scholarly journals Retrobulbar Cryptococcoma Mimicking Tumor in a Labrador Retriever

2021 ◽  
Vol 49 ◽  
Author(s):  
Fábio Luiz da Cunha Brito ◽  
Eduardo Perlmann ◽  
Jéssica Naiara Voitena ◽  
Andrea Kuner ◽  
Rayssa Dias Faleiro
Keyword(s):  
Computed Tomography ◽  
Olfactory Bulb ◽  
Cryptococcus Neoformans ◽  
Frontal Bone ◽  
Labrador Retriever ◽  
Dorsal Region ◽  
Fungal Propagules ◽  
Ocular Ultrasound ◽  
Orbital Wall ◽  
History Of

Background: Cryptococcosis is a systemic mycotic disease caused by encapsulated yeasts C. neoformans and C. gattii. Cryptococcus neoformans is predominantly found in soils and feces of pigeons and psittacids. Infection occurs mainly through the respiratory tract, through the inspiration of fungal propagules (basidiospores and/or desiccated yeast cells). The main lesions observed are in the nasal cavity and lungs, but in dogs, the central nervous system and eyes are widely affected. Despite some previously mentioned reports, the retrobulbar form has not been described in the literature. Therefore, the purpose of this report is to describe a case of retrobulbar cryptococcoma mimetizing a tumor in a young bitch.  Case: A 2-year-old female Labrador Retriever,  was admitted to one Veterinary Hospital with exophthalmia on the left eye for 15 days and other signs included negative retropulsion, mydriasis, and abscence of menace and pupillary reflexes. Ocular ultrasound imaging revealed a hyperecotic and heterogeneous retrobulbar mass in the mid-dorsal region compressing the optic nerve. Computed tomography of the skull showed the presence of proliferation of neoplastic tissue in a locally invasive retrobulbar region promoting      moderate rostrolateral displacement of the left ocular bulb, discrete osthelysis in maxillary bone, palatine, medial wall of the orbital bone and frontal bone, with destruction of cribiform plate adjacent to the dorsal region of the orbital wall and presence of mild contrast uptake in the region of the left olfactory bulb lobe, characterizing a picture compatible with neoplasia with malignancy and locally invasive characteristics. Exenteration and excision of part of the frontal bone were performed and histopathological examination revealed granulation with the presence of fibroblasts and  numerous typical blastoconidia of Cryptococcus neoformans. The patient was treated with Itraconazole [10 mg/kg, v.o, SID, for 90 days] and one year after diagnosis, X-ray was performed to control the lesion and radiographic aspects were within normal limits.Discussion: Cryptococcus sp. is an environmental fungus that has the potential to be pathogenic to humans and animals. Fungus present as a basidiospores in pigeon droppings. The patient described had a history of contact with free-living pigeons, making it a risk factor for the occurrence of cryptococcosis, being the possible cause of the infection. In dogs, the disease is mainly described in immunosuppressed animals, which was not the case of the patient, who presented clinical and laboratory results within the normal range and without a previous history of use of immunosuppressants. The alterations described in the computed tomography, such as destruction of the cribriform plate adjacent to the dorsal region of the left orbital wall and the presence of slight contrast uptake in the left olfactory bulb lobe region, are compatible with the main entry point for propagules of Cryptococcus sp. In the present case, no periocular and ocular alterations were observed as described in the literature, and the lesion was restricted to the retrobulbar space. Ultrasonography and computed tomography revealed a neoformation mimicking a malignant neoplasm and the diagnosis of cryptococcoma was revealed by histopathology.  Based on the present case, cytology through aspiration of retrobulbal neoformations is imperative as a diagnostic method, especially in endemic areas for fungal diseases that can mimic ocular neoplasms. Keywords: cryptococcosis, fungus, Cryptococcus sp., dog. Descritores: criptococose, fungo, Cryptococcus sp., cão.

Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

2014 ◽  
Vol 17 (1) ◽  
pp. 42
Author(s):  
Shi-Min Yuan
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Female Patient ◽  
Constrictive Pericarditis ◽  
Delayed Diagnosis ◽  
Young Female ◽  
Refractory Ascites ◽  
Diagnostic Challenge ◽  
Massive Ascites ◽  
History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

Outer Table Frontal Bone Fracture: When Need Surgical Intervention?

2018 ◽  
Vol 2 (3) ◽  
pp. 167
Author(s):  
Adam Mohamad ◽  
Irfan Mohamad ◽  
Khairulzaman Adnan ◽  
Syed Yusoff Alzawawi Syed Abdul Fattah
Keyword(s):  
Bone Fracture ◽  
Open Reduction ◽  
Surgical Intervention ◽  
Rectus Muscle ◽  
Frontal Bone ◽  
Facial Bone ◽  
Orbital Roof ◽  
Orbital Wall ◽  
Outer Table ◽  
Superior Rectus Muscle

Frontal bone fracture is a common facial bone fracture which commonly involved the outer table part. Most of the time outer table fracture is treated conservatively. However, when there is involvement of orbital wall fracture, as well as entrapment of extraocular muscle, surgical intervention via open reduction and internal fixation is needed. We described a case of outer table frontal bone fracture with left orbital roof fracture complicated with superior rectus muscle entrapment which was successfully treated via open reduction and internal fixation.International Journal of Human and Health Sciences Vol. 02 No. 03 July’18. Page : 167-169

scholarly journals Scopolamine fatal outcome in an inmate after buscopan® smoking

2021 ◽  
Author(s):  
Sabina Strano-Rossi ◽  
Serena Mestria ◽  
Giorgio Bolino ◽  
Matteo Polacco ◽  
Simone Grassi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Drug Abuse ◽  
Muscarinic Receptors ◽  
Histopathological Examination ◽  
Fatal Outcome ◽  
Post Mortem ◽  
Butyl Bromide ◽  
Cannabis Abuse ◽  
Toxic Concentration ◽  
History Of

AbstractScopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

The diagnosis of early pneumoconiosis in dust-exposed workers: comparison of chest radiography and computed tomography

2021 ◽  
pp. 028418512110225
Author(s):  
Hideyuki Hayashi ◽  
Kazuto Ashizawa ◽  
Masashi Takahashi ◽  
Katsuya Kato ◽  
Hiroaki Arakawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Radiography ◽  
Pulmonary Emphysema ◽  
Early Stage ◽  
Pathological Changes ◽  
Occupational History ◽  
Exposed Workers ◽  
History Of ◽  
Ct Data ◽  
Positive Results

Background Chest radiography (CR) is employed as the evaluation of pneumoconiosis; however, we sometimes encounter cases in which computed tomography (CT) is more effective in detecting subtle pathological changes or cases in which CR yields false-positive results. Purpose To compare CR to CT in the diagnosis of early-stage pneumoconiosis. Material and Methods CR and CT were performed for 132 workers with an occupational history of mining. We excluded 23 cases of arc-welder’s lung. Five readers who were experienced chest radiologists or pulmonologists independently graded the pulmonary small opacities on CR of the remaining 109 cases. We then excluded 37 cases in which the CT data were not sufficient for grading. CT images of the remaining 72 cases were graded by the five readers. We also assessed the degree of pulmonary emphysema in those cases. Results The grade of profusion on CR (CR score) of all five readers was identical in only 5 of 109 cases (4.6%). The CR score coincided with that on CT in 40 of 72 cases (56%). The CT score was higher than that on CR in 13 cases (18%). On the other hand, the CT score was lower than that on CR in 19 cases (26%). The incidence of pulmonary emphysema was significantly higher in patients whose CR score was higher than their CT score. Conclusion CT is more sensitive than CR in the evaluation of early-stage pneumoconiosis. In cases with emphysema, the CR score tends to be higher in comparison to that on CT.

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

scholarly journals Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

2021 ◽  
Vol 07 (03) ◽  
pp. e124-e126
Author(s):  
Mark Portelli ◽  
Mark Bugeja ◽  
Charles Cini
Keyword(s):  
Computed Tomography ◽  
Young Adult ◽  
Rare Case ◽  
Surgical Repair ◽  
Bochdalek Hernia ◽  
Case Presentation ◽  
Atypical Case ◽  
Accident And Emergency ◽  
History Of ◽  
Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

scholarly journals Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Predictive Value ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Left Portal Vein ◽  
History Of ◽  
Associated Malformations ◽  
Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

scholarly journals Are RNA-Based Tests Sufficient for COVID-19 Diagnosis? An Inspiration of Three Asymptomatic Cases

2021 ◽  
Vol 30 ◽  
pp. 096368972098545
Author(s):  
Tao Hu ◽  
Xiao Liu ◽  
Qinan Yin ◽  
Xingting Duan ◽  
Li Yan
Keyword(s):  
Computed Tomography ◽  
Nucleic Acid ◽  
Virus Infection ◽  
Severe Acute Respiratory Syndrome ◽  
The Other ◽  
Computed Tomography Scan ◽  
Health Authorities ◽  
History Of ◽  
Tomography Scan ◽  
Nucleic Acid Tests

In this work, we discovered a new phenomenon—asymptomatic COVID-19 infection, or covert case, during the pandemic. All the 3 patients had a history of exposure, with no symptoms, and no abnormalities were found in computed tomography scan or lab tests. Except for case 2, the other patients’ severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) nucleic acid tests were negative. But their anti-SARS-COV-2 nucleocapsid antibody showed a dynamic trend, consistent with the process of virus infection and clearance. A growing number of asymptomatic or covert cases need more attention. Lack of surveillance may lead to another outbreak. We hope to demonstrate our cases to attract the attention of governments or health authorities that covert cases should be the focus as well.

scholarly journals Additive value of positron emission tomography/computed tomography scan for detection of aortic tube graft infection: a case report

2020 ◽  
Author(s):  
Farnoosh Larti ◽  
Mohammad Amin Khadembashiri ◽  
Mehrshad Abbasi ◽  
Alborz Sherafati
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Graft Infection ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
History Of ◽  
Pet Ct Scan

Abstract Background Diagnosis of aortic graft infection is challenging, and delayed diagnosis is associated with poor prognosis. Positron emission tomography/computed tomography (PET/CT) has improved diagnostic accuracy. Case summary A patient with a history of congenital heart disease was admitted due to fever. He had a history of four cardiac surgeries, including the Bentall procedure for endocarditis. Blood cultures were negative. A semi-mobile mass was detected in the distal portion of the aortic tube graft in echocardiography. PET/CT scan was used to confirm tube graft infection and to support proceeding to cardiac surgery. Discussion Using multimodality imaging, including PET/CT scan in combination with echocardiography, can improve diagnostic accuracy for the detection of aortic tube graft infection, infection of prosthetic valves, or intra-cardiac devices, especially in high-risk surgical cases.

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