scholarly journals A confusing final diagnosis in the differential diagnosis of SARS-CoV-2 associated Multisystem Inflammatory Syndrome in Children: Salmonellosis

2022 ◽  
pp. 1-6
Author(s):  
Saliha KANIK YÜKSEK ◽  
Belgin GÜLHAN ◽  
Gülsüm İclal BAYHAN ◽  
Aslınur ÖZKAYA PARLAKAY
Keyword(s):  
Differential Diagnosis ◽  
Final Diagnosis ◽  
Inflammatory Syndrome

scholarly journals Large multicystic spinal lesion in a young African migrant: a problem of differential diagnosis

2021 ◽  
Vol 14 (7) ◽  
pp. e242690
Author(s):  
Tamara Ursini ◽  
Paola Rodari ◽  
Geraldo Badona Monteiro ◽  
Valeria Barresi ◽  
Carmelo Cicciò ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cystic Echinococcosis ◽  
Bone Cyst ◽  
Spinal Tuberculosis ◽  
Final Diagnosis ◽  
Lower Limbs ◽  
Migration Flow ◽  
Spinal Lesion ◽  
African Migrant ◽  
Expansive Lesion

We describe a rare case of large, fully cystic spinal schwannoma in a young adult from The Gambia. The initial clinical suspicion was spinal cystic echinococcosis. He came to our attention reporting progressive walking impairment and neurological symptoms in the lower limbs. An expansive lesion extending from L2 to S1 was shown by imaging (ie, CT scan and MRI). Differential diagnoses included aneurysmal bone cyst and spinal tuberculosis and abscess; the initial suggested diagnosis of spinal cystic echinococcosis was discarded based on contrast enhancement results. The final diagnosis of cystic schwannoma was obtained by histopathology of the excised mass. Cystic spinal lesions are rare and their differential diagnosis is challenging. Awareness of autochthonous and tropical infectious diseases is important, especially in countries experiencing consistent migration flow; however, it must be kept in mind that migrants may also present with ‘non-tropical’ pathologies.

The Significance of “Fractional Excretion of Urea” in The Differential Diagnosis of Acute Kidney Injury in Cirrhotic Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sameh Mohamed Ghaly ◽  
Moataz Serry Seyam ◽  
Mohamed Osama Aly ◽  
Ahmed Mohamed Hesham Abdelfattah ◽  
Ahmed R. Mashaal
Keyword(s):  
Acute Kidney Injury ◽  
Differential Diagnosis ◽  
Kidney Injury ◽  
Fractional Excretion ◽  
Final Diagnosis ◽  
Good Alternative ◽  
Decompensated Cirrhosis ◽  
Eligibility Criteria ◽  
Significant Difference ◽  
Cirrhotic Patients

Abstract Background Patients with cirrhosis are more susceptible to develop AKI than the non-cirrhotic individuals. AKI has an estimated prevalence of approximately 20% to 50% among hospitalized patients with cirrhosis. Physicians caring for patients with cirrhosis should recognize the acute or chronic character of renal disease, the causes of renal injury, the clinical conditions leading concomitantly to AKI and liver dysfunction, and the prognostic factors associated with the progression of AKI. Hypovolemia (due to diuretics, hemorrhage and diarrhea), acute tubular necrosis (ATN), sepsis, nephrotoxic agents (such as nonsteroidal anti-inflammatory drugs, aminoglycosides and/or radiological contrasts) and hepatorenal syndrome (HRS)-type 1 are the most common causes of AKI in cirrhotic patients. Objective To evaluate the sensitivity of fractional excretion of urea (FEUrea) vas a diagnostic biomarker for different causes of acute kidney injury in liver cirrhosis. Patients and Methods This study was conducted in co-operation between Tropical Medicine Department, Ain-Shams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute between July 2019 to January 2020. It included 70 adult Egyptian patients admitted for treatment of complications of cirrhosis who fulfilled the eligibility criteria and compared to 10 cirrhotic patients without renal impairment. All patients were subjected to; full history taking, thorough clinical examination, laboratory investigations, Child-Pugh score was calculated for admission and urine samples were collected for urinary urea and creatinine levels to calculate FEUrea. Results Concerning the gender distribution in this study, male to female percent was 40 (57.10%) males and 30 (42.90%) females for gender, respectively. As regards to the causes of AKI, there were 24 (34.30%) PRA, 7 (10.00%) HRS and 39 (55.70%) ATN for final diagnosis. In the current study, there was significant difference (P = 0.0001; P < 0.05) in FE urea % among PRA, HRS and ATN groups (26.28±2.89, 11.76±3.44, and 47.37±10.53, respectively). Findings showed a higher FEUrea cut-off for ATN (>33%) compared to lower cut-off values for PRA (<33% and >21%) and HRS (<21%). Conclusion FEUrea was found to be an excellent simple tool for the differential diagnosis of AKI in patients with decompensated cirrhosis and ascites. FEUrea has also proven to be a useful “tubular injury” marker by differentiating ATN from non-ATN with high diagnostic accuracy (Sensitivity and Specificity exceeding >90%). FEUrea was found to be a good alternative and noninvasive tool for differentiating causes of AKI in cirrhotic patients instead of other non-available or expensive markers.

scholarly journals Somatically derived Yolk Sac tumor of the urinary bladder: A case report and differential diagnosis

2020 ◽  
Author(s):  
Nadia Espejo-Herrera ◽  
Enric Condom Mundó
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Final Diagnosis ◽  
Yolk Sac ◽  
Yolk Sac Tumor ◽  
High Grade ◽  
Yolk Sac Tumors ◽  
Urinary Bladder Tumor

Abstract Background: Yolk sac tumor is a germ cell neoplasm that arises predominantly in the gonads, but can also derive from somatic neoplasms in extragonadal locations. These cases have been denominated recently as “somatically derived Yolk sac tumors”, and have been documented in several locations, although reports from the urinary tract are scarce. To our knowledge, this is the first report of a Yolk sac tumor derived from urothelial carcinoma. Case presentation: We present a unique case of a 76-year-old man with a recurrent urinary bladder tumor, initially interpreted as a high grade urothelial carcinoma with glandular differentiation. In the recurrent tumor, diverse histological patterns were identified, including glandular, hepatoid and sarcomatoid. This tumor showed positivity for AFP, GLP3 and SALL4, and negativity for CK7 and EMA. Fluorescent in situ hybridization study showed a polysomic pattern of chromosome 12. All these findings led to the final diagnosis of a Yolk sac tumor derived from urothelial carcinoma. Conclusions: Somatically derived Yolk Sac tumors should be considered in the differential diagnosis of a high grade urothelial carcinoma, particularly when glandular and other unusual patterns are observed. Key words: Yolk sac tumor, somatically derived, urothelial carcinoma, urinary bladder, case report.

scholarly journals Cystic pancreatic lesions: MR imaging findings and management

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Giovanni Morana ◽  
Pierluigi Ciet ◽  
Silvia Venturini
Keyword(s):  
Differential Diagnosis ◽  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Main Pancreatic Duct ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Morphological Findings ◽  
History Of ◽  
Cystic Pancreatic Lesions ◽  
Radiological Examinations

AbstractCystic pancreatic lesions (CPLs) are frequently casual findings in radiological examinations performed for other reasons in patients with unrelated symptoms. As they require different management according to their histological nature, differential diagnosis is essential. Radiologist plays a key role in the diagnosis and management of these lesions as imaging is able to correctly characterize most of them and thus address to a correct management. The first step for a correct characterization is to look for a communication between the CPLs and the main pancreatic duct, and then, it is essential to evaluate the morphology of the lesions. Age, sex and a history of previous pancreatic pathologies are important information to be used in the differential diagnosis. As some CPLs with different pathologic backgrounds can show the same morphological findings, differential diagnosis can be difficult, and thus, the final diagnosis can require other techniques, such as endoscopic ultrasound, endoscopic ultrasound-fine needle aspiration and endoscopic ultrasound-through the needle biopsy, and multidisciplinary management is important for a correct management.

scholarly journals Orbital pseudotumor: a differential diagnosis of Graves' ophthalmopathy

2011 ◽  
Vol 55 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Luciana Souza Cruz Caminha ◽  
Elisa Rebelo Pinto ◽  
Priscila Alves Medeiros de Sousa ◽  
Ricardo Andrade Oliveira ◽  
Flavia Lucia Conceiçao ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Inflammatory Disease ◽  
Final Diagnosis ◽  
Response To Therapy ◽  
Orbital Pseudotumor ◽  
Graves Ophthalmopathy

The objective of this study is to report and discuss a rare and inflammatory cause of exophthalmos. This report describes a patient with exophthalmos, who was initially diagnosed with euthyroid Graves' with good response to therapy. After 8 years of follow-up, she had recurrence of symptoms and a new evaluation revealed the final diagnosis of orbital pseudotumor. Orbital pseudotumor is an uncommon disorder that both radiologically and clinically mimics a malignant process or other inflammatory disease, such as Graves' ophthalmopathy.

scholarly journals A Case Study of Intractable Vomiting with Final Diagnosis of Neuromyelitis Optica

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Rachel Bramson ◽  
Angela Hairrell
Keyword(s):  
Differential Diagnosis ◽  
Rural Community ◽  
Neuromyelitis Optica ◽  
Neurological Disorder ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Neurological Symptoms ◽  
Nausea And Vomiting ◽  
Physical Findings

This case study presents a patient living in a suburban/rural community who received appropriate referral to secondary and tertiary care for nausea and vomiting, accompanied by waxing and waning neurological symptoms, yet proved difficult to diagnose. This patient is presented to draw attention to a rare neurological disorder which should be included in the differential diagnosis of nausea and vomiting with some key neurological complaints, even in the absence of physical findings.

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

99mTc-hexamethylpropyleneamine oxime leukocyte scintigraphy and C-reactive protein levels in the differential diagnosis of brain abscesses

1992 ◽  
Vol 77 (5) ◽  
pp. 732-736 ◽  
Author(s):  
Ivar Amund Grimstad ◽  
Henry Hirschberg ◽  
Kjell Rootwelt
Keyword(s):  
Differential Diagnosis ◽  
Brain Abscess ◽  
Protein Level ◽  
Final Diagnosis ◽  
C Reactive Protein ◽  
Content Type ◽  
Reactive Protein ◽  
Leukocyte Scintigraphy ◽  
Mass Lesions ◽  
Fine Print

✓ The demonstration and accurate localization of intracerebral mass lesions are commonly performed with computerized tomography (CT), which often cannot determine the nature of the lesion. As an aid in the differential diagnosis between brain abscess and neoplasm, the authors have evaluated both 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) leukocyte scintigraphy and the serum C-reactive protein level. Of 23 patients with intracranial mass lesions, 22 individuals showed ring-like contrast enhancement on CT scans; the one exception was a patient treated for a meningioma who had a negative CT scan despite clinical suspicion of intra- or extracranial abscess. The final diagnosis was invariably established by microscopic examination of tissue specimens. In 10 patients the final diagnosis was brain abscess; the other 13 patients harbored a brain neoplasm (glioma in nine, astrocytoma in one, and metastasis in three). The 99mTc-HMPAO leukocyte scintigraphy detected all cases of abscess. There were no false-positive results. An elevated C-reactive protein level (> 13 mg/liter) was found in all but one patient with abscess and in three patients with neoplasm; two of these three patients had dental root infections which could account for the elevation of C-reactive protein. It is concluded that 99mTc-HMPAO leukocyte scintigraphy should be performed when there is a possibility that a brain abscess may exist. Any steroid treatment should be discontinued for 48 hours prior to leukocyte scintigraphy. Also, C-reactive protein determination should be performed and is useful even when steroids are given.

scholarly journals Clinical case of observation of patient with primary systemic amyloidosis

2020 ◽  
pp. 46-48
Author(s):  
Yu. N. Fedulaev ◽  
N. V. Khabazov ◽  
A. Yu. Chuprakova ◽  
M. V. Ezhikova ◽  
A. A. Kurshin ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Histological Examination ◽  
Clinical Picture ◽  
Clinical Case ◽  
Final Diagnosis ◽  
Amyloid Deposition ◽  
Systemic Amyloidosis ◽  
Primary Amyloidosis ◽  
Amyloid Protein

Amyloidosis combines diseases that are characterized by extracellular deposition of a specific insoluble fibrillar amyloid protein. The prevalence of amyloidosis is an average of 10 cases per 100 thousand people. The clinic of the disease is polymorphic and depends on the organ with amyloid deposition. The article discusses the clinical case of systemic amyloidosis with damage to the stomach, liver and other organs. The differential diagnosis was carried out with tuberculosis, cancer, cirrhosis. The final diagnosis was made by histological examination of biopsy samples of the liver and stomach. Difficulties in diagnosing primary amyloidosis are due to the attrition and non‑specificity of the clinical picture of the disease. Amyloidosis is diagnosed based on organ biopsy data.

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