scholarly journals Spinal Brucellosis: A Case Report and Review of the Literature

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
James M Rizkalla ◽  
Khalid Alhreish ◽  
Ishaq Y Syed

Introduction: The most common location of infection of brucellosis is the musculoskeletal system. It is estimated that the spine is involved in 2–54% of brucellosis infections, with the lumbar spine most commonly affected. We report an uncommon case of brucellar spondylodiscitis, in addition to the pathology, common presentation, and management of spinal brucellosis through additional literature review. Case Report: A 65-year-old Hispanic male presented to an orthopedic spine surgeon with signs and symptoms concerning for metastatic disease to the spine. Investigation revealed that the patient had the rare diagnosis of brucellar spondylodiscitis. This only became apparent after detailed questioning of the patient’s history revealed his employment within a Mexican meat slaughterhouse and a regular consumer of unpasteurized Mexican cheeses. Conclusion: Although uncommon, brucellosis spondylodiscitis should remain as a differential diagnosis in any patient who presents with back pain and fever. Detailed history taking and thorough physical examination remain vital in the work-up of brucellar spondylodiscitis. Understanding the pathology, radiographic findings, and necessary work-up are essential to properly treat this infection. Keywords: Spine, Brucella, spinal brucellosis, infection, spondylodiscitis, discitis, abscess.

2021 ◽  
Vol 14 (4) ◽  
pp. 1398-1401
Author(s):  
Ashwag Y Aloyouny

Clear Cell Odontogenic Carcinoma (CCOC) is a slow-growing, locally invasive odontogenic tumor affecting the jaws. It usually has confusing clinical characteristics, radiographical and histological features, making its recognition more challenging. In (2005), the WHO has reclassified CCOC as a malignant odontogenic tumor due to its aggressive behavior. This case report is about a woman who aged 42 years old, experienced swelling of the lower jaw and complained of paresthesia of the lips for two years. Radiographic findings showed an extensive, large, multilocular radiolucency lesion associated with scalloping, non-sclerotic border, and crossing the midline of the mandible. Histopathologically, the high-power view illustrated lobules of clear epithelial cells with clear cytoplasm. A review of English literature in PubMed Medline revealed few similar cases of CCOC affecting the mandible. The definitive diagnosis was consistent with CCOC; therefore, the patient was admitted to the hospital and surgical resection of the mandibular tumor was performed under general anesthesia. Long-term follow-up visits showed no signs of recurrence or post-surgical complications. We explain the signs and symptoms of CCOC such as symptomatic or asymptomatic jaw swelling, teeth loosening, displacement and mobility of teeth, and thinning of the mandible. Also, differential diagnosis and the nature of CCOC under the microscope were discussed and explained. The presentation of clear cell tumors is challenging, and it needs a meticulous investigation to determine the type of the tumor for proper diagnosis and management. CCOC should be included in the differential diagnosis list of jaw swelling that associated with slow-growing mass and paresthesia in the affected jaw.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Marly Simoncini ◽  
Mario Miniati ◽  
Federica Vanelli ◽  
Antonio Callari ◽  
Giulia Vannucchi ◽  
...  

We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms. The patient’s history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked. We believe that this case is representative of an important and barely researched topic: what happens to children with nondiagnosed and nontreated subthreshold forms of autism when they grow old. The issue of early recognition of autism spectrum signs and symptoms is discussed, raising questions on the diagnostic boundaries between autism and childhood onset psychotic spectrums among patients who subsequently develop a full-blown psychotic disorder.


2020 ◽  
Vol 13 (7) ◽  
pp. e234822
Author(s):  
William Hope ◽  
Faye Smith-Chakmakova ◽  
Justin Snyder

This is a case of a 31-year-old male patient who presented with signs and symptoms of an incarcerated inguinal hernia. The patient’s preoperative imaging showed a tubular structure in the inguinal canal and given the patient’s history at presentation, there was a concern for herniation of the appendix, known as an Amyand hernia. On laparoscopy, there was no evidence of appendiceal involvement and a standard open inguinal hernia was completed. On the final pathology of the hernia sac, roundworms were identified with Y-shaped lateral cords suggesting infection by Anisakis spp. On a further interview with the patient, he revealed that he had recently travelled to Alaska and had consumed raw salmon on a fishing trip. This case demonstrates the importance of a thorough social and travel history. One should also have a low threshold to broaden the differential diagnosis when medical work-up deviates from the standard course.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Nik Abdul Ghani Nik Rozainah ◽  
Azih Nurul Farah ◽  
Mohmed Isaqali Karobari

Root canal treatment failure can be determined based on a patient’s complaint and on the basis of clinical examination and radiographic findings. Most of the signs and symptoms for the failure are pain and discomfort, swelling and sinus formation at the surrounding soft tissue, and discoloration of the subjected tooth. Factors such as mechanical perforation during the procedures, overfilled or underfilled root canal, and missed or unfilled canals are the main factors for the failure outcome. This case report presents a discolored and infected upper lateral incisor which was previously root canal treated. The tooth was successfully managed under nonsurgical and surgical retreatment followed by an internal bleaching and full porcelain veneer. Apical tissue healing and acceptable tooth appearance was observed during a 12-month review.


2019 ◽  
Vol 30 (4) ◽  
pp. 541-544
Author(s):  
Justin Slavin ◽  
Marcello DiStasio ◽  
Paul F. Dellaripa ◽  
Michael Groff

The authors present a case report of a patient discovered to have a rotatory subluxation of the C1–2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process eventually proving to be caused by gout. This patient represented a diagnostic conundrum as she had known prior diagnoses of not only gout but also sarcoidosis and possible rheumatoid arthritis, and was in the demographic range where concern for an oncological process cannot fully be ruled out. Because she presented with signs and symptoms of atlantoaxial instability, she required posterior stabilization to reduce the rotatory subluxation and to stabilize the C1–2 instability. However, despite the presence of a large retroodontoid pannus, she had no evidence of spinal cord compression on physical examination or imaging and did not require an anterior procedure to decompress the pannus. To confirm the diagnosis but avoid additional procedures and morbidity, the authors proceeded with the fusion as well as a posterior biopsy to the retroodontoid pannus and confirmed a diagnosis of gout.


Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.


Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 262
Author(s):  
Antonello Falco ◽  
Francesco Bataccia ◽  
Lorenzo Vittorini Orgeas ◽  
Federico Perfetti ◽  
Mariangela Basile ◽  
...  

The aim of the present study is to assess the clinical and histological healing of a post-extractive alveolus following the procedure for socket preservation, in a patient receiving oral bisphosphonates for more than 6 years. After the extraction, enzymatically-deantigenated horse bone granules and an equine pericardium membrane were used to preserve the tooth socket. The patient was placed on a monthly follow-up in order to monitor the healing process. A 3 mm trephine bur was used to drill the bone for implant site preparation and to collect the bone sample. No signs and symptoms related to osteonecrosis of the jaws were reported. Histological data showed that, after 5 months, the mean percentages of trabecular bone, bone marrow and residual bone graft were respectively 45.74 ± 0.09%, 48.09 ± 0.08%, and 6.16 ± 0.01%. The residual graft material appeared to be osteointegrated and none of the particles appeared to be encapsulated. The present case report supports the guidelines that assume that patients undergoing oral bisphosphonate therapy can be eligible for surgical therapy. More clinical studies with larger sample sizes are needed to support this clinical evidence.


2021 ◽  
Vol 16 (9) ◽  
pp. 2357-2361
Author(s):  
Abdellatif Bensalah ◽  
Hiba Oudrhiri Benaaddach ◽  
Imane Gouzi ◽  
Meryem Haloua ◽  
Nizar Elbouardi ◽  
...  

Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.


Author(s):  
Melanie Thanh Phuong Le ◽  
Jochen Herrmann ◽  
Michael Groth ◽  
Konrad Reinshagen ◽  
Michael Boettcher

Background Gallbladder perforation is a very rare finding in children. Clinical and radiografic presentations are often vague. Hence it is a challenging diagnosis, often missed during initial evaluation with potentially fatal consequences. The aim of this case report and review was to identify factors that might help to diagnose and manage future cases. Methods We present a case of gallbladder perforation in an 8-year-old child after blunt abdominal trauma caused by a handlebar in which imaging modalities such as ultrasound and magnetic resonance imaging (MRI) helped us to determine proper management. We identified and evaluated comparable cases for isolated traumatic gallbladder injury. A review of the recent literature was performed by online search in Pubmed and Google Scholar using “gallbladder injury in children”, “gallbladder perforation children”, “blunt abdominal trauma children” as keywords. We focused on articles exclusively in the pediatric section. The literature from the period 2000–2020 was taken into account to review the state of the art in diagnosis and management. Results and Conclusion Recent literature for gallbladder injury in pediatrics is sparse compared to the adult counterpart. Only eight published cases of isolated gallbladder injury in children were identified. Since the onset of symptoms may not develop acutely and often develops in an indistinct manner, radiografic examinations play an important role in the diagnostic progress. The authors advise caution in cases of blunt abdominal trauma especially involving handlebars, intraperitoneal free fluid, and severe abdominal pain. We advocate high suspicion of gallbladder perforation if the gallbladder wall displays discontinuation or cannot be definitively differentiated in sonografic examination. Echogenic fluid within the gallbladder should always lead to suspicion of intraluminal bleeding. Repeated clinical and imaging examinations are mandatory since the onset of signs and symptoms may be delayed. Key Points:  Citation Format


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