scholarly journals Acute Hematogenous Osteomyelitis of the Rib in 14 Years Old Child: Clinical Case

2021 ◽  
Vol 20 (2) ◽  
pp. 144-148
Author(s):  
Vasily P. Gavrilyuk ◽  
Elena V. Donskaya ◽  
Maria I. Statina ◽  
D. A. Severinov ◽  
Margarita V. Dovbnya
Keyword(s):  
Clinical Case ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Final Diagnosis ◽  
Intercostal Space ◽  
Local Form ◽  
Satisfactory Condition ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
The Right

Background. Rib osteomyelitis is extremely rare in childhood. This localization of purulent focus represents only 1% of all osteomyelitis cases. The typical manifestations of ribs osteomyelitis are fever, chest or back pain. However, these clinical signs are not always present, and the disease can manifest in other way.Clinical Case Description. Mother with 14 years old child K. have applied to the regional children's hospital admission department. The child had complains of right upper quadrant abdominal pain and in right part of the chest, difficulty in breathing. The disease began 2 days before admission with fatigue, weakness, and pyretic fever (39 °C). Complaints remained over time. The patient was hospitalized with the diagnosis: “Chest impact injury with severe pain syndrome? Right lung contusion?". The ultrasound examination of pleural cavities and the right anterior chest surface has revealed osteomyelitic phlegmon in VII intercostal space on the 3rd day of hospitalization. It was lanced and drained under general anesthesia, about 7 ml of liquid pus were obtained. The child received treatment according to clinical guidelines for the management of patients with such nosology. The final diagnosis was: «Acute hematogenous osteomyelitis of the VII rib, local form. Osteomyelitic phlegmon of VII intercostal space. Right pneumonitis. Bilateral mild hydrothorax». The boy was discharged on the 10th day since surgery in satisfactory condition.Conclusion. The described clinical case is interesting for pediatric surgeons, traumatologists, infectious disease specialist. Particular attention should be paid to the clinical features of the disease and anamnestic information in such unclear clinical cases. It will allow to exclude traumatic injuries and assume the local inflammatory process.

scholarly journals Late onset familial Mediterranian fever: a clinical case

2021 ◽  
Vol 49 ◽  
Author(s):  
V. B. Grinevich ◽  
I. V. Gubonina ◽  
M. I. Shperling ◽  
S. I. Lapteva ◽  
T. V. Kolodin ◽  
...  
Keyword(s):  
Clinical Case ◽  
Late Onset ◽  
Past History ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Signs And Symptoms ◽  
Mediterranean Coast ◽  
Renal Amyloidosis ◽  
Positive Trend ◽  
The Right

Familial Mediterranean fever (FMF) is a rare genetic autosomal recessive disease typical for special ethnic groups, such as Arabs, Greeks, Armenians, Jews, Turks and other ethnicities inhabiting the Mediterranean coast. The characteristic clinical signs and symptoms of the disease are recurrent episodes of fever, associated with polyserositis, in particular, with benign (aseptic) peritonitis. The disease is caused by mutation in the MEFV gene encoding the synthesis of the protein pyrine, which leads to an uncontrolled release of pro-inflammatory cytokines by granulocytes. The criterion for the severe course of the disease is AA-renal amyloidosis associated with an unfavorable prognosis.Here we present a clinical case of classic FMF with high fever and abdominal pain syndrome. A 26-year-old Armenian patient had a sudden attack of fever and severe pain in the right iliac area several months before his first hospital admission. Non-steroid anti-inflammatory drugs and antispasmodics were unable to relieve the symptoms, with the attack ceasing spontaneously after 3 days from the beginning. Thereafter, the attacks recurred 1 to 2 times per month within a year. During hospital stay at the peak of the attack, peritoneal symptoms at abdominal palpation, together with neutrophilic leukocytosis and a significant increase in acute phase parameters of inflammation (C-reactive protein, fibrinogen, erythrocyte sedimentation rate) were found. Based on the characteristics of the complaints, past history, laboratory and instrumental results, we excluded infections, autoimmune and surgical disorders and made a decision to perform genetic testing to detect the MEFV gene mutation. Confirmation of the mutation has led to the definitive diagnosis of FMF. This clinical case is remarkable for its late onset, which is not typical for FMF. As a result, the patient was prescribed continuous therapy with сolchicine. Six months of the follow up have demonstrated a positive trend with no attacks during this period.

scholarly journals Late Neonatal Sepsis with Acute Haematogenous Osteomyelitis Foci: Clinical Case

2020 ◽  
Vol 17 (4) ◽  
pp. 345-351
Author(s):  
Marietta V. Manucharyan ◽  
Tatiana V. Turti ◽  
Irina A. Belyaeva ◽  
Tatiana E. Privalova ◽  
Ludmila M. Makarova ◽  
...  
Keyword(s):  
Body Weight ◽  
Clinical Case ◽  
Pain Syndrome ◽  
Positive Outcome ◽  
Multiple Organ ◽  
Diagnostic Process ◽  
Satisfactory Condition ◽  
X Ray Imaging ◽  
Further Development ◽  
Haematogenous Osteomyelitis

Background. The incidence of sepsis among newborns ranges from 1–12 to 38 per 1,000 live births in the world according to scientific literature [1, 2]. The clinical case demonstrates the features of the newborn organism sensitivity and the therapeutic and diagnostic process difficulties.Clinical case description. The boy was born on the 37th week of gestation, 1st of twins, with body weight 3330 g, height 51 cm, APGAR score 8/9 points. He was on breastfeeding. His condition has deteriorated rapidly on the 9th day of life. The condition was severe due to intoxication syndrome, necrotising enterocolitis (NEC) manifestation, further development of systemic inflammatory response syndrome and multiple organ dysfunction syndrome. Severe pain syndrome and movement restraint in limbs have appeared on the 20th day of life. X-ray imaging: NEC signs, multiple osteomyelitis foci in the limbs.Conclusion. Modern adequate diagnosis and justified treatment tactics have led to positive outcome: child’s condition has improved, body weight has increased, pain syndrome has been managed, the volume of movements in the limbs has increased, inflammatory markers have stabilised. The child was discharged from hospital in satisfactory condition at the age of 2 months.

scholarly journals Surgical treatment of Lhermitte–Duclos disease (dysplastic gangliocytoma of the cerebellum)

2020 ◽  
Vol 22 (1) ◽  
pp. 77-82
Author(s):  
A. A. Bimurzin ◽  
A. V. Kalinovsky
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Right Hemisphere ◽  
Surgical Removal ◽  
Study Objective ◽  
Dysplastic Gangliocytoma ◽  
Satisfactory Condition ◽  
Suboccipital Craniotomy ◽  
Intact Brain ◽  
The Right

The study objective is to describe a clinical case of a rare disorder of the cerebellum, Lhermitte–Duclos disease.Clinical case. The Federal Neurosurgical Center (Novosibirsk) admitted a male patient, 40 years old. Medical history showed that in 2017 he underwent ventriculoperitoneal shunt due to hypertensive hydrocephalus syndrome caused by space-occupying mass of the right hemisphere of the cerebellum. In June of 2017, the patient was consulted by a neurosurgeon. Later, an increase in the mass, partial atrophy of the optic disks were observed. Due to the patient’s complaints of headache, ataxia, vertigo, as well as insufficient effect of the shunt, microsurgical removal of the space-occupying mass in the cerebellum by right paramedian suboccipital craniotomy was performed. Gangliocytoma removal was performed under constant neurophysiological control which allowed to fully resect the gangliocytoma inside intact brain tissue. Histological and immunohistological examinations allowed to diagnose grade I dysplastic gangliocytoma of the cerebellum (Lhermitte–Duclos disease). In the postoperative period, brain symptoms regressed fully, vestibulocerebellar syndrome persisted. The patient was discharged in satisfactory condition. No negative dynamics were observed in 7 months of follow-up.Conclusion. Due to the rareness of Lhermitte–Duclos disease, currently there are no established approaches to treatment, however, in symptomatic course there are indications for surgical removal of the gangliocytoma. Radicality of resection should be correlated with the risk of neurological defects. In our case, surgical treatment allowed to improve the patient’s condition, prevent further progression of the gangliocytoma and obtain an accurate histological diagnosis.

ACUTE HEMATOGENOUS OSTEOMYELITIS

PEDIATRICS ◽  
1956 ◽  
Vol 17 (3) ◽  
pp. 368-382
Author(s):  
Morris Green ◽  
William L. Nyhan ◽  
Mildred D. Fousek
Keyword(s):  
Age Groups ◽  
Clinical Signs ◽  
Extended Period ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Common Finding ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Clinical Records ◽  
Time Of Admission

The clinical records of 99 infants and children admitted to the Grace-New Haven Community Hospital with acute hematogenous osteomyelitis are reviewed. The presenting symptomatology and physical findings are discussed. Detection of localized tenderness is the most significant early clinical sign. This was not, however, a common finding at the time of admission. The diagnoses entertained in these patients at the time of admission are reviewed and the differential diagnosis is discussed. The distribution of the bony lesions was similar to that noted by other authors. However, attention is called to the frequent involvement of the bony pelvis. A specific bacteriologic diagnosis was made in 87 per cent of the patients. In 63 per cent staphylococcus was the etiologic agent. Beta-hemolytic streptococcus was considered the etiologic agent in 18 per cent. Staphylococcus was the most frequent offender in all age groups. In infants less than 2 years of age osteomyelitis was streptococcal in 27 per cent. The average interval from the onset of symptoms to the development of positive roentgenographic signs was 10 days. The range was 3 to 17 days. In treatment of patients suspected of having osteomyelitis, vigorous antibiotic therapy should be continued until at least 3 weeks have elapsed since the onset of symptoms. If at the end of that period roentgenograms remain normal and clinical signs and symptoms have been absent for at least 1 week, it would seem safe to discontinue treatment. A detailed program for medical therapy is Presented and the indications for surgery are considered. Emphasis is placed on vigorous search for the infecting organism. The necessity for intensive treatment given over an extended period of time is stressed.

scholarly journals Usefulness and Limitation of Ultrasonography in the Diagnosis of Intestinal Intussusception in Cows

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Sheikh Imran ◽  
S. P. Tyagi ◽  
Adarsh Kumar ◽  
Amit Kumar ◽  
Arvind Sharma ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Signs ◽  
Chronically Ill ◽  
Intercostal Space ◽  
Intestinal Intussusception ◽  
Ultrasonographic Finding ◽  
The Right ◽  
Bull's Eye

The present study was conducted on 6 chronically ill Jersey/Red Sindhi cross-bred cows, which were suspected for intestinal obstruction on the basis of history and clinical signs. These cows were ultimately diagnosed with intestinal intussusception based on a combination of clinical, ultrasonographic and surgical examinations. “Bull’s eye lesion” was the most prominent ultrasonographic finding, diagnostic for intussusception either trans-abdominally or transrectally. Dilated intestinal loops greater than 3.1 cm (mean ± SE, 4.41 ± 0.25) were imaged in the lower flank and the 12th intercostal space on the right side. Ultrasonography proved to be a useful tool in supplementing and substantiating the transrectal findings in cases of the bovine intestinal intussusception. However, ultrasonography was not significantly helpful where transrectal examination of the cows did not reveal any suspected intestinal mass.

scholarly journals SYNDROME OF THE FIRST GILL ARCH IN A NEWBORN CHILD (CLINICAL CASE)

2020 ◽  
Vol 20 (4) ◽  
pp. 237-240
Author(s):  
M. Yе. Fesenko ◽  
O. A. Scherban ◽  
M. M. Fastovets ◽  
O.O. Kalyuzhka ◽  
Yu. I. Chernyavska
Keyword(s):  
At Risk ◽  
Clinical Case ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Facial Asymmetry ◽  
Final Diagnosis ◽  
Gill Arch ◽  
Dynamic Monitoring ◽  
Large Variability ◽  
Neuropsychological Development

The article describes a clinical case of “First Gill Arch Syndrome" in a newborn girl, the peculiarities of the syndrome, its diagnosis. The characteristics of this disease is that the mother of the child was at risk group due to smoking, anaemia during the pregnancy and medical abortions in the past obstetric history. The aetiology of "First Gill Arch Syndrome" is insufficiently studied, but, according to latest concepts, this condition results from the mutations in the TCOF1 gene. The aetiology of the disease also does not exclude the role of adverse obstetric and gynaecological anamnesis and diseases of the mother, previous medical abortions and teratogenic factors. Difficulties in diagnosis are due to the large variability of clinical manifestations and course of the disease. The final diagnosis of the child was based on specific clinical signs of the disease: facial asymmetry, unilateral facial paralysis (lesions of the facial nerve on the right), the presence of blind fistula of the left cheek and skin suspension of the left auricle. We can conclude about the necessity to elaborate preventive measures to reduce the occurrence of this disease: timely ultrasound examination of pregnant women, who are at risk and mandatory dynamic monitoring of a child with this disease to assess physical and neuropsychological development.

scholarly journals Unilateral segmental aplasia of uterine horn associated with pyometra and vulvar hypoplasia in a bitch

2020 ◽  
Vol 23 (2) ◽  
pp. 262-267
Author(s):  
A. Antonov
Keyword(s):  
Abdominal Pain ◽  
Rare Case ◽  
Clinical Case ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Uterine Horn ◽  
Laboratory Analysis ◽  
The Right ◽  
Fluid Blood

The aim of this report was to describe a clinical case of unilateral segmental aplasia of the uterine horn and vulvar hypoplasia associated with pyometra as a complication in a bitch. The patient was presented with abdominal pain, excessive vulvar licking, anorexia and lethargy. The vulva was found hypoplastic, flushed and without any discharge. Ultrasonography revealed an enlarged tip of the left uterine horn filled with fluid. Blood laboratory analysis showed a marked leukocytosis, so diagnosis of pyometra was made. Laparotomy and ovariohysterectomy were performed. During the operation unilateral segmental aplasia of the right uterine horn was observed. This is a very rare case of segmental aplasia of the uterus associated with hypoplasia of the vulva and with clinical signs of systemic disease in the bitch.

scholarly journals METASTATIC INTRAVENOUS LEIOMYOMATOSIS

2018 ◽  
pp. 117-126
Author(s):  
S. V. Yadrentseva ◽  
N. V. Nudnov
Keyword(s):  
Lung Injury ◽  
Clinical Case ◽  
Surgical Intervention ◽  
Molecular Genetic ◽  
Genetic Research ◽  
Final Diagnosis ◽  
Intravenous Leiomyomatosis ◽  
Heart Damage ◽  
Metastatic Lung ◽  
The Right

Сlinical case of a rare and poorly studied disease – intravenous leiomyomatosis (IVL) is presented. Presented the literature data and our own clinical case of this rare pathology with dissemination to the v. cava inferior, to the right ventricle of the heart. The radiology semiotics of metastatic intravenous leiomyomatosis is described, the advantages and limitations of the methods of radiation diagnosis are noted. The clinical case is of particular interest, because there is a combination of simultaneous intravenous injury, heart damage and benign metastatic lung injury. The final diagnosis is verified by the data of morphological and molecular-genetic research based on the results of surgical intervention.

scholarly journals ESP-block in thoracic surgery: a case report

2021 ◽  
Vol 15 (1) ◽  
pp. 57-62
Author(s):  
Anatoliy V. Stukalov ◽  
Roman E. Lakhin ◽  
Evgeniy N. Ershov
Keyword(s):  
Case Report ◽  
Clinical Case ◽  
Pain Syndrome ◽  
Erector Spinae ◽  
Respiratory Complications ◽  
High Quality ◽  
Combined Anesthesia ◽  
Ultrasound Assisted ◽  
The Right ◽  
Atypical Resection

This report presents a clinical case of combined anesthesia in a patient with videothoracoscopic atypical resection of the right lung. In the operating room, the patient underwent ultrasound-assisted blockade in the plane of the m. erector spinae (ESP block) using 20 mL of 0.375% levobupivacaine solution, after which general anesthesia was induced. Opioid consumption per surgery was 0.3 mg of fentanyl. In the postoperative period, high-quality multimodal pain relief was achieved without the use of opioids. Within 7 h after the operation, the patient could actively expectorate with minimal discomfort. The article demonstrates the possibility of the effective application of the ESP block to reduce the risk of respiratory complications during lung surgery and to prevent the development of neuropathic post-thoracotomy pain syndrome.

scholarly journals Staged surgical treatment of brachioplexopathy in an adolescent with Klippel-Feil syndrome: a rare clinical case and literature review

2021 ◽  
Vol 18 (1) ◽  
pp. 6-13
Author(s):  
E. V. Petrova ◽  
O. E. Agranovich ◽  
M. V. Savina ◽  
E. L. Gabbasova ◽  
V. P. Snishchuk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Brachial Plexus ◽  
Clinical Case ◽  
Pain Syndrome ◽  
Neurogenic Pain ◽  
Neurophysiological Studies ◽  
Vertebral Bodies ◽  
The Right ◽  
Rapid Relief ◽  
Cervical Ribs

Klippel-Feil syndrome is a congenital malformation, the leading component of which is a violation of segmentation of the cervical vertebral bodies. The syndrome can be combined with other skeletal anomalies: skull asymmetry, scoliosis, high shoulder blades, and cervical ribs. Treatment of the syndrome is usually symptomatic; indications for surgical treatment are progressive neurological disorders and persistent pain syndrome, which usually develop due to instability of unblocked segments, or neurogenic pain. A clinical case of treatment of a 17-year-old patient with Klippel-Feil syndrome who developed a picture of severe upper limb monoparesis during three years due to compression of the brachial plexus associated with cervical ribs is presented. Decompression of the brachial plexus was performed, which led to rapid relief of pain syndrome and gradual partial regression of motor disorders. Due to incomplete restoration of the gripping function, tendon-muscle plasty of the right hand was performed, which significantly improved the possibility of self-care. The results of radiation and staged neurophysiological studies are described, as well as a review of the literature on the Klippel-Feil syndrome.

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