Acute Bilateral Blindness in the Setting of Sudden Onset of Bilateral Proptosis and Ophthalmoplegia: A Case Report With Literature Review

2021 ◽  
pp. 10.1212/CPJ.0000000000001090
Author(s):  
sara zarei ◽  
Phuong Vo ◽  
Christian Sam ◽  
Robert W Crow ◽  
Charles Stout ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Visual Pathway ◽  
Rapid Onset ◽  
Sudden Onset ◽  
Acute Onset ◽  
Posterior Chamber ◽  
Ischemic Optic Neuropathy ◽  
Radiographic Findings ◽  
Underlying Pathophysiology ◽  
Eye Retina

ABSTRACTPurposeof review: Acute bilateral blindness has an extensive differential diagnosis that requires a careful history and physical exam to narrow down. In this paper we discuss the pathophysiology and radiographic findings of each possible diagnosis for acute bilateral blindness.Recent findings:Visual pathology with respect to bilateral blindness can be broadly broken down into three anatomic categories: media (i.e. the anterior and posterior chamber of the eye), retina, and neural visual pathway. Possible causes of rapid onset bilateral blindness include bilateral occipital infarcts, endogenous bacterial endophthalmitis, orbital cellulitis, orbital compartment syndrome, cavernous sinus thrombophlebitis, thyroid disease and bilateral non-arteritic ischemic optic neuropathy.Summary:In this case we present a patient with acute onset of bilateral blindness, in addition to bilateral ophthalmoplegia, proptosis, and orbital chemosis. We believe this rare case of acute bilateral blindness is thought provoking and aids in the understanding of the differential diagnosis and underlying pathophysiology of visual loss.

Acute Cerebellar Ataxia

PEDIATRICS ◽  
1957 ◽  
Vol 20 (5) ◽  
pp. 781-781
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Cerebellar Ataxia ◽  
Rapid Onset ◽  
Sudden Onset ◽  
Demyelinating Diseases ◽  
Cerebellar Tumor ◽  
Intention Tremor ◽  
Acute Cerebellar Ataxia ◽  
Principal Source

This is a report of seven cases of acute cerebellar ataxia and an analysis of 33 cases from the literature. The syndrome is characterized by a sudden onset of ataxia in a previously well child. It occurs usually in children less than 5 years of age. The symptoms include staggering, falling, a drunken and uncertain gait; gross intention tremor, staccato speech and nystagmus are frequently present. There are no abnormal findings in the cerebrospinal fluid and fever is absent. Recovery usually takes place in a period from a few days to 6 months. The principal source of concern in the differential diagnosis is a posterior fossa tumor. The rapid onset of symptoms and absence of increase in pressure of the cerebrospinal fluid serve to distinguish the condition from a cerebellar tumor. Because of the favorable outcome, the nature of the pathologic process is not known. In some cases there was an increase in protein in the cerebrospinal fluid at some time during the later course of the disorder. The differential diagnosis from brain tumor, labyrinthine ataxia, and acute demyelinating diseases is discussed.

scholarly journals Perforated Diverticulitis of the Transverse Colon: An Unexpected Cause of Abdominal Pain During Preoperative Bowel Preparation

2018 ◽  
Vol 102 (9-10) ◽  
pp. 427-430
Author(s):  
N. A. Shah ◽  
Y. H. Ho
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Bowel Preparation ◽  
Transverse Colon ◽  
Bowel Perforation ◽  
Sudden Onset ◽  
Acute Onset ◽  
Perforated Diverticulitis ◽  
Preoperative Bowel Preparation ◽  
Tomography Scan

Diverticulitis affecting the transverse colon is uncommon, with perforation being exceptionally rare. It is not usually considered in the differential diagnosis of a patient with acute abdominal pain. We report a case of nonspecific abdominal pain secondary to a perforated diverticulum in the transverse colon during preoperative bowel preparation. A 74-year-old Caucasian female had sudden onset abdominal pain and nausea with routine bowel preparation. This undifferentiated acute abdomen was suggestive of a bowel perforation, which was later confirmed by a computed tomography scan. Surgical exploration determined the location of the perforation in the transverse colon. We report an unusual presentation of preoperative abdominal pain during routine bowel preparation. It is extraordinarily uncommon to see rupture of a transverse colon diverticulum in a patient with sigmoid involvement, and bowel preparation as a cause of rupture has not been previously documented. Because perforation of a transverse colon diverticulum generally has a nonspecific clinical presentation, it should be considered in the differential diagnosis for a patient with known diverticular disease who has acute onset abdominal pain and signs of peritonism.

scholarly journals Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected

2021 ◽  
Vol 43 (05) ◽  
pp. 414-416
Author(s):  
Daniela Alexandra Gonçalves Pereira ◽  
Eliana Patrícia Pereira Teixeira ◽  
Ana Cláudia Martins Lopes ◽  
Ricardo José Pina Sarmento ◽  
Ana Paula Calado Lopes
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Course ◽  
Malignant Tumors ◽  
Sudden Onset ◽  
Drug Reactions ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
Inflammatory Processes ◽  
Genital Ulcers

AbstractThe diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.

scholarly journals Ovarian Torsion after Hysterectomy: Case Report and Concise Review of the Reported Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Demetrio Larraín ◽  
Andrés Casanova ◽  
Iván Rojas
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Literature Review ◽  
Rare Event ◽  
Laparoscopic Hysterectomy ◽  
Acute Onset ◽  
Ovarian Torsion ◽  
Adnexal Torsion ◽  
Concise Review ◽  
History Of

Ovarian torsion after hysterectomy is a rare event. The diagnosis of ovarian torsion is challenging because symptoms are nonspecific. We present a case of ovarian torsion 2 years after laparoscopic hysterectomy (LH). Furthermore, we performed a literature review about ovarian torsion after hysterectomy. This case shows that, in cases of acute onset pelvic pain in patients with history of hysterectomy, the adnexal torsion must be kept in mind in the differential diagnosis, especially in those women who had undergone LH.

scholarly journals ATP1A3-Related Disorders: An Ever-Expanding Clinical Spectrum

2021 ◽  
Vol 12 ◽  
Author(s):  
Philippe A. Salles ◽  
Ignacio F. Mata ◽  
Tobias Brünger ◽  
Dennis Lal ◽  
Hubert H. Fernandez
Keyword(s):  
Original Description ◽  
Rapid Onset ◽  
Acute Onset ◽  
Clinical Spectrum ◽  
Pes Cavus ◽  
Sodium Potassium ◽  
Pathogenic Variants ◽  
Alternating Hemiplegia Of Childhood ◽  
The Central Nervous System ◽  
Neurological Features

The Na+/K+ ATPases are Sodium-Potassium exchanging pumps, with a heteromeric α-β-γ protein complex. The α3 isoform is required as a rescue pump, after repeated action potentials, with a distribution predominantly in neurons of the central nervous system. This isoform is encoded by the ATP1A3 gene. Pathogenic variants in this gene have been implicated in several phenotypes in the last decades. Carriers of pathogenic variants in this gene manifest neurological and non-neurological features in many combinations, usually with an acute onset and paroxysmal episodes triggered by fever or other factors. The first three syndromes described were: (1) rapid-onset dystonia parkinsonism; (2) alternating hemiplegia of childhood; and, (3) cerebellar ataxia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS syndrome). Since their original description, an expanding number of cases presenting with atypical and overlapping features have been reported. Because of this, ATP1A3-disorders are now beginning to be viewed as a phenotypic continuum representing discrete expressions along a broadly heterogeneous clinical spectrum.

scholarly journals Gyulladás vagy daganat?

2021 ◽  
Vol 162 (15) ◽  
pp. 595-600
Author(s):  
Tamás Major ◽  
Krisztina Szarka ◽  
Zsófia Nagy ◽  
Ilona Kovács ◽  
Csaba Balog ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Age At Onset ◽  
Sudden Onset ◽  
Lateral Neck ◽  
Neck Masses ◽  
Branchial Cleft ◽  
Branchial Cleft Cysts

Összefoglaló. A lateralis cysticus nyaki terimék két leggyakoribb oka a branchiogen cysta és a cysticus nyaki áttét. Az átfedő lokalizáció (a leggyakrabban a IIA nyaki régióban), a betegek életkora és az esetenként hirtelen kezdet alapján a két leggyakoribb ok differenciáldiagnózisa nagy kihívást jelenthet. Egy hirtelen fellépő fájdalmas, bal oldali nyaki duzzanattal, dysphagiával és lázzal jelentkező 72 éves férfi esetét ismertetjük. A nyak komputertomográfiás vizsgálata egy 6 cm legnagyobb átmérőjű, vastag falú, többrekeszes cysticus terimét igazolt. Infektív branchiogen cysta lehetőségére gondolva az elváltozást eltávolítottuk. A szövettan azonban p16-pozitív laphámrákot igazolt. A primer tumort végül az ipsilateralis tonsilla palatina állományában sikerült azonosítani. A beteg definitív radioterápiában részesült, és 18 hónappal a diagnózis után tumormentes. A nyaki cystákon, az infektív nyaki cystákon és a cysticus metastasisokon kívül a humán papillómavírussal összefüggő szájgarati laphámrákok infektív cysticus vagy necroticus metastasisait is figyelembe kell venni a lateralis cysticus nyaki terimék differenciáldiagnózisában. Orv Hetil. 2020; 162(15): 595–600. Summary. Branchial cleft cysts and cystic neck metastases are the two most common causes of cystic lateral neck masses. Based on the overlapping location (neck level IIA), patient age at onset and the occasionally sudden onset, their differential diagnosis is challenging. We present a 72-year-old male presenting with a suddenly emerging painful, left-sided neck swelling, dysphagia and fever. Computed tomography showed a 6 cm thick-walled multicystic mass. With the suspected diagnosis of an infected branchial cleft cyst, the lesion was removed. Histology confirmed p16 positive squamous cell carcinoma. Primary tumor was identified in the ipsilateral palatine tonsil. Definive radiotherapy was performed and the patient is free of disease at the 18-month follow-up. Beyond pure and infected branchial cleft cysts and pure cystic metastases, infected cystic or necrotic metastasis of human papillomavirus associated oropharyngeal squamous cell carcinoma should be included in the differential diagnosis of cystic lateral neck lesions. Orv Hetil. 2021; 162(15): 595–600.

scholarly journals The Differential Diagnosis of Acute Onset Truncal Ataxia: The Importance of Dysgeusia in Miller Fisher Syndrome

2018 ◽  
Vol 57 (14) ◽  
pp. 2057-2060 ◽  
Author(s):  
Tatsuya Ueno ◽  
Ryoya Kimura ◽  
Tomoya Kon ◽  
Rie Haga ◽  
Haruo Nishijima ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Acute Onset ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
Truncal Ataxia

Pancreatic Panniculitis Associated with Acinar Cell Pancreatic Carcinoma

2008 ◽  
Vol 12 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Susan M. Poelman ◽  
Khue Nguyen
Keyword(s):  
Differential Diagnosis ◽  
Pancreatic Disease ◽  
Acute Onset ◽  
Clinical Approach ◽  
Rare Entity ◽  
Subcutaneous Nodules ◽  
History Of ◽  
Practical Tool ◽  
Pancreatic Disorders ◽  
Pancreatic Panniculitis

Background: Pancreatic panniculitis is a rare entity, occurring in less than 2% of patients with pancreatic disorders. Skin manifestations may precede the diagnosis of a pancreatic disease by many months. When treatable, correction of the underlying pancreatic disorder may lead to prompt resolution of the panniculitis. Objective: We present the case of a 74-year-old-man with a history of chronic pancreatitis who presented with an acute onset of tender, nonulcerating nodules. The clinical and histologic features of pancreatic panniculitis are discussed, with a brief review of the differential diagnosis and clinical approach to panniculitis. Conclusions: Pancreatic panniculitis is a recognizable clinical entity with characteristic histologic features that may resolve with treatment of the underlying pancreatic disorder. The algorithm-based clinical approach to panniculitis presented in this study is a practical tool designed to guide clinicians in ordering investigations and determining the appropriate management for patients presenting with subcutaneous nodules.

Acute-onset abdominal pain in a woman in her 30s

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 275-322 ◽  
Author(s):  
Rory O’Donohoe ◽  
Samantha Fitzsimmons ◽  
Timothy J C Bryant
Keyword(s):  
Abdominal Pain ◽  
Hepatocellular Adenoma ◽  
Sudden Onset ◽  
Acute Onset ◽  
Arterial Phase ◽  
List Type ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
Axial Ct ◽  
Multiphase Ct

Clinical introductionA woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A–C).Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT.QuestionWhat is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellular carcinomaFocal nodular hyperplasiaHepatoblastoma

Fibrinolysis of an Acute Myocarditis Mimicking an Acute Myocardial Infarction

2020 ◽  
Author(s):  
Safir Soukaina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Myocarditis ◽  
Clinical Signs ◽  
Acute Onset ◽  
St Segment Elevation ◽  
The Difference

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.

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