Bee sting presumed endophthalmitis: a devastating ocular outcome

Abstract Background To report a rare case of bee sting presumed endophthalmitis that resulted in a devastating ocular outcome. Case presentation A 43-year-old patient presented 24 h after bee sting ocular injury in his left eye. He had a mild inflammatory sign at presentation, and he underwent surgical exploration to rule out a scleral defect, which revealed a sealed defect. During his hospital course, he developed signs of endophthalmitis 48 h following trauma for which he received vitreous tap and intravitreal antibiotic. Microbial culture revealed gram-negative rods, Pseudomonas aeruginosa, and Aeromonas veronii. Condition escalated to reach the panophthalmitis stage and cellulitis like picture with visual acuity of no light perception. Visual evoked response (VER) demonstrated a flat response. Infection was controlled by evisceration of the globe at the end as salvage therapy against the spreading of infection Conclusions Bee sting ocular injury is an exceedingly rare type of ocular trauma. Concomitant infection can happen, and severity depends on the pathogen involved. It is crucial to have insight and start appropriate treatment based on to the patient presentation.

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Imaging findings and 4 years follow-up of adrenal cavernous hemangioma: a case report

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00552-8 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Valentina Testini ◽

Laura Eusebi ◽

Willy Giannubilo ◽

Vincenzo Ferrara ◽

Francesco Bartelli ◽

...

Keyword(s):

Cavernous Hemangioma ◽

Mass Effect ◽

Histopathological Diagnosis ◽

Case Presentation ◽

First Case ◽

Appropriate Treatment ◽

Cavernous Hemangiomas ◽

Adrenal Masses ◽

Rule Out

Abstract Background Adrenal hemangioma is a rare and non-functional benign tumor. Since the first case in 1955, approximately 90 cases have been reported in literature frequently presenting as a large and incidentally discovered retroperitoneal mass or as a result of hemorrhage caused by spontaneous rupture. Case presentation A 69-year-old man was admitted to our hospital for right hypocondrium pain and anemia. A computed tomography (CT) scan was performed and a large right adrenal mass measured 18 cm was found. The patient underwent laparoscopic right adrenalectomy. Histopathological diagnosis revealed a cavernous adrenal hemangioma. Conclusion Cavernous hemangiomas are uncommon tumors. We reported a case of adrenal cavernous hemangioma incidentally discovered by ultrasound and CT. In the case of finding adrenal masses, cavernous hemangiomas, although rare, should be considered a possible diagnosis. The appropriate treatment is surgical resection to rule out any potential for malignancy, to relieve symptoms secondary to the mass effect, and to prevent complications such as retroperitoneal bleeding.

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Muscle Tone Assessment under General Anesthesia for Sjögren-Larsson Syndrome and Spasticity

Pediatric Neurosurgery ◽

10.1159/000514329 ◽

2021 ◽

Vol 56 (2) ◽

pp. 163-165

Author(s):

George Georgoulis ◽

Argyrios Dinopoulos ◽

Emmanouil Gkliatis

Keyword(s):

General Anesthesia ◽

Muscle Tone ◽

Muscle Relaxants ◽

Spastic Diplegia ◽

Case Presentation ◽

Neurosurgical Procedure ◽

Dorsal Rhizotomy ◽

Severe Spasticity ◽

Larsson Syndrome ◽

Rule Out

Introduction: Study of muscle tone in individuals with severe spasticity (Modified Asworth Scale – MAS:3) under general anesthesia can confirm or rule out the eventual necessity of the impending spasticity relieving ablative neurosurgery by observing the hypertonia reduction and passive range of motion expansion. Therefore, what we measure under muscle relaxants is practically a fixed deformity. Case Presentation: The study was performed on a girl with Sjögren-Larsson syndrome, presenting with icthyosis and spastic diplegia. Proposed intervention was Dorsal Rhizotomy. Under general anesthesia, with and without muscle relaxants, hypertonia was significantly reduced (MAS:1), but the angle of motion did not increase much. Conclusion: We decided not to perform such a neurosurgical procedure. In ambiguous situations, the proposed study can help in decision-making for spasticity treatment.

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Primary small cell type of non-Hodgkin lymphoma of the colon: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02500-y ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Eyal Meir ◽

Chovav Handler ◽

Uri Kaplan ◽

Doron Kopelman ◽

Ossama A. Hatoum

Keyword(s):

Case Report ◽

Hodgkin Lymphoma ◽

Small Cell ◽

Primary Lymphoma ◽

Cell Type ◽

Rare Type ◽

Case Presentation ◽

Carcinoma Of The Colon ◽

Non Hodgkin Lymphoma ◽

High Level

Abstract Introduction Primary lymphoma of the colon is exceedingly rare and comprises 0.2–1% of all colon tumors. The most common subtype of lymphoma in the colon is non-Hodgkin lymphoma. Symptoms are often nonspecific, and treatment varies between chemotherapy alone and a combination of surgery and chemotherapy. Case presentation We describe a case of a Ashkenazi Jew patient who presented in the typical way that carcinoma of the colon might present but turned out to have a very rare type of tumor in both its histology and its location. Conclusion There was apparent discordance between the relative bulkiness and gross appearance of the tumor with the unrevealing result of the biopsies, demanding a high level of suspicion as to the actual presence and possible type of such a tumor in the future.

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Tétanos en un preescolar de 5 años con abandono familiar: Reporte de caso

REVISTA BIOMÉDICA ◽

10.32776/revbiomed.v30i3.662 ◽

2019 ◽

Vol 30 (3) ◽

Author(s):

Juan Pablo Guillermo-Durán ◽

Salvador Gómez-Carro ◽

Nina Mendez-Dominguez

Keyword(s):

Foreign Body ◽

Clinical Findings ◽

Battered Child Syndrome ◽

Clostridium Tetani ◽

Case Presentation ◽

Battered Child ◽

Symptomatic Management ◽

Child Syndrome ◽

Terapia Intensiva ◽

Rule Out

Introducción: El tétanos es una enfermedad infecciosa causada por Clostridium tetani, con un cuadro clínico grave y una elevada mortalidad. En Yucatán, la tasa de incidencia es baja (0.09 por 100,000 habitantes), reportándose únicamente dos casos en 2017, por lo que actualmente es una enfermedad de baja sospecha diagnóstica en la región. Caso clínico: Preescolar masculino de 5 años, originario de una comunidad rural de Yucatán y con esquema de inmunización incompleto, quien fue atendido por espasmos musculares generalizados, así como heridas recientes por cuerpo extraño y síndrome del niño maltratado. En la Unidad de Terapia Intensiva, se integró el diagnóstico de tétanos, por lo que recibió manejo etiológico y sintomático, logrando mejoría a su egreso. Discusión: Yucatán es una de las entidades federativas con mayor índice de maltrato infantil. Ante la presencia de dicha problemática social, es importante descartar un esquema de inmunización incompleto, mismos que con la coexistencia de hallazgos clínicos típicos y herida reciente por cuerpo extraño, se debe sospechar tétanos.Background: Tetanus is an infectious disease caused by Clostridium tetani, with severe symptoms and a high mortality rate. In Yucatan, the incidence rate is low (0.09 per 100,000 population), reporting only two cases in 2017, so it is now a disease of low diagnostic suspicion in the region. Case presentation: A 5-year-old male preschool, from a rural community of Yucatán and with incomplete immunization scheme, who was attended by generalized muscle spasms as well as recent foreign body wounds and battered child syndrome. In the Intensive Care Unit, the diagnosis of tetanus was integrated, for which he received etiological and symptomatic management, achieving improvement at his discharge. Discussion: Yucatan is a state with high child abuse rate of. In the presence of this social problem, it is important to rule out an incomplete immunization scheme, which with the coexistence of typical clinical findings and recent foreign body wound, tetanus should be suspected.

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Reworsening of Recurrent Guillain-Barré Syndrome Triggered by COVID-19 Infection

The Open Neurology Journal ◽

10.2174/1874205x02115010048 ◽

2021 ◽

Vol 15 (1) ◽

pp. 48-51

Author(s):

Gian Luca Vita ◽

Carmen Terranova ◽

Maria Sframeli ◽

Antonio Toscano ◽

Giuseppe Vita

Keyword(s):

Viral Infection ◽

Neurological Diseases ◽

Intravenous Immunoglobulins ◽

Guillain Barre Syndrome ◽

Case Presentation ◽

Appropriate Treatment ◽

Immune Mediated ◽

Guillain Barré Syndrome ◽

Guillain Barré

Introduction: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated, generalized polyradiculoneuropathy often triggered by a bacterial or viral infection, vaccination, or surgery. During the SARS-CoV-2 pandemic, some patients were reported with GBS associated COVID-19 infection. Case Presentation: We report, herein, a patient who had a recurrent GBS after forty years. Intravenous immunoglobulins (IVIg) induced improvement, but her condition worsened suddenly after twenty days, coinciding with a COVID-19 infection. A second IVIg cycle was administered, and she improved again. Conclusion: The take-home message is that in the current pandemic, any re-worsening or lack of improvement after appropriate treatment of GBS or possibly other autoimmune neurological diseases must be checked to determine if it is related to COVID-19 infection.

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Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? – case report and literature review

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0440 ◽

2020 ◽

Vol 33 (2) ◽

pp. 319-322

Author(s):

Krzysztof Jeziorny ◽

Arleta Waszczykowska ◽

Dobromiła Barańska ◽

Agnieszka Szadkowska ◽

Wojciech Młynarski ◽

...

Keyword(s):

Type 1 Diabetes ◽

Cerebral Edema ◽

Diagnostic Methods ◽

Newly Diagnosed ◽

Cns Disorders ◽

Case Presentation ◽

Non Invasive ◽

Appropriate Treatment ◽

Life Threatening

AbstractBackgroundCerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient.Case presentationWe present the case of a 11-year-old boy with severe DKA in the course of newly diagnosed type 1 diabetes (T1D). The delay in the diagnosis of DKA and some therapeutic problems contributed to the development of CE and direct life-threatening conditions. Early diagnosis of CE development in the course of DKA using non-invasive methods such as pachymetry or transorbital ultrasound seems to be a very important prognostic factor.ConclusionsThis case highlights the importance of appropriate treatment according to the newest recommendations and presents the usefulness of new diagnostic methods to assess the risk of CE in children with newly diagnosed T1D.

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Fatal deep venous thrombosis and pulmonary embolism secondary to melioidosis in China: case report and literature review

BMC Infectious Diseases ◽

10.1186/s12879-019-4627-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Hua Wu ◽

Dongliang Huang ◽

Biao Wu ◽

Mengjie Pan ◽

Binghuai Lu

Keyword(s):

Pulmonary Embolism ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Fatal Case ◽

Therapeutic Interventions ◽

Case Presentation ◽

Reduce Mortality Rate ◽

Left Lower Extremity ◽

Appropriate Treatment ◽

History Of

Abstract Background Burkholderia pseudomallei is a gram-negative bacterium and the causative pathogen of melioidosis, which manifests a variety ranges of infection symptoms. However, deep venous thrombosis (DVT) and pulmonary embolism (PE) secondary to bacteremic melioidosis are rarely documented in the literature. Herein, we reported a fatal case of melioidosis combined with DVT and PE. Case presentation A 54-year-old male construction worker and farmer with a history of diabetes was febrile, painful in left thigh, swelling in left lower limb, with chest tightness and shortness of breath for 4 days. He was later diagnosed as DVT of left lower extremity and PE. The culture of his blood, sputum and bone marrow samples grew B. pseudomallei. The subject was administrated with antibiotics (levofloxacin, cefoperazone/tazobactam, and imipenem) according to antimicrobial susceptibility testing and low molecular heparin for venous thrombosis. However, even after appropriate treatment, the patient deteriorated rapidly, and died 2 weeks after admission. Conclusions This study enhanced awareness of the risk of B. pseudomallei bloodstream infection in those with diabetes. If a patient has predisposing factors of melioidosis, when DVT is suspected, active investigation and multiple therapeutic interventions should be implemented immediately to reduce mortality rate.

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Thermography as a means for quantitative assessment of stump and phantom pains

Prosthetics and Orthotics International ◽

10.3109/03093648409145352 ◽

1984 ◽

Vol 8 (2) ◽

pp. 76-81 ◽

Cited By ~ 11

Author(s):

H. Kristen ◽

G. Lukeschitsch ◽

F. Plattner ◽

R. Sigmund ◽

P. Resch

Keyword(s):

Quantitative Assessment ◽

Operative Intervention ◽

Phantom Pain ◽

Appropriate Treatment ◽

Thermographic Image ◽

Rule Out

Exact differentiation into stump and phantom pain is required when pain is reported after amputation. In a majority of cases appropriate treatment can improve the pain. Thermography is simple and gives a good indication of the circulation in the stump without operative intervention. It provides a key to the nature of the pain in stump and phantom. Although typical patterns occur for pain in the stump or phantom, in this study the thermographic image could confirm the presence of phantom pain, but it could not rule out errors or false statements.

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The Trapezium Dislocation: Case Presentation, Review of the Literature, Radiographic Analysis, Proposed Classification, and Treatment

Hand ◽

10.1177/1558944717744339 ◽

2017 ◽

Vol 14 (3) ◽

pp. 299-304

Author(s):

Andrew P. Harris ◽

Avi D. Goodman ◽

Joseph A. Gil ◽

Neill Li ◽

Jeremy Raducha ◽

...

Keyword(s):

Treatment Algorithm ◽

Delayed Diagnosis ◽

Relevant Information ◽

Radiographic Analysis ◽

Inclusion Criteria ◽

Case Presentation ◽

Appropriate Treatment ◽

Pubmed Search ◽

Classification And Treatment ◽

Timely Treatment

Background: Trapezium dislocations are rare injuries. Methods: A PubMed search of the term “trapezium dislocation” was conducted. Publications reporting a complete trapezium dislocation were included in the review. Results: The PubMed search resulted in 168 results. Fourteen publications reporting on 16 complete trapezium dislocations met inclusion criteria. A case of delayed diagnosis of a trapezium dislocation is presented. The literature is reviewed for pertinent clinically relevant information with respect to trapezium dislocations. A systematic method for radiographic analysis of trapezium dislocations and classification are described, and a treatment algorithm is presented. Conclusions: Trapezium dislocations are infrequent injuries with few cases reported in the literature. Given the rarity of this injury, diagnosis and appropriate treatment may be delayed due to difficulty in recognition. Using the described method of radiographic analysis, delayed diagnosis may be avoided with implementation of timely treatment.

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Infection-provoked reversible posterior leukoencephalopathy syndrome in an adult with nephrotic syndrome: a case report

BMC Neurology ◽

10.1186/s12883-020-01922-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Kuan-Ying Li ◽

Ching-Fang Chien ◽

Chin-Ling Tsai ◽

Huang-Chi Chen ◽

Meng-Ni Wu ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Altered Mental Status ◽

Reversible Posterior Leukoencephalopathy Syndrome ◽

Asian Woman ◽

Case Presentation ◽

Reversible Posterior Leukoencephalopathy ◽

Posterior Leukoencephalopathy ◽

Appropriate Treatment ◽

Visual Disturbances

Abstract Background Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare and heterogeneous clinico-neuroradiological syndrome characterized by headache, altered mental status, seizures, and visual disturbances. Hypertension and immunosuppression are two of the main factors that predispose an individual to RPLS. However, RPLS can develop when no major risk factors are present. RPLS has been reported in pediatric nephrotic patients, but rarely in adults. Case presentation A 42-year-old Asian woman with nephrotic syndrome presented with seizures, headaches, and nausea. Her blood pressure was controlled, and no immunosuppressants had been prescribed. All symptoms and tests indicated RPLS following infection with pneumonia, which was successfully treated by immediate administration antibiotic and anti-epileptic medications. Seizures did not recur during a 2-year follow-up period. Conclusions When patients with nephrotic syndrome have an infection, RPLS symptoms should be investigated thoroughly. With early diagnosis and appropriate treatment of RPLS, morbidity and mortality can be prevented.

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