Neonate born with ischemic limb to a COVID-19 positive mother: management and review of literature

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.

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Metastatic adrenal pheochromocytoma to the thoracic spine

Coluna/Columna ◽

10.1590/s1808-18512010000300017 ◽

2010 ◽

Vol 9 (3) ◽

pp. 343-346 ◽

Cited By ~ 4

Author(s):

Michael T. Scalfani ◽

Paul M. Arnold ◽

Karen K. Anderson

Keyword(s):

Differential Diagnosis ◽

Surgical Intervention ◽

Hepatic Metastases ◽

Posterior Fixation ◽

Original Diagnosis ◽

Average Survival ◽

Progression Of Disease ◽

Adrenal Pheochromocytoma ◽

History Of ◽

Work Up

To report on a case of pheochromocytoma metastases to the spine occurring more than 20 years after initial diagnosis. A 34-year-old female with a history of metastatic pheochromocytoma diagnosed at age 12 presented with weakness, heart palpitations, and circumferential back pain of five months duration. The patient had undergone multiple laparatomies for abdominal and hepatic metastases. Work-up revealed a destructive lesion at T9. After two weeks of preoperative phenoxybenzamine to control her hypertension, she underwent decompression, posterior fixation and fusion. Surgical intervention was followed by radiation therapy, zoledronic acid, and only one cycle of chemotherapy due to intolerance of side effects. The patient survived 25 years after original diagnosis, which far exceeds the average survival of less than 15 years. The patient died 26 months postoperatively due to progression of disease. Pheochromocytoma with spine metastases occurring more than 20 years after diagnosis is very uncommon, and should be considered in the differential diagnosis of a patient with a history of pheochromocytoma.

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Ectopic decidua of the appendix: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01204-9 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Manabu Kaneko ◽

Hiroaki Nozawa ◽

Hirofumi Rokutan ◽

Koji Murono ◽

Tetsuo Ushiku ◽

...

Keyword(s):

Differential Diagnosis ◽

Acute Appendicitis ◽

Rare Entity ◽

Lower Quadrant ◽

Case Presentation ◽

Decidual Tissue ◽

Abdominal Symptoms ◽

History Of ◽

Myxoid Degeneration ◽

Right Lower Quadrant

Abstract Background Ectopic decidua is the presence of decidual tissue outside the uterus. Ectopic decidua of the appendix is a rare entity that can present with abdominal symptoms mimicking appendicitis. We report a case of a 39-year-old female patient at 27 weeks gestational age with a 2-day history of right lower quadrant abdominal pain. Case presentation The patient was referred to our hospital with suspicion of either acute appendicitis or threatened rupture of the uterus, the latter of which was considered unlikely following close examination. Therefore, she underwent emergency appendectomy via laparotomy. Microscopic examination revealed decidual tissue with myxoid degeneration in the subserosal layer of the tip side of the appendix, without endometriosis, which was compatible with ectopic decidua (deciduosis). Conclusions Because it is extremely difficult to distinguish ectopic decidua of the appendix from acute appendicitis, even with various imaging modalities, we should be aware that ectopic decidua of the appendix is a differential diagnosis for acute appendicitis in pregnant women.

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Age-related aspects of differential diagnosis of acute cough in children and adults

Russian Pulmonology ◽

10.18093/0869-0189-2017-28-4-461-468 ◽

2018 ◽

Vol 28 (4) ◽

pp. 461-468

Author(s):

I. V. Leshchenko ◽

S. A. Tsar’kova ◽

A. D. Zherebtsov

Keyword(s):

Differential Diagnosis ◽

Anatomical Location ◽

Pathological Changes ◽

Review Of Literature ◽

Acute Cough ◽

Age Related ◽

Common Causes ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

Cough is one of the most common causes of seeking the primary medical care, especially during the autumn and the spring. This article is a review of literature aimed at differential diagnosis of possible causes of acute cough in children and adults. Given a vast majority of diseases associated with cough, differential diagnosis have to consider several issues. The key issue is cough duration and possible anatomical location of the pathological changes. An algorithm of differential diagnosis of acute cough in children and adults and description of most common diseases associated with acute cough are given in the review. Further diagnostic work-up should be driven by the duration of cough as soon as the acute cough could be first manifestation of a chronic disease.

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Subacute Thyroiditis from COVID-19 Infection: A Case Report and Review of Literature

European Thyroid Journal ◽

10.1159/000511872 ◽

2020 ◽

pp. 1-5

Author(s):

Akshay Khatri ◽

Esti Charlap ◽

Angela Kim

Keyword(s):

Clinical Features ◽

Clinical Laboratory ◽

Early Recognition ◽

Subacute Thyroiditis ◽

The Novel ◽

Review Of Literature ◽

Successful Management ◽

Case Presentation ◽

Radiologic Findings ◽

History Of

Introduction: The novel severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) virus has led to the ongoing Coronavirus disease 2019 (COVID-19) disease pandemic. There are increasing reports of extrapulmonary clinical features of COVID-19, either as initial presentations or sequelae of disease. We report a patient diagnosed with subacute thyroiditis precipitated by COVID-19 infection, as well as review the literature of similar cases. Case Presentation: A 41-year-old female with no significant personal or family history of endocrinologic disorders presented with clinical features of thyroiditis that began after COVID-19 infection. Clinical, laboratory, and radiologic findings were indicative of subacute thyroiditis. Workup for potential triggers other than SARS-CoV-2 was negative. Discussion/Conclusion: We compared the clinical and diagnostic findings of our patient with other well-documented cases of subacute thyroiditis presumed to be triggered by SARS-CoV-2 viral infection. We also reviewed the literature related to the potential mechanisms leading to thyroiditis. Clinicians must be aware of the possibility of thyroid dysfunction after COVID-19 infection. Early recognition and timely anti-inflammatory therapy help in successful management.

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Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02517-3 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Ahmad Al-Mousa ◽

Mohammad Nour Shashaa ◽

Mohamad Shadi Alkarrash ◽

Mohamad Alkhamis ◽

Lina Ghabreau ◽

...

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Elderly Patients ◽

Unusual Case ◽

Medical Literature ◽

Testicular Tumor ◽

Testicular Seminoma ◽

Case Presentation ◽

History Of ◽

Pure Seminoma

Abstract Background Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30–49 years, but decreases to a very low level in men in their 60s or older. Case presentation A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature. Conclusion This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

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Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

Case Reports in Orthopedics ◽

10.1155/2018/3204714 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

John G. Skedros ◽

James S. Smith ◽

Marshall K. Henrie ◽

Ethan D. Finlinson ◽

Joel D. Trachtenberg

Keyword(s):

Compartment Syndrome ◽

Upper Extremity ◽

General Medicine ◽

Clinical History ◽

Acute Gout ◽

Exertional Compartment Syndrome ◽

Concurrent Infections ◽

History Of ◽

Multiple Symptoms ◽

Gout Flare

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

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Upper Extremity Anomalies

Genetic Consultations in the Newborn ◽

10.1093/med/9780199990993.003.0030 ◽

2019 ◽

pp. 203-210

Author(s):

Robin D. Clark ◽

Cynthia J. Curry

Keyword(s):

Valproic Acid ◽

Differential Diagnosis ◽

Upper Extremity ◽

Clinical Case ◽

Background Information ◽

Amniotic Band ◽

Case Presentation ◽

Vascular Disruption ◽

Common Causes ◽

Malformation Syndromes

This chapter reviews background information about the incidence, epidemiology, genetics, and other anomalies associated with common congenital anomalies of the upper extremity. The discussion reviews the differential diagnosis of transverse, longitudinal (amelia, radial, ulnar), intercalary (phocomelia), and central (split hand/foot) defects of the radius and ulna and combined upper and lower extremity defects. The chapter summarizes common causes of upper extremity anomalies, including amniotic band disruption sequence, teratogenic agents (misoprostol, thalidomide, valproic acid), vascular disruption, chromosome anomalies, and Mendelian congenital malformation syndromes, and it gives recommendations for evaluation and management. A clinical case presentation features an infant with Holt–Oram syndrome.

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Calcific Myonecrosis of the Leg: A Case Report

Case Reports in Orthopedic Research ◽

10.1159/000502031 ◽

2019 ◽

Vol 2 (1-3) ◽

pp. 47-53

Author(s):

Kewal Gangrade ◽

Girish Yeotikar ◽

Arjun Wadhwani ◽

Vinod Naneria

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Compartment Syndrome ◽

Muscle Mass ◽

Rare Presentation ◽

Complete Excision ◽

Radiological Features ◽

Calcific Myonecrosis ◽

Asymptomatic Patients ◽

History Of

Calcific myonecrosis is characterized by central liquefaction and peripheral calcification involving the entire muscle mass and is considered to be a late sequel of compartment syndrome. Being a rare presentation, considering differential diagnosis is important. Diagnosis is based on history of trauma and typical radiological features. Symptomatic patients require complete excision of the mass while asymptomatic patients can be treated nonoperatively.

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36-year-old Male with Syncope

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.6.48419 ◽

2020 ◽

Vol 4 (3) ◽

pp. 272-276

Author(s):

Samantha King ◽

Ryan Spangler ◽

Zachary Dezman ◽

Laura Bontempo

Keyword(s):

Emergency Department ◽

Differential Diagnosis ◽

Initial Examination ◽

Case Presentation ◽

Work Up

Case Presentation: A 36-year-old incarcerated male presented to the emergency department (ED) after an episode concerning for syncope. The patient had nystagmus and ataxia on initial examination. Discussion: There is a broad differential diagnosis for syncope, and for patients presenting to the ED we tend to focus on cardiogenic and neurologic causes. This case takes the reader through the differential diagnosis and systemic work-up of a patient presenting to the ED with syncope.

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Sporadic Hemiplegic Migraine with SCN1A Gene Mutation—A Case Report

US Neurology ◽

10.17925/usn.2018.14.2.108 ◽

2018 ◽

Vol 14 (2) ◽

pp. 108 ◽

Cited By ~ 1

Author(s):

Mukesh Dube ◽

Akshay Navalkishor Lakhotia ◽

Vaibhav Yadav ◽

Rahul Jain ◽

◽

...

Keyword(s):

Family History ◽

Positive Family History ◽

Conversion Disorder ◽

Severe Form ◽

Hemiplegic Migraine ◽

Case Presentation ◽

Missense Variation ◽

History Of ◽

Work Up ◽

First Time

Sporadic hemiplegic migraine (SHM) is a subtype of hemiplegic migraine, characterized by episodes of migraine with a reversible motor aura, without a positive family history, and is a mimicker of an atypical severe form of migraine, stroke, epilepsy, multiple sclerosis, metabolic disorders, or conversion disorder.Case presentation:We present the case of a young 28-year-old female, who had a history of recurrent reversible attacks of headache with sensory aura accompanied with left hemiparesis for the past 5 years, with no positive family history of similar symptoms. The work-up ruled out differential diagnoses and genetic work-up found a novelSCN1Agene missense variation in exon 26 (c.4855A>G; p.Met1619Val) in a case of SHM. She was discharged on flunarizine for prophylaxis.Conclusions:We describe, for the first time, a case of SHM with a mutation in theSCN1Agene.

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