scholarly journals Histiocytoid Giant Cellulitis-Like Sweet Syndrome At The Site of Sternal Aspiration: A Case Report

Author(s):  
Dewan Zhao ◽  
Jing Ni ◽  
Xiuli Sun

Abstract Background: Sweet syndrome with both histiocytoid pathology and giant cellulitis-like lesion feature is extremely rare and has only been reported once. Our case is different from the previous report because the cutaneous lesion was caused by local invasive irritation, which made it much more difficult to distinguish from cellulitis.Case presentation: A 52-year-old male was diagnosed with myelodysplastic syndrome with multilineage dysplasia (MDS-MLD) associated with myelofibrosis (MDS-F) as well as angioneurotic edema of the tongue and floor of the mouth. Seven days after sternal aspiration, a cellulitis-like lesion was formed at the puncture site. Since he had neutropenia, history of glucocorticoid use and didn't keep the site dry and clean after aspiration, cellulitis was diagnosed, followed by broad-spectrum antibiotics and debridement. However, the lesion continued to expand, associated with blisters formation, accompanied by chills and fever. Blood cultures and blister smears didn't detect any pathogens. Biopsy of the lesion was performed and histiocytoid Sweet syndrome was diagnosed. He received prednisone treatment, and the fever relieved within 24 hours and the cutaneous lesion resolved within one week. He has had no recurrence during two-month follow-up.Conclusions: This case can provide help for timely diagnosis and treatment and a reference for further summarizing the characteristics of this rare variant.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci

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.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Odion-Obomhense Kesiena Helen ◽  
Ntaji Maureen Iru ◽  
Ekpebe Patrick Akpofure ◽  
Afeyodion Akhator

Abstract Background Uterovaginal prolapse occurs when damaged connective tissues allow the uterus to drop into the vagina. Rare in children, uterovaginal prolapse can occur as a result of violent sexual assault. This case is being reported because there has been no previous report of acquired pelvic organ prolapse following trauma suspected to be sexual abuse in a child in our setting. Case presentation Two-year-old female presented to our hospital with a 3-day history of abnormal protrusion from the vagina and a 2-day history of bleeding per vagina. Traumatic rupture of the hymen was observed. The urethra was not edematous or hyperemic. The reduction was done successfully under sedation and maintained using a crepe bandage. There was no recurrence after 3-month follow-up. Conclusions Uterovaginal prolapse presenting among children below 5 years is rare. If bleeding per vagina is reported in a child, the clinician should be aware of the possibility of uterovaginal prolapse.


2018 ◽  
Vol 12 (02.1) ◽  
pp. 25S ◽  
Author(s):  
Christelle Georges Ephrem ◽  
Madonna J Matar ◽  
Gaelle C Chalhoub ◽  
Wafaa G Greige

Introduction: Brucellosis is a multisystemic infectious disease, which can manifest as endocarditis. Diagnosis can be challenging. Case Presentation: An 80-year-old male patient presented with fever 38.5 °C, cough and progressive shortness of breath of 14 days. History of Brucellosis 18 months earlier inadequately treated. Physical examination showed a mid-frequency mitral and aortic murmur. Brucella serologies and blood cultures were positive. He was discharged on Doxycycline and Rifampicin for 3 months and was lost to follow up. Four months later, he presented for recurrent fever. Physical examination showed a radiating heart murmur. Blood cultures were negative; however, blocking antibodies were 1/2560. Echocardiography showed calcified aortic stenosis. TEE showed an abscess formation at the level of the non-coronary cusp. Ceftriaxone 3g IV q24h, gentamicin 80mg IV q8h, doxycycline 100mg po q12h and trimethoprim-sulfamethoxazole 160/800 mg po q12h were initiated (shortage of rifampicin). Aortic bio-prosthesis was successfully inserted, one week after initiating antibiotics. Intraoperative cultures were negative. He was discharged 18 days following surgery on doxycycline 100 mg po q12h, and rifampicin 900mg po q24h and ciprofloxacin 500mg po q 12h for 3 more months, with twice a month follow up. Discussion: Endocarditis is one of the most lethal complication of Brucellosis. Early diagnosis and effective medical and surgical management are essential.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Zhang ◽  
Haiyan Li ◽  
Shuping Hou ◽  
Huanxin Yu ◽  
Wei Yue

Abstract Background Ureaplasma urealyticum (UU) is found among the normal vaginal flora in a considerable proportion of asymptomatic women; however, adult central nervous system (CNS) infection of UU is extremely rare. Good's syndrome (GS) is an adult-onset immunodeficiency characterized by thymoma, hypogammaglobulinaemia, low or absent B‑cells, and an inverted CD4+/CD8+ T‑cell ratio. Patients with GS usually have severe or recurrent infections. Case presentation We describe the case report of a 49-year-old woman who developed UU meningitis. Initial routine anti-viral and anti-bacterial therapy showed no improvement in the patient's condition. Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) identified the UU DNA sequence. Accordingly, a diagnosis of UU meningitis was made, and minocycline therapy was initiated. The patient responded favourably, with no signs of disease at subsequent follow-up. According to the severity and rarity of the case, secondary immunodeficiency was suspected. Flow cytometry found hypogammaglobulinaemia. Combined with the previous history of thymoma, the patient was diagnosed with immune deficiency disease of GS. Conclusions This case may be the first adult case report in the literature describing UU meningitis in a patient with GS. The diagnosis of GS should be considered in patients presenting with unexplained antibody deficiency and thymoma.


2020 ◽  
Vol 16 (1) ◽  
pp. 81-83
Author(s):  
Malihe Hasanzadeh ◽  
Somayeh Moeindarbari ◽  
Leila Mousavi Seresht ◽  
Amir Hosein Jafarian ◽  
Anahita Hamidi ◽  
...  

Introduction: Vulvar leiomyomas are rare and usually misdiagnosed as Bartholin’s cyst on initial presentation. Leiomyoma of vulva accounts for only 0.03% of all gynecological neoplasm. Definite diagnosis is based on surgical excision of the tumor. The aim of this report is to introduce a case of leiomyoma of the vulva which was initially misdiagnosed as Bartholin’s cyst. Case Presentation: We present a case of a 36-year old virgin female (BMI>30) who was referred to the clinic with a 5-year history of left labial mass which was initially diagnosed as Bartholin’s cyst. The mass was removed and the pathologist confirmed that the final diagnosis was vulvar leiomyoma. Conclusion: Vulvar leiomyoma is usually misdiagnosed with Bartholin cyst and distinguishing between benign and malignant forms is confusing, so it is a diagnostic challenge. Surgical excision is the treatment of choice in all smooth muscle tumors of the vulva. Continuing follow-up after treatment is highly recommended.


2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.


2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan

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.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.


2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.


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