Tuberculous Pericarditis with tamponade in COVID-19: A case report

Abstract IntroductionTuberculous pericarditis is a rare manifestation of tuberculosis infection. COVID-19 pandemic poses a challenge in detecting uncommon disease. Pericardial effusion with tamponade has been described with COVID-19 but the association with tuberculosis is not yet known. Case presentationA 47-year-old man was admitted with symptoms of COVID-19 infection. Rapid progression of cardiomegaly on radiograph with clinical deterioration were suggestive of pericardial tamponade. Urgent pericardiocentesis revealed hemoserous fluid, elevated adenosine deaminase and positive TB PCR. He was started on steroid, anti-tuberculous therapy and Remdesivir with marked improvement of symptoms. Repeat echocardiogram and CT Thorax showed resolution of pericardial fluid and patient was discharged well. ConclusionsThis case highlights the difficulty in detecting a concomitant rare but important disease. The development of massive pericardial tamponade acutely is not pathognomonic for COVID-19, and a careful diagnostic process involving multi-modality imaging, occurred to arrive at a diagnosis of tuberculosis.

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Tuberculous pericarditis with tamponade diagnosed concomitantly with COVID-19: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa491 ◽

2020 ◽

Author(s):

Shiun Woei Wong ◽

Jessica Ke Xuan Ng ◽

Yew Woon Chia

Keyword(s):

Pericardial Tamponade ◽

Pericardial Fluid ◽

Diagnostic Process ◽

Rapid Progression ◽

Chain Reaction ◽

Tuberculous Pericarditis ◽

Case Summary ◽

Rare Manifestation ◽

Polymerase Chain ◽

Important Disease

Abstract Background Tuberculous pericarditis is a rare manifestation of tuberculosis infection. COVID-19 pandemic poses a challenge in detecting uncommon diseases. Case summary A 47-year-old man was admitted with symptoms of COVID-19 infection. Rapid progression of cardiomegaly on radiograph with clinical deterioration were suggestive of pericardial tamponade. Urgent pericardiocentesis revealed haemoserous fluid, elevated adenosine deaminase, and positive tuberculous (TB) polymerase chain reaction (PCR). He was started on anti-TB therapy and Remdesivir with marked improvement of symptoms. Repeat echocardiogram and CT thorax showed resolution of pericardial fluid, and the patient remained well on discharge. Discussion This case highlights the difficulty in detecting a concomitant rare but important disease. The development of massive pericardial tamponade acutely is not pathognomonic for COVID-19, and a careful diagnostic process involving multi-modality imaging occurred to arrive at a diagnosis of tuberculosis.

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The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

The Heart Surgery Forum ◽

10.1532/hsf.1328 ◽

2016 ◽

Vol 19 (1) ◽

pp. 023 ◽

Cited By ~ 2

Author(s):

Mehmet Yildirim ◽

Recep Ustaalioglu ◽

Murat Erkan ◽

Bala Basak Oven Ustaalioglu ◽

Hatice Demirbag ◽

...

Keyword(s):

Pericardial Effusion ◽

Thoracoscopic Surgery ◽

Pericardial Tamponade ◽

Pericardial Fluid ◽

Pathological Examination ◽

Common Disease ◽

Pericardial Window ◽

Surgical Interventions ◽

History Of ◽

Recurrent Pericardial Effusion

Background: Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. Methods: We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. Results: Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. Conclusion: Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

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Ileoileal knotting: a rare cause of intestinal obstruction: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02910-6 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Yusuf Mohammed ◽

Kirubel Tesfaye

Keyword(s):

Abdominal Pain ◽

Intestinal Obstruction ◽

Sudden Onset ◽

Rapid Progression ◽

Case Presentation ◽

Postoperative Course ◽

Child Bearing ◽

Mechanical Intestinal Obstruction ◽

Tentative Diagnosis ◽

Very High

Abstract Background Ileoileal knotting is one of the rarest causes of intestinal obstruction. The pathology involves knotting of the ileum around itself, leading to mechanical intestinal obstruction that can rapidly evolve to gangrene. Case presentation Here we will discuss the case of an 18-year-old Oromo girl who presented with sudden onset of severe abdominal pain and signs of generalized peritonitis.Ultrasound examination showed massive peritoneal and cul-de-sac fluid. Explorative laparotomy was done, with a tentative diagnosis of ruptured ovarian cyst. Intraoperative finding was a gangrenous ileoileal knot. The gangrenous segment was resected and ileotransverse anastomosis done. Postoperative course was uneventful, and the patient was discharged improved on the sixth postoperative day. Conclusion We present this case to highlight the diagnostic difficulty that one can face in females of child-bearing age and to create awareness of this rare cause of intestinal obstruction, as morbidity and mortality are very high because of rapid progression to gangrene.

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Malignant phyllodes tumor of the breast with rapid progression: a case report

Surgical Case Reports ◽

10.1186/s40792-020-00986-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Hajime Abe ◽

Atsuko Teramoto ◽

Yumiko Takei ◽

Yoshihito Tanaka ◽

Genichiro Yoneda

Keyword(s):

Therapeutic Strategy ◽

Muscle Flap ◽

Skin Grafting ◽

Phyllodes Tumor ◽

Rapid Progression ◽

Total Mastectomy ◽

Latissimus Dorsi Muscle Flap ◽

Case Presentation ◽

Dorsi Muscle ◽

Short Period

Abstract Background Malignant phyllodes tumors (PTs) of the breast occur infrequently and are difficult to treat with adjuvant therapy. Here, we present a case of a female patient with a huge malignant PT with rapid progression in a short period. Case presentation A 44-year-old woman presented to our hospital with a rapid growth mass in her right breast, measuring 20 cm. She was initially diagnosed as having a borderline phyllodes tumor by core needle biopsy and underwent total mastectomy and artificial dermis was grafted, 20 days later, latissimus dorsi muscle flap and free skin grafting were performed. Two courses of doxorubicin–ifosfamide therapy were administered because of recurrence, but the patient died 4 months after the mastectomy. Conclusions A standard therapeutic strategy for malignant PTs is needed in urgently to reduce the risk of tumor recurrence.

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BRAF-MAD1L1 and BRAF-ZC3H7A: novel gene fusion in Rhabdomyosarcoma and Lung adenocarcinoma

10.21203/rs.3.rs-368083/v1 ◽

2021 ◽

Author(s):

Jiang Da ◽

Hui Jin ◽

Xinliang Zhou ◽

Shaoshuang Fan ◽

Mian Xu ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Gene Fusion ◽

Tumor Resection ◽

Kinase Domain ◽

Rapid Progression ◽

First Line ◽

Case Presentation ◽

First Case ◽

Exon 11 ◽

Domain Exon

Abstract Background: Rhabdomyosarcoma (RMS) and lung adenocarcinoma (LADC) epitomizes the success of cancer prevention by the development of conventional therapy, but huge challenges remain in the therapy of advanced diseases.Case presentation: We reported two cases of novel BRAF gene fusion. The first case was a 34-year-old female with RMS harboring a BRAF-MAD1L1 fusion. She suffered tumor resection, recurrence and rapid progression. The second case was a 72-year-old female with LADC harboring a BRAF-ZC3H7A fusion, and she gained rapid progression after receiving a first-line course of chemotherapy.Conclusions: These two BRAF fusions retain the intact BRAF kinase domain (exon 11-18) and showed poor prognosis in RMS and LADC.

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Eosinophilic Gastroenteritis with a Relapsing and Remitting Course with Presence of Autoimmune Antibodies

Case Reports in Medicine ◽

10.1155/2020/1745834 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Chathuranga Lakmal Fonseka ◽

Sunali Nanayakkara ◽

S. D. A. L. Singhapura ◽

H. M. M. Herath ◽

C. K. Bodinayake

Keyword(s):

Autoimmune Disease ◽

Ascitic Fluid ◽

Peripheral Blood ◽

Elimination Diet ◽

Eosinophilic Gastroenteritis ◽

Normal Diet ◽

Parasitic Disease ◽

Case Presentation ◽

Autoimmune Antibodies ◽

Uncommon Disease

Background. Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the digestive tract, which occurs due to an uncertain aetiology. Although autoimmune diseases can later present as EGE, it is unusual for EGE to have positive autoimmune antibodies without the presence of an overt autoimmune disease. Case presentation. We report a 38-year-old previously healthy man who presented with abdominal discomfort and loose stools with pleural and peritoneal effusions progressing over several weeks. His investigations revealed severe eosinophilia in peripheral blood and ascitic fluid, and a laparoscopic full-thickness biopsy from the ileum demonstrated infiltration of eosinophils in all three layers of the intestine. There were no clinical features or investigations suggestive of parasitic disease, other diseases associated with eosinophilia, or autoimmune disease. Further investigations showed a highly positive ANA, positive p-ANCA, but did not meet the criteria to diagnose a specific autoimmune disease. The eosinophilia responded to an elimination diet with gradual resolution of eosinophilia and effusions, and once it reappeared after introduction of a normal diet. Conclusion. EGE presenting as peripheral blood and ascitic fluid eosinophilia with the presence of pleural and/or peritoneal effusions is uncommon. Eosinophilic gastroenteritis can be associated with autoantibody positivity without any evidence of overt autoimmune disease manifestations. Elimination diet can be used as a potential option to prevent recurrences of EGE.

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Epigastric pain associated with herpes esophagitis: case report

BMC Infectious Diseases ◽

10.1186/s12879-020-05487-5 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Nabil Antaki ◽

Ziad Aljarad ◽

Howayda Dabbas ◽

Walid Haddad ◽

M. Amin Akil ◽

...

Keyword(s):

Medical Literature ◽

Epigastric Pain ◽

Lower Esophagus ◽

Case Presentation ◽

Main Symptom ◽

Abdominal Symptoms ◽

Multiple Biopsies ◽

Uncommon Disease ◽

Simplex Virus ◽

Compromised Patients

Abstract Background Herpes esophagitis is uncommon disease caused by Herpes simplex virus (HSV). While the disease most often occurs in immunocompromised patients, including post-chemotherapy, immunosuppression with organ transplants, and in AIDS, Herpes esophagitis can also occur in immunocompetent individuals. Case presentation We report a case of herpes esophagitis in a 72 year- old woman who was presumed to be immunocompromised following prolonged radiotherapy and chemotherapy for lymphoma. Her main symptom was epigastric pain. Upper endoscopy showed multiple rounded ulcers in lower esophagus. The diagnosis was confirmed histologically by multiple biopsies. The patient received Valacyclovir for 2 weeks and started to get better within 3 days of treatment. Conclusion Although there are few published cases of Herpes esophagitis disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing immuno-compromised patients presenting with non-specific abdominal symptoms.

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Tuberculous Pericarditis: Importance of Adenosine Deaminase Activity in Pericardial Fluid.

Internal Medicine ◽

10.2169/internalmedicine.32.675 ◽

1993 ◽

Vol 32 (8) ◽

pp. 675-677 ◽

Cited By ~ 1

Author(s):

Tetsurou INOUE ◽

Kanji IGA ◽

Kenjirou HORI ◽

Tadashi MATSUMURA ◽

Hiromitsu GEN ◽

...

Keyword(s):

Adenosine Deaminase ◽

Pericardial Fluid ◽

Tuberculous Pericarditis ◽

Adenosine Deaminase Activity

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Rapid Progression of Kaposi’s sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection: a case report

AIDS Research and Therapy ◽

10.1186/s12981-020-00312-0 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Pingzheng Mo ◽

Liping Deng ◽

Xiaoping Chen ◽

Yong Xiong ◽

Yongxi Zhang

Keyword(s):

Hiv Infection ◽

Kaposi's Sarcoma ◽

Hemophagocytic Syndrome ◽

Kaposi’S Sarcoma ◽

Rapid Progression ◽

Immunosuppressed Patient ◽

Timely Manner ◽

Cutaneous Lesions ◽

Case Presentation ◽

Life Threatening

Abstract Background AIDS-related KS generally involves cutaneous lesions, that slowly progress over months to years. Neither rapidly progressing of KS nor KS complicated with hemophagocytic syndrome (HPS) has rarely been reported. Case presentation We report a rare case of rapid progression of Kaposi’s sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection. The symptoms of this patient were atypical, showing only persistent high fever and rapid progressed to hemophagocytic syndrome. This patient was successfully treated with antiretroviral therapy combined with liposomal doxorubicin. Conclusions The condition of the KS patient could deteriorate rapidly over a period of days and even developeded into HPS, which was life-threatening. However, chemotherapy initiated in a timely manner might improve prognosis.

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