case Presentation ◽

Rehabilitation Programs ◽

Abnormal Chest ◽

History Of ◽

Postural Correction ◽

Chronic Pulmonary Aspergillosis ◽

Pulmonary Aspergilloma ◽

Breathing Retraining

Introduction: Complete resection of aspergilloma in chronic pulmonary aspergillosis (CPA), may has several health problem after surgery berupa sesak napas, batuk yang tidak efektif. Methods: A case presentation of 45 years old woman, after lobectomy on right upper of lung due to aspergilloma, with history of cough and haemoptysis for 3 months. Pulmonary Rehabilitation were breathing retraining exercise (BE), mobilization technique (MT), chest mobility exercise (CM), active cycle breathing technique (ACBT), postural correction exercise (PC) for three weeks. Results: There were dyspnea, peak flow rate (PFR:60-70-60), peak cough flow (PCF: 70-90-60 L/m), and abnormal chest expansion (CE: 2.5 – 3 – 2) cm. After three weeks of Pulmonary Rehabilitation, there were no dyspnea, increased the PCF: 193L/m, and CE: 2.5-4 -3. Conclusion: Pulmonary Rehabilitation programs for three weeks were relieved dyspnea, increased cough capacity and CE.

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