scholarly journals Undiagnosed Case of Klippel-Trenaunnay Syndrome Presenting as Extensive Heterotrophic Ossification and Flexion Deformity of Right Lower Limb Requiring Amputation : A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 938-941
Author(s):  
Kushal Gautam ◽  
Sangharsha Thapa ◽  
Anu Radha Twayana ◽  
Lokendra Chhantyal ◽  
Puskar Poudel ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Recurrent Infection ◽  
Flexion Deformity ◽  
Life Threatening ◽  
Clinical Triad ◽  
Chronic Severe Pain ◽  
The Right ◽  
High Index Of Suspicion ◽  
Asymptomatic Disease ◽  
Variable Presentation

Klippel-Trenaunnay Syndrome is a rare disease characterized by a clinical triad of capillary malformation, soft tissue and bony hypertrophy, and atypical varicosity. This syndrome ranges from asymptomatic disease to life-threatening bleeding, embolism, and deformities. Management includes early diagnosis, prevention, and treatment of complications. We present a case of a 43-year-old male presenting with pain, swelling and deformity of the right leg for 30 years. On examination, diffusely enlarged tender right limb with several dark patchy discolorations, multiple tortuous vessels were found. Right leg X-ray showed heterotrophic ossification and distortion of ankle joint. Due to chronic severe pain, recurrent infection, contracture and flexion deformity of right leg, the patient underwent above knee amputation. This case focuses on the variable presentation and multiple problems faced by patients with Klippel-Trenaununay Syndrome as they get diagnosed late and shows the importance of high index of suspicion for early diagnosis and prevention of complications.

scholarly journals Obturator internus and externus muscle abscess caused by methicillin-resistant Staphylococcus aureus in a 6-year-old boy: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110443
Author(s):  
Mawanane Hewa Aruna Devapriya De Silva ◽  
Janath Liyanage ◽  
Chanika Roshini Kulatunge ◽  
Bangirallage Dhanawardana
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Rare Condition ◽  
Tropical Country ◽  
Methicillin Resistant ◽  
Obturator Externus ◽  
Obturator Internus ◽  
Clinical Triad ◽  
The Right ◽  
High Index Of Suspicion

Obturator abscess is a rare condition in children which usually occurs commonly in tropical countries. Because of its rarity, vague symptomatology and a lack of focus about this condition, the diagnosis of obturator abscess is commonly delayed or missed. Hence, physicians should be familiar with this condition and have a high index of suspicion when a patient presents with fever, pain in the thigh, hip or abdomen and a limp on the affected side which are considered as the classic clinical triad of obturator abscess. Herein, we present a 6-year-old previously healthy Russian boy who was on holiday in Sri Lanka. He presented on the third day of the fever associated with pain in the right thigh and abdomen. This is the first reported case of an obturator externus muscle abscess due to methicillin-resistant Staphylococcus aureus in a European boy visiting a tropical country.

scholarly journals Neurologic Disorder Masquerading as Postpregnancy Progression of Keratoconus

2012 ◽  
Vol 1 (3) ◽  
pp. 205-208
Author(s):  
Samaresh Srivastava ◽  
Vardhaman P Kankariya ◽  
Rohit Shetty ◽  
Sharon D’Souza ◽  
Viraj Vasavada ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Index ◽  
Field Analysis ◽  
Postpartum Women ◽  
Neurologic Disorder ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
High Index Of Suspicion ◽  
Ophthalmologic Disorders

ABSTRACT A 28-year-old woman with bilateral stable keratoconus for 2 years came with a complaint of recent blurring of vision 4 weeks postpartum. Her best-corrected visual acuity had dropped by three lines in the right eye and two lines in the left eye with the same manifest refraction. Corneal topography and Scheimpflug imaging revealed mild progression of the keratoconus, but not enough to explain the drop in visual acuity. However, fundus examination revealed temporal disk pallor in both eyes. Visual field analysis revealed classic bitemporal hemianopia. Subsequently, magnetic resonance imaging (MRI) of brain was performed which revealed a pituitary macroadenoma with pituitary apoplexy that was impinging on the pons. Based on these findings, urgent neurosurgery was performed, and the patient regained her visual acuity and fields 2 weeks later. Neuro-ophthalmologic disorders should always be kept as a differential diagnosis in pregnant and postpartum women. A high index of suspicion from the ophthalmologist can often avert life-threatening problems. Key message Neuro-ophthalmologic disorders can masquerade as a variety of clinical presentations in pregnant and postpartum women. A high index of suspicion from the ophthalmologist can often avert life-threatening problems. How to cite this article Shetty R, D’Souza S, Kankariya VP, Srivastava S, Vasavada V, Wadia K. Neurologic Disorder Masquerading as Postpregnancy Progression of Keratoconus. Int J Kerat Ect Cor Dis 2012;1(3):205-208.

scholarly journals The challenges of a Lemierre’s syndrome in COVID-19 times

2020 ◽  
Vol 6 (12) ◽  
pp. 2299
Author(s):  
Vikram Kemmannu Bhat ◽  
Jino Johns Lalitha ◽  
Suhas Suresh Desai ◽  
Nidhi Mohan Sreedevi
Keyword(s):  
Jugular Vein ◽  
Subcutaneous Tissue ◽  
Bone Marrow Suppression ◽  
High Morbidity ◽  
Lemierre’S Syndrome ◽  
Chest Computed Tomography ◽  
Life Threatening ◽  
The Right ◽  
Lemierre's Syndrome ◽  
High Index Of Suspicion

<p>Lemierre’s syndrome is a type of necrotizing fasciitis of the head and neck that is an uncommon rapidly spreading infection involving the skin, subcutaneous tissue and the fascia leading to life-threatening complications like septicaemia, bone marrow suppression, disseminated intravascular coagulation and multi-organ failure. The management of this disease, especially in COVID-19 pandemic is a challenge as it is associated with high morbidity. A 46-year-old male presented to us with complaints of swelling in the neck with discoloration of skin in the neck and chest. Computed tomography (CT) scan of the neck revealed thrombosis of the right internal jugular vein (IJV) and diffuse abscesses on both sides of the neck. A high index of suspicion is required for the diagnosis of Lemierre’s syndrome in the absence of typical clinical features. The rapid, unpredictable dissemination of infection and occult thrombus within the IJV make both diagnosis and management a challenge especially, during COVID-19 times.</p>

scholarly journals A Rare Case of Orbital Cellulitis with Progressive Calvarial Osteomyelitis

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110421
Author(s):  
Tejas Kotwal ◽  
Samantha Goh ◽  
Eishaan Bhargava ◽  
Philip Touska ◽  
Victoria Possamai
Keyword(s):  
Multimodal Imaging ◽  
Rare Complication ◽  
Antibiotic Use ◽  
Orbital Cellulitis ◽  
Abscess Drainage ◽  
Intravenous Antibiotics ◽  
Life Threatening ◽  
Ct Head ◽  
The Right ◽  
High Index Of Suspicion

Orbital cellulitis is a potentially sight and life-threatening complication of acute sinusitis, and the association with osteomyelitis is rare in the era of antibiotic-use. A 13-year-old girl presented with coryzal symptoms and severe headache, with a CT head being consistent with a diagnosis of pansinusitis and orbital cellulitis with abscess formation. She proceeded to have surgical drainage through a combined endoscopic and external approach to intraorbital abscess drainage with frontal trephine. She was also diagnosed with progressive calvarial osteomyelitis involving the right frontal bone, treated with a prolonged course of intravenous antibiotics. Our case highlights the importance of a high index of suspicion for complications of sinusitis. Multimodal imaging is essential to establish the extent of infection, and a multi-disciplinary approach is integral to manage this rare complication.

scholarly journals 27 Weeks Abdominal Pregnancy wıth Mısdıagnosed at the Fırst Center, A Case Report

2019 ◽  
Vol 4 (09) ◽  
Author(s):  
Recep ERİN ◽  
Kadri TEZEL ◽  
Ahmed ISAK ◽  
Samira AHMED ◽  
Mustafa KUŞAK
Keyword(s):  
Abdominal Pregnancy ◽  
Successful Management ◽  
Intrauterine Pregnancy ◽  
Incorrect Diagnosis ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Failed Induction ◽  
Ectopic Pregnancies ◽  
The Right ◽  
High Index Of Suspicion

Abdominal pregnancy is a potentially life threatening form of ectopic gestation and is seen in 1% of all ectopic pregnancies. It’s a major cause of maternal morbidity and mortality and the potential mortality can be reduced seriously with early diagnosis and treatment. It is rarely seen in advanced pregnancy weeks due to detectability on ultrasonography in early weeks. We aimed to present a rare, misdiagnosed, abdominal pregnancy. We present a case of 20 years old primigravida with 27 weeks abdominal pregnancy who presented at the emergency room with abdominal pain and minimal vaginal bleeding. She was referred from another hospital after 2 days failed induction for incorrect diagnosis of intrauterine dead fetus. The ultrasonography was performed and seen a normal uterus with no intrauterine pregnancy but seen a single extra uterine fetus with 27 weeks gestational age lying in the peritoneal cavity on the right side. We managed successfully with laparotomy. Abdominal pregnancy is rare, and successful management depends on a high index of suspicion. Ultrasonography and serial human chorionic gonadotrophin may help in the diagnosis. Teamwork, a multidisciplinary approach and expert opinion cannot be overemphasised to ensure successful management of these cases.

scholarly journals Recurrent Aspergillus endocarditis in an immunocompetent patient: challenges in diagnosis and management

Res Medica ◽  
2017 ◽  
Vol 24 (1) ◽  
pp. 75-78
Author(s):  
Yuan Ye Beh ◽  
Grace Li Hsien Lim ◽  
Andrew Stewart
Keyword(s):  
Aortic Root ◽  
Immunocompetent Patient ◽  
Primary Angioplasty ◽  
Replacement Surgery ◽  
Significant Life ◽  
Life Threatening ◽  
The Many ◽  
The Right ◽  
High Index Of Suspicion ◽  
Angioplasty And Stenting

We describe an unusual case of recurrent Aspergillus endocarditis in an immunocompetent 64-year-old lady. Four weeks after aortic valve replacement surgery, she presented with an inferior ST elevation myocardial infarction. Coronary angiography demonstrated compromise of the ostium of the right coronary artery, which was successfully treated by primary angioplasty and stenting. Six weeks later, she suffered from a subarachnoid haemorrhage secondary to a mycotic aneurysm. A transoesphageal echocardiogram suggested a large aortic root vegetation. She underwent urgent aortic root replacement with removal of the vegetation, which was subsequently confirmed to be caused by Aspergillus. She was discharged on long term anti-fungal medication (Voriconazole), which she discontinued after seventeen weeks. Several years later, she presented with non-specific symptoms and was ultimately diagnosed with a recurrence of Aspergillus endocarditis. This case illustrates one of the many non-specific ways Aspergillus endocarditis can present. A high index of suspicion can prevent significant life-threatening complications.  

scholarly journals Second trimester Abdominal Pregnancy: A Case Report in a Resource Limited Setting

2021 ◽  
Vol 8 (2) ◽  
pp. 1-4
Author(s):  
Jimah B Bashiru ◽  
Keyword(s):  
Abdominal Ultrasound ◽  
High Index ◽  
Emergency Laparotomy ◽  
Abdominal Pregnancy ◽  
Resource Limited ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with very high feto-maternal morbidity and mortality. Diagnosis and management can pose difficulties in low-resource centres. High index of suspicion is vital in making a prompt diagnosis. Case Presentation: A 23year old, gravida 2, para 1, who presented with a two-day history of severe abdominal pain was referred from a satellite clinic. Abdominal ultrasound scan revealed a live 18week 5day intra-abdominal pregnancy. Emergency laparotomy showed an intact gestational sac at the superior aspect of the uterus with massive hemoperitoneum. The placenta was attached to the right ovary, omentum, and fimbriae of the right fallopian tube. Conclusion: Abdominal pregnancy is a rare occurrence and requires a high index of suspicion for prompt diagnosis. Massive hemoperitoneum can be life threatening and prompt surgical intervention is key in saving the life of the mother.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

2020 ◽  
Vol 8 (1) ◽  
pp. 9-15
Author(s):  
Petrov Nikolay ◽  
◽  
Marinova R. ◽  
Odiseeva Ev.
Keyword(s):  
Intracranial Aneurysm ◽  
Endovascular Treatment ◽  
Clinical Case ◽  
Endovascular Coiling ◽  
Published Data ◽  
Military Medical Academy ◽  
Life Threatening ◽  
Arachnoid Hemorrhage ◽  
The Right ◽  
Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

Sonographic Diagnosis of Bilateral Tubal Pregnancies

2021 ◽  
pp. 875647932199235
Author(s):  
Amber R. Matuzak
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Tubal Ligation ◽  
Tubal Pregnancy ◽  
Rare Form ◽  
Sonographic Diagnosis ◽  
Ectopic Pregnancies ◽  
The Right ◽  
Preoperative Sonography ◽  
Bilateral Tubal Pregnancy

Bilateral tubal pregnancy (BTP) is a very rare form of ectopic twin gestation. Many times, they occur after the use of assisted reproductive therapy. Most cases of BTP are diagnosed during laparoscopy. This case report demonstrates a rare preoperative, sonography diagnosis of a spontaneous BTP which occurred after a tubal ligation. The sonogram revealed two corpus luteal cysts, both located on the right ovary, which suggests that the left tubal pregnancy most likely occurred as a result of ovum transmigration. This case demonstrates the important role that sonography plays in the early diagnosis of ectopic pregnancies as well as the importance of thoroughly examining the entire pelvis during a pelvic sonogram.

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