scholarly journals Rosai-Dorfman disease: a rare presentation of extranodal involvement of isolated bone. Case report

Case reports ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 22-27
Author(s):  
Camilo Andrés García-Prada ◽  
Tomás Rodríguez-Yanez ◽  
Carlos Alberto Ferrer-Santos
Keyword(s):  
Case Report ◽  
Adult Population ◽  
Tertiary Care ◽  
Poor Response ◽  
Rare Presentation ◽  
Systemic Corticosteroids ◽  
Rosai Dorfman Disease ◽  
The Face ◽  
History Of ◽  
Cartagena De Indias

Introduction: Rosai-Dorfman disease (RDD), also known as sinus histiocytosis, is a rare disorder characterized by histiocyte proliferation. Case presentation: A 33-year-old man consulted the emergency department of a tertiary care institution in Cartagena de Indias, Colombia, due to a 6-month history of progressive deformity in the frontal right side of the face, associated with pain of slow progression, without any other symptoms or dermatological involvement. There were no other major findings on physical examination and laboratory tests performed were negative. Imaging scans obtained showed extensive inflammatory involvement of the frontal bone, which led to suspect osteomyelitis as the first diagnostic possibility. A biopsy of the lesion was performed with negative cultures for bacteria, which allowed establishing a diagnosis of extranodal Rosai-Dorfman disease with isolated bone involvement. Treatment with systemic corticosteroids was indicated with poor response, so methotrexate was added, achieving an evident improvement after 2 months. Conclusions: Little is known about the manifestations of Rosai-Dorfman disease and its treatment in the adult population. The present case report contributes to expanding the literature on this topic, which can present with rare symptoms that may pose challenges for its diagnosis.

scholarly journals Psoriasiform Mycosis Fungoides Involving the Face- A Rare Case Report

2021 ◽  
pp. 94-99
Author(s):  
N. R. Vignesh ◽  
Shreya Srinivasan ◽  
G. Sukanya ◽  
S. Arun Karthikeyan
Keyword(s):  
Case Report ◽  
Mycosis Fungoides ◽  
Rare Case ◽  
Cell Lymphoma ◽  
Punch Biopsy ◽  
Cutaneous T Cell Lymphoma ◽  
Rare Presentation ◽  
Rare Case Report ◽  
Atypical Cells ◽  
The Face

Mycosis fungoides is represented as the most common epidermotropic cutaneous T-cell lymphoma, which is mainly characterized by the proliferation of atypical cells within the epidermis. We report a rare presentation of mycosis fungoides in a 60-year-old male presenting with chronic psoriasiform plaque involving the face. Punch biopsy of the lesion from the forehead was taken for routine histological examination and immunohistochemical stains. Results of biopsy and immunohistochemical findings were consistent with mycosis fungoides and diagnosed as psoriasiform presentation of mycosis fungoides involving the face.

scholarly journals Rhino-orbital COVID-19 associated mucormycosis- A case report

2021 ◽  
Vol 7 (4) ◽  
pp. 304-307
Author(s):  
Shanmuga Vadivoo Natarajan ◽  
B Usha
Keyword(s):  
Diabetes Mellitus ◽  
Infectious Disease ◽  
Case Report ◽  
Tertiary Care ◽  
Notifiable Disease ◽  
Health Ministry ◽  
First Case ◽  
Uncontrolled Diabetes ◽  
History Of ◽  
Second Wave

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.

Stridor: a rare presentation of motor neuron disease

2021 ◽  
Vol 14 (7) ◽  
pp. e241923
Author(s):  
Brian Gordon ◽  
Eimear Joyce ◽  
Timothy J Counihan
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Vocal Cord ◽  
Poor Response ◽  
Vocal Cord Palsy ◽  
Pharmacological Therapy ◽  
Rare Presentation ◽  
Emergency Tracheostomy ◽  
Life Threatening ◽  
History Of

A 74-year-old farmer presented to the emergency department with a subacute history of progressive dyspnoea, wheeze and dysphonia. He was treated for an exacerbation of asthma with poor response to pharmacological therapy. Investigation of dysphonia via laryngoscopy identified a bilateral vocal cord palsy. Subsequently, the patient developed an episode of life-threatening stridor and hypercapnic respiratory failure requiring an emergency tracheostomy. Neurology input identified evidence of widespread muscle fasciculations on clinical examination. MRI of the brain and cervical spine were unremarkable. Electromyogram testing identified changes of acute denervation in several limbs consistent with a diagnosis of motor neuron disease (MND). Bilateral vocal cord palsy has been rarely reported in the literature as the heralding symptom resulting in the diagnosis of MND. In patients with a subacute onset of dysphonia, dyspnoea and stridor, MND should be a differential diagnosis.

scholarly journals Clinical Study of Bell's Palsy at Tertiary Care: Our Experience

2019 ◽  
Vol 02 (01) ◽  
pp. 16-20
Author(s):  
M. B. Bharathi ◽  
Thanzeem Unisa ◽  
Swathi Chandresh ◽  
Venkatesh C. R. ◽  
Harsha S.
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Cross Sectional Study ◽  
Bell's Palsy ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Face ◽  
History Of

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.

scholarly journals Ectodermal Dysplasia presenting with Atrophic Rhinitis: A Report of Two Cases and a Review of the Literature

2016 ◽  
Vol 9 (1) ◽  
pp. 53-55
Author(s):  
Sampurna Pati ◽  
Sudipta Pal ◽  
Surajit Biswas ◽  
Somnath Saha
Keyword(s):  
Case Report ◽  
Conservative Therapy ◽  
Ectodermal Dysplasia ◽  
Tertiary Care ◽  
Atrophic Rhinitis ◽  
Mucosal Biopsy ◽  
Review Of The Literature ◽  
History Of ◽  
Conventional Manner ◽  
Nose And Throat

ABSTRACT Aims To present two rare cases of ectodermal dysplasia presenting with maggot infestation due to atrophic rhinitis. Study design Case report. Setting A tertiary care referral hospital. Presentation Two male children aged about 5 and 8 years presented to the ear, nose, and throat emergency with a history of maggot infestation of the nose. Results Clinical examination was suggestive of ectodermal dysplasia. Intranasal examination was suggestive of atrophic rhinitis. Maggots were removed in the conventional manner. Following a conservative treatment, skin biopsy and nasal mucosal biopsy were done, which confirmed the diagnosis of ectodermal dysplasia. Conclusion Any ectodermal dysplasia patient should be suspected of having atrophic rhinitis and intranasal conservative therapy should be initiated at the earliest to prevent complications like maggots in the nose. How to cite this article Pati S, Pal S, Saha S, Biswas S. Ectodermal Dysplasia presenting with Atrophic Rhinitis: A Report of Two Cases and a Review of the Literature. Clin Rhinol An Int J 2016;9(1):53-55.

scholarly journals Spontaneous subcutaneous emphysema in a male toddler in a health facility in Nasarawa state: A case report

2021 ◽  
Vol 2 ◽  
pp. 53-55
Author(s):  
Surajudeen Oyeleke Bello ◽  
Sandra Umejiaku ◽  
Taofik Oluwaseun Ogunkunle ◽  
Oyetundun Fausat Afolabi ◽  
Ahmed Ashuku Yakubu
Keyword(s):  
Case Report ◽  
Supportive Care ◽  
Subcutaneous Emphysema ◽  
Complete Resolution ◽  
Rare Complication ◽  
Childhood Pneumonia ◽  
Peripheral Hospital ◽  
The Face ◽  
History Of ◽  
Subcutaneous Tissues

Background: Spontaneous subcutaneous emphysema (SSE) is a clinical condition in which air escapes into the subcutaneous tissues. It is a rare complication of childhood pneumonia and often occurs with pneumothorax and/or pneumomediastinum. Although the sight of a child with SSE could be frightening, it is mostly benign requiring in most cases supportive care. We report a case of SSE complicating pneumonia in an 18-month-old toddler that was managed conservatively. Case Report: An 18-months-old toddler was admitted with a 5-day history of progressive swelling of the face, scalp, upper limbs, and trunk. He was referred from a peripheral hospital where he was admitted for 5 days with pneumonia and had received antibiotics, intravenous fluid, and oxygen therapy. Clinical evaluation revealed extensive subcutaneous emphysema and right-sided pneumothorax. Antibiotics were optimized and the patient was provided supportive care and monitored for 7 days with complete resolution of the emphysema. Conclusion: SSE could complicate childhood pneumonia but it has a benign course. Effective treatment of underlying pneumonia alongside supportive care will achieve complete resolution.

scholarly journals A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression

2021 ◽  
Vol 12 ◽  
Author(s):  
Eduardo Jorge Muniz Magalhães ◽  
Luciana Maria Sarin ◽  
Lorena Catarina Del Sant ◽  
Ana Cecília Lucchese ◽  
Carolina Nakahira ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Adult Population ◽  
Positive Family History ◽  
Poor Response ◽  
Depression Symptom ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
History Of ◽  
Resistant Depression ◽  
The Impact

Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD).Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients.Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction.Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.

Incidence and characteristics of cancer-associated thrombosis in a racially diverse population: A population-based study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13088-e13088
Author(s):  
Gary E. Raskob ◽  
Aaron M. Wendelboe ◽  
John Grady Heller ◽  
Kai Ding ◽  
Nimia L. Reyes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Population ◽  
Tertiary Care ◽  
Population Based ◽  
Incidence Rates ◽  
Diverse Population ◽  
Racially Diverse ◽  
Imaging Results ◽  
History Of ◽  
History Of Cancer

e13088 Background: Venous thromboembolism (VTE) is a common complication in cancer patients, but contemporary data on the incidence and characteristics of cancer-associated VTE in different racial populations is limited. We sought to measure the incidence rate and characteristics of cancer-associated VTE in a racially diverse population. Methods: We performed a prospective, population–based cohort study of VTE in Oklahoma County, OK during April 1, 2012–March 31, 2014. Surveillance staff regularly visited all tertiary care and relevant outpatient facilities in the county and reviewed the text from all imaging results of chest computed tomography or magnetic resonance imaging, lung perfusion scans, and ultrasound of the extremities to identify cases of VTE. Data on patient characteristics were collected from the electronic medical record. VTE was considered cancer-associated if the patient had a history of cancer other than basal or squamous cell skin cancer. Cancer was defined as “active” if metastatic or diagnosed within 6 months prior to VTE. Associations and incidence were calculated using the chi-square test and Poisson regression, respectively. Results: Of 3,255 patients with ≥1 VTE event (deep-vein thrombosis and/or pulmonary embolism), 732 (23%) had a history of cancer, of whom 309 had active cancer. The types of cancer varied widely. The age-adjusted incidence of cancer-associated VTE was 648 per 100,000 adult population (age ≥ 18). Incidence increased with each decade of age. The racial/ethnic-specific incidence rates were as follows (each per 100,000): Whites non-hispanic (607), Blacks non-Hispanic (557), Native Americans (128), Asian/Pacific Islanders (113) and Hispanics (70). Risk factors for VTE among the 732 with cancer-associated VTE included previous VTE (19%), hospitalization (37%), surgery (33%), and central venous catheter (22%). Of those with a history of cancer ≥ 6 months previously, 32% had no other identifiable VTE risk factor. Conclusions: Cancer-associated VTE comprised about 20-25% of the total population burden of VTE. The incidence varied substantially by race/ethnicity. An appreciable proportion of those with a history of cancer ≥ 6 months previously subsequently developed VTE in the absence of other risk factors.

scholarly journals Calcific Myonecrosis of the Leg: A Case Report

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.

scholarly journals High-Pressure Injection Injury of the Face: A Case Report on Presentation and Management

2020 ◽  
Vol 4 (2) ◽  
pp. 211-213
Author(s):  
Edan Zitelny ◽  
Blake Briggs ◽  
Rachel Little ◽  
David Masneri
Keyword(s):  
High Pressure ◽  
Case Report ◽  
Young Male ◽  
Rare Presentation ◽  
Injection Injury ◽  
Pressure Injection ◽  
Time Sensitivity ◽  
The Face ◽  
Extensive Debridement ◽  
High Pressure Injection

Introduction: High-pressure injection injuries have been chronicled for decades. These injuries often affect distal extremities as they are most commonly involved in workplace accidents. However, we discuss a young male with a paint-gun injection injury to his face. Case Report: We discuss the case of a young man presenting to the emergency department after high-pressure injection injury to the face. He eventually underwent extensive debridement of the face. We discuss differences in caring for an injection wound to an extremity versus the face, including time sensitivity of treatment, initial stabilizing measures, and critical steps. Discussion: This case demonstrates a rare presentation of a high-pressure paint injection injury. This injury presented a unique surgical challenge where, despite compartment syndrome being less common, cosmetic outcome and infectious complication prevention remained critical priorities. Conclusion: While similarities exist in management of an injection injury to a limb, due to the rarity and deceptive appearance of this particular injury to the face, high suspicion along with urgent imaging and surgical consultation is warranted.

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