scholarly journals Primary Infective Pyomyositis of the Hip Abductors Presenting as Trochanteric Bursitis

2019 ◽  
pp. 1-3
Author(s):  
Sheridan GA ◽  
Johnson DP ◽  
Heffernan EJ ◽  
Curtin PD
Keyword(s):  
Diabetes Mellitus ◽  
White Cell Count ◽  
Sudden Onset ◽  
Hip Pain ◽  
Trochanteric Bursitis ◽  
Incision And Drainage ◽  
Lateral Incision ◽  
Trochanteric Region ◽  
History Of ◽  
Suppurative Infection

Introduction: Pyomyositis is an uncommon suppurative infection of skeletal muscle. In recent times, it is becoming more prevalent in the context of immunosuppression and diabetes and it is known to show a preponderance for pelvic girdle muscles. We present a case of a primary infective pyomyositis of the gluteal musculature in a diabetic patient which presented initially as a typical greater trochanteric bursitis. Case Report: A 52 year old female presented with sudden onset left lateral thigh pain localized to the greater trochanteric region. Relevant comorbidities included a BMI of 35, uncontrolled non insulindependent diabetes mellitus and hypertension. Her HbA1c on presentation was 97mmol/mol. She had a raised CRP of 92 with a normal white cell count. MRI confirmed an ill-defined collection overlying the gluteal tendon insertions with extensive surrounding oedema. The patient was surgically managed and underwent incision and drainage through a direct lateral incision. Samples sent were positive for staphylococcus aureus and the patient was commenced on IV flucloxacillin. They progressed to a full recovery. Conclusion: We recommend that consideration be given to infective pyomyositis in the differential for patients presenting acutely with trochanteric hip pain. Pyrexia, raised inflammatory markers and a history of diabetes mellitus or other immunosuppressive conditions should raise clinical suspicion for occult infection even in the setting of a common clinical complaint such as trochanteric hip pain. MRI is essential in achieving early diagnosis and surgical drainage and medical management can lead to a good clinical recovery.

scholarly journals Yellow fever vaccine-associated neurological disease: it is not just the silver generation at risk

2019 ◽  
Vol 12 (5) ◽  
pp. e229558 ◽  
Author(s):  
Emily J Goldstein ◽  
David J Bell ◽  
Rory N Gunson
Keyword(s):  
Yellow Fever ◽  
Neurological Disease ◽  
White Cell Count ◽  
Sudden Onset ◽  
Yellow Fever Vaccine ◽  
Viral Pathogens ◽  
Elevated Protein ◽  
History Of ◽  
Simplex Virus ◽  
Sixth Nerve

A 35-year-old man presented to his optician with sudden onset diplopia and a 1-week history of headaches. He was noted to have sixth nerve palsy. The following day he was admitted to hospital with confusion and expressive dysphasia. He had been due to travel to Ghana on business and had received yellow fever (YF) vaccination 18 days prior to onset of headaches. His initial cerebrospinal fluid (CSF) revealed elevated protein, increased white cell count but was PCR negative for standard viral pathogens. Herpes simplex virus (HSV)-1 was detected by PCR in CSF at a very low level from a second lumbar puncture performed 6 days later, and the patient was treated for HSV meningoencephalitis. However, retrospective investigation for yellow fever vaccine-associated neurological disease revealed increasing titres of YF IgG in three serial CSF samples, and no evidence of HSV antibodies in CSF or plasma, ruling out HSV encephalitis.

scholarly journals Catheter-Directed Thrombolysis in Patient with Acute Limb Ischemia Grade IIB

2016 ◽  
pp. 88-93
Author(s):  
Yanna Indrayana ◽  
Djanggan Sargowo
Keyword(s):  
Diabetes Mellitus ◽  
Limb Ischemia ◽  
Sudden Onset ◽  
Leg Pain ◽  
Acute Limb Ischemia ◽  
Catheter Directed Thrombolysis ◽  
Limb Perfusion ◽  
History Of ◽  
Sudden Decrease ◽  
Flow Improvement

Acute limb ischemia was defined as sudden decrease in limb perfusion of less than 14 days duration, resulting in variable ischaemic clinical manifestation and potential risk of limb loss. We reported a case female 64 years old with sudden onset of right leg pain in last 3 days with history of hipertension, Diabetes Mellitus and heart failure. From physical examination of lower extremity was found pulselessness, pallor, paresthesi, poikilothermia, paralysis, and pain at the level of A. Poplitea dextra. Diagnosis was confirmed with Duplex Ultrasonography. From arteriography we found thrombus with subtotal occlusion at proximal a. Femoralis dextra and diffuse stenosis at the distal. Operation was not carried out as the request of the patient and it was decided to performed Catheter-directed Thrombolysis. In evaluation there was flow improvement at a. Femoralis dextra but it did not reach peripheral perfussion due to reperfussion injury.

scholarly journals A case of diabetic myonecrosis: A rare complication of a common disease

2019 ◽  
Vol 7 ◽  
pp. 2050313X1882346
Author(s):  
Rami Alkhoury
Keyword(s):  
Diabetes Mellitus ◽  
Rare Complication ◽  
Diabetic Control ◽  
Serum Glucose ◽  
Sudden Onset ◽  
Common Disease ◽  
Diabetic Patients ◽  
History Of ◽  
Uncommon Condition

Diabetes mellitus is a growing concern in today’s population and a common cause of significant morbidity and mortality in those affected. Diabetic myonecrosis is an uncommon condition that can be seen in uncontrolled, long-standing diabetic patients who complain of localized, sudden-onset muscle pain. We present a 57-year-old woman with type 2 diabetes mellitus who presented to the emergency department with left-sided pelvic pain for the past 2 months. The pain had progressively gotten worse with a significant reduction in the range of motion of her left hip. Magnetic resonance imaging imaging revealed focal enhancement, edema, and enlargement of the left iliacus muscle. Assessment of serum glucose and hemoglobin A1c revealed a history of poor diabetic control, eventually giving rise to a diagnosis of diabetic myonecrosis. She was discharged with a new diabetic regimen, pain control, and outpatient physical therapy.

scholarly journals Lateral Hip Pain in an Athletic Population: Differential Diagnosis and Treatment Options

2010 ◽  
Vol 2 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Robert C. Grumet ◽  
Rachel M. Frank ◽  
Mark A. Slabaugh ◽  
Walter W. Virkus ◽  
Charles A. Bush-Joseph ◽  
...  
Keyword(s):  
Treatment Options ◽  
Pain Syndrome ◽  
Hip Pain ◽  
Treatment Modalities ◽  
Diagnostic Tools ◽  
Iliotibial Band ◽  
Trochanteric Bursitis ◽  
Medline Search ◽  
Trochanteric Region ◽  
Lateral Hip Pain

Context: Historically, the term greater trochanteric pain syndrome has been used to describe a spectrum of conditions that cause lateral-sided hip pain, including greater trochanteric bursitis, snapping iliotibial band, and/or strains or tendinopathy of the abductor mechanism. Diagnosis of these conditions may be difficult because clinical presentations are variable and sometimes inconclusive. Especially difficult is differentiating intrinsic pain from pain referred to the greater trochanteric region. The purposes of this article are to review the relevant anatomy and pathophysiology of the lateral hip. Evidence Acquisition: Data were collected through a thorough review of the literature conducted through a MEDLINE search of all relevant papers between 1980 and January 2010. Results: Recent advances in imaging and an improved understanding of pathomechanics have helped to guide the evaluation, diagnosis, and appropriate treatment for patients presenting with lateral hip pain. Conclusion: Various diagnostic tools and treatment modalities can be used to effectively manage the athletic patient presenting with lateral hip pain.

scholarly journals A Type 2 Diabetes Patient who Suffered with Fournier’s Gangrene

2021 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Kholidatul Husna ◽  
Hermina Novida
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Patient ◽  
Fournier’S Gangrene ◽  
Risk Of Infection ◽  
Fournier's Gangrene ◽  
Drainage Procedure ◽  
Incision And Drainage ◽  
Uncontrolled Diabetes ◽  
History Of

Diabetes mellitus increases the risk of infection, including Fournier’s gangrene. Fournier’s gangrene (FG) is a rare case, with an average incidence of 1.6 cases per 100,000 population per year. We report a case of a 60 year old male, presented with the history of wounds of the buttocks, penis and scrotum. The patient had a history of uncontrolled diabetes mellitus for 3 years. There were perianal abscesses and necrotic tissue on the penis and scrotum. Radiological evaluation in the patient showed the present of gas forming in scrotal area. Therefore, incision and drainage procedure with necrotomy and debridement were performed, together with antibiotics and blood glucose regulation, then followed by closure of the defect with skin graft and use of flap. The patient was discharge with an improved clinical condition.

scholarly journals Spontaneous coronary artery dissection

2013 ◽  
Vol 9 (1) ◽  
pp. 59-62
Author(s):  
Ranjit Sharma ◽  
Rajeeb Rajbhandari ◽  
Yubraj Limbu ◽  
Satish Singh ◽  
YKD Bhatt ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chest Pain ◽  
Healthy Woman ◽  
Lateral Wall ◽  
Sudden Onset ◽  
Cardiac Biomarkers ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
History Of ◽  
St Elevation

A 38 year old previously healthy woman was referred to ER for ongoing chest pain. She had sudden onset of central, crushing chest pain 3 h back and her ECG was found to have evidence of acute infero-lateral wall MI. There was no history of cardiovascular disease or identifiable CAD risk factors. She had a history of bone TB 10 y back. She was on oral contraceptive pills 5 y back. Her mother had hypertension and diabetes mellitus. Her father died at the age of 75 y due to unknown cause and had a history of hypertension. There is no history of hypertension, diabetes mellitus or CVD in her siblings. General Examination: O2 saturation-95%, Pulse-88bpm, Bp-110/90mmHg.Systemic Examination: no abnormality detected. Investigation: CBC, RFT, BSR, and Electrolytes were WNL. ECG: ST elevation in infero-lateral leads 3 h back but minimal ST elevation in lll and AVF in our ER. Cardiac Biomarkers: CPK-MB-50u/l and Trop + .Echo screening: hypokinetic apex, apical IVS and apical inferior LV wall. She was diagnosed as acute infero-lateral wall MI and was admitted in CCU was treated with Aspirin, Clopidogrel ,LMWH ,Atorvastatin ,IV GTN , Beta-Blocker, Anxiolytics ,PPI and Stool softener .She was well on first post MI day but suddenly developed chest pain on second post MI day and her ECG showed ST elevation in V3-V6. She was taken to Cath lab for rescue PCI. Her coronary angiography studies revealed a linear dissection involving the distal LAD with TIMI 3 distal flow (Fig1). She was conservatively management and was discharged on 7 post MI day. DOI: http://dx.doi.org/10.3126/njh.v9i1.8352 Nepalese Heart Journal Vol.9(1) 2012 pp.59-62

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

Minocycline-Induced Agranulocytosis Presenting as Ecthyma Gangrenosum

2017 ◽  
Vol 1 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Katherine Nolan ◽  
Reema Ishteiwy ◽  
John Alexis ◽  
Martin Zaiac ◽  
Anna Nichols
Keyword(s):  
Care Facility ◽  
Urgent Care ◽  
Severe Neutropenia ◽  
Dramatic Improvement ◽  
Therapy Discontinuation ◽  
Incision And Drainage ◽  
Ecthyma Gangrenosum ◽  
Minimal Improvement ◽  
History Of ◽  
Acute And Chronic Inflammation

A 51-year-old female with a history of rheumatoid arthritis was admitted for progressive fevers, chills and malaise. Five weeks prior, she started minocycline for an RA exacerbation. Two weeks after starting minocycline she developed an abscess on her right ankle that was treated at an urgent care facility with ceftriaxone and trimethoprim-sulfamethoxazole. She had minimal improvement so was switched to clindamycin. She developed additional abscesses on her right ankle and right axilla and spiking fevers so she was treated with incision and drainage under general anesthesia. Routine blood work obtained prior to surgery revealed severe neutropenia (0.74 103/ul) and the patient was urgently referred to the emergency department.  Skin biopsy was obtained on admission and revealed ulceration, necrosis, acute and chronic inflammation, vasculitis with vascular thrombosis and rod-shaped bacteria in blood vessel walls and lumina consistent with ecthyma gangrenosum. The following day tissue and blood cultures confirmed the growth of Pseudomonas aureginosa. Bone-marrow biopsy showed decreased granulopoiesis and hematopoiesis, and a diagnosis of minocycline-induced agranulocytosis presenting as ecthyma gangrenosum was made.  The patient had dramatic improvement with appropriate antibiotic therapy, discontinuation of minocycline and initiation of filgrastrim. She has remained healthy without recurrence for 17 months.    

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

Eksplorasi Kesadaran Diri, Persepsi Dan Sikap Pada Individu Yang Memiliki Riwayat Keluarga Diabetes Melitus Tipe 2

2019 ◽  
Vol 1 (1) ◽  
pp. 52-62
Author(s):  
Mulia Mayangsari
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Family History ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Self Awareness ◽  
Perceptions And Attitudes ◽  
History Of ◽  
Diabetes Melitus

 Individuals who have a family history oftype 2 diabetes mellitus (DM) have a highrisk for type 2 diabetes. Type 2 diabetescan be prevented by improving modifiablerisk factors, supported by self-awareness,perceptions and attitudes of individualswho have a high family history of DM. Thisstudy used a qualitative phenomenologicaldesign. A Purposive Sampling techiniquewas applied to determine individuals whohad parents with type 2 diabetes. Nineindividuals participated in this study. AQualitative content analysis with Collaiziapproach used as a data analysis method.The main themes depicted individuals selfawareness,perceptions, & attitudes were:denials that diabetes caused by heredityfactors; misperception about diabetes;“traditional modalities” as a preventionmeasurement toward type 2 diabetes; andDM is perceived as a “threatening disease”.Further study is needed to examine indepth the themes that have been identifiedon the number of participants are morenumerous and varied.

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