scholarly journals Fulminant necrotizing streptococcal myositis with dramatic outcome – a rare case report

2021 ◽  
Author(s):  
Tudor Morar ◽  
Radu Pirlog ◽  
Sonia Vlaicu ◽  
Vasile Bintintan ◽  
Doinita Crisan
Keyword(s):  
Soft Tissue ◽  
Rapid Development ◽  
Multiple Organ ◽  
Penicillin G ◽  
High Dose ◽  
Streptococcal Toxic Shock Syndrome ◽  
Necrotizing Myositis ◽  
Rare Case Report ◽  
History Of ◽  
The Right

Necrotizing myositis represents a rare, aggressive form of bacterial-induced soft tissue necrotizing infection. We present a fulminant case of a 44-year-old patient with a necrotizing soft tissue infection  and a history of rheumatoid arthritis transferred to our service, Cluj-Napoca Emergency County Hospital, from a local hospital where he had been admitted two days before with chills and light-headedness after an accidental minor blunt trauma in the right thigh region. After admission to our hospital and first assessment, broad spectrum antibiotherapy was started with Meropenem, Vancomycin and Metronidazole along with surgical debridement. The evolution was fulminant with rapid development of multiple organ dysfunction syndrome, therefore he was transferred to the intensive care unit, intubated, and started the volemic resuscitation and vasopressor therapy. The blood culture was positive for group A beta-hemolytic streptococcus (GAS) and high dose Penicillin G was added to the therapeutic scheme. Despite all efforts, the patient developed disseminated intravascular coagulation syndrome and died in the next hours. The clinical picture together with the findings from the autopsy were suggestive for a streptococcal toxic shock syndrome developed as a complication of GAS induced necrotizing myositis.

scholarly journals Late Oesteoradionecrosis of Mandible Five Years after Radiotherapy for Carcinoma Base of Tongue

2018 ◽  
Vol 26 (2) ◽  
pp. 137-140
Author(s):  
Somesh Mozumder ◽  
Shirish Dubey ◽  
Aniruddha Dam ◽  
Anup Kumar Bhowmick
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
External Beam Radiotherapy ◽  
Late Presentation ◽  
Nodal Metastasis ◽  
High Dose ◽  
Invasive Squamous Cell Carcinoma ◽  
Early Presentation ◽  
History Of ◽  
The Right

Introduction Osteoradionecrosis (ORN) is a process where irradiated bone undergoes necrosis and becomes exposed through soft-tissue. It is a late effect of radiotherapy. Early presentation within 2 years, is thought to be related to high dose of Radiation therapy, whereas late presentation is usually secondary to trauma and delayed wound healing with in compromised tissue. We present a case of late presentation where there was no history of trauma to the associated region; therefore making the case unique. Case report                                              50 years old male patient from rural Bengal presented with history of invasive squamous cell carcinoma (SCC) of right base tongue with bilateral cervical nodal metastasis treated with external beam radiotherapy of 70 Gy in 35 fractions in 2009. In April 2014 he developed pain in the right side of lower jaw with foul breath and progressive difficulty and pain while opening mouth. Biopsy established the diagnosis of oesteoradionecrosis. Discussion ORN can be spontaneous, but most commonly results from tissue injury. The absence of reserve reparative capacity is a result of the prior radiation injury. The irradiated mandible, periosteum, and overlying soft tissue undergo hyperemia, inflammation, and endarteritis. Conclusion During follow up any lesion suspicious of recurrence or second malignancy with clinical features of pain, swelling, trismus, halitosis, mucosal ulceration, bare bone etc a differential diagnosis of oesteoradionecrosis should be kept in mind, even long time after radiotherapy & absence of trauma.

scholarly journals Congenital Syngnathia in Bangladesh: A Very Rare Case Report

2015 ◽  
Vol 26 (2) ◽  
pp. 114-117 ◽  
Author(s):  
Muhammad Mizanur Rahaman ◽  
Mohammad Iqbal Kabir ◽  
Md Atiqul Islam Rabby ◽  
Md Masudur Rahman ◽  
Md Nasir Uddin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Alveolar Bone ◽  
Bony Union ◽  
Successful Operation ◽  
College Hospital ◽  
Bone Fusion ◽  
Rare Case Report ◽  
History Of ◽  
Maxilla And Mandible ◽  
The Right

Syngnathia is a rare anomaly involving fusion between the maxilla and mandible. The fusion may be due to soft tissue adhesion between the two or true bony fusion between maxilla and mandible. This condition ranges from only soft tissue fusion between gums known as synechia to bony union known as synostosis with different grades of fusion. It was first reported in 1936, with only 41 cases reported till 2009. In this case a 11 years old girl reported to the maxillofacial department of Dhaka Dental College Hospital, with the complaint of inability to open the mouth and as a diagnosed case of alveolar bone fusion of mandible with palatal alveolar bone in the left side & bone fusion of alveolar process of mandibular angle region with maxilla in the right side. She was also bone fusion of the coronoid process with zygoma in the right side. Immediate after birth she had a history of synechia (Bilateral) & it was correct by making stoma by maxillofacial surgeon. The patient was subjected to a surgical procedure, after successful operation she enabled to open her mouth up to 35 mm.Medicine Today 2014 Vol.26(2): 114-117

scholarly journals P046 Pointing the finger: an unusual presentation of dactylitis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Natalia Cernovschi - Feasey ◽  
Julekha Wajed
Keyword(s):  
Pleural Effusion ◽  
Soft Tissue ◽  
Middle Finger ◽  
Joint Involvement ◽  
Long Bones ◽  
History Of ◽  
Systemic Symptoms ◽  
The Right ◽  
Hands And Feet ◽  
Radiographic Changes

Abstract Background/Aims  Dactylitis is commonly associated with psoriatic arthritis, and regularly presents at Rheumatology clinics. We discuss a case where progressive systemic symptoms lead to the consideration of alternate diagnoses. Methods  A 46-year-old Nepalese woman presented to the Rheumatology department with a 3 month history of diffuse swelling of the right middle finger proximal interphalangeal joint, with the appearance of dactylitis. There was pain on movement, but no other joint involvement. Simultaneously she noticed blurred and decreased vision, which on review by the ophthalmologists, was diagnosed with bilateral uveitis. There was no history of psoriasis, inflammatory bowel disease, or other past medical history of note. There was no travel history in the past 12 months. A diagnosis of a presumed inflammatory arthritis was made. Results  Blood tests showed elevated c-reactive protein 55 (normal <4 mg/l), erythrocyte sedimentation rate 138 (normal 0-22 mm/hr) and an iron deficiency anaemia. Rheumatoid factor and Anti-CCP antibody were negative. Hand radiographs were reported as normal. MRI of the third digit confirmed an enhancing soft tissue collection at the proximal phalanx of the right middle finger. She was referred for a biopsy of this lesion. Interestingly over the subsequent few months, she developed progressive breathlessness. Chest radiograph showed a left pleural effusion. Further tests showed negative serum ACE, Lyme and Toxoplasma screen. Quantiferon test was negative. Pleural aspirate showed a transudate with negative Acid-fast bacillus (AFB) test and culture. CT chest and abdomen showed a persistent pleural effusion, inflammatory changes in the small bowel and thickening of the peritoneum and omentum. In view of the systemic involvement, a peritoneal tissue biopsy was performed. This confirmed chronic granulomatous inflammation with positive AFB stain for mycobacterium tuberculosis. Our patient was started on quadruple anti- TB antibiotics for 6 months. Her systemic symptoms and dactylitis have improved, although there is on-going treatment for her ocular involvement. Conclusion  Approximately 10% of all cases of extrapulmonary TB have osteoarticular involvement. Dactylitis is a variant of tuberculous osteomyelitis affecting the long bones of the hands and feet. It occurs mainly in young children; however adults may be affected also. The first manifestation is usually painless swelling of the diaphysis of the affected bone followed by trophic changes in the skin. The radiographic changes are known as spina ventosa, because of the ballooned out appearance of the bone, although this was not seen in our case. Fibrous dysplasia, congenital syphilis, sarcoidosis and sickle cell anaemia may induce similar radiographic changes in the metaphysis of long bones of hands and feet, but do not cause soft tissue swelling or periosteal reaction. This case highlights the importance of testing for TB, especially in atypical cases of dactylitis, with other systemic features. Disclosure  N. Cernovschi - Feasey: None. J. Wajed: None.

scholarly journals Actinomyces meyeriEmpyema: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hae Won Jung ◽  
Chong Rae Cho ◽  
Ji Yoon Ryoo ◽  
Hyun Kyo Lee ◽  
So Young Ha ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Response To Treatment ◽  
Penicillin G ◽  
Review Of The Literature ◽  
Short Term ◽  
Oral Amoxicillin ◽  
History Of ◽  
Multiple Lung Nodules ◽  
The Right ◽  
Radiological Studies

Actinomyces meyeriis an uncommon cause of human actinomycosis. Here, we report a rare case of empyema caused byA. meyeri. A 49-year-old male presented with a history of 10 days of dyspnea and chest pain. A large amount of loculated pleural effusion was present on the right side and multiple lung nodules were documented on radiological studies. A chest tube was inserted and purulent pleural fluid was drained.A. meyeriwas isolated in anaerobic cultures of the pleural fluid. The infection was alleviated in response to treatment with intravenous penicillin G (20 million IU daily) and oral amoxicillin (500 mg every 8 hours) for 4 months, demonstrating that short-term antibiotic treatment was effective.

Congenital Facial Palsy- A Rare Case Report

2021 ◽  
Author(s):  
Meenakshi Wadhwani
Keyword(s):  
Facial Palsy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Rare Entity ◽  
Provisional Diagnosis ◽  
Live Births ◽  
Rare Case Report ◽  
History Of ◽  
The Right

Congenital facial palsy is a very rare entity with an incidence of 2 per 1000 live births. It can be congenital, traumatic associated with birth trauma in the form of forceps delivery or developmental. We present the case of a 1-year-old girl who presented to the eye department of our tertiary care hospital with a deviation of face to the right side since birth along with watering of left eye and difficulty in taking feeds. There was a history of forceps-assisted vaginal delivery; a provisional diagnosis of congenital facial palsy was done with the probable cause of trauma.

The fatal cholera like diarrhoea in coronavirus disease 2019(COVID-19)- a rare case report in toddler

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1894-1897
Author(s):  
Varsha Gajbhiye ◽  
Shubhangi Patil (Ganvir) ◽  
Sarika Gaikwad
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Digestive System ◽  
Gastrointestinal Symptoms ◽  
Female Child ◽  
Multiple Organ ◽  
Mild Case ◽  
Severe Dehydration ◽  
Rare Case Report ◽  
History Of

A 14-month female child came with complain of cholera like watery loose stool 10-12 times and vomiting 6-7 times, 24 hrs before admission. She was in severe dehydration, hypotension, unconscious with no recorded fever during her stay in hospital and no history of contact with COVID-19. Patient was COVID-19 positive Dehydration and hypotension was corrected, metabolic acidosis continued and eventually patient succumb due to multiple organ failure. This case report should arouse us to suspect COVID infection in every acute Gastroenteritis child who may not have any common symptoms as seen in COVID patient, also who have no history of significant contact with COVID positive patient in family. Some people with COVID-19 develop gastrointestinal symptoms either alone or with respiratory symptoms. Recently, researchers at Stanford University found that a third of patients they studied with a mild case of COVID-19 had symptoms affecting the digestive system. Another recent study Trusted Source published by researchers in Beijing found that anywhere from 3 to 79 percent of people with COVID-19 develop gastrointestinal symptoms.

scholarly journals Rare Case of Servelle Martorelle Syndrome

2014 ◽  
Vol 10 (4) ◽  
pp. 91-94
Author(s):  
A Bhatnagar ◽  
M Deshpande
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Rare Case ◽  
Prompt Treatment ◽  
Congenital Vascular Malformation ◽  
History Of ◽  
The Right ◽  
Scapular Region

Servelle Martorelle Syndrome is a congenital vascular malformation associated with soft tissue hypertrophy and bony hypoplasia. This rarely involves whole of an extremity, with involvement of part of limbs reported in literature. We present a case of a twelve year boy who presented to the Department of Plastic Surgery SGPGIMS in April 2011 ,with history of circumferential soft tissue hypertrophy involving whole of left upper limb, scapular region and axilla since birth. The entire left upper limb length was lesser than the right upper limb. Hence this is a very rare case of Servelle Martorelle Syndrome having extensive limb involvement at a very young age. Highlighted is the role of conservative treatment and close follow-up to understand the natural history of the diseases, with prompt treatment of complications. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11011 Kathmandu Univ Med J 2012;10(4):91-94

scholarly journals A maxillary ameloblastic fibrosarcoma tumor: a rare case report from Syria

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Amjad Soltany ◽  
Ghazal Asaad ◽  
Rami Daher ◽  
Mouhannad Dayoub ◽  
Ali Khalil ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Rare Case ◽  
Soft Tissue Sarcomas ◽  
Surgical Excision ◽  
Low Grade ◽  
Rare Case Report ◽  
Ameloblastic Fibrosarcoma ◽  
The Right

Abstract Ameloblastic fibrosarcoma (AFS) is a rare, aggressive malignant odontogenic tumor. AFS is seen most frequently in second and third decades of life. We are reporting a case of a low grade AFS in a 21-year-old male complaining of a painless swelling in the right side of the maxilla. The patient was treated with surgical excision followed by radiotherapy, which is considered the most effective approach for most of soft tissue sarcomas. AFS has a high-reported recurrence rate (up to 37%); therefore, long-term surveillance for recurrence is crucial.

Avascular necrosis of the jaw in multiple myeloma (MM) patients (pts) treated with bisphosphonates (BP)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18538-18538
Author(s):  
L. Curreli ◽  
A. D. Palmas ◽  
G. Latte ◽  
A. Murgia ◽  
A. Gabbas
Keyword(s):  
Oral Cavity ◽  
Progressive Disease ◽  
Alveolar Bone ◽  
High Dose ◽  
Allogenic Bone ◽  
History Of Disease ◽  
Aggressive Surgical Approach ◽  
History Of ◽  
The Right

18538 Background: Oral cavity avascular bone necrosis (ABN) has been recently reported as an emerging serious complication in pts receiving BP for the treatment of hypercalcemia related to MM or metastatic solid tumors. Methods: We report the cases of 6 pts with MM treated initially with pamidronate and later with zoledronic acid (ZA). Results: Pts characteristics : M/F 3/3; mean age 58.4 (46–78); 4 IgG κ,1 γ and 1 κ MM; 5 St IIIA and 1 IIIB; mean history of disease 61.3 mo. (23–103); 5 pts had a relapsing MM refractory to several lines of therapy but 1 pt had received only high dose dexametazone (D); 2 pts had received autologous stem cell transplantation and 1 pt allogenic bone marrow transplantation; mean n.° of BP doses was 41.3 (17–81). At the time of ABN onset all pts were receiving ZA along with, respectively: D (2 pts); cyclophosphamide plus D (1 pt), bortezomib plus D (2 pts) and oral melphalan (1 pt). ABN was localized in 2 pts at alveolar bone of the right maxilla and presented as an inflammation of the gum, followed by a painful bone exposure. In the other 4 pts ABN was localized at mandible and presented as dental abscesses followed in 2/4 pts by cutaneous fistulization. Treatment has included in all pts discontinuation of ZA, antibiotics, chlorhexidine mouthwashes, pain control, minor regional débridement, and bone trimming. In 1 pt a more aggressive surgical approach was attempted at an other Institution and postoperative course was complicated by massive haemorrhage and complete loss of chewing. Four pts dead with progressive disease with a mean overall survival after ABN presentation of 6 mo.; 2 pts are alive after 3 and 4 mo. after ABN presentation; however in all pts ABN significantly worsened quality of life. Conclusions: Oral cavity ABN is a severe complication in refractory MM pts receiving BP. Mechanisms of action of BP that determine a reduction in osteoclastic activity and an accumulation of nonvital osteocytes with microfractures of old mineral matrix appear to play an important role. However other causes may be involved as a long history of disease; an uncontrolled progressive disease; type and doses of previous and present therapies, primarily steroids; status of oral cavity and teeth of pts and possibly the n.° of doses of BP. No significant financial relationships to disclose.

scholarly journals Ectopic intraconal orbital meningioma – A rare case report

2021 ◽  
Vol 12 ◽  
pp. 305
Author(s):  
Anil Kumar Sharma ◽  
Charandeep Singh Gandhoke ◽  
Somen Misra ◽  
Ashik Ravi ◽  
Rakesh Kumar Gupta ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual Outcome ◽  
Surgical Excision ◽  
Histopathological Diagnosis ◽  
Who Grade ◽  
Rare Case Report ◽  
History Of ◽  
The Right ◽  
Orbital Meningioma

Background: Ectopic orbital meningiomas (OM) are a rare subset of OMs which are neither attached to the optic nerve sheath nor to the surrounding bone. Case Description: We report the case of a 65-year-old female who presented with a 1 year history of proptosis followed by visual loss and restricted right eye movements since 3 months. Radiology of the orbits was suggestive of intraorbital, intraconal, and heterogeneous contrast enhancing right eye lesion which was completely excised through supraorbital orbitotomy approach. Intraoperatively, the right optic nerve, though compressed, and displaced inferiorly, was free from the lesion. The final histopathological diagnosis was “Meningioma WHO Grade I.” At 3 months follow-up, patient’s vision in the right eye improved from perception of light positive to 6/12 and there was no evidence of recurrence. Conclusion: Rarity of ectopic OM, total surgical excision with an excellent postoperative visual outcome prompted us to report this case.

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