scholarly journals A “Crazy Paving” Pattern on CT Scan in a Patient Treated with Pembrolizumab

2019 ◽  
Vol 14 (3) ◽  
pp. 242-245
Author(s):  
Maurizio Marvisi ◽  
Sara Ramponi ◽  
Laura Balzarini ◽  
Chiara Mancini
Keyword(s):  
Ct Scan ◽  
Morbidity And Mortality ◽  
Great Promise ◽  
Significant Morbidity ◽  
Exertional Dyspnea ◽  
Standard Management ◽  
First Case ◽  
History Of ◽  
Contrast Ct

Background: Programmed cell death protein 1 (PD-1) and its ligand, PD-L1, have shown great promise in clinical practice and have been incorporated into standard management of NSCLC. Pneumonitis is a serious autoimmune toxicity associated with the use of anti-PD-1/PD-L1 antibodies, resulting in significant morbidity and mortality. Methods: We described the case of a 73-year-old woman with no history of smoking developing exertional dyspnea four months after taking Pembrolizumab. Results: High resolution contrast CT scan (HRCT) presented a unilateral “crazy paving” pattern, and bronchoalveolar lavage (BAL) an important lymphocytosis (20% of total cell count). The patient reached clinical stability after the administration of systemic steroids (2mg\Kg\die) and was discharged with long term oxygen therap Discussion: Pulmonary toxicity is frequent when using PD-1 inhibitors, resulting in significant morbidity and mortality, often leading to the discontinuation of therapy. Clinical presentation is usually protean and HRCT pattern is nonspecific. This is the first case presenting a “crazy paving” pattern associated with BAL lymphocytosis. Conclusion: Oncologists, pulmonologists, radiologists and general practitioners have to consider PD-1 and PD-L1 inhibitor pneumonitis as a potentially disabling and fatal event.

scholarly journals Mucormycosis in CAPA, a Possible Fungal Super-Infection

2021 ◽  
Vol 7 (9) ◽  
pp. 708
Author(s):  
Paola Saltini ◽  
Emanuele Palomba ◽  
Valeria Castelli ◽  
Marco Fava ◽  
Laura Alagna ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Pulmonary Aspergillosis ◽  
First Case ◽  
Super Infection

The occurrence of pulmonary fungal superinfection due to Aspergillus spp. in patients with COVID-19 is a well-described complication associated with significant morbidity and mortality. This can be related to a directed effect of the virus and to the immunosuppressive role of the therapies administered for the disease. Here, we describe the first case of pulmonary infection due to Mucorales occurring in a patient with a concomitant diagnosis of COVID-19-associated pulmonary aspergillosis.

Mitral balloon valvuloplasty

2010 ◽  
pp. 668-683
Author(s):  
Alec Vahanian ◽  
Dominique Himbert ◽  
Eric Brochet ◽  
Grégory Ducrocq ◽  
Bernard Iung
Keyword(s):  
Rheumatic Fever ◽  
Mitral Stenosis ◽  
Morbidity And Mortality ◽  
Balloon Valvuloplasty ◽  
Long Term Results ◽  
Significant Morbidity ◽  
Mitral Valvuloplasty ◽  
Western Countries ◽  
Number Of Patients

Although the prevalence of rheumatic fever has greatly decreased in Western countries, mitral stenosis (MS) still results in significant morbidity and mortality worldwide. The treatment of MS has been revolutionized since the development of balloon mitral valvuloplasty (BMV). Until the first publication by Inoue in 1984, surgery was the only treatment for patients with mitral stenosis. Since then, the technique has evolved considerably. A large number of patients with varied conditions have now been treated worldwide, enabling us to assess the efficacy and risk of the technique, and long-term results make us better able to select the most appropriate candidates for treatment using this method.

Repeated Nucleic Acid Tests Are Necessary for Early Diagnosis of Atypical COVID-19: A Case Report

Nano LIFE ◽  
2020 ◽  
Vol 10 (01n02) ◽  
pp. 2040005 ◽  
Author(s):  
Lihong Qu ◽  
Wujun Xiong ◽  
Chenghui Fan ◽  
Sheng Kang
Keyword(s):  
Nucleic Acid ◽  
Early Diagnosis ◽  
Ct Scan ◽  
Infected Individual ◽  
Left Lung ◽  
Atypical Symptoms ◽  
First Case ◽  
History Of ◽  
Ground Glass Nodules ◽  
Nucleic Acid Tests

In Wuhan, China, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported on December 8, 2019. The patient’s symptoms included fever, coughing and breathing difficulties. According to the sixth China version of 2019 coronavirus disease (COVID-19) diagnostic criteria, some patients with COVID-19 may present atypical symptoms and have negative nucleic acid tests (NATs), possibly leading to misdiagnosis and viral transmission. Our patient was a 29-year-old woman who complained of a three-day history of nasal obstruction, and no fever, coughing or breathing difficulties were noted. Physical examination revealed no obvious signs of pneumonia. On January 16, 2020, the patient flew from Wuhan to Germany for a business trip and returned to Shanghai on January 28, a passenger on her flight was tested positive for SARS-CoV-2 later. Although two consecutive NATs performed at an interval of 24 h were negative, considering her direct contact with a SARS-CoV-2-infected individual, a 64-slice computed tomography (CT) scan showed a few scattered ground-glass nodules in the left lung, suggesting possible viral pneumonia. Given the clinical characteristics, epidemiological records, CT findings and a third positive NAT, our patient was diagnosed with COVID-19. The combination of history of epidemiology, clinical symptom, lung CT scan and routine blood test will improve the clinical diagnosis of asymptomatic COVID-19, but the early diagnosis of COVID-19 can be confirmed only by the repeated NATs.

Coincidental Pituitary Adenoma and Parasellar Meningioma: Case Report

Neurosurgery ◽  
1986 ◽  
Vol 19 (2) ◽  
pp. 267-270 ◽  
Author(s):  
Kenji Yamada ◽  
Takashi Hatayama ◽  
Masahiro Ohta ◽  
Katsuaki Sakoda ◽  
Tohru Uozumi
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Head Injury ◽  
Ct Scan ◽  
The Other ◽  
Histopathological Findings ◽  
Computed Tomographic ◽  
First Case ◽  
History Of

Abstract We report a patient who had pituitary adenoma and parasellar meningioma coincidentally, with neither irradiation nor a history of head injury. Preoperative computed tomographic (CT) scan had shown a large intrasellar mass with ringlike enhancement; in contact with this mass, another well-enhanced mass had been shown. Histopathologically, the intrasellar mass was diagnosed as chromophobic pituitary adenoma and the other mass as meningotheliomatous meningioma. We present clinical, radiological, and histopathological findings and discuss previously reported cases of coincidental pituitary adenoma and meningioma without irradiation. This is the first case report since the advent of CT that pituitary adenoma and parasellar meningioma in contact with each other could be clearly demonstrated by CT.

Case of relapsing sulfasalazine-induced hypersensitivity syndrome upon re-exposure

2020 ◽  
Vol 13 (9) ◽  
pp. e235803 ◽  
Author(s):  
Jason Winward ◽  
Laurel Lyckholm ◽  
Samuel M Brown ◽  
Mohamad Mokadem
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Crohn’S Disease ◽  
Hypersensitivity Syndrome ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Timely Initiation ◽  
Source Of Infection ◽  
First Case ◽  
Appropriate Treatment

Sulfasalazine-induced hypersensitivity syndrome (SIHS) is a serious systemic delayed adverse drug reaction that is associated with significant morbidity and mortality. Here, we report the first case, to our knowledge, of a patient with previously unidentified SIHS who developed a significantly more rapid and extreme recurrence on re-exposure to sulfasalazine. The patient is a 58-year-old woman with asymptomatic Crohn’s disease who, 10 days after initiating sulfasalazine, developed fevers, diffuse rash, pancytopenia, hypotension and hepatitis without a definitive source of infection. Sixteen days after her first hospitalisation, she was restarted on sulfasalazine and was readmitted within 10 hours with a similar but more serious presentation, requiring vasopressors. She did recover completely without any further recurrence to date, after definitively discontinuing sulfasalazine. This case demonstrates the importance of recognising SIHS early in patients to prevent re-exposure to sulfasalazine and to ensure timely initiation of appropriate treatment.

scholarly journals Bacteria-ball in the urinary tract: a rare entity

2020 ◽  
Vol 6 (3) ◽  
pp. 20200039
Author(s):  
Lim Tze Ying Benjamin ◽  
Wai Loon Yam ◽  
Angeline Choo Choo Poh ◽  
Victor Ng ◽  
Sey Kiat Lim ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Ct Scan ◽  
Bladder Stone ◽  
Rare Entity ◽  
Indwelling Catheter ◽  
Diabetic Cystopathy ◽  
First Case ◽  
Gross Haematuria ◽  
Bacterial Mass

A bacterial mass in the urinary tract is a very rare entity. We report the first case of a bacterial ball within the urinary tract of a patient with diabetic cystopathy on long term urinary indwelling catheter. She presented with fever and gross haematuria. CT scan of abdomen and pelvis revealed a gas containing hyperdense mass within the bladder suspicious of bladder stone. The lesion was resected, and histopathology revealed a matrix of acellular materials with bacteria colony.

Acquired Factor VIII Inhibitors: Pathophysiology and Treatment

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 432-437 ◽  
Author(s):  
Alice D. Ma ◽  
Daniel Carrizosa
Keyword(s):  
Factor Viii ◽  
Hemophilia A ◽  
Morbidity And Mortality ◽  
Prior History ◽  
Significant Morbidity ◽  
Acquired Hemophilia A ◽  
Acquired Hemophilia ◽  
Congenital Deficiency ◽  
History Of ◽  
Bleeding Episodes

Abstract Hemophilia A is classically caused by a congenital deficiency of factor VIII, but an acquired form due to inhibitors to factor VIII (FVIII) typically presents later in life. Patients who develop such acquired factor VIII inhibitors may present with catastrophic bleeding episodes, despite having no prior history of a bleeding disorder. Though the disorder is rare, it is known to cause significant morbidity and mortality. This review will focus on what is currently known about acquired hemophilia A, its pathogenesis, its associated etiologies, and its treatment.

scholarly journals Capnocytophaga canimorsus-associated sepsis presenting as acute abdomen: do we need to think outside the box?

2019 ◽  
Vol 12 (3) ◽  
pp. e228167 ◽  
Author(s):  
Soban Ahmad ◽  
Amman Yousaf ◽  
Faisal Inayat ◽  
Shahzad Anjum
Keyword(s):  
Acute Abdomen ◽  
Present Report ◽  
Capnocytophaga Canimorsus ◽  
First Case ◽  
Clinical Presentations ◽  
History Of ◽  
Successful Clinical Outcome ◽  
Aggressive Care ◽  
Infectious Aetiology

Capnocytophaga canimorsus is a commensal bacterium commonly found in the oral cavity of dogs and cats. Although this organism rarely causes infection, prompt diagnosis is crucial for survival of these patients. Several unusual clinical presentations of this infection have been reported in the published medical literature. The present report represents the first case of C. canimorsus-related sepsis presenting with symptoms of acute abdomen in a patient with no known history of immunodeficiency. Prompt aggressive care and appropriate antibiotic therapy resulted in a successful clinical outcome with no long-term morbidity. This paper illustrates that clinicians should include this infectious aetiology among the differentials of patients presenting with acute abdomen, regardless of their immune status. Additionally, this paper outlines our current understanding of the epidemiology of and risk factors for C. canimorsus-associated sepsis, the pathophysiology of this disorder, and currently available approaches to diagnosis and management.

Primary medulla oblongata teratomas

2014 ◽  
Vol 14 (3) ◽  
pp. 296-300 ◽  
Author(s):  
Da Li ◽  
Shu-Yu Hao ◽  
Zhen Wu ◽  
Li-Wei Zhang ◽  
Jun-Ting Zhang
Keyword(s):  
Medulla Oblongata ◽  
Histopathological Examination ◽  
Mature Teratoma ◽  
Radiographic Findings ◽  
First Case ◽  
Cystic Component ◽  
Long Term Follow Up ◽  
History Of

Medulla oblongata teratomas are rare. The authors report 2 new cases of teratomas that occurred exclusively in the medulla oblongata. The first case was in a 9-year-old boy who presented with a 6-month history of neck pain and repeated paroxysmal vomiting. Based on preoperative radiographic findings, the initial diagnosis was of an intraaxial medulla oblongata hemangioblastoma. Intraoperatively, the cystic component of the tumor was gray, gelatinous, and soft in consistency. The solid component was light pink, rubbery, and nodular in appearance, with an identifiable boundary. The lesion was completely removed. Histopathological investigation revealed a mature teratoma. Postoperatively, the patient was supported with ventilator assistance and received a tracheotomy, but died of intracranial infection. The second case was in a 10-year-old boy with intermittent headache for 1 month. Radiographs revealed an exophytic cystic and solid lesion with dorsal involvement of the medulla oblongata. The lesion was predominantly solid, pinkish gray, tenacious, and moderately vascularized, with clearly delineated surgical dissection planes. The histopathological examination confirmed a diagnosis of immature teratoma. Total resection was achieved, followed by postoperative chemotherapy. He was alive without recurrence of the lesion or symptoms at 59 months after surgery. Resection of medulla oblongata teratoma is challenging, with inherent surgical risks that are contingent on the tumor growth pattern. Teratomas should be considered in the differential diagnosis of brainstem lesions. Chemotherapy has been suggested for immature teratomas. Long-term follow-up and larger studies of teratomas in unusual locations are required to improve practitioners' understanding of this disease's treatment and outcomes.

scholarly journals Melioidosis in a Returned Traveller

2014 ◽  
Vol 25 (4) ◽  
pp. 225-226 ◽  
Author(s):  
Zain Chagla ◽  
Natasha Aleksova ◽  
Jaclyn Quirt ◽  
Joel Emery ◽  
Christian Kraeker ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Present Report ◽  
The Philippines ◽  
Clinical Suspicion ◽  
Morbidity And Mortality ◽  
Northern Australia ◽  
Significant Morbidity ◽  
Clinical Specimens ◽  
History Of

Melioidosis is an infection endemic to Southeast Asia and Northern Australia, and is associated with significant morbidity and mortality. The present report describes a case of chronic melioidosis in a returning traveller from the Philippines. Clinical suspicion of this illness is warranted in individuals with a history of travel to endemic regions. Safety in handling clinical specimens is paramount because laboratory transmission has been described.

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