scholarly journals Uncommon differential diagnosis of a breast ulcer: a case study

2021 ◽  
Vol 30 (Sup9a) ◽  
pp. XIIi-XIIiv
Author(s):  
Francesca Combi ◽  
Simona Papi ◽  
Denise Marchesini ◽  
Alessia Andreotti ◽  
Anna Gambini ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Erythema Migrans ◽  
Left Breast ◽  
Wide Excision ◽  
Representative Specimen ◽  
Scorpion Sting ◽  
Prurigo Nodularis ◽  
Diagnostic Hypothesis ◽  
Spider Bites ◽  
Spider Bite

Introduction: Spider bites are common worldwide. Frequently symptoms resolve without any adverse outcome, but in rare cases the bite can cause severe morbidity. The most typical presentation of Mediterranean recluse spider (Loxosceles Rufescens) bite is a dermatonecrotic lesion of the skin (skin loxoscelism). When the only manifestation of a spider bite is an ulcerated skin lesion, clinical suspicion and differential diagnosis strongly depend on its site. We present the case of an ulcerated wound of the breast, diagnosed as a Mediterranean recluse spider bite. Case presentation: A 79-year-old woman presented a 10cm-wide soft tissue ulceration of her left breast. At first, the diagnostic hypothesis of an ulcerated cancer was ruled out. Two family members revealed a recent history of Mediterranean recluse spider bite and the same clinical diagnosis was made for our patient. A wide excision was performed, with complete resolution of symptoms. Discussion: No specific diagnostic criteria for spider bites are available. Diagnosis is usually clinical. Skin loxoscelism could be easily mistaken for cellulitis, various types of skin infections, cutaneous anthrax, vasculitis, scorpion sting, pyoderma gangrenosum, erythema migrans of Lyme disease or prurigo nodularis. A thorough anamnestic interview is fundamental to raise the diagnostic hypothesis. When possible, a biopsy is recommended and it is extremely important when the ulcer can mimic a cancer, as is the case in breast tissue. Conclusion: We recommend a wide excision of the wound after failure of conservative treatment, in order to obtain local control and to perform histological examination on a more representative specimen.

Arterial Thrombosis and Gangrene Secondary to Arachnidism

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 239-242
Author(s):  
Jan M. Eckermann ◽  
Theodore H. Teruya ◽  
Christian Bianchi ◽  
Ahmed M. Abou-Zamzam
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Vascular Disease ◽  
Tissue Damage ◽  
Arterial Thrombosis ◽  
Progressive Necrosis ◽  
Life Threatening ◽  
History Of ◽  
Spider Bites ◽  
Spider Bite

Spider bites can cause local tissue damage as well as life-threatening complications. This is a case report of a female with no history of lower extremity vascular disease who presented with a spider bite on the dorsum of her foot. She developed progressive necrosis and eventually suffered limb loss despite attempts at revascularization.

A two year study of verified spider bites in Switzerland and a review of the European spider bite literature

Toxicon ◽  
2013 ◽  
Vol 73 ◽  
pp. 104-110 ◽  
Author(s):  
Wolfgang Nentwig ◽  
Markus Gnädinger ◽  
Joan Fuchs ◽  
Alessandro Ceschi
Keyword(s):  
Spider Bites ◽  
Spider Bite

Pemphigoid Nodularis

2015 ◽  
Vol 19 (2) ◽  
pp. 153-155 ◽  
Author(s):  
Waleed Al-Salhi ◽  
Ru'aa Alharithy
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Effective Treatment ◽  
Bullous Pemphigoid ◽  
Clinical Features ◽  
Rare Variant ◽  
Early Recognition ◽  
Prurigo Nodularis ◽  
Clinical Variant ◽  
Pemphigoid Nodularis

Background Pemphigoid nodularis is a rare clinical variant of bullous pemphigoid characterized by overlapping clinical features of both prurigo nodularis lesions and bullous pemphigoid blisters. The condition appears to be more common in females and is often resistant to treatment. Objective To raise awareness of this rare variant of bullous pemphigoid. Methods Case report. Results and Conclusion Dermatologists should include this variant in differential diagnosis of prurigo nodularis because early recognition can lead to an effective treatment for the prurigo component.

S104 – Treatment of a Brown Recluse Spider Bite to the Face

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P112-P112
Author(s):  
Katherine K. Hamming ◽  
Peter A Hilger ◽  
Holly Boyer
Keyword(s):  
Conservative Management ◽  
Treatment Options ◽  
Complete Healing ◽  
Aesthetic Outcome ◽  
Upper Lip ◽  
Aesthetic Result ◽  
The Face ◽  
Topical Treatments ◽  
Spider Bites ◽  
Spider Bite

Objectives 1) To raise awareness among otolaryngologists about the presentation, complications, and treatment options of brown recluse spider bites. 2) To present a case of a brown recluse spider bite to the face that was treated conservatively and had an excellent aesthetic result. Methods A 48-year-old woman was referred to the otolaryngology clinic with a dermonecrotic wound on the left upper lip from a brown recluse spider bite. The lesion consisted of a 4mm eschar with surrounding erythema, and the necrosis extended almost through the lip, sparing only the oral mucosa. She was given antibiotics and followed clinically. The eschar was left in place without debridement or topical treatments, and it fell off on day 40. Results After the eschar fell off on its own, the patient was left with complete healing of the necrotic area and a 1mm scar with mild erythema, giving her an excellent aesthetic result. Conclusions This case represents conservative management of a self-limited dermonecrotic lesion of the upper lip that resulted from a brown recluse spider bite. Conservative management should be considered with brown recluse spider bites, especially on the face, which has an excellent blood supply and where good aesthetic outcome is crucial.

scholarly journals 18-FDG PET ANALYSYS FOR DEMENTIA DIAGNOSIS- BASELINE RESULTS FROM A REFERENCE CENTER IN RECIFE, BRAZIL

2021 ◽  
Author(s):  
Júlia Xavier Ramos ◽  
Bruno Zacarias ◽  
Breno Barbosa ◽  
Simone Brandão
Keyword(s):  
Differential Diagnosis ◽  
Lewy Bodies ◽  
Diagnostic Uncertainty ◽  
Medical Evaluation ◽  
Pet Ct ◽  
Diagnosis Of Dementia ◽  
Diagnostic Hypothesis ◽  
The Mean ◽  
Near Future

Background: Positrons emission tomography associated with computed tomography- PET/CT using the 18 F-fluorodeoxyglucose is a well-established exam for the medical evaluation of dementia, mainly helping in differential diagnosis to determine the specific type of dementia. Objectives: To describe the role of the PET/CT in the differential diagnosis of dementia in patients. Methods: a single-center, descriptive and records-based analysis of patients with Dementia evaluated in a clinic of Neurology at Recife and referred to PET/ CT due to diagnosis uncertainty, between 2020-2021. Results: 29 patients were included. The mean age was 65 years-old and 62% were female. Alzheimer’s dementia was the main diagnostic hypothesis (41.3%). PET/CT was suggestive of Alzheimer’s in 24%, Frontotemporal dementia in 21% and Lewy Bodies Dementia in 17% of patients. PET/CT results disagreed from clinical hypothesis in 21% o and in 10% it was inconclusive. In 38% it corroborated the clinical suspicion. Conclusions: in this sample the use of PET/CT FDG contributed to improve diagnostic accuracy in a significant subset of patients, mostly in the scenery of diagnostic uncertainty or atypical syndromes such as earlyonset dementias. A larger sample size and the continuation of this research will give us more information in the near future.

scholarly journals Interstitial pneumonitis in the COVID-19 era: a difficult differential diagnosis in patients with lung cancer

2020 ◽  
pp. 030089162095186 ◽  
Author(s):  
Chiara Catania ◽  
Valeria Stati ◽  
Gianluca Spitaleri
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Checkpoint Inhibitors ◽  
Tumour Progression ◽  
Diagnostic Algorithm ◽  
Target Population ◽  
Drug Induced ◽  
Correct Treatment ◽  
Diagnostic Hypothesis ◽  
Interstitial Disease

In this coronavirus 2019 (COVID-19) era, when pneumonitis occurs in patients with lung cancer receiving immune checkpoint inhibitors (ICIs), a major challenge is to make a rapid and correct differential diagnosis among drug-induced pulmonary toxicity, tumour progression, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–induced pneumonitis. While waiting for polymerase chain reaction (PCR) testing results, an accurate evaluation of the symptoms and serologic features can help us make a first diagnostic hypothesis and quickly start correct treatment. Physicians need a collaborative effort to develop and share a common database reporting clinical (anosmia, dysgeusia), serologic, and radiologic data in ICI-treated patients with lung cancer developing interstitial disease to create an evidence-based clinical diagnostic algorithm. This tool will continue to be helpful when we emerge from the pandemic crisis into a world in which COVID-19 may not have been eradicated to better select the target population requiring the most resource-consuming PCR tests.

Differential Diagnosis Based on Age. Diagnostic Difficulties

2016 ◽  
Vol 33 (S1) ◽  
pp. S473-S473
Author(s):  
S. Rodrígue Vargas
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Review Of The Literature ◽  
Diagnostic Difficulties ◽  
Diagnostic Hypothesis ◽  
Competing Interest

IntroductionFollowing a case presented in our inpatient unit as well as various interdepartmental from internal medicine and other emergencies, we decided to conduct a literature review on the different organic causes that can trigger the onset of psychotic symptoms in elderly.ObjectivesA correct differential diagnosis of psychiatric symptoms in elderly.AimsLiterature review of the literature on the presentation of psychotic symptoms in the elderly.MethodsDescription of a clinical case and development of diagnostic hypotheses.Results and conclusionsFor several decades are experiencing a gradual aging of the population, which means that we are at the onset of clinical symptoms not described by classical authors. Furthermore, scientific advances make infectious causes (such as neurosyphilis was our first diagnostic hypothesis) are increasingly rare. The elderly usually has multiple comorbidities, which are receiving various treatments that must be ruled out possible adverse effects.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Acute urinary retention after Black Widow envenomation: a case report

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 640-642 ◽  
Author(s):  
Matthew Carere ◽  
Russel Sterret ◽  
Nicholas Timmerman ◽  
Ian Taylor
Keyword(s):  
Climate Change ◽  
Differential Diagnosis ◽  
Case Report ◽  
Acute Abdomen ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Black Widow ◽  
Spider Bite ◽  
Work Up ◽  
Widow Spider

AbstractLatrodectism following Black Widow envenomation is rare in Canada. We present the case of a previously healthy 50 year old male who presented with an acute abdomen, hypertension, and urinary retention. After a thorough work up it was determined to be as a result of a Black Widow spider bite. Due to climate change we may see more cases of Latrodectism in the future and it should be considered as a differential diagnosis in anyone presenting with an acute abdomen after an insect bite.

Uncommon site of metastatic neuroblastoma in a 15-year-old girl: case report and description of sonographic and radiographic features

2021 ◽  
pp. 030089162110022
Author(s):  
Emanuele Avola ◽  
Vincenzo Giannetta ◽  
Catherine Depretto ◽  
Gianfranco P. Scaperrotta
Keyword(s):  
Differential Diagnosis ◽  
Left Breast ◽  
Maximum Diameter ◽  
Breast Metastasis ◽  
Breast Masses ◽  
Computed Tomographic ◽  
Imaging Tool ◽  
Rapid Enlargement ◽  
Malignant Breast ◽  
Malignant Lesions

Background: Although most breast masses in children are benign, breast cancer must be considered in the differential diagnosis. The majority are represented by sarcomas and secondary lesions. Literature reports only four cases of neuroblastoma breast metastasis, with no emphasis on radiologic features. Our work aims to furnish a description of radiologic and sonographic features of neuroblastoma metastasis in the breast. Case description: A 15-year-old girl had a round nodular mass in the outer upper quadrant of the left breast that had rapidly enlarged over the last month. An ultrasound showed two subcutaneous nodules (3.8 cm and 1.3 cm in maximum diameter), with an irregular shape, heterogeneous echogenicity (isohypoechoic), and hyperechoic foci with a posterior acoustic shadow inside. Overall, the features were highly suspicious of secondary malignant lesions. Computed tomographic scan was performed and found a large retroperitoneal mass and multiple mixed secondary lesions to the spine and hip. A 14G core needle biopsy of breast masses was performed and showed a secondary localization of neuroblastoma. Conclusions: In adolescents, metastases are the most frequent cause of malignant breast masses. Ultrasound examination should be preferred as the first imaging tool. For the differential diagnosis of breast metastasis with benign masses, a rapid enlargement, a heterogeneous echogenicity, and intralesional hyperechogenic foci could be considered features of malignancy.

scholarly journals Trichilemmal Cyst of the Eyelid: Masquerading as Recurrent Chalazion

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Manju Meena ◽  
Ruchi Mittal ◽  
Debarati Saha
Keyword(s):  
Differential Diagnosis ◽  
Postoperative Period ◽  
Rare Case ◽  
Excisional Biopsy ◽  
Lower Eyelid ◽  
Wide Excision ◽  
Histopathological Findings ◽  
Trichilemmal Cyst ◽  
History Of ◽  
One Year

A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis was confirmed on histopathology. There was no recurrence seen till 2 months of postoperative period. Trichilemmal cyst, although rare, should be considered as differential diagnosis of recurrent chalazion.

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