Delayed-Onset Interface Fluid Syndrome After LASIK Following Phacotrabeculectomy

Abstract Background Interface fluid syndrome (IFS) is an unusual complication after laser-assisted in-situ keratomileusis (LASIK). We report the first case of IFS after uncomplicated phacotrabeculectomy in a patient who had undergone LASIK 10 years previously. This case emphasizes the importance of intraocular pressure (IOP) interpretation in eyes that have undergone LASIK. Case presentation A 30-year-old woman with a history of LASIK surgery presented to glaucoma clinic due to uncontrolled IOP despite of maximally tolerable medical treatment. After receiving phacotrabeculectomy, IOP decreased to 3mmHg on the first postoperative day, but again increased up to 21mmHg and a diffuse corneal edema with cloudy flap interface was demonstrated by slit-lamp microscopy. Corneal edema was sustained even after the IOP was lowered to 14 mmHg. Spectral-domain optical coherence tomography scanning of the cornea revealed a diffuse, thin fluid pocket in the corneal interface. After laser lysis of the scleral flap sutures, IOP was further decreased to 9mmHg and interface fluid was resolved. Conclusion IFS should be considered as a possible cause of postoperative corneal edema despite of low IOP in the eyes that underwent LASIK surgery. Additional IOP lowering may be helpful for resolving the corneal edema.

Download Full-text

Delayed-Onset Interface Fluid Syndrome After LASIK Following Phacotrabeculectomy

10.21203/rs.2.160/v1 ◽

2019 ◽

Author(s):

Chung Young Kim ◽

Young Ho Jung ◽

Eun Ji Lee ◽

Joon Young Hyon ◽

Kyu Hyung Park ◽

...

Keyword(s):

Corneal Edema ◽

Unusual Complication ◽

Scleral Flap ◽

Case Presentation ◽

First Case ◽

History Of ◽

Possible Cause ◽

Slit Lamp Microscopy ◽

Tomography Scanning

Abstract Background: Interface fluid syndrome (IFS) is an unusual complication after laser-assisted in-situ keratomileusis (LASIK). We report the first case of IFS after uncomplicated phacotrabeculectomy in a patient who had undergone LASIK 10 years previously. This case emphasizes the importance of intraocular pressure (IOP) interpretation in eyes that have undergone LASIK. Case presentation: A 30-year-old woman with a history of LASIK surgery presented to glaucoma clinic due to uncontrolled IOP despite of maximally tolerable medical treatment. After receiving phacotrabeculectomy, IOP decreased to 3mmHg on the first postoperative day, but again increased up to 21mmHg and a diffuse corneal edema with cloudy flap interface was demonstrated by slit-lamp microscopy. Corneal edema was sustained even after the IOP was lowered to 14 mmHg. Spectral-domain optical coherence tomography scanning of the cornea revealed a diffuse, thin fluid pocket in the corneal interface. After laser lysis of the scleral flap sutures, IOP was further decreased to 9mmHg and interface fluid was resolved. Conclusion: IFS should be considered as a possible cause of postoperative corneal edema despite of low IOP in the eyes that underwent LASIK surgery. Additional IOP lowering may be helpful for resolving the corneal edema. Key Words : Interface fluid syndrome, LASIK, Glaucoma, Phacotrabeculectomy.

Download Full-text

Immediate post partum macular subretinal bleeding in a highly myopic patient: a case report

BMC Ophthalmology ◽

10.1186/s12886-021-01814-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Karen Bitton ◽

J.-L. Bacquet ◽

F. Amoroso ◽

S. Mrejen ◽

M. Paques ◽

...

Keyword(s):

Valsalva Maneuver ◽

Post Partum ◽

Pathologic Myopia ◽

Pathological Myopia ◽

Case Presentation ◽

Sudden Loss ◽

Corrected Visual Acuity ◽

First Case ◽

History Of ◽

Macular Hemorrhage

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.

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

Tocilizumab for massive refractory pleural effusion in an adolescent with systemic lupus erythematosus

Pediatric Rheumatology ◽

10.1186/s12969-021-00635-w ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Arianna De Matteis ◽

Emanuela Sacco ◽

Camilla Celani ◽

Andrea Uva ◽

Virginia Messia ◽

...

Keyword(s):

Pleural Effusion ◽

Lupus Erythematosus ◽

High Dose ◽

Common Symptom ◽

Systemic Lupus ◽

Malar Rash ◽

Case Presentation ◽

Double Stranded Dna ◽

First Case ◽

History Of

Abstract Background Pleural effusion in systemic lupus erythematous (SLE) is a common symptom, and recent studies demonstrated that IL-6 has a pivotal role in its pathogenesis. Case presentation We report a case of a 15 years old Caucasian boy with a history of persistent pleural effusion without lung involvement or fever. Microbiological and neoplastic aetiologies were previously excluded. Based on the presence of pleuritis, malar rash, reduction of C3 and C4 levels and positivity of antinuclear antibody (ANA) and anti-double stranded DNA (dsDNA), the diagnosis of juvenile SLE (JSLE) was performed. Treatment with high dose of intravenous glucocorticoids and mycophenolate mofetil was started with partial improvement of pleural effusion. Based on this and on adults SLE cases with serositis previously reported, therapy with intravenous tocilizumab (800 mg every two weeks) was started with prompt recovery of pleural effusion. Conclusion To the best of our knowledge, this is the first case of JSLE pleuritis successfully treated with tocilizumab.

Download Full-text

Septic Pulmonary Embolism Secondary to Klebsiella pneumoniae Epididymitis: Case Report and Literature Review

Case Reports in Radiology ◽

10.1155/2019/5395090 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Juan Sebastián Alonso Ojeda Gómez ◽

Jorge Alberto Carrillo Bayona ◽

Laura Cristina Morales Cifuentes

Keyword(s):

Pulmonary Embolism ◽

Pulmonary Circulation ◽

Respiratory Symptoms ◽

Unusual Complication ◽

Chest Imaging ◽

Case Presentation ◽

History Of ◽

Septic Pulmonary Embolism ◽

Uncommon Condition ◽

Acute Epididymitis

Background. Septic pulmonary embolism (SPE) is defined as the occurrence of septic thrombi in the pulmonary circulation. We report a case of SPE secondary to K. pneumoniae epididymitis. Case Presentation. A 74-year-old male with a history of diabetes mellitus experienced SPE secondary to epididymitis, with isolation of K. pneumoniae in blood and presence of lung nodules, with a chest computed tomography showing the halo and reversed halo signs. Discussion. SPE is characterized by the presence of septic thrombi in the pulmonary circulation coming from an extrapulmonary infective focus. SPE secondary to K. pneumoniae epididymitis is an uncommon condition that is characterized by the presence of multiple bilateral nodules of peripheral distribution. Conclusion. SPE is an unusual complication of acute epididymitis. Suspicion of SPE should be considered in patients with a diagnosis of epididymitis, respiratory symptoms, and multiple nodules in chest imaging assessments.

Download Full-text

Giant Nodular Fasciitis Originating From The Humeral Periosteum: A Diagnostic Challenge

10.21203/rs.3.rs-86216/v1 ◽

2020 ◽

Author(s):

Shili Yu ◽

Jian Li ◽

Meng Jia ◽

Ping-Li Sun ◽

Hongwen Gao

Keyword(s):

Gene Rearrangement ◽

Molecular Detection ◽

Histopathological Examination ◽

Low Grade ◽

Superficial Fascia ◽

Nodular Fasciitis ◽

Diagnostic Challenge ◽

Case Presentation ◽

First Case

Abstract Background: Nodular fasciitis (NF) is a self-limiting, benign, fibroblastic, and myofibroblastic tumor that mostly occurs in the subcutaneous superficial fascia, although there are reports of NF occurrences at atypical sites, such as intraneural and intra-articular locations. However, NF originating from the appendicular periosteum is extremely rare, and NF lesions usually are smaller than 4 cm. A large NF lesion of periosteal origin can be misdiagnosed as a malignant bone tumor and may cause overtreatment.Case presentation: This case report presents a large NF that originated from the humeral periosteum in an adult and was initially diagnosed intraoperatively as low-grade sarcoma, but later diagnosed as NF after post-resection histopathological evaluation. Furthermore, fluorescence in situ hybridization analysis revealed a USP6 gene rearrangement that confirmed the diagnosis. To the best of our knowledge, this is the first case of NF in the humeral periosteum.Discussion and Conclusions: NF poses a diagnostic challenge especially occurrences at rare sites as it is often mistaken for a sarcoma. Postoperative histopathological examination of whole sectionscan be combined with immunohistochemical staining and, if necessary, the diagnosis can be confirmed by molecular detection, and thus help avoid overtreatment.

Download Full-text

Malignant Gastrointestinal Neuroectodermal Tumor in the Right Atrium: The First Case Report Presenting with an Extra-Gastrointestinal Mass

10.21203/rs.3.rs-620292/v1 ◽

2021 ◽

Author(s):

Zhiwen Li ◽

Xiaohong Pu ◽

Yao Fu ◽

Lin Li ◽

Yuemei Xu ◽

...

Keyword(s):

Case Report ◽

Right Atrium ◽

Tumor Location ◽

Neuroectodermal Tumor ◽

Case Presentation ◽

First Case ◽

Mitotic Figures ◽

The Right ◽

Whole Transcriptome

Abstract Background: Malignant gastrointestinal neuroectodermal tumor is an extremely rare soft tissue sarcoma which was firstly described in 2003 but until recently it had been designated as a definite new entity. According to the previous literatures, Malignant gastrointestinal neuroectodermal tumor was almost exclusively occurred in gastrointestinal tract.Case presentation: A 62-year-old male showed a mass in right atrium and the occupying mass was founded on the right ventricular diaphragm and involved the right atrium along the coronary sinus during the operation. Microscopically, the tumor characterized by the solid sheet and pseudopapillary focally architectures, and was composed of small to medium cells with round or oval nuclei, variable amount of eosinophilic or clear, and frequent mitotic figures. Immunohistochemically, the neoplastic cells were positive for S100 and SOX-10 but negative for HMB-45, A103 and CD99. EWSR1-AFTF1 rearrangement was detected by fluorescence in situ hybridization and further confirmed involving fusion of EWSR1 exon 8 with ATF1 exon 4 by whole transcriptome sequence analysis.Conclusions: This is the first case report of extra-gastrointestinal Malignant gastrointestinal neuroectodermal tumor that occurring in the right atrium，which remind of the new prospect of the tumor location.

Download Full-text

Spinal subarachnoid haemorrhage secondary to spinal rheumatoid vasculitis: a case report

BMC Neurology ◽

10.1186/s12883-021-02497-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yeqing Xiao ◽

Jie Yang ◽

Jian Xia ◽

Yunhai Liu ◽

Qing Huang ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Central Nervous System ◽

Subarachnoid Haemorrhage ◽

Therapeutic Effects ◽

Rheumatoid Vasculitis ◽

Low Disease Activity ◽

Case Presentation ◽

First Case ◽

History Of ◽

The Central Nervous System

Abstract Introduction Spinal subarachnoid haemorrhage is extremely rare in cases of subarachnoid haemorrhage and possesses servere characteristics. Additionally, spinal rheumatoid vasculitis is rare for spinal subarachnoid haemorrhage. The pathogenesis is unknown. Case presentation A 52-year-old woman with a 10-year history of seropositive rheumatoid arthritis was managed with leflunomide and celecoxib, and stable low disease activity was achieved. The patient had also been diagnosed with spinal subarachnoid haemorrhage secondary to isolated spinal rheumatoid vasculitis and obtained good therapeutic effects. Conclusion This is the first case to describe spinal subarachnoid haemorrhage secondary to isolated spinal vasculitis in a patient with rheumatoid arthritis, which provides more proof of anomalous neovascularization in the central nervous system in rheumatoid arthritis.

Download Full-text

Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00134-3 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Arti Khatri ◽

Nidhi Mahajan ◽

Niyaz Ahmed Khan ◽

Natasha Gupta

Keyword(s):

Past History ◽

Case Reports ◽

Final Diagnosis ◽

Adrenal Carcinoma ◽

Case Presentation ◽

First Case ◽

Contrast Enhanced ◽

Paediatric Age ◽

History Of ◽

Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

Download Full-text