Abdominal angiostrongyliasis: report of two cases with different clinical presentations

Abdominal angiostrongyliasis is a sporadic infectious disease caused by the nematode Angiostrongylus costaricensis. It usually presents as acute abdomen, secondary to mesenteric ischemia, and pronounced eosinophilia. In some cases its course is insidious and transient, and the diagnosis is suspicious. The disease is confirmed by the detection of A. costaricensis elements in surgical specimen. The treatment is supportive, with avoidance of antihelminthic administration due to a possible erratic migration followed by worsening of the disease. We report two cases, both with intense eosinophilia and serum IgG-ELISA positive to A. costaricensis. The first case presented ileal perforation and was surgically treated. The second one showed hepatic nodules at ultrasound and was only symptomatically treated, evolving to an apparent protracted resolution. These two cases exemplify different clinical forms of the disease, one of them with liver involvement.

Download Full-text

Necrotizing sarcoid granulomatosis with clinical presentations of recurrent acute abdomen. Case report and literature review

Terapevticheskii arkhiv ◽

10.17116/terarkh2017891160-68 ◽

2017 ◽

Vol 89 (11) ◽

pp. 60-68 ◽

Cited By ~ 1

Author(s):

V I Vasilyev ◽

S G Palshina ◽

B D Chaltsev ◽

S G Radenska-Lopovok ◽

T N Safonova

Keyword(s):

Acute Abdomen ◽

Clinical Laboratory ◽

Morphological Changes ◽

Abdominal Cavity ◽

High Dose ◽

Drug Induced ◽

Serological Tests ◽

Surgical Interventions ◽

First Case ◽

Clinical Presentations

The authors have described the world’s first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis. The patient underwent five surgical interventions, several needle biopsies for recurrent abdominal syndrome, and long-term antibiotic treatment for presumed sepsis, which had caused drug-induced hepatitis. Bacteriological examination of blood, puncture samples, and removed abdominal cavity tissues, serological tests, and immunomorphogical study of biopsy samples and removed tissues yielded negative results for the presence of bacterial, fungal, and tuberculosis infections. NSG was diagnosed on the basis of the systemic nature of the lesion, the presence of granulomas with severe abdominal lymph nodal necrosis and necrotizing granulomatous/lymphocytic vasculitis in the mesentery and removed spleen, as well as the absence of granulomas in the spleen, appendix, and biopsy materials of the liver, colonic mucosa, and parotid gland. Fludarabine therapy was first used in world practice due to the inefficient treatment with high-dose glucocorticoids and cyclophosphamide and to a disease relapse when reducing their doses. The paper gives a detailed review of the literature on the clinical, laboratory, radiological, and morphological manifestations of the disease, which allow the differential diagnosis of NSG with different variants of granulomatous lesions. Based on the 5-year follow-up of the patient and on the analysis of clinical, laboratory, radiological, and morphological changes, the authors uphold the concept that the disease is an independent nosological entity: necrotizing angiitis with sarcoid reactions, rather than the entity of nodular or classic sarcoidosis.

Download Full-text

Capnocytophaga canimorsus-associated sepsis presenting as acute abdomen: do we need to think outside the box?

BMJ Case Reports ◽

10.1136/bcr-2018-228167 ◽

2019 ◽

Vol 12 (3) ◽

pp. e228167 ◽

Cited By ~ 2

Author(s):

Soban Ahmad ◽

Amman Yousaf ◽

Faisal Inayat ◽

Shahzad Anjum

Keyword(s):

Acute Abdomen ◽

Present Report ◽

Capnocytophaga Canimorsus ◽

First Case ◽

Clinical Presentations ◽

History Of ◽

Successful Clinical Outcome ◽

Aggressive Care ◽

Infectious Aetiology

Capnocytophaga canimorsus is a commensal bacterium commonly found in the oral cavity of dogs and cats. Although this organism rarely causes infection, prompt diagnosis is crucial for survival of these patients. Several unusual clinical presentations of this infection have been reported in the published medical literature. The present report represents the first case of C. canimorsus-related sepsis presenting with symptoms of acute abdomen in a patient with no known history of immunodeficiency. Prompt aggressive care and appropriate antibiotic therapy resulted in a successful clinical outcome with no long-term morbidity. This paper illustrates that clinicians should include this infectious aetiology among the differentials of patients presenting with acute abdomen, regardless of their immune status. Additionally, this paper outlines our current understanding of the epidemiology of and risk factors for C. canimorsus-associated sepsis, the pathophysiology of this disorder, and currently available approaches to diagnosis and management.

Download Full-text

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2003.sepoct02 ◽

2003 ◽

Vol 8 (5) ◽

pp. 4-12

Author(s):

Lorne Direnfeld ◽

James Talmage ◽

Christopher Brigham

Keyword(s):

Upper Extremity ◽

Radicular Pain ◽

Illness Behavior ◽

Orthopedic Surgeon ◽

First Case ◽

Clinical Presentations ◽

Whole Person ◽

Physical Examinations ◽

Upper Extremity Impairment ◽

The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

Download Full-text

Proteus syndrome in pregnancy: A case report

Obstetric Medicine ◽

10.1177/1753495x20970791 ◽

2020 ◽

pp. 1753495X2097079

Author(s):

Niccole Ranaei-Zamani ◽

Mandeep K Kaler ◽

Rehan Khan

Keyword(s):

Case Report ◽

Case Reports ◽

Proteus Syndrome ◽

Cutaneous Lesions ◽

Genetic Syndrome ◽

Skeletal Tissue ◽

First Case ◽

Large Teaching Hospital ◽

Clinical Presentations ◽

In Pregnancy

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.

Download Full-text

Vernix Caseosa Peritonitis after Vaginal Delivery

Clinical Medicine Insights Case Reports ◽

10.4137/ccrep.s12771 ◽

2013 ◽

Vol 6 ◽

pp. CCRep.S12771 ◽

Cited By ~ 2

Author(s):

Shameema A. Sadath ◽

Fathiya I. Abo Diba ◽

Surendra Nayak ◽

Iman Al Shamali ◽

Michael F. Diejomaoh

Keyword(s):

Cesarean Section ◽

Acute Abdomen ◽

Vaginal Delivery ◽

Vacuum Extraction ◽

Unusual Complication ◽

Case Presentation ◽

Vernix Caseosa ◽

First Case ◽

Surgical Emergencies ◽

Uterine Scar

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.

Download Full-text

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

IP International Journal of Medical Microbiology and Tropical Diseases ◽

10.18231/j.ijmmtd.2021.063 ◽

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.

Download Full-text

Immunity against COVID-19: Potential role of Ayurveda: A Review

International Journal of Integrative Medical Sciences ◽

10.16965/ijims.2021.109 ◽

2021 ◽

Vol 8 (3) ◽

pp. 989-992

Author(s):

Mula Ram Suthar ◽

◽

Manjry Anshumala Barla ◽

Rakesh Roushan ◽

◽

...

Keyword(s):

Infectious Disease ◽

Potential Role ◽

Defense Mechanism ◽

Well Being ◽

Communicable Diseases ◽

The Body ◽

Disease Concept ◽

First Case ◽

Modern Perspective

The Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is an infectious disease caused by coronavirus disease 2019 (COVID-19) and has affected people's lives globally, since first case was detected in Wuhan, China in December 2019. The coronavirus pandemic has turned the world’s attention to the immune system, the body’s defense mechanism against disease. Concept of Ojas is well explained in all ayurvedic classics, in modern perspective it is considered as immunity (Vyadhikshamatava). Ojas is necessary for well-being of the body, and mind. In Ayurveda textbook, the epidemics and along with their management are discussed under the term of Janapadodhvansa. The preventive and curative treatments for communicable diseases of the Janapadodhvansa (epidemics) are Panchkarma (five bio-purification therapies), Rasayana Chikitsa (rejuvenation treatment), Achara Rasayana (good conducts), and migrate to the place, free from communicable diseases. The intake of all types Rasayanas leads to increase of Ojas and reduce all psychological (mainly stress and emotional) disorder, thereby causes increase immunity responses and help to fight against covid-19. Key Words: Ayurveda, Covid-19, Immunity, Janapadodhvansa, Ojas, Rasayana Chikitsa.

Download Full-text

Synchronous gynecologic cancer and the use of imaging for diagnosis

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.02.116 ◽

2016 ◽

Vol 62 (2) ◽

pp. 116-119

Author(s):

Camila Silva Boaventura ◽

José Lucas Scarpinetti Galvão ◽

Giovanna Milanes Bego Soares ◽

Almir Galvão Vieira Bitencourt ◽

Rubens Chojniak ◽

...

Keyword(s):

Gynecological Cancer ◽

Gynecologic Cancer ◽

Imaging Evaluation ◽

Surgical Specimen ◽

Cervical Cancers ◽

Gynecology And Obstetrics ◽

First Case ◽

Young Subjects ◽

Gynecologic Neoplasms ◽

Case Diagnosis

Summary Endometrial and cervical cancers are the most prevalent gynecologic neoplasms. While endometrial cancer occurs in older women, cervical cancer is more prevalente in young subjects. The most common clinical manifestation in these two gynecological cancers is vaginal bleeding. In the first case, diagnosis is made based on histological and imaging evaluation of the endometrium, while cervical cancers are diagnosed clinically, according to the International Federation of Gynecology and Obstetrics (FIGO). The authors present a case of synchronous gynecological cancer of the endometrium and cervix diagnosed during staging on MRI and confirmed by histological analysis of the surgical specimen.

Download Full-text

Variance in clinical presentation of Ectopic pregnancy

10.53350/pjmhs2115102845 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2845-2847

Author(s):

Areeba Aftab ◽

Memoona Faiyaz ◽

Uzma Fahim ◽

Humaira Tabassum ◽

Saima Rafique ◽

...

Keyword(s):

Ectopic Pregnancy ◽

Key Words ◽

Acute Abdomen ◽

Vaginal Bleeding ◽

Clinical Presentation ◽

Uterine Cavity ◽

Cross Sectional ◽

Clinical Presentations ◽

Gestational Sac ◽

Labour Ward

Objective: To adjudge the prevalence of distinct presentations in ectopic pregnancy. Research Design: Descriptive cross-sectional. Place and Duration of Study: Emergency Labour Ward Department of Obstetrics & Gynecology, Nishtar Hospital Multan from 1.07.2017 to 31.12.2017. Methodology: Ninety five patients having positive pregnancy tests and uterine cavity with no intrauterine gestational sac on ultrasound were included. Clinical presentation like amenorrhea, vaginal bleeding, acute abdomen, shock or asymptomatic were assessed. Results: Amenorrhea observed in 73(76.8%) women, vaginal bleeding was seen in 32 (33.7%) women, 88 (92.6%) patients presented with acute abdomen and vitals instability was seen in 8 (8.4%) patients and 6(6.3%) patients were without symptoms. Conclusion: The two most common clinical presentations in patients included in study were amenorrhea and acute abdomen. Thorough evaluation of the patients with sub-acute or chronic presentation should be adopted to diagnose the cases of ectopic pregnancy. Key words: Ectopic pregnancy; Clinical presentation; Variations

Download Full-text

Cross-segment spinal plasma cell granuloma:a case report

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03759-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Renqin Lin ◽

Shenglin Wang ◽

Jianhua Lin ◽

Zhenzhen Zhang ◽

Xuanwei Chen

Keyword(s):

Plasma Cell ◽

Plasma Cells ◽

Osteolytic Lesion ◽

Thoracolumbar Spine ◽

Pathological Examination ◽

Complete Excision ◽

Surgical Specimen ◽

Osteolytic Lesions ◽

First Case ◽

Thoracolumbar Region

Abstract Background Plasma cell granuloma (PCG) is a rare non-neoplastic entity, with the precise etiology remaining unclear. Vertebra-affected spinal PCG has not been reported yet. This report presented a case with cross-segment spinal PCG in thoracolumbar region. Case presentation A 32-year-old male patient presented to the authors’ hospital since his health check-up results showed osteolytic lesions in the thoracolumbar spine. He felt asymptomatic throughout the course. Radiological examination revealed destructive changes at T12 and L1 vertebrae. Whereas laboratory examination excluded malignant tumor. The results of routine incisional biopsy remained inconclusive, thereby necessitating complete excision of the lesions. Finally, the infiltration of plasma cells observed by pathological examination of the surgical specimen confirmed the diagnosis of PCG. Conclusions To the authors’ knowledge, this was the first case of cross-segment spinal PCG with osteolytic property. The possibility of PCG should be considered for the diagnosis and differential diagnosis of an osteolytic lesion in the spine. Since the etiology of PCG is unknown, the disorder was confirmed based on excluded diagnosis. Surgical resection is recommended both for the definite diagnosis and treatment of spinal PCG.

Download Full-text