scholarly journals Pancytopenia with Severe Thrombocytopenia in Asymptomatic Malaria in Advanced Pregnancy: A Case Report

2021 ◽  
Author(s):  
Grant Murewanhema ◽  
Tapuwa Carol Musiniwa ◽  
Maxwell Takura Chimhina ◽  
Simbarashe Madombi ◽  
Munyaradzi Innocent Nyakanda ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Severe Disease ◽  
Severe Thrombocytopenia ◽  
Asymptomatic Malaria ◽  
Tertiary Institution ◽  
Case Presentation ◽  
Frequent Finding ◽  
History Of ◽  
Emergency Hysterectomy

Abstract BackgroundMalaria in pregnancy is associated with significant morbidity and mortality, and requires early diagnosis and intervention. Plasmodium falciparum is responsible for 98% of malaria cases in Zimbabwe and causes the most severe disease. Abnormal haematological parameters are a frequent finding in patients with malaria; however, they are rarely the sole presenting feature. Case presentationWe present the case of a 32-year-old woman in her fifth pregnancy, with a history of one previous caesarean section, who presented for caesarean section and was incidentally noted to have severe thrombocytopenia. Subsequent investigations at a tertiary institution revealed a pancytopenia with thrombocytopenia as the most prominent feature in an asymptomatic patient. The unavoidable caesarean section done under platelet cover was eventful, with severe intractable haemorrhage necessitating an emergency hysterectomy. However, the patient made a full recovery with antimalarial treatment and blood product transfusions. ConclusionThis case is presented to illustrate the need to consider malaria as a differential diagnosis in pregnant patients from malaria-transmitting areas who have thrombocytopenia. Previous studies have shown that thrombocytopenia can be a predictor of malaria in patients who present with fever, and a marker of disease severity, but has no utility in prognostication and follow-up.

scholarly journals Pancytopenia with severe thrombocytopenia in asymptomatic malaria in advanced pregnancy: a case report

2020 ◽  
Author(s):  
Grant Murewanhema ◽  
Tapuwa Carol Musiniwa ◽  
Maxwell Takura Chimhina ◽  
Simbarashe Madombi ◽  
Munyaradzi Innocent Nyakanda ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Severe Disease ◽  
Severe Thrombocytopenia ◽  
Asymptomatic Malaria ◽  
Tertiary Institution ◽  
Case Presentation ◽  
Frequent Finding ◽  
History Of ◽  
Emergency Hysterectomy

Abstract Background Malaria in pregnancy is associated with significant morbidity and mortality, and requires early diagnosis and intervention. Plasmodium falciparum is responsible for 98% of malaria cases in Zimbabwe and causes the most severe disease. Abnormal haematological parameters are a frequent finding in patients with malaria; however, they are rarely the sole presenting feature. Case presentation We present the case of a 32-year-old woman in her fifth pregnancy, with a history of one previous caesarean section, who presented for caesarean section and was incidentally noted to have severe thrombocytopenia. Subsequent investigations at a tertiary institution revealed a pancytopenia with thrombocytopenia as the most prominent feature in an asymptomatic patient. The unavoidable caesarean section done under platelet cover was eventful, with severe intractable haemorrhage necessitating an emergency hysterectomy. However, the patient made a full recovery with antimalarial treatment and blood product transfusions. Conclusion This case is presented to illustrate the need to consider malaria as a differential diagnosis in pregnant patients from malaria-transmitting areas who have thrombocytopenia. Previous studies have shown that thrombocytopenia can be a predictor of malaria in patients who present with fever, and a marker of disease severity, but has no utility in prognostication and follow-up.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

2021 ◽  
Author(s):  
Zahra Tavoli ◽  
Ali Montazeri
Keyword(s):  
Renal Agenesis ◽  
Primary Diagnosis ◽  
Case Presentation ◽  
Uterus Didelphys ◽  
Future Fertility ◽  
History Of ◽  
Ohvira Syndrome ◽  
Obstructed Hemivagina ◽  
Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty
Keyword(s):  
Frontal Sinus ◽  
Surgical Excision ◽  
Extramedullary Plasmacytoma ◽  
High Rate ◽  
Solitary Plasmacytoma ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

scholarly journals Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

2021 ◽  
Author(s):  
Tao Sun ◽  
Wentao Wang ◽  
Longshuang He ◽  
Yu Su ◽  
Ning Li ◽  
...  
Keyword(s):  
Nervous System ◽  
Trigeminal Neuralgia ◽  
Hemifacial Spasm ◽  
Treatment Strategies ◽  
Glossopharyngeal Neuralgia ◽  
Case Presentation ◽  
Involuntary Contraction ◽  
History Of ◽  
Primary Trigeminal Neuralgia

Abstract Background: Primary trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN) are common diseases of nervous system, with similar pathogenesis and treatment strategies. Coexistent of such disease, especially coexistent of TN-HFS-GN simultaneously, is very rare. To date, only nine cases have been reported.Case Presentation: A 70-year-old male with a history of hypertension and diabetes complained of severe involuntary contraction for about 10 years, knife-like and lighting-like pain, which was restricted to the distribution of the second and third branches of trigeminal nerve and pharynx and root of tongue, for about 2 years. Coexistent of TN HFS and GN was diagnosed and MVD was carried out. After MVD, the patient completely free from symptoms and no recurrence and hypoesthesia were recorded in 18 months follow up.Conclusion: Here we report the tenth and oldest male patient with coexistent of TN-HFS-GN. Despite limited reports, MVD is the preferred choice for such diseases which can free patients from spasm and neuralgia.

Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

2019 ◽  
Vol 64 (3) ◽  
pp. 116-118
Author(s):  
Özant Helvacı ◽  
Seyma Yıldız ◽  
Berfu Korucu ◽  
Ulver Derici ◽  
Turgay Arinsoy
Keyword(s):  
Nephrotic Syndrome ◽  
Coeliac Disease ◽  
Post Partum ◽  
Lower Extremity Weakness ◽  
Case Presentation ◽  
Multisystem Involvement ◽  
Life Threatening ◽  
History Of ◽  
Rare Occasion

Background Coeliac crisis is a life-threatening presentation of coeliac disease. Severe diarrhoea, weight loss, electrolyte imbalances and malnutrition are prominent features. Although mainly a disease of childhood, it can on the rare occasion be diagnosed in adults. Case presentation A 25-year-old female with severe generalised oedema, lower extremity weakness, hypokalemia and profound hypoalbuminemia was referred with an initial diagnosis of nephrotic syndrome. Three months previously she had given birth to a healthy child following an uneventful pregnancy. She did not have proteinuria. She had a history of diarrhoea with gluten-containing food since childhood but lacked a formal diagnosis of coeliac disease. A duodenal biopsy confirmed the suspected diagnosis. Coeliac crisis was diagnosed with life-threatening multisystem involvement. Introduction of a gluten-free diet abolished all disease symptoms and ameliorated laboratory parameters at six months’ follow-up. Conclusion Coeliac crisis is a rare, yet dangerous presentation of coeliac disease in adults. As this case suggests, it can present with generalised oedema and hypoalbuminemia mimicking nephrotic syndrome. Rapid diagnosis is the key to successful treatment.

scholarly journals A case of hypokalemia-induced bidirectional ventricular tachycardia

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097144
Author(s):  
Yanan Xie ◽  
Jingzhe Han ◽  
Jinming Liu ◽  
Jie Hao ◽  
Xiuguang Zu ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Electrical Storm ◽  
Case Presentation ◽  
Cardioverter Defibrillator ◽  
Long Term Follow Up ◽  
History Of

Background Bidirectional ventricular tachycardia (BVT) is a rare, but serious, arrhythmia. Hypokalemia is commonly found in clinical practice, but hypokalemia-induced BVT has rarely been reported. Case presentation A 74-year-old male patient with the symptoms of chest distress and palpitations was admitted owing to frequent discharge of his implantable cardioverter defibrillator (ICD) for 4 days. Before admission, the patient experienced diarrhea after intake of crabs, and felt frequent discharge of his ICD with a total of approximately 17 discharges in 4 days. He had no history of digitalis use. The serum potassium level after admission was 3.1 mmol/L and an electrocardiogram was consistent with BVT. The diagnosis was ventricular tachycardia, electrical storm, and hypokalemia. His ventricular tachycardia was completely relieved after correction of hypokalemia. Conclusions After correction of hypokalemia in this patient, the episode of BVT was terminated and no recurrence of BVT was observed during long-term follow-up. Our findings suggest the diagnosis of hypokalemia-induced BVT.

scholarly journals Primary orbital extraskeletal osteosarcoma and review of literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jingwen Hui ◽  
Yun Zhao ◽  
Lei Zhang ◽  
Jinyong Lin ◽  
Hong Zhao
Keyword(s):  
Soft Tissues ◽  
Malignant Tumour ◽  
Extraskeletal Osteosarcoma ◽  
Complete Excision ◽  
Case Presentation ◽  
Left Orbit ◽  
Orbital Wall ◽  
Previous Trauma ◽  
History Of

Abstract Background Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. Case presentation The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. Conclusions ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.

scholarly journals Gastric schwannoma: a case report and literature review

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095782
Author(s):  
Changsheng Pu ◽  
Keming Zhang
Keyword(s):  
Wedge Resection ◽  
Postoperative Recovery ◽  
Postoperative Treatment ◽  
Laparoscopic Wedge Resection ◽  
Case Presentation ◽  
Gastric Tumors ◽  
Gastric Schwannoma ◽  
History Of ◽  
Upper Abdominal

Background Gastric schwannoma is a rarely seen gastric tumor accounting for only 0.2% of all gastric tumors. It is difficult to distinguish a gastric schwannoma from other gastric tumors preoperatively. Case presentation: A 30-year-old man with no significant medical history or physical examination findings presented with a 1-month history of right upper abdominal discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor, but the postoperative pathologic and immunohistochemical examinations confirmed a gastric schwannoma. The patient underwent laparoscopic wedge resection of the stomach without additional postoperative treatment, and his postoperative recovery was uneventful. No recurrence or metastasis was found at the 2-year follow-up examination. Conclusion Although gastric schwannomas are usually not malignant, they are difficult to distinguish from other malignant stromal tumors preoperatively. Surgical resection should be recommended when a schwannoma is malignant or considered to be at risk of becoming malignant.

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