Kawasaki disease; rare; or misdiagnosed: A case report in a tertiary hospital in Nigeria

2021 ◽  
Vol 5 ◽  
pp. 35-39
Author(s):  
Callistus Achuri Okwuchukwu Enyuma ◽  
Anthony Chimereze Amajor ◽  
Enobong Ufot Akpah ◽  
Ekaete Samuel Brown-Abang
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Delayed Diagnosis ◽  
Male Infant ◽  
Tertiary Hospital ◽  
Moderate Dose ◽  
Diagnostic Dilemma ◽  
Dose Aspirin ◽  
High Index Of Suspicion ◽  
Children Under 5

Kawasaki disease (KD) is a self-limiting, acute febrile vasculitis with predilection for children under-5 years. Most reports have emanated from Japan with only a few cases reported in Africa. KD presents a diagnostic dilemma and a high index of suspicion is critical as early treatment reduces the incidence of complications. We describe a 5-month-old male infant who presented with classical clinical features though with delayed diagnosis. Received moderate dose aspirin with limitation of access to intravenous immunoglobulin and who did not develop coronary artery complication. The case report highlights the diagnostic challenges faced by practitioners, made worse by the low index of suspicion inherent in our setting. The fatal complications that may be associated with KD can, therefore, be avoided. It is hoped that pediatricians in particular would become conversant with the diagnostic criteria to facilitate early diagnosis and intervention in children.

scholarly journals Acute bilateral renal vein thrombosis diagnosis and management: a case report

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Paul Ghaly ◽  
Jim Iliopoulos ◽  
Mehtab Ahmad
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Renal Vein ◽  
Significant Proportion ◽  
Delayed Diagnosis ◽  
Renal Vein Thrombosis ◽  
Diagnostic Dilemma ◽  
Delay In Diagnosis ◽  
Vein Thrombosis ◽  
Persistent Abdominal Pain

Abstract Undifferentiated abdominal pain accounts for a significant proportion of emergency presentations and often presents as a diagnostic dilemma. Renal vein thrombosis (RVT) has many aetiologies including nephrotic syndrome, malignancy, trauma, infection and hypercoagulable states. RVT should be considered in cases of persistent abdominal pain where other, more common, pathologies have been excluded. We present the case of a 42-year-old male with a delayed diagnosis of bilateral RVT after presenting with multiple episodes of intractable abdominal pain and adverse sequelae of this condition. This case report aims to emphasize the importance of prompt RVT recognition and the utility of bedside emergency department (ED) investigations, which can guide initial differential diagnoses of abdominal pain, reduce the delay in diagnosis as well as limit unnecessary investigations.

scholarly journals Unusual Presentation of Gastric Perforation by Foreign Body: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
V. S. R. Rao ◽  
R. Sarkar ◽  
Richard Turner ◽  
K. R. Wedgwood
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Gastric Perforation ◽  
Interesting Case ◽  
Atypical Presentation ◽  
Diagnostic Dilemma ◽  
Ingested Foreign Body ◽  
High Index Of Suspicion

Perforation of the gastrointestinal tract by ingested foreign body is rare. The majority of patients do not recall ingestion of the foreign body, and dietary foreign bodies are most commonly involved. We present an interesting case where the offending foreign body gave rise to a diagnostic dilemma masquerading as a pancreatic mass. A high index of suspicion is indicated especially when dealing with atypical presentation and nonspecific symptoms as highlighted in this case.

scholarly journals Diagnostic Dilemma in Groove Pancreatitis: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Uttam Laudari ◽  
Roshan Ghimire ◽  
Rosi Pradhan ◽  
Dhiresh Kumar Maharjan ◽  
Prabin Bikram Thapa
Keyword(s):  
Case Report ◽  
Chronic Pancreatitis ◽  
Ductal Adenocarcinoma ◽  
Diagnostic Dilemma ◽  
Perioperative Morbidity ◽  
Persistent Symptoms ◽  
Groove Pancreatitis ◽  
History Of ◽  
High Index Of Suspicion

Groove pancreatitis is uncommon form of chronic pancreatitis common in patients with history of smoking and alcohol abuse. High index of suspicion is required as it may masquerade pancreatic ductal adenocarcinoma and both of these conditions are difficult to differentiate preoperatively. Pancreaticoduodenectomy has good outcome in patient with Groove pancreatitis. Hence, we are reporting a case report of Groove pancreatitis in 40 years gentleman, who was being managed by multiple endoscopic dilatations, later underwent pancreaticoduodenectomy for persistent symptoms. He had no perioperative morbidity and doing well in 24 months follow up.

scholarly journals Ocular Dirofilariasis - A Diagnostic Dilemma

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Case Report ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Index ◽  
Diagnosis And Treatment ◽  
Care Hospital ◽  
Diagnostic Dilemma ◽  
Main Species ◽  
Proper Diagnosis ◽  
High Index Of Suspicion

Dirofilariasis is a zoonotic filariasis primarily affecting canines. It may infect humans causing pulmonary infarcts, subcutaneous and subconjunctival nodules. Dirofilaria repens is the main species inplicated in subconjunctival lesions. Proper diagnosis and treatment can cure the patient of all his symptoms. Hence it is important to have a high index of suspicion about this emerging zoonosis. This is a case report of ocular Dirofilariasis from a tertiary care hospital in Thrissur, Kerala.

scholarly journals Kawasaki disease: A case report

2012 ◽  
Vol 1 (1) ◽  
pp. 26-28 ◽  
Author(s):  
AR Ojha ◽  
A Nepal ◽  
R Acharya ◽  
KN Shakya
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Diagnostic Criteria ◽  
High Index ◽  
Uneventful Recovery ◽  
Medical College ◽  
Prolonged Fever ◽  
History Of ◽  
High Index Of Suspicion

Kawasaki disease is a vasculitis of medium sized arteries which is diagnosed by exclusion and by use of diagnostic criteria. It needs a high index of suspicion to diagnose and should be suspected in any child with history of fever for more than a week with rash and lymphadenopathy. Such patients should be treated with intravenous immunoglobulin and Aspirin to prevent complications. Here we report a case of Kawasaki Disease who presented with prolonged fever, rash and lymphadenopathy and made an uneventful recovery. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7252 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.26-28

scholarly journals Incomplete Kawasaki Disease: A Rising Trend

2016 ◽  
Vol 36 (2) ◽  
pp. 208-212
Author(s):  
Madiha Zainab ◽  
Suparna Guha
Keyword(s):  
Kawasaki Disease ◽  
Developed Countries ◽  
Aneurysm Rupture ◽  
Incomplete Kawasaki Disease ◽  
Diagnostic Dilemma ◽  
Paediatric Department ◽  
Male Preponderance ◽  
The Developed Countries ◽  
One Year ◽  
High Index Of Suspicion

Kawasaki Disease is the most common cause of acquired heart disease in the developed countries. The diagnosis of typical Kawasaki Disease (KD)is not much of a problem. However incomplete Kawasaki Disease where only two to three clinical features are present, poses a diagnostic dilemma. Here we report our experience with the disease in the paediatric department of Vivekananda Institute of Medical Sciences (VIMS). In one year retrospective study from Jan 2015 to Jan 2016, 20 cases were diagnosed as KD, of which five were complete and 15 incomplete. Fifty percent of cases were less than one year’s age and there was male preponderance. More than 90% showed echo changes and all except one responded to IVIG and aspirin who succumbed due to aneurysm rupture. So we conclude that high index of suspicion for diagnosing KD must be there and early treatment to prevent echocardiographic changes.J Nepal Paediatr Soc 2016;36(2):208-212

Tick infestation masquerading as a nodule in the eye lid

2020 ◽  
Vol 12 (1) ◽  
pp. 106-109
Author(s):  
Nirsara Shrestha ◽  
Sangeeta Shrestha ◽  
Arjun Shrestha ◽  
Barsha Suwal ◽  
Samata Sharma
Keyword(s):  
Case Report ◽  
Tick Infestation ◽  
Tick Bite ◽  
Diagnostic Dilemma ◽  
Recent Onset ◽  
Pigmented Lesions ◽  
Pigmented Lesion ◽  
The Right ◽  
High Index Of Suspicion ◽  
Pigmented Nevi

Introduction: Ticks are ectoparasites which can lead to various blood borne diseases. Tick bite may resemble pigmented nevi, mole or nodule resulting a diagnostic dilemma. Tick bite in eye lid is rare and this case report describes tick bite in lower eye lid mimicking a traumatized pigmented nodule where the tick was identified only on magnification and was successfully removed mechanically. Case: A 61-year-old man presented to the eye out patient department with a sudden and painful black pigmented lesion on the right lower lid for four days. The tick was manually removed with forceps. Conclusion: This case report explains the need for a high index of suspicion as tick bite in sudden or recent onset pigmented lesions especially in endemic areas.

scholarly journals COVID-19 ile Olası İlişkili İnkomplet Kawasaki Hastalığı: Olgu Sunumu

2021 ◽  
Vol 2 (2) ◽  
pp. 56-59
Author(s):  
Muzaffer ALTINTAŞ ◽  
Engin YURDAKUL ◽  
Feyza Ayşenur PAÇ ◽  
Meltem REFİKER EGE
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Inflammatory Disease ◽  
Clinical Aspects ◽  
Incomplete Kawasaki Disease ◽  
Small Vessels ◽  
Systemic Inflammatory Disease ◽  
Rapid Spread ◽  
Children Under 5

Incomplete Kawasaki Disease Probable Associated with COVID-19: A Case Report Kawasaki disease is an acute systemic inflammatory disease affecting the medium and small vessels mostly in children under 5 years old. Although SARS-CoV2 less severely affects children, with the rapid spread of disease some new clinical aspects like Kawasaki-like disease have been reported in children affected by COVID-19. Here in we present a child with incomplete Kawasaki disease probably associated with COVID-19. Keywords: Kawasaki-like disease, incomplete Kawasaki, SARS-CoV2, COVID-19

CASE REPORT: RARE FORM OF HIRSCHPRUNG’S DISEASE

2020 ◽  
Vol 30 (5) ◽  
pp. 82-84
Author(s):  
Ilja Skalskis
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Clinical Symptoms ◽  
Hirschsprung Disease ◽  
Distal Colon ◽  
Total Colonic Aganglionosis ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
History Of ◽  
High Index Of Suspicion

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.

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