scholarly journals Peripartum cardiomyopathy: a rare complication in a teenage pregnancy

2021 ◽  
Vol 10 (7) ◽  
pp. 2854
Author(s):  
Uma Chourasia ◽  
Jyoti Nath Modi
Keyword(s):  
Multidisciplinary Team ◽  
Teenage Pregnancy ◽  
Rare Complication ◽  
Clinical Findings ◽  
Peripartum Cardiomyopathy ◽  
Team Approach ◽  
Successful Management ◽  
Emergency Cesarean ◽  
Life Threatening ◽  
High Index Of Suspicion

The aim of this case report was to present a rare case of peripartum cardiomyopathy (PPCM) in an adolescent primigravida, and discuss its presentation and successful management. PPCM is a relatively rare yet life threatening cardiac complication of pregnancy. It often remains undiagnosed as its symptoms may simulate the physiological symptoms of pregnancy and peripartum period. An early diagnosis is crucial for improving survival. We herein report an unusual case of PPCM in an young and otherwise healthy primigravida. A 19-year-old primigravida presented at 33 weeks of gestation with, severe pre-eclampsia with dyspnea, cough and discomfort in the chest. Based on clinical findings and ECG, the echocardiography was done, and a definitive diagnosis of PPCM was made. The patient was managed for heart failure and preeclampsia by a multidisciplinary team. Emergency cesarean was done for obstetric indication and patient was managed conservatively in intensive care unit. Patient improved clinically and was discharged at day 10. Peripartum cardiomyopathy though typically associates with advanced maternal age can occur in very young women as well. A high index of suspicion for PPCM is recommended on a background of `severe preeclampsia with breathlessness. Timely echocardiography for diagnosis, and a multidisciplinary team approach are a key to successful management. Clinical significance of the study was to shed new light on the unusual presentation of PPCM and to contribute to the existing knowledge of PPCM.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Ascending Paralysis in a 36-Year-Old Woman With Bipolar Disorder and Recent Aspiration Pneumonia

2020 ◽  
Vol 8 ◽  
pp. 232470962093164
Author(s):  
Aditi Vian Varma-Doyle ◽  
Kristen Garvie ◽  
Seema Walvekar ◽  
Mae Igi ◽  
Radha Mayuri Garikepati
Keyword(s):  
Bipolar Disorder ◽  
Respiratory Failure ◽  
Aspiration Pneumonia ◽  
Ivig Therapy ◽  
Conversion Disorder ◽  
Clinical Findings ◽  
Symptom Improvement ◽  
Csf Analysis ◽  
Life Threatening ◽  
High Index Of Suspicion

Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy affecting both motor and sensory peripheral nerves. Typically presenting after a gastrointestinal or a respiratory tract infection, it manifests as ascending paralysis with concomitant areflexia in patients. Cytoalbuminologic dissociation is a supportive finding on cerebrospinal fluid (CSF) analysis. Due to variability in presentation, misdiagnosis and delay in treatment can occur, and consequently, GBS can become life threatening due to respiratory failure. We report ascending paralysis in a 36-year-old woman with known history of bipolar disorder who recently recovered from aspiration pneumonia following a drug overdose event. Given her psychiatric history, she was initially misdiagnosed as conversion disorder. Intravenous immunoglobulin (IVIG) therapy was initiated at our hospital due to strong suspicion of GBS, based on history and physical examination findings consistent with flaccid quadriparesis and impending respiratory failure. CSF analysis and radiological findings subsequently supported our clinical suspicion and clinical findings. Concurrent IVIG therapy, pain management, aggressive physical and respiratory therapy, and monitoring resulted in symptom improvement. One must have a high index of suspicion for GBS when presented with acute inflammatory demyelinating neuropathies in patients who present with ascending paralysis. Early initiation of therapy is key and can prevent life-threatening complications.

scholarly journals The “Fountain of Death”: A Case Series on Tracheo-innominate Artery Fistula

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Jason Lo ◽  
Marina Mat Baki ◽  
Yeoh Xing Yi ◽  
Nik Hisyam Amirul ◽  
Zahirrudin Zakaria
Keyword(s):  
Potential Role ◽  
Rare Complication ◽  
Case Series ◽  
Innominate Artery ◽  
Survival Outcomes ◽  
Permissive Hypotension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion

Tracheo-innominate artery fistula (TIF) is a very rare complication related to tracheostomy and has been reported in 0.7% of patients, but certainly is one of the most life-threatening conditions. It is of paramount importance to maintain a high index of suspicion in evaluating patients with TIF and to anticipate occurrence of massive haemorrhage even during simple procedures related to tracheostomy such as tube change. We report 3 cases of TIF, each with a unique and unsuspecting history of the condition and review the emergency protocol in arresting the bleeding. We’ve also highlighted the potential role of permissive hypotension with sedation in improving survival outcomes of patients with TIF.

scholarly journals Haemophagocytic Lymphohistiocytosis (HLH) in Adult with Dengue Infection

2021 ◽  
Vol 16 (2) ◽  
pp. 287-294
Author(s):  
Ahmad Khaldun Ismail ◽  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Presentation ◽  
Dengue Infection ◽  
Specific Treatment ◽  
Bone Marrow Aspiration ◽  
Clinical Findings ◽  
Severe Dengue ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Life Threatening ◽  
High Index Of Suspicion

Haemophagocytic lymphohistiocytosis (HLH) or haemophagocytic syndrome is a rare but life-threatening syndrome of excessive immune activation with nonspecific clinical presentation. HLH is one of the complications in dengue infection. A 69-year-old lady was treated for severe dengue with multi-organ dysfunction with superimposed pneumonia, requiring mechanical ventilation. However, persistent cytopenia despite blood transfusion without evidence of haemorrhage raised the suspicion of HLH. Further blood investigations revealed hypertriglyceridaemia, hypofibrinogenaemia and hyperferritinaemia. Bone marrow aspiration showed haemophagocytosis. Patient fulfilled the diagnostic criteria for HLH by HLH-2004 trial. Her HScore is 281, with the probability of having HLH is 99.9%. Patient’s condition improved after administration of intravenous immunoglobulin (IVIG) and intravenous dexamethasone in tapering doses. Early specific treatment of HLH with IVIG and/or corticosteroid is important but diagnosis is usually delayed due to nonspecific clinical findings and laboratory results. High index of suspicion with the aid of diagnostic criteria by HLH-2004 trial and HScore is helpful to recognise this syndrome.

scholarly journals Addison’s disease in antiphospholipid syndrome: a rare complication

2018 ◽  
Vol 2018 ◽  
Author(s):  
Diana Oliveira ◽  
Mara Ventura ◽  
Miguel Melo ◽  
Sandra Paiva ◽  
Francisco Carrilho
Keyword(s):  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Rare Complication ◽  
Addison’S Disease ◽  
Addison's Disease ◽  
List Type ◽  
Adrenal Imaging ◽  
Significant Clinical Improvement ◽  
Life Threatening ◽  
High Index Of Suspicion

Summary Addison’s disease (AD) is the most common endocrine manifestation of antiphospholipid syndrome (APS), but it remains a very rare complication of the syndrome. It is caused by adrenal venous thrombosis and consequent hemorrhagic infarction or by spontaneous (without thrombosis) adrenal hemorrhage, usually occurring after surgery or anticoagulant therapy. We present a clinical case of a 36-year-old female patient with a previous diagnosis of APS. She presented with multiple thrombotic events, including spontaneous abortions. During evaluation by the third episode of abortion, a CT imaging revealed an adrenal hematoma, but the patient was discharged without further investigation. A few weeks later, she presented in the emergency department with manifestations suggestive of adrenal insufficiency. Based on that assumption, she started therapy with glucocorticoids, with significant clinical improvement. After stabilization, additional investigation confirmed AD and excluded other etiologies; she also started mineralocorticoid replacement. This case illustrates a rare complication of APS that, if misdiagnosed, may be life threatening. A high index of suspicion is necessary for its diagnosis, and prompt treatment is crucial to reduce the morbidity and mortality potentially associated. Learning points: AD is a rare but life-threatening complication of APS. It is important to look for AD in patients with APS and a suggestive clinical scenario. APS must be excluded in patients with primary adrenal insufficiency and adrenal imaging revealing thrombosis/hemorrhage. Glucocorticoid therapy should be promptly initiated when AD is suspected. Mineralocorticoid replacement must be started when there is confirmed aldosterone deficiency. Hypertension is a common feature of APS; in patients with APS and AD, replacement therapy with glucocorticoids and mineralocorticoids may jeopardize hypertension management.

scholarly journals Neonatal Heparin Overdose—A Multidisciplinary Team Approach to Medication Error Prevention

2008 ◽  
Vol 13 (2) ◽  
pp. 96-98
Author(s):  
Jason Arimura ◽  
Robert L. Poole ◽  
Michael Jeng ◽  
William Rhine ◽  
Paul Sharek
Keyword(s):  
Medication Error ◽  
Medication Errors ◽  
Multidisciplinary Team ◽  
Team Approach ◽  
Contributing Factors ◽  
Error Prevention ◽  
System Failures ◽  
Multidisciplinary Team Approach ◽  
Life Threatening ◽  
Medication Error Prevention

Despite the efforts of many hospitals, system failures can result in medication errors that may be life threatening. During 2006 and 2007, nine neonates received potentially fatal doses of heparin. This paper will review contributing factors to the heparin medication errors and ways to minimize the risk of heparin overdose.

scholarly journals Successful management of fetal atrial flutter at term pregnancy with postnatal electrocardioversion.

2021 ◽  
Author(s):  
Nnadozie Igbokwe ◽  
Aisha Firzana Ibrahim ◽  
Samy Mutalab ◽  
Oonagh Cleland
Keyword(s):  
Mortality Rate ◽  
Atrial Flutter ◽  
Multidisciplinary Team ◽  
Fetal Mortality ◽  
Team Approach ◽  
Term Pregnancy ◽  
Successful Management ◽  
Multidisciplinary Team Approach ◽  
Uncommon Condition

Fetal Atrial flutter (AF) is an uncommon condition accounting for about 30% of all fetal tachyarrhythmias. It is associated with structural heart anomalies and hydrops, with 10% fetal mortality rate. This case demonstrates a successfully managed atrial flutter at term with postnatal electrocardioversion using multidisciplinary team approach.

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