Recurrent Episodes of Pericardial Effusion as Isolated Manifestation of Tuberculosis: Case Report

Author(s):  
Oscar Westin ◽  
Abbas Ali Qayyum

Background: Recurrent episodes of isolated pericardial effusion due to tuberculosis, leading to reduced Left Ventricle Ejection Fraction (LVEF), are uncommon. Methods: This is a case report of a previously healthy 32-years old male with tuberculous induced pericardial effusion as isolated manifestation. The only known exposure of tuberculosis was a brother with whom the patient did not have physical contact during the last year. The pericardial effusion repeatedly appeared after being drained a total of three times. Due to recurrent episodes of pericardial effusion, severe thickening of the pericardium, pericardial adherences and increasing affection on the heart, pericardiectomy was ultimately performed. Results: Biochemical examination, chest X-ray, computed tomography of thorax and abdomen and cytology report did not reveal any signs of malignancy, connective tissue disease or other infections including extra-pulmonary/pulmonary tuberculosis. However, the pericardial biopsy was Polymerase Chain Reaction positive (PCR) for tuberculosis DNA and showed granulomatous inflammation with necrosis. After 6 months anti-tuberculous therapy, biochemical parameters, LVEF and the clinical condition of the patient were normalized. Conclusion: Tuberculosis can be difficult to diagnose when it only manifests as pericardial effusion especially if the time for exposure is long before the appearance of symptoms and admission.

2016 ◽  
Vol 2 (3) ◽  
pp. 129-133
Author(s):  
Ioan Manițiu ◽  
Iulia Cobârje ◽  
Ionuț Bitea ◽  
Radu Cojan ◽  
Andra-Maria Bebeşelea

Abstract Introduction: Pericardiocentesis is a procedure performed for diagnostic and therapeutic purposes, and it consists in draining the pericardial effusion liquid in sterile conditions. The accumulation of fluid in the pericardial space may be caused by several systemic conditions, including viral or bacterial infections, autoimmune disease, cancer, as well as thyroid malfunction. A rapidly growing pericardial effusion can lead to cardiac tamponade, and consequently to acute hypodiastolic heart failure. Case report: We report the case of a 79-year-old female, without previously known cardiovascular pathologies, who presented to the Emergency Room due to a gradual deterioration in her health status. Imaging procedures included a chest X-ray and an echocardiography that confirmed the diagnosis of pericardial effusion. Pericardiocentesis was performed using cardiac ultrasound guidance, resulting in the draining of a small quantity of yellowish, partly haemorrhagic fluid. The patient's general condition did not improve, thus another pericardiocentesis was carried out, this time with fluoroscopical and cardiac ultrasound guidance, and 1200 milliliters of sero-haemorrhagic fluid was drained. The laboratory analysis revealed that the patient had hypothyroidism, and the cytological analysis of the drained pericardial fluid excluded a neoplastic origin, tuberculosis, and other infectious etiologies. The particularity of the case consists in a pericardial effusion evolving into cardiac tamponade, for which the pericardiocentesis was guided using echocardiographic, fluoroscopic and radiologic methods, because simple ultrasound-guided drainage was not efficient. Conclusion: The superiority of a combined imaging-guided approach in cases of pericardial effusion recommends it as an alternative to a surgical procedure, guided solely by echocardiography, which is often used in cases of unsuccessful drainage of pericar-dial effusion fluid.


Author(s):  
Fotis Konstantinou ◽  
Natalia Vallianou ◽  
Victoria Gennimata ◽  
Angelos Konstantinou ◽  
Evangelos Kokkinakis

Author(s):  
Vishu Madaan ◽  
Aditya Roy ◽  
Charu Gupta ◽  
Prateek Agrawal ◽  
Anand Sharma ◽  
...  

AbstractCOVID-19 (also known as SARS-COV-2) pandemic has spread in the entire world. It is a contagious disease that easily spreads from one person in direct contact to another, classified by experts in five categories: asymptomatic, mild, moderate, severe, and critical. Already more than 66 million people got infected worldwide with more than 22 million active patients as of 5 December 2020 and the rate is accelerating. More than 1.5 million patients (approximately 2.5% of total reported cases) across the world lost their life. In many places, the COVID-19 detection takes place through reverse transcription polymerase chain reaction (RT-PCR) tests which may take longer than 48 h. This is one major reason of its severity and rapid spread. We propose in this paper a two-phase X-ray image classification called XCOVNet for early COVID-19 detection using convolutional neural Networks model. XCOVNet detects COVID-19 infections in chest X-ray patient images in two phases. The first phase pre-processes a dataset of 392 chest X-ray images of which half are COVID-19 positive and half are negative. The second phase trains and tunes the neural network model to achieve a 98.44% accuracy in patient classification.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.


Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 343
Author(s):  
Adela Saco ◽  
Natalia Rakislova ◽  
Lorena Marimon ◽  
Aureli Torne ◽  
Berta Diaz-Feijoo ◽  
...  

Malacoplakia is an uncommon chronic granulomatous inflammation that rarely affects the female genital tract. A case of a 78-year-old woman with malacoplakia involving the uterine cervix and the vagina is described. The patient complained of vaginal bleeding. Clinically, a 13-mm mass was detected in the cervix, which was confirmed by ultrasound scan and magnetic resonance imaging. Histological examination showed a dense histiocytic infiltrate with abundant Michaelis–Gutmann bodies involving the uterine cervix and the upper vagina. The presence of Escherichia coli was confirmed in the lesion by immunohistochemistry and polymerase chain reaction. Only 12 cases of cervical malacoplakia have been reported to date. This condition should be included in the differential diagnosis of cervical tumors.


Author(s):  
Valentina Angelini ◽  
Alberta Villanacci ◽  
Angelo Belotti ◽  
Francesca Castagnoli ◽  
Barbara Frittoli ◽  
...  

Abstract Background The purpose of this case report is to emphasize the importance of curing any clinical radiological elements in this historical period, especially in the area of endemic to coronavirus disease 19 (COVID-19) such as Lombardy and to stress the importance of the management of the asymptomatic patient, their crucial role in the spread of contagion. Case presentation We reported the case of incidental diagnosis of interstitial pneumonia by first finding on whole-body MR (WB-MR) in the patient affected by multiple myeloma (MM), with a negative respiratory symptoms at the time and with previous (1 month before) negative chest X-ray. The patient was promptly subjected to chest CT, which confirmed the suspicion of interstitial COVID-19 pneumonia and, in hospitalization, performed nasopharyngeal swabs for real-time polymerase chain reaction (RNA-PCR), with a doubtful outcome. Once the bacterial nature of the alterations was serologically and radiologically excluded, the patient was definitively diagnosed with COVID-19 and appropriately treated in hospitalization. Conclusion The clinical choices must, therefore, to make use of all the diagnostic tools available and full knowledge of the limitation of each of them.


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