scholarly journals Cerebral phaeohyphomycosis due to Cladophialophora bantiana in an immunocompetent individual: A case report and brief review of literature

2020 ◽  
Author(s):  
Prachala G. Rathod ◽  
Bibhabati Mishra ◽  
Archana Thakur ◽  
Poonam S. Loomba ◽  
Abha Sharma ◽  
...  
Keyword(s):  
Case Report ◽  
Brain Abscess ◽  
Fungal Infections ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Clinical Suspicion ◽  
Laboratory Evaluation ◽  
Cns Infection ◽  
Dematiaceous Fungi ◽  
High Clinical Suspicion

Background and Purpose: Fungal infections of the central nervous system (CNS) are life-threatening conditions that are frequently misdiagnosed with bacterial and viral CNS infections. Cerebral phaeohyphomycosis is a cerebral infection caused by dematiaceous fungi, especially Cladophialophora bantiana. Very few cases of fungal CNS infection have been reported across the world. High clinical suspicion should be cast for the patients with brain abscess that do not respond to conventional antibiotic therapy. Case report: We report a case of a 21-year-old male presenting with headache, seizures and weakness in the limbs. Radiological examination revealed multiple brain abscesses. After surgical excision and laboratory evaluation, it was found to be caused by C. bantiana. The patient’s outcome was good with surgical excision and voriconazole therapy. Conclusion: Brain abscess caused by C. bantiana is on rise, especially in immunocompromised groups. Thus, high clinical suspicion, accurate diagnosis and management are the fundamentals for good prognosis.

scholarly journals Platypnea orthodeoxia syndrome in a patient with patent foramen ovale and normal atrial pressure. Case report and presentation of underlying pathophysiological mechanisms

2021 ◽  
Author(s):  
Fotios Sampsonas ◽  
Matthaios Katsaras ◽  
Ourania Papaioannou ◽  
Theodoros Karampitsakos ◽  
Lampros Lakkas ◽  
...  
Keyword(s):  
Case Report ◽  
Patent Foramen Ovale ◽  
Rare Case ◽  
Clinical Suspicion ◽  
Laboratory Evaluation ◽  
Foramen Ovale ◽  
Full Spectrum ◽  
High Clinical Suspicion ◽  
Physiological Abnormalities ◽  
Clinically Significant

Platypnea-orthodeoxia Syndrome is characterized by clinically significant postural hypoxia. The full spectrum of the syndrome includes intracardial and extracardial abnormalities with R->L shunt. Various concurrent underlying physiological abnormalities are usually encountered that require thorough clinical and laboratory evaluation. A high clinical suspicion in patients with unexplained dyspnea is also required to reach a firm diagnosis. We herein present a rare case of an 82-years-old patient with episodic unexplained dyspnea, patent foramen ovale with normal pulmonary pressures and we review the underlying physiologic mechanisms.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

scholarly journals Benign Osteoblastoma Involving Maxilla: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
K. Bokhari ◽  
M. S. Hameed ◽  
M. Ajmal ◽  
Rafi A. Togoo
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Long Term Follow Up ◽  
Rare Benign Tumor ◽  
Benign Osteoblastoma ◽  
Maxilla And Mandible

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma.Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free.Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

scholarly journals Giant dermoid cyst mimicking posterior fossa tumors in a child: A Case Report and Review of the Literature

2020 ◽  
Vol 2 (2(May-August)) ◽  
pp. e452020
Author(s):  
Leopoldo Mandic Ferreira Furtado ◽  
José Aloysio da Costa Val Filho ◽  
Bruno Lacerda Sandes ◽  
Plínio Duarte Mendes ◽  
Patrícia Salomé Gouvea Braga
Keyword(s):  
Case Report ◽  
Dermoid Cyst ◽  
Clinical Suspicion ◽  
Review Of The Literature ◽  
Benign Lesions ◽  
Posterior Fossa Tumors ◽  
Case Presentation ◽  
High Clinical Suspicion ◽  
Neuroimaging Data ◽  
Epidemiological Characteristics

Introduction: Intracranial dermoid cysts are rare, congenital and, benign lesions. The etiology of these lesions is related to an embryonic defect during neurulation. Case presentation: The present study describes a case of a 3-year-old girl with a giant cerebellar dermoid cyst, which initially manifested as hydrocephalus. Discussion: We discuss its epidemiological characteristics as well as diagnostic and therapeutic management. The combination of high clinical suspicion, anamnesis, thorough physical examination, and adequate interpretation of neuroimaging data is crucial for the early diagnosis and timely therapeutic intervention for such cysts. Conclusion: Surgical approach involving complete lesion resection considerably improves prognosis.

scholarly journals Primary Retroperitoneal Paraganglioma Simulating a Pancreatic Mass: A Case Report and Review of the Literature

HPB Surgery ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Guillermo Sangster ◽  
Daniel Do ◽  
Carlos Previgliano ◽  
Benjamin Li ◽  
Delecia LaFrance ◽  
...  
Keyword(s):  
Case Report ◽  
Vascular Malformations ◽  
Frozen Section ◽  
Abdominal Cavity ◽  
Pancreatic Head ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Adrenal Tumors ◽  
Palpable Mass ◽  
Primary Retroperitoneal

Paragangliomas are extra-adrenal tumors of the autonomic nervous system and may be found within the skull base, neck, chest, and abdomen. When presenting within the abdominal cavity, they may arise as a primary retroperitoneal neoplasm and can mimic vascular malformations or other conditions related to specific retroperitoneal organs such as the pancreas, kidneys, or adrenals. Retroperitoneal paragangliomas are mostly benign with good prognosis; however, they can present with abdominal pain, palpable mass, or hypertensive episodes. Patients should be initially evaluated with catecholamine levels, followed by computed tomography or magnetic resonance imaging to locate the primary lesion. Surgical excision remains the mainstay of treatment, although advanced disease and proximity to vital organs can make excision difficult or impossible. This case report describes a patient who initially underwent work up for a suspected pancreatic head mass which was discovered to be a retroperitoneal paraganglioma by frozen section.

scholarly journals Cladophialophora bantiana brain abscess masquerading cerebral tuberculoma in an immunocompetent host

2014 ◽  
Vol 21 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Amit Agrawal ◽  
Vissa Shanthi ◽  
K.V. Murali Mohan ◽  
Kishor V. Hegde ◽  
Umamaheshwar Reddy V.
Keyword(s):  
Brain Abscess ◽  
Cell Walls ◽  
Fungal Infections ◽  
Surgical Excision ◽  
Immunocompetent Host ◽  
Neutrophilic Infiltrate ◽  
Fungal Hyphae ◽  
The Right ◽  
Thalamic Region ◽  
Cerebral Tuberculoma

Abstract Phaeohyphomycosis is a term that collectively describes fungal infections caused by moulds and yeasts that have brown-pigmented cell walls (due to the presence of melanin). We report a case of 45 year female who had multiple coalescing lesions in the right basal ganglionic and thalamic region. Based on the imaging and investigation findings a diagnosis of cerebral tuberculoma was suspected. Histopathology of the excised specimen showed brown colored fungal hyphae surrounded by neutrophilic infiltrate. A diagnosis of phaeohyphomycosis caused by Cladophialophora bantiana was made and accordingly antifungal treatment was started. Brain abscess caused by Cladophialophora bantiana in an immunocompetent host is relatively uncommon and usually associated with overall high mortality. The best outcomes have been reported in patients who receive both surgical excision of the abscess followed by systemic antifungal therapy. In view of its rarity of these lesions preoperative diagnosis is difficult particularly in an immunocompetent host and absence of other risk factors.

scholarly journals Septic Shock due to Capnocytophaga: A Case Report

2021 ◽  
pp. 18-22
Author(s):  
Guillermo Jiménez-Álvarez ◽  
Sonia López-Cuenca ◽  
Belén Quesada-Bellver
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Close Contact ◽  
Blood Cultures ◽  
Clinical Suspicion ◽  
Common Cause ◽  
Gram Negative ◽  
High Clinical Suspicion ◽  
Risk Patients ◽  
First Time

The genus Capnocytophaga spp., recorded for the first time in 1979, comprises gram-negative bacilli, that colonize the oral mucosa of dogs and, to a lesser extent, cats, so that human transmission can be due to biting, scratching or close contact. Though it is not a common cause of infection in humans, it is a potentially serious one, which can occasionally go unnoticed causing sepsis, bacteremia, meningitis and endocarditis. A high clinical suspicion is essential for its diagnosis, especially in high-risk patients, such as alcoholics or splenectomized patients, as time to positivity of blood cultures may take as long as 6 days. Antibiotic treatment should last several weeks.

scholarly journals Primary Hepatic Neuroendocrine Tumor and its Metastasis to Breast; Case Report of an Unusual Malignancy

2021 ◽  
Vol 6 (4) ◽  
pp. 14-25
Author(s):  
Amjad Zafar ◽  
Rabia Iqbal ◽  
Amina Jafar ◽  
Taimoor Bajwa ◽  
Sobia Yaqub ◽  
...  
Keyword(s):  
Case Report ◽  
Mass Effect ◽  
Typical Feature ◽  
Clinical Suspicion ◽  
Unusual Site ◽  
Rare Tumors ◽  
High Clinical Suspicion ◽  
Clinical Presentations ◽  
Metastasis To Breast ◽  
Primary Hepatic Neuroendocrine Tumor

Introduction: Neuroendocrine tumors (NETs) are rare tumors with varied clinical presentations. Entero-pancreatic and respiratory systems are usually involved but it can also affect unusual sites like the liver. Purpose: This paper presents a case of a 45 years female who developed progressive and disabling symptoms of mass effect and carcinoid but remained undiagnosed for many years due to extremely low suspicion of such a tumor in liver. Methods: Diagnosis was made after extensive radiological, histopathological, and biochemical investigations. By that time, disease had spread to her breast which is also not a typical feature of NETs. Findings: Diagnosis of rare tumors at an unusual site is challenging and requires high clinical suspicion and appropriate workup.

scholarly journals Choriocarcinoma (stage IV) despite two normal dilation and curettages: A case report

2021 ◽  
Vol 12 (5) ◽  
pp. 312-314
Author(s):  
Bijan Morshedi ◽  
Laura Haworth ◽  
Traci Ito
Keyword(s):  
Case Report ◽  
Pregnancy Loss ◽  
Care Center ◽  
Stage Iv ◽  
Clinical Suspicion ◽  
Molar Pregnancy ◽  
Early Pregnancy Loss ◽  
High Clinical Suspicion ◽  
Clear Explanation ◽  
Ectopic Pregnancies

Choriocarcinoma is a highly metastatic subtype of gestational trophoblastic neoplasia (GTN) following pregnancy. It can arise from any type of pregnancy (50% occur after term pregnancies, 25% after molar pregnancies, and 25% after early pregnancy loss and ectopic pregnancies) (Soper, 2006). This case report describes an interesting diagnostic conundrum with normal histology findings on two separate endometrial dilation and curettages (D&C) and a unilateral oophorectomy in the context of high clinical suspicion for molar pregnancy that progressed to stage IV choriocarcinoma with brain and lung metastasis. The patient presented to our hospital nearly aphasic but would only say “molar pregnancy”. Due to her brain metastasis and worsening intraparenchymal hematoma, she underwent craniotomy confirming the diagnosis. After stabilization, she was transferred to a quaternary care center to complete chemotherapy with etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristine and had a good response. At this time, there is no clear explanation for normal histology on two separate D&Cs and a unilateral oophorectomy in the context of a classic case of choriocarcinoma with progression from a molar pregnancy. It reminds us as providers that medicine remains an imperfect science and requires astute clinical judgement to properly treat patients when diagnostic data such as pathology findings and lab values appear to be incongruent with the larger clinical picture.

scholarly journals Peripheral Facial Palsy in the Setting of Melkersson-Rosenthal Syndrome

2001 ◽  
Vol 20 (2) ◽  
pp. 233-235
Author(s):  
Sabrina Pimentel ◽  
Amélia Mendes ◽  
Maria José Rosas
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Clinical Suspicion ◽  
Peripheral Facial Palsy ◽  
High Clinical Suspicion ◽  
Clinical Triad ◽  
Suspicion Index ◽  
Fissured Tongue

Melkersson-Rosenthal syndrome is characterized by recurrent periph­eral facial palsy, recurrent or persistent orofacial edema and a fissured tongue. However, this clinical triad occurs only in a minority of cases; mono or oligosymptomatic forms are much more common. The au­thors describe a case report of a 39-year-old woman with Melkersson- Rosenthal syndrome, discuss the evolution of the disease and treat­ment, highlighting the need of a high clinical suspicion index and a regular follow-up to reduce progression of deficits

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