scholarly journals Melioidosis complicated with pericardial effusion - An emerging disease with a rare presentation

2021 ◽  
Vol 7 (2) ◽  
pp. 116-119
Author(s):  
Apurba Sankar Sastry ◽  
Monika Sivaradjy ◽  
Lokesh Koumar ◽  
Lakshmi Shanmugam ◽  
Ketan Priyadarshi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Blood Culture ◽  
Rare Case ◽  
Cardiac Involvement ◽  
Clinical Presentation ◽  
Pericardial Fluid ◽  
Rare Presentation ◽  
Gram Negative

Melioidosis, caused by a non-fermenting gram negative bacilli, can mimic a variety of diseases due to its diverse clinical presentation. The incidence of cardiac involvement in melioidosis is less than 1%. We report a rare case of melioidosis in a 65 year old male with chronic kidney disease who presented with fever and pericardial effusion which was misdiagnosed and treated as tuberculous pericardial effusion. Later, on isolation of from paired blood culture samples, pericardial fluid and also from pleural fluid confirmed the diagnosis of disseminated melioidosis. The patient was treated with intravenous ceftazidime after which clinical improvement was observed. Cardiac melioidosis should always be considered in the differential diagnosis of tuberculous pericardial effusion and it should be ruled out before the start of anti-tubercular treatment. This will prevent unnecessary exposure to anti-tubercular drugs and also aids to start early treatment for melioidosis thereby reducing the mortality.

scholarly journals A Solitary Ventral Scapular Osteochondroma causing Pseudo-winging of Scapula: A Case Report

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Eknath Pawar ◽  
Nihar Modi ◽  
Amit Kumar Yadav ◽  
Jayesh Mhatre ◽  
Sachin Khemkar ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Soft Tissue ◽  
Young Child ◽  
Chest Wall ◽  
Rare Case ◽  
Rare Presentation ◽  
Medial Border ◽  
Soft Tissue Masses ◽  
Scapular Region

Introduction: Winging of scapula is defined as a failure of dynamic stabilizing structures that anchor the scapula to the chest wall, leading to prominence of the medial border of scapula. It could be primary, secondary, or voluntary. Primary winging could be true winging due to neuromuscular causes or pseudo-winging due to osseous or soft-tissue masses. A scapular osteochondroma is a very rare presentation site and causes pseudo-winging leading to pushing away of the scapula away from the chest wall presenting as medial border prominence. Here, we are reporting a rare case of a scapular osteochondroma causing a pseudo-winging of the scapula. Case Report: A 2-year-old male child presented with painless, immobile, and non-fluctuant swelling over the left scapular region, insidious in onset and progressive in nature. On examination, a non-tender, immobile swelling was palpable with a painless and unrestricted range of motion at the shoulder joint. After evaluating radiographs and CT scan, the patient was diagnosed to have a ventral scapular osteochondroma leading to pseudo-winging of the scapula. Conclusion: Despite the rarity, a differential diagnosis of a scapular osteochondroma should be kept in mind while examining a young child presenting with a winged scapula. Keywords: Scapula, osteochondroma, pseudo-winging.

scholarly journals Blue Rubber Bleb Nevus Syndrome: A Possible Cause for Growth Retardation and Pubertal Delay

2018 ◽  
Vol 28 (3) ◽  
pp. 294-296
Author(s):  
Yi Pan ◽  
Lu Zhang ◽  
Minghui Duan ◽  
Hong Yang ◽  
Duoduo Zhao ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Growth Retardation ◽  
Rare Case ◽  
Clinical Presentation ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Pubertal Delay ◽  
Intravenous Iron Therapy ◽  
Possible Cause

Objective: The aim of this paper was to describe a rare case of blue rubber bleb nevus (BRBNS) with growth retardation and pubertal delay. Clinical Presentation and Intervention: A 16-year-old boy with severe iron deficiency anemia was diagnosed with BRBNS, showing growth retardation and pubertal delay simultaneously. The patient was treated conservatively with intravenous iron therapy, and his puberty advanced gradually. Conclusion: Given that growth retardation and pubertal delay are rare in BRBNS patients, this case reminds us to include BRBNS in the differential diagnosis of growth retardation.

scholarly journals Retroperitoneal Pleomorphic Rhabdomyosarcoma in Adult: A Rare Case Report

2020 ◽  
Vol 4 (2) ◽  
pp. 62
Author(s):  
Budi Martono ◽  
Sri Inggriani
Keyword(s):  
Rare Case ◽  
Clinical Presentation ◽  
Systemic Treatment ◽  
Abdominal Mass ◽  
Common Type ◽  
Common Site ◽  
Rare Presentation ◽  
Rare Case Report ◽  
Case Surgery ◽  
Rare Malignancy

Background: Rhabdomyosarcoma (RMS) is the most common type of soft tissue sarcoma in children, however, RMS is a rare malignancy in adults. Head and neck are the most common site for RMS, while intrabdominal RMS are rare in adults. Case: We present a rare case of a retroperitoneal abdominal mass, treated surgically with histopathology results of a retroperitoneal RMS. We discuss the clinical presentation, image findings, and treatment for this case. Conclusion: Intraabdominal tumours need to be identified quickly and precisely. CT scan or MRI can help clinicians to determine the staging, therefore plans the best treatment for the patient. In our case, surgery and radiotherapy showed promising outcome. The lack of literature and consensus on a standardized approach to systemic treatment and outcome in retroperitoneal pleomorphic RMS in adults makes our case a rare presentation of rhabdomyosarcoma and thus the need for reporting.  

scholarly journals Disseminated melioidosis with native valve endocarditis: a case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Hariharan Subramony ◽  
Sengottuvelu Gunasekaran ◽  
Vinodh Kumar Paul Pandi
Keyword(s):  
Infective Endocarditis ◽  
Burkholderia Pseudomallei ◽  
Cardiac Involvement ◽  
Clinical Presentation ◽  
South East Asia ◽  
Northern Australia ◽  
Native Valve ◽  
Gram Negative ◽  
Native Valve Endocarditis ◽  
Case Summary

Abstract Background  Burkholderia pseudomallei is a Gram negative, soil-water saprophytic bacterium endemic in South-East Asia and Northern Australia. Melioidosis is being increasingly diagnosed in other regions like India, China, and Sri Lanka during recent years. The clinical presentation of melioidosis is extremely variable. Case summary  We present a case of melioidosis presenting as native valve infective endocarditis with concomitant hepatic and splenic abscesses. This is the second case of melioidosis with infective endocarditis reported from India. Discussion  Melioidosis can present with pneumonia, pleural effusion, subcutaneous abscesses, visceral abscesses, osteomyelitis, and septicaemia, but cardiac involvement is rare. Endocarditis due to melioidosis is rare (∼1%) and is rarely reported in literature. This case highlights the unusual presentation of this emerging disease.

scholarly journals Melioidosis and the Heart: A Systematic Review

2020 ◽  
Vol 5 (3) ◽  
pp. 121
Author(s):  
Ragani Velusamy ◽  
Stephen Muhi
Keyword(s):  
Systematic Review ◽  
Quantitative Data ◽  
Burkholderia Pseudomallei ◽  
Cardiac Involvement ◽  
Clinical Presentation ◽  
Eradication Therapy ◽  
Microbiological Diagnosis ◽  
Negative Bacterium ◽  
Gram Negative ◽  
Cardiac Manifestations

Melioidosis is caused by Gram-negative bacterium Burkholderia pseudomallei. Clinical presentation can vary from pneumonia, sepsis and multi-focal abscess formation. The aim of this study was to systemically review the cardiac manifestations of melioidosis in the literature and describe their epidemiology, microbiological diagnosis and outcomes. A systematic review of the peer-reviewed literature was carried out in PubMed and Google Scholar for human melioidosis cases with cardiac involvement. Quantitative data for cases of melioidosis were obtained, including age, sex, microbiological diagnosis, treatment, and outcome. 980 articles were screened, of which 31 articles were eligible. The most common cardiac site of infection was pericarditis, followed by endocarditis and myocarditis. Over 95% of cardiac involvement occurred in males, and mortality was the lowest in pericarditis and highest in myocarditis. Valvular vegetations were all small, left-sided, and did not require surgery. Antibiotic treatment included a bactericidal induction therapy with ceftazidime or a carbapenem ± TMP-SMX, followed by eradication therapy with TMP–SMX in most patients as previously established. In conclusion, melioidosis varies in clinical presentation and is also known as a great imitator. Although cardiac involvement is rare, this is the first systematic review to summarise all cases reported in the literature to date.

scholarly journals Cardiac tamponade and massive pleural effusion in a young COVID-19-positive adult

2021 ◽  
Vol 14 (9) ◽  
pp. e244518
Author(s):  
Dilip Johny ◽  
Kodangala Subramanyam ◽  
Nandakishore Baikunje ◽  
Giridhar Belur Hosmane
Keyword(s):  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Low Voltage ◽  
Pericardial Fluid ◽  
Rare Presentation ◽  
Large Pericardial Effusion ◽  
Left Pleural Effusion ◽  
Dimensional Echocardiography ◽  
Cardiac Manifestations

COVID-19 has a broad spectrum of cardiac manifestations, and cardiac tamponade leading to cardiogenic shock is a rare presentation. A 30-year-old man with a history of COVID-19-positive, reverse transcription polymerase chain reaction (RT-PCR) done 1 week ago and who was home-quarantined, came to the emergency department with palpitations, breathlessness and orthopnoea. His ECG showed sinus tachycardia with low-voltage complexes, chest X-ray showed cardiomegaly and left pleural effusion and two-dimensional echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. He was taken up for emergency pericardiocentesis which showed haemorrhagic pericardial fluid. Intercostal drainage insertion was done for left-sided large pleural effusion. After ruling out all the other causes for haemorrhagic pericardial effusion, the patient was started on colchicine, steroids, ibuprofen and antibiotics to which he responded. Both pericardial and pleural effusions resolved completely on follow-up.

scholarly journals Rare case of extra-peritoneal brown fat (hibernoma) mimicking dumbbell-shaped liposarcoma

2021 ◽  
pp. 20200162
Author(s):  
Alex Kiu ◽  
Tiffany Fung ◽  
Sungmi Jung ◽  
Rehana Jaffer ◽  
Marie-Helen Martin
Keyword(s):  
Differential Diagnosis ◽  
Adipose Tissue ◽  
Soft Tissue ◽  
Rare Case ◽  
Clinical Presentation ◽  
Soft Tissue Tumour ◽  
Radiological Features ◽  
Tissue Tumour ◽  
Brown Adipose ◽  
Patient Stress

Hibernomas are a very rare and benign soft tissue tumour that originate from brown adipose tissue. While they are not histologically malignant, they may be indistinguishable from aggressive tumours such as liposarcomas on imaging. It is, therefore, important to consider it as a differential diagnosis when a suspicious fatty lesion is seen on imaging. This may prevent unnecessary invasive surgery and patient stress. This paper illustrates the clinical presentation, radiological features, and histological diagnosis of a patient with a rare dumbbell-shaped hibernoma in the pelvis.

scholarly journals Focal Fibroadipose Overgrowth of the Forehead: A Case Report

2020 ◽  
Vol 3 (3) ◽  
pp. 234-240
Author(s):  
Boon B ◽  
De Praeter M ◽  
Jentjens S ◽  
van Heerden J
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Surgical Management ◽  
Rare Case ◽  
Patient Management ◽  
Clinical Presentation ◽  
Future Perspective ◽  
Proteus Syndrome ◽  
Best Interest ◽  
Overgrowth Syndromes

This article describes a rare case of isolated focal fibroadipose overgrowth of the forehead in a 15-year-old patient. Various overgrowth syndromes were considered in the differential diagnosis, including Proteus syndrome, facial infiltrating lipomatosis, and macrodystrophia lipomatosa. The diagnosis is primarily based on clinical presentation and imaging modalities. However, for academic and supporting diagnostic purposes a biopsy is advised, yet may not be in the best interest of the patient. Management was conservative with future perspective for surgical management after cessation of growth.

Mycobacterium Endocarditis- A Case Report

2021 ◽  
Vol 14 (1) ◽  
pp. 76-78
Author(s):  
Md Abu Zahid ◽  
Mst Ferdousy Sultana ◽  
Shakil Ghafur ◽  
Hasanul Islam
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Mitral Valve ◽  
Pericardial Effusion ◽  
Rare Case ◽  
Pericardial Fluid ◽  
History Of

Mycobacterium Endocarditis is a very rare case. A 5 years old boy presented us with the history of fever and breathlessness. CXR shows huge cardiomegaly, patient is anemic and temperature is raised. On echo revels vegetation on Tricuspid &Mitral valve ç huge pericardial effusion ç features of early tamponade. Pericardial fluid was drawn and the symptoms improved. Pericardial fluid colour was milky and exudative in nature. ADA for mycobacterium tuberculosis was positive. The patient was given anti tuberculosis drug & improved with time. Cardiovasc j 2021; 14(1): 76-78

Bronchoalveolar Carcinoma Presenting as Malignant Pericardial Effusion

1997 ◽  
Vol 5 (4) ◽  
pp. 244-246
Author(s):  
Raju S Iyer ◽  
Sanjeev Agarwal ◽  
Bharadwaja Vamaraju ◽  
Srinivasu Kola ◽  
Srinivas Bhavanarushi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Lung Lesion ◽  
Pericardial Fluid ◽  
Malignant Cells ◽  
Computed Tomography Scan ◽  
Rare Presentation ◽  
Malignant Pericardial Effusion ◽  
Tomography Scan

A 35-year-old male underwent emergency pericardiectomy for repeated tamponade. A computed tomography scan of the thorax showed a consolidated lung lesion with pleural effusion. Emergency aspiration removed hemorrhagic pericardial fluid and straw colored pleural effusion. Both fluids tested negative for malignant cells. He later underwent a pneumonectomy after a biopsy revealed carcinoma of the lung. The case is reported to illustrate this rare presentation of bronchoalveolar carcinoma.

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