Case for diagnosis

Human scabies is an intensely pruritic skin infestation caused by Sarcoptes scabiei var. hominis. Crusted scabies (previously known as Norwegian scabies) is a rare form, very contagious and transmitted by direct contact with the skin. Despite being readily treatable, a delayed diagnosis often leads to widespread infestation of contacts, and therefore difficult to restrain. This case concerns a patient where dermoscopy (with scabetic burrows and a visible hand-glider structure), together with direct microscopic examination, allowed a prompt diagnosis, thereby reinforcing the increasing importance of this technique in daily practice.

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Four common diseases causing sudden blindness or death in the eye emergency department

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-138163 ◽

2020 ◽

pp. postgradmedj-2020-138163

Author(s):

Ana Leonor Rei da Cruz Escaleira ◽

Dimitrios Kalogeropoulos ◽

Chris Kalogeropoulos ◽

Soon Wai Ch’Ng ◽

Velota C T Sung ◽

...

Keyword(s):

Emergency Department ◽

Delayed Diagnosis ◽

Signs And Symptoms ◽

Ocular Motility ◽

Ocular Manifestations ◽

Ischaemic Attack ◽

High Index Of Suspicion ◽

Sudden Blindness ◽

Patient At Risk ◽

Prompt Diagnosis

Neuro-ophthalmological emergency disorders typically present with symptoms of visual loss, diplopia, ocular motility impairment or anisocoria. The ocular manifestations of these disorders are sometimes indicative of a more serious global neurology disease rather than an isolated ocular disease. The aim of this review is to highlight four important neuro-ophthalmological emergency disorders that must not be missed by an ophthalmologist. These include acute painful Horner’s syndrome, painful cranial nerve III palsy, giant cell arteritis and transient ischaemic attack with amaurosis fugax. The delayed diagnosis of these clinical entities puts the patient at risk of blindness or death. Therefore, prompt diagnosis and management of these conditions are essential. This can be acquired from understanding the main signs and symptoms of the disease presentation together with a high index of suspicion while working at a busy eye emergency department.

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Handling of Scabies in Domestic Cat at Q-one Petklinik Surabaya

Journal of Applied Veterinary Science And Technology ◽

10.20473/javest.v2.i2.2021.50-53 ◽

2021 ◽

Vol 2 (2) ◽

pp. 50

Author(s):

Bagus Uda Palgunadi ◽

Katarina Kole Grace Wangge ◽

Lailia Dwi Kusuma Wardhani

Keyword(s):

Physical Condition ◽

Microscopic Examination ◽

Direct Contact ◽

Supportive Therapy ◽

Sarcoptes Scabiei ◽

The Body ◽

Domestic Cat ◽

Domestic Cats ◽

Scabies Mite ◽

Facial Area

Background: Scabies is a skin disease caused by Sarcoptes scabiei. Scabies is transmitted through direct contact with animals affected by scabies or contact with the source of scabies mite in area of cat lives. Purpose: This study aims to determine the management of scabies at Q-One PetKlinik Surabaya. Method: Handling domestic cats affected by S.scabiei began with an interview with the owner and examinated with the physical condition of cats, and observed the body that was infected with S.scabiei. Scrabbing on scabs was conducted in the cat’s body which was located in the facial area, and followed by microscopic examination to observe the S.scabiei mite. Results: During April 2021, there were 13 domestic cats affected by scabies. Treatment for scabies was by administrated drugs containing 5% Permethrin. Cats were also given supportive therapy by grooming with antiectoparasite shampoo after two weeks from being given drugs. Conclusion: Handling cases of scabies in domestic cats at Q-One PetKlinik Surabaya is performed by cleaning the scab, applying an ointment containing 5% permethrin, and giving anti-histamine and anti-parasitic as well as providing supportive therapy in the form of grooming using shampoo containing anti-ectoparasites.

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A Case of Scabies Presenting as Chronic Urticaria

Military Medicine ◽

10.1093/milmed/usaa040 ◽

2020 ◽

Vol 185 (9-10) ◽

pp. e1854-e1856

Author(s):

Imelda Muller ◽

Alyson Brinker

Keyword(s):

Delayed Diagnosis ◽

Sarcoptes Scabiei ◽

Active Duty ◽

Military Recruits ◽

Typical Finding ◽

Missed Diagnosis ◽

Communal Living ◽

The Many ◽

Dermatologic Manifestations ◽

Military Barracks

Abstract Scabies outbreaks are relatively common worldwide, particularly in communal living settings such as military barracks. The infestation is caused by the parasite Sarcoptes Scabiei and is easily treated once properly diagnosed. Classic symptoms include pruritus around the waist, wrists, and ankles.1 On physical examination, linear burrows visualized in finger web spaces is a typical finding.1 It is not uncommon, however, for scabies to present with a variety of other dermatologic manifestations, which can lead to a delayed or missed diagnosis. This case highlights a delayed diagnosis of scabies, initially presenting as urticaria in a 26-year-old active duty male living in military barracks where multiple previous outbreaks were identified. Providers should be aware of the oftentimes-elusive diagnosis of scabies and the many nonclassic dermatologic manifestations. A thorough skin examination with skin scrapings and examination of the finger web spaces should be considered in those with ambiguous skin rashes who are particularly at risk for scabies infection, such as military recruits, submariners, and other service members living in communal settings. Timely and accurate diagnosis and treatment is crucial to prevent reinfection and spread of scabies throughout these communal living settings.

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Nosocomial outbreak of crusted scabies in immunosuppressed patients caused by Sarcoptes scabiei var. canis

British Journal of Dermatology ◽

10.1111/bjd.18539 ◽

2019 ◽

Vol 182 (2) ◽

pp. 498-500 ◽

Cited By ~ 1

Author(s):

L. Stingeni ◽

M. Tramontana ◽

M. Principato ◽

I. Moretta ◽

S. Principato ◽

...

Keyword(s):

Sarcoptes Scabiei ◽

Nosocomial Outbreak ◽

Immunosuppressed Patients ◽

Crusted Scabies

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Crusted Scabies: A Molecular Analysis of Sarcoptes scabiei Variety hominis Populations from Patients with Repeated Infestations

Clinical Infectious Diseases ◽

10.1086/313466 ◽

1999 ◽

Vol 29 (5) ◽

pp. 1226-1230 ◽

Cited By ~ 41

Author(s):

S. F. Walton ◽

J. McBroom ◽

J. D. Mathews ◽

D. J. Kemp ◽

B. J. Currie

Keyword(s):

Molecular Analysis ◽

Sarcoptes Scabiei ◽

Crusted Scabies

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Identification of ABC transporters inSarcoptes scabiei

Parasitology ◽

10.1017/s0031182005009716 ◽

2006 ◽

Vol 132 (6) ◽

pp. 883-892 ◽

Cited By ~ 16

Author(s):

K. E. MOUNSEY ◽

D. C. HOLT ◽

J. McCARTHY ◽

S. F. WALTON

Keyword(s):

Abc Transporters ◽

Potential Role ◽

Sarcoptes Scabiei ◽

Degenerate Pcr ◽

P Glycoprotein ◽

Resistance Protein ◽

Multiple Treatments ◽

Crusted Scabies

We have identified and partially sequenced 8 ABC transporters from an EST dataset ofSarcoptes scabieivar.hominis, the causative agent of scabies. Analysis confirmed that most of the known ABC subfamilies are represented in the EST dataset including several members of the multidrug resistance protein subfamily (ABC-C). Although P-glycoprotein (ABC-B) sequences were not found in the EST dataset, a partial P-glycoprotein sequence was subsequently obtained using a degenerate PCR strategy and library screening. Thus a total of 9 potentialS. scabieiABC transporters representing the subfamilies A, B, C, E, F and H have been identified. Ivermectin is currently used in the treatment of hyper-infested (crusted) scabies, and has also been identified as a potentially effective acaricide for mass treatment programmes in scabies-endemic communities. The observation of clinical andin vitroivermectin resistance in 2 crusted scabies patients who received multiple treatments has raised serious concerns regarding the sustainability of such programmes. One possible mechanism for ivermectin resistance is through ABC transporters such as P-glycoprotein. This work forms an important foundation for further studies to elucidate the potential role of ABC transporters in ivermectin resistance ofS. scabiei.

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Missed Diagnosis of Cholangiocarcinoma Presenting with Atypical Symptoms

European Journal of Case Reports in Internal Medicine ◽

10.12890/2021_002207 ◽

2021 ◽

Author(s):

Ren Kawamura ◽

Yukinori Harada ◽

Taro Shimizu

Keyword(s):

Abdominal Pain ◽

Distribution Pattern ◽

Diagnostic Test ◽

Acute Abdominal Pain ◽

Delayed Diagnosis ◽

Referred Pain ◽

Good Communication ◽

Atypical Symptoms ◽

Missed Diagnosis ◽

Prompt Diagnosis

We report a case of delayed diagnosis of cholangiocarcinoma. A 62-year-old man developed acute abdominal pain in multiple sites. As the distribution pattern of the abdominal pain was not correctly interpreted based on the mechanisms of visceral and referred pain, the patient was not investigated with the best diagnostic test at first presentation. Moreover, miscommunication between physicians in a clinic and separate hospital delayed diagnosis. For prompt diagnosis, physicians should be practice careful reasoning and focus on good communication with physicians outside their hospital.

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Birth of a healthy baby from abdominal pregnancy, a rare event: A case report

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v9i1.28953 ◽

2016 ◽

Vol 9 (1) ◽

pp. 71

Author(s):

Nahreen Akhtar ◽

Firoza Begum ◽

Tabassum Parveen ◽

Syeda Sayeeda ◽

Sabina Karim

Keyword(s):

Rare Event ◽

Young Lady ◽

High Morbidity ◽

Abdominal Pregnancy ◽

Rare Form ◽

Healthy Baby ◽

Prompt Diagnosis ◽

Very High ◽

Transverse Lie

Abdominal pregnancy is a rare form of ectopic pregnancy with very high morbidity and mortality for both the mother and the fetus. Diagnosis and management can pose some difficulties especially in low resource centres. High index of suspicious is vital in making prompt diagnosis in such situations. A young lady of 30 years presented with 2nd gravida at 31 wks pregnancy with pain in the whole abdomen having loose motion admitted in Dept of Obs and Gynae BSMMU. She was diagnosed as a case of 31 wks pregnancy with gastroenteritis. She was treated conservatively according to advice of gastroenterologist and was discharged after improvement. Patient was readmitted again with pervaginal watery discharge. Decision for cesarean section was taken because of transverse lie, fetal growth restriction with severe oligohydramnios. After opening the abdomen, abdominal pregnancy was diagnosed. Following delivery of the baby significant bleeding started which was secured with ligature. Placenta was kept in situ. Mother and baby were discharged healthy on fourteenth postoperative day.

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Benign Intracranial Hypertension -Is it Really Benign Always?

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v10i1.21726 ◽

2018 ◽

Vol 10 (1) ◽

pp. 102-106

Author(s):

Anita Ganger ◽

Narahari Kishore Kumar ◽

Praveen Kumar ◽

R K Sabharwal ◽

Amit Khosla ◽

...

Keyword(s):

Intracranial Hypertension ◽

Adolescent Girls ◽

Surgical Intervention ◽

Delayed Diagnosis ◽

Benign Intracranial Hypertension ◽

Delay In Diagnosis ◽

Presenting Symptoms ◽

Severe Visual Loss ◽

Visual Damage ◽

Prompt Diagnosis

Background: In children, benign or idiopathic intracranial hypertension (IIH) is uncommon. The presenting symptoms are usually variable, which attribute to delay in diagnosis. Frequently encountered symptoms include; headache, vomiting, visual impairment, neck pain and diplopia. IIH in pre-pubertal children has distinct characteristics from the adult form. Delayed diagnosis in children usually attributes to the inability in picking subtle visual changes, which can subsequently leads to permanent visual damage.Objective: We report cases of two adolescent girls having IIH who presented with papilloedema, could be managed with lumboperitoneal shunting which resulted in favorable outcomes in terms of improved visual acuity and relief of symptoms.Case: We report two cases of IIH, presented with headache and severe visual loss, which showed non responsiveness to medical management and improved with a lumboperitoneal shunt procedure.Conclusion: In IIH cases, enhanced awareness, prompt diagnosis and treatment are important, to avoid the risk of permanent visual damage. Urgent surgical intervention is essential in patients who do not respond to medical treatment.

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