scholarly journals Bilateral sacroiliitis: a rare cause for a common presentation

2018 ◽  
Vol 6 (12) ◽  
pp. 4119
Author(s):  
Subodh Kumar Mahto ◽  
Praveen Kumar Singh ◽  
Ankita Sheoran ◽  
Afroz Jamal ◽  
Nagina Agarwal
Keyword(s):  
Infectious Disease ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Axial Skeleton ◽  
Clinical Suspicion ◽  
Musculoskeletal Complaints ◽  
Common Presentation ◽  
Lethal Complications ◽  
High Degree ◽  
Bone Sarcoidosis

Fever and osteoarticular involvement of axial skeleton are hallmark clinical manifestations of brucellosis but other diseases like ankylosing spondylitis, tuberculosis, Paget’s disease of bone, sarcoidosis should also be considered as differential diagnosis. Brucellosis is an uncommon infectious disease in India. Signs and symptoms of the disease are highly variable, with musculoskeletal complaints occurring frequently. Authors hereby reported a case of brucellosis presenting with fever, polyathralgia, bilateral sacroiliitis and enthesitis. Knowledge of geographical distribution, evidence of exposure to the cattle and a high degree of clinical suspicion of brucellosis are very important for early differentiation from other diseases to prevent lethal complications and institute early treatment and a prompt recovery.

Dengue fever in infants: report of three cases

2016 ◽  
Vol 47 (2) ◽  
pp. 173-176
Author(s):  
Sumit Mehndiratta ◽  
Ritika Singhal ◽  
Krishnan Rajeshwari ◽  
Anand P Dubey
Keyword(s):  
Young Adults ◽  
Dengue Fever ◽  
Clinical Features ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Clinical Suspicion ◽  
Diagnostic Methods ◽  
Children And Young Adults ◽  
High Degree

Dengue fever has classically been described as a disease of children and young adults. Infants are naturally protected by virtue of maternally derived immunoglobulins, especially in endemic countries. The resurgence of dengue, coupled with the availability of early and sensitive diagnostic methods and a high degree of clinical suspicion, has led to an increasing number of infants being diagnosed. There is a wide spectrum of clinical manifestations, particularly in infancy. Here we describe three cases presenting with diverse clinical features, their subsequent management and outcome.

Onodi Cell Mucocele: Case Report and Review of the Literature

2016 ◽  
Vol 95 (9) ◽  
pp. E4-E8 ◽  
Author(s):  
John M. Lee ◽  
Michael Au
Keyword(s):  
Primary Care Physicians ◽  
Multidisciplinary Approach ◽  
Signs And Symptoms ◽  
Surgical Decompression ◽  
Clinical Suspicion ◽  
Review Of The Literature ◽  
Ocular Complications ◽  
Wide Range ◽  
Onodi Cell ◽  
High Degree

Onodi cell mucoceles are rare entities that can cause devastating ocular complications if not treated promptly. Delays in the diagnosis are possible because of the wide range of differential diagnoses of unilateral retrobulbar optic neuropathy. We describe a new case of Onodi cell mucocele in a 39-year-old woman, and we present a comprehensive review of the literature on this entity. To the best of our knowledge, no review of Onodi cell mucoceles has been previously published. Our review found that 69% of patients with an Onodi cell mucocele experienced an improvement in vision after surgical decompression. The vast majority of these patients underwent endoscopic decompression; the timing of surgical decompression did not appear to affect outcomes in terms of vision. Onodi cell mucocele requires a high degree of clinical suspicion for diagnosis and a multidisciplinary approach to management that involves primary care physicians, ophthalmologists, and otolaryngologists. Early surgical treatment via an endoscopic approach is recommended for most patients, regardless of the duration of their ophthalmologic signs and symptoms.

scholarly journals Traumatic diaphragmatic hernia: a case report

2018 ◽  
Vol 5 (6) ◽  
pp. 2375 ◽  
Author(s):  
Anand Kishore ◽  
Ajeet Singh ◽  
Ashutosh Jain
Keyword(s):  
Signs And Symptoms ◽  
Diaphragmatic Injury ◽  
Clinical Suspicion ◽  
Diaphragmatic Rupture ◽  
Rare Entity ◽  
Mortality And Morbidity ◽  
Traumatic Diaphragmatic Hernia ◽  
Associated Injury ◽  
Trauma Case ◽  
High Degree

Diaphragmatic injury is a rare entity and clinically difficult to be diagnosed as symptoms are often masked due to associated injury in a poly trauma case. There are no specific signs and symptoms for diagnosing diaphragmatic rupture. High degree of clinical suspicion is needed in all cases of thoraco-abdominal injury to diagnose a case of diaphragmatic rupture. Computed Tomography (CT) chest and abdomen is very useful in diagnosis. When in doubt a diagnostic laparoscopy should be undertaken to establish a diagnosis to reduce mortality and morbidity.

scholarly journals When to Suspect a Diagnosis of Amyloidosis

2020 ◽  
Vol 143 (4) ◽  
pp. 304-311 ◽  
Author(s):  
Iuliana Vaxman ◽  
Morie Gertz
Keyword(s):  
Early Diagnosis ◽  
Cardiac Amyloidosis ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Clinical Suspicion ◽  
Al Amyloidosis ◽  
Urine Albumin ◽  
Routine Assessment ◽  
Etiological Heterogeneity

Amyloidosis is a group of complex diseases caused by extracellular deposition of pathological insoluble fibrillary protein in organs and tissues and may result in severe organ dysfunction. Despite the etiological heterogeneity of systemic amyloidosis, the clinical manifestations of the different forms of amyloidosis largely overlap and depend upon the effected organ. The signs and symptoms that should raise suspicion for the potential diagnosis of amyloidosis are usually nonspecific; therefore, establishing the diagnosis is difficult, and early diagnosis requires clinical suspicion. Light chain (AL) amyloidosis may present with highly specific signs such as macroglossia and periorbital purpura, but these signs are insensitive. Amyloidosis is still underdiagnosed, even though treatments are now available and are effective in improving patient’s survival and quality of life. Cardiac amyloidosis is the major determinant of survival, and the earlier it is detected the better the survival. All MGUS patients should be routinely screened for AL amyloidosis by a focused history and physical examination and routine assessment of urine albumin. The aim of this review is to provide clinicians with knowledge about the signs and symptoms that raise the suspicion of amyloidosis, bearing in mind the importance of early diagnosis of this disease.

scholarly journals Lyme Meningoradiculitis: Case Reports and Literature Review

2016 ◽  
Vol 62 (3) ◽  
pp. 373-375
Author(s):  
Maier Smaranda ◽  
Stirbu Nicoleta ◽  
Bajko Zoltan ◽  
Moţăţăianu Anca ◽  
Ţilea Brânduşa ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Endemic Area ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Clinical Suspicion ◽  
Neurological Manifestations ◽  
Serological Testing ◽  
Excellent Outcome ◽  
High Degree

AbstractThe clinical manifestations of Lyme disease are protean. The meningoradiculitis is a common and well-recognized complication of neuroborreliosis but can be easily misdiagnosed without a high degree of clinical suspicion, mainly if the tick bite is not present in the medical history. We report two cases of Lyme meningoradiculitis with excellent outcome after appropriate antibiotic therapy. In an endemic area in case of neurological manifestations suggestive for neuroborreliosis the serological testing for B. burgdorferi in serum and cerebrospinal fluid is imperative for the correct diagnosis.

Tissue section lifting for electron microscopy

1978 ◽  
Vol 36 (2) ◽  
pp. 86-87
Author(s):  
Adrian F. van Dellen
Keyword(s):  
Infectious Disease ◽  
Electron Microscopy ◽  
Tissue Culture ◽  
Organ System ◽  
Surrounding Tissue ◽  
Paraffin Sections ◽  
Surface Areas ◽  
Specific Determination ◽  
High Degree ◽  
Accuracy And Repeatability

The morphologic pathologist may require information on the ultrastructure of a non-specific lesion seen under the light microscope before he can make a specific determination. Such lesions, when caused by infectious disease agents, may be sparsely distributed in any organ system. Tissue culture systems, too, may only have widely dispersed foci suitable for ultrastructural study. In these situations, when only a few, small foci in large tissue areas are useful for electron microscopy, it is advantageous to employ a methodology which rapidly selects a single tissue focus that is expected to yield beneficial ultrastructural data from amongst the surrounding tissue. This is in essence what "LIFTING" accomplishes. We have developed LIFTING to a high degree of accuracy and repeatability utilizing the Microlift (Fig 1), and have successfully applied it to tissue culture monolayers, histologic paraffin sections, and tissue blocks with large surface areas that had been initially fixed for either light or electron microscopy.

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

scholarly journals Chronic Constrictive Pericarditis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Hossein Doustkami ◽  
Afshin Hooshyar ◽  
Nasrollah Maleki ◽  
Zahra Tavosi ◽  
Iraj Feizi
Keyword(s):  
Cardiac Catheterization ◽  
Constrictive Pericarditis ◽  
Gold Standard ◽  
Elevated Serum ◽  
Disease Process ◽  
Clinical Suspicion ◽  
Rare Clinical Entity ◽  
Good Recovery ◽  
Prompt Treatment ◽  
High Degree

Constrictive pericarditis (CP) is a rare clinical entity that can pose diagnostic problems. The diagnosis of CP requires a high degree of clinical suspicion. The gold standard for diagnosis is cardiac catheterization with analysis of intracavitary pressure curves, which are high and, in end diastole, equal in all chambers. We present a patient with unexplained dyspnea, recurrent right-side pleural effusion, and ascites. Analysis of the ascitic fluid revealed a high protein content and an elevated serum-ascites gradient. Echocardiography, computed tomography, and cardiac catheterization revealed the diagnosis of CP. He underwent complete pericardiectomy and to date has made a good recovery. The diagnosis of CP is often neglected by admitting physicians, who usually attribute the symptoms to another disease process. This case exemplifies the difficulty in diagnosing this condition, as well as the investigation required, and provides a discussion of the benefit and outcomes of prompt treatment.

POLYNEURITIS IN CHILDREN

PEDIATRICS ◽  
1958 ◽  
Vol 22 (5) ◽  
pp. 972-990
Author(s):  
Niels L. Low ◽  
Julia Schneider ◽  
Sidney Carter
Keyword(s):  
Clinical Picture ◽  
Cranial Nerve ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Severity Of The Disease ◽  
Clinical Records

Polyneuritis in children is becoming more common. The clinical picture is variable; it may be manifested by motor and sensory findings, or by a combination of peripheral and cranial nerve signs and symptoms. The etiology is usually obscure. The pathologic picture varies with the severity of the disease and differs according to the stage at which the patient dies, but all fatal cases show the same main characteristic changes. Clinical records of 30 cases, 17 boys and 13 girls from 17 months to 16 years of age, are reviewed. The clinical manifestations, course and treatment are described.

scholarly journals Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil

2005 ◽  
Vol 47 (6) ◽  
pp. 315-320 ◽  
Author(s):  
Elizabeth De Francesco Daher ◽  
Geraldo Bezerra da Silva Júnior ◽  
Marúsia Thomaz Ferreira ◽  
Fernando Antonio de Sousa Barros ◽  
Tiago Magalhães Gurgel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Hemodynamic Instability ◽  
Human Rabies ◽  
Tubular Necrosis ◽  
Post Mortem Findings ◽  
Histopathologic Findings

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

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