Genetically-induced deep venous thrombosis presenting as acute mastoiditis

2005 ◽  
Vol 119 (4) ◽  
pp. 308-310 ◽  
Author(s):  
Maurizio Barbara ◽  
Calogera Consagra ◽  
Giuseppe Buongiorno ◽  
Simonetta Monini ◽  
Giorgio Bandiera ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Chronic Otitis Media ◽  
Coagulation Factors ◽  
Prothrombin G20210a ◽  
Unusual Complication ◽  
Still Life ◽  
Early Assessment ◽  
Acute Mastoiditis ◽  
Predisposing Factor ◽  
Life Threatening

Sigmoid sinus thrombosis (SST) usually follows acute as well as chronic otitis media with coalescent mastoiditis. A singular case of noncoalescent mastoiditis complicated with thrombosis of deep cerebral sinuses occurring in a young child is presented. A genetic thrombophilic disorder (prothrombin G20210A allele mutation) was identified as the predisposing factor for this unusual complication. Particular emphasis is placed on the course of the disease, which showed regression only after surgical exploration and additional anticoagulant therapy. We conclude that a thorough and early assessment of coagulation factors should always be performed, especially in the population at risk, in order to rule out unusual aetiologies of these rare but still life-threatening pathological processes.

scholarly journals Hereditary angioedema - an otolaryngologist’s perspective

2016 ◽  
Vol 6 (23) ◽  
pp. 133-138
Author(s):  
Alexis Vuzitas ◽  
Codrut Sarafoleanu
Keyword(s):  
Head And Neck ◽  
Hereditary Angioedema ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Coagulation Factors ◽  
Still Life ◽  
Complement Components ◽  
Life Saving ◽  
Dominant Disease ◽  
Life Threatening

Abstract Hereditary angioedema (HAE) is a rare autosomal dominant disease consisting of recurrent angioedema attacks, varying in severity, possibly life-threatening and with frequent involvement of the head and neck areas. The patophysiology of HAE differs from histamine-mediated allergic angioedema. Three types of reduced quality or quantity in various complement or coagulation factors, leading to massive release of bradykinin, increase vascular permeability and produce capilary leakage. Clinical manifestations of HAE include swelling located predominantly in the head and neck area, hands, feet and urogenital area and abdominal pain caused by edema of the gastrointestinal tract mucosa. Diagnosis requires laboratory tests for complement components and genetic tests. A timely and correct diagnosis in the emergency room is of utmost importance, the medical treatment of HAE being substantially different from that of allergic angioedema. Although new therapies are available and in development, airway intervention and surgery are still life-saving procedures and the ENT surgeon is an important part of the multidisciplinary team managing an HAE attack.

Cerebral venous sinus thrombosis in a patient with concomitant Graves’ disease and squamous cell carcinoma of the cervix

2020 ◽  
Vol 13 (12) ◽  
pp. e236730
Author(s):  
Yong Chuan Chee ◽  
Sanihah Abdul Halim
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Predisposing Factor ◽  
Venous Sinus Thrombosis ◽  
Life Threatening

Cerebral venous sinus thrombosis (CVST) is caused by either acquired or inherited pro-thrombotic states. Hyperthyroidism is a less recognised predisposing factor of CVST, and the causality has been debated. We report a case of a life-threatening CVST in a 40-year-old woman, with uncommon dual risk factors: hyperthyroidism and advanced squamous cell carcinoma of the cervix. CVST should be considered as a differential diagnosis when a patient with hyperthyroidism presents with new-onset headache or other neurological symptoms. Further assessment to elucidate other covert risk factors may need to be continuously carried out, when the causal relationship of one apparent cause has not been well established.

scholarly journals Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview

2019 ◽  
Vol 8 (1) ◽  
pp. 101 ◽  
Author(s):  
Sara Torretta ◽  
Claudio Guastella ◽  
Paola Marchisio ◽  
Tal Marom ◽  
Samantha Bosis ◽  
...  
Keyword(s):  
Visual Loss ◽  
Care Setting ◽  
Sinus Thrombosis ◽  
Clinical Manifestations ◽  
Urgent Care ◽  
Pediatric Diseases ◽  
Life Threatening ◽  
Infectious Disease Specialists ◽  
Urgent Care Setting ◽  
Practical Recommendations

Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3–4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians.

Diagnostic difficulties in a patient with multiple sclerosis who presents with cranial nerve palsies: an unusual complication of dental work

2020 ◽  
Vol 13 (10) ◽  
pp. e232903
Author(s):  
Jennifer Cathcart ◽  
Rebecca Caitlin Johnson ◽  
Nicholas Hughes ◽  
Manish Patel
Keyword(s):  
Multiple Sclerosis ◽  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Unusual Complication ◽  
Cavernous Sinus Thrombosis ◽  
Dental Abscess ◽  
First Case ◽  
Cranial Nerve Palsies ◽  
Diagnostic Difficulties

A woman in her 60s with multiple sclerosis (MS) presented with right-sided ptosis, right sixth nerve palsy, right facial paraesthesia and signs of sepsis. She had a recent diagnosis of a dental abscess. Investigations revealed a right submasseter abscess leading to bacterial meningitis (Streptococcus intermedius) and a cavernous sinus thrombosis. She was managed in intensive care and underwent surgical drainage of the abscess. Anticoagulation for 6 months was planned. Cavernous sinus thrombosis is a very rare complication of a dental abscess, and even less frequently associated with submasseter abscesses. The case was complicated by a history of MS, to which the patient’s symptoms and signs were initially attributed to. This case highlights the diagnostic pitfalls, and aims to enhance learning around similar cases. To the best of our knowledge, this is the first case report of a masseter/submasseter abscess leading to cavernous sinus thrombosis.

scholarly journals Acquired Factor XI Inhibitor Presenting as Spontaneous Bilateral Subdural Hematoma in an Elderly Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Natale Vazzana ◽  
Luca Scarti ◽  
Chiara Beltrame ◽  
Antonella Picchi ◽  
Gianni Taccetti ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Coagulation Factors ◽  
Spontaneous Bleeding ◽  
Autoimmune Conditions ◽  
Life Threatening ◽  
History Of ◽  
Uncommon Condition ◽  
High Degree ◽  
History Of Cancer ◽  
Mucocutaneous Bleeding

Development of autoantibodies against coagulation factors is an uncommon bleeding disorder associated with cancer, autoimmune conditions, pregnancy, or no apparent disease. Spontaneous FVIII inhibitors are the most frequently encountered; those against FXI have been only anecdotally reported. We report a case of acquired FXI inhibitor presenting as fatal intracranial spontaneous bleeding in an elderly patient with history of cancer and previous transfusions. Few cases of acquired FXI inhibitor have been reported in association with connective tissue disease, cancer, or surgery. Bleeding includes mucocutaneous bleeding, postsurgical hemorrhage, or life-threatening events. Treatment consists of arresting the bleeding and inhibitor eradication. High degree of suspicion is essential to promptly diagnose and treat this uncommon condition.

scholarly journals Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media

2013 ◽  
Vol 5 (3) ◽  
pp. 133-138
Author(s):  
Sunali Khanna ◽  
R Rangasayee
Keyword(s):  
Hearing Loss ◽  
Down Syndrome ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Conductive Hearing Loss ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Predisposing Factor ◽  
Lateral Cephalometry ◽  
Conductive Hearing

ABSTRACT Objective Cephalometric assessment of Eustachian tube (ET) parameters and audiological evaluation in Down syndrome (DS) and Chronic Otitis Media (COM) and comparison with controls. The ET length, Total Cranial Base (TCB), Posterior Upper Facial Height (PUFH), Maxillary Depth (MD), s-ba (sella-basion) to Palatal Line (PL) and s-ba to ET length were considered. Materials and methods The study comprised of 75 subjects of both sexes in the age range of 7 to 20 years. Digital lateral cephalometry was performed for DS, COM and controls (n = 25). Pure tone audiometry (PTA) and immittance audiometry (IA) was performed to assess audiological status. Results ET length, PUFH, TCB and MD was found to be significantly reduced in DS and COM. s-ba to PL and s-ba to ET was significantly reduced in DS and COM. The s-ba to PL and s-ba to ET length angle in moderate and severe CHL (Conductive Hearing Loss) was decreased significantly. The s-ba to ET length was significantly decreased in patients with B and C tympanogram. Conclusion Aberration in the dimension of the region of the ET can be considered as a predisposing factor for otitis media and conductive hearing loss in DS. How to cite this article Khanna S, Rangasayee R. Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media. Int J Otorhinolaryngol Clin 2013;5(3):133-138.

scholarly journals Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Konstantinos Bouliaris ◽  
Dimos Karangelis ◽  
Marios Daskalopoulos ◽  
Konstantinos Spanos ◽  
Michael Fanariotis ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Infectious Mononucleosis ◽  
Potential Role ◽  
Splenic Rupture ◽  
Emergency Laparotomy ◽  
Hemorrhagic Complication ◽  
Spontaneous Splenic Rupture ◽  
Predisposing Factor ◽  
Life Threatening

Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

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