scholarly journals Clinical Correlations Delirium and other Comorbid in Elderly with COVID-19 Infection

2021 ◽  
Vol 5 (10) ◽  
pp. 949-952
Author(s):  
Khoirun Mukhsinin Putra ◽  
Nur Riviati ◽  
Djunaidi AR
Keyword(s):  
The Elderly ◽  
Decubitus Ulcer ◽  
Blurred Vision ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Her Family ◽  
Atypical Symptoms ◽  
Presenting Symptoms ◽  
History Of ◽  
Isolation Ward

Background. Delirium is a common condition in geriatric patients. One of the trigger factors for this condition is an infection, such as COVID-19 infection. Elderly with COVID-19 show atypical symptoms such as delirium. Elderly patients with COVID-19 who present with delirium, either as a primary symptom or showing symptoms or signs, have a poor prognosis. This study were aimed to presents covid-19 elderly patient with comorbid delirium. Case presentation. A 77-year-old woman with disorientation for one day came to Emergency Department with her family. She had no history of headaches, blurred vision, or seizures. However, she had a fever, did not want to eat for three days, and had a purulent decubitus ulcer. The patient was diagnosed with acute delirium syndrome, confirmed COVID-19 with sepsis, malnutrition, hypercoagulation, grade III decubitus ulcer, suspected dementia, immobilization, total dependence. The patient admitted to the isolation ward. The patient had meropenem 500 mg every 12 hours, anticoagulants and favipiravir according to the dose and parenteral nutrition. Conclusion. Patients with COVID-19 who present with delirium, either as a primary symptom or presenting symptoms or signs, have a worse outcome. Delirium relationship with comorbid factors can increase mortality and morbidity in the elderly with COVID-19.

scholarly journals Clinical Correlations Delirium and other Comorbid in Elderly with COVID-19 Infection

2021 ◽  
Vol 5 (4) ◽  
pp. 886-889
Author(s):  
Khoirun Mukhsinin Putra ◽  
Nur Riviati ◽  
Djunaidi AR
Keyword(s):  
The Elderly ◽  
Decubitus Ulcer ◽  
Blurred Vision ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Her Family ◽  
Atypical Symptoms ◽  
Presenting Symptoms ◽  
History Of ◽  
Isolation Ward

Background. Delirium is a common condition in geriatric patients. One of the trigger factors for this condition is an infection, such as COVID-19 infection. Elderly with COVID-19 show atypical symptoms such as delirium. Elderly patients with COVID-19 who present with delirium, either as a primary symptom or showing symptoms or signs, have a poor prognosis. This study were aimed to presents covid-19 elderly patient with comorbid delirium. Case presentation. A 77-year-old woman with disorientation for one day came to Emergency Department with her family. She had no history of headaches, blurred vision, or seizures. However, she had a fever, did not want to eat for three days, and had a purulent decubitus ulcer. The patient was diagnosed with acute delirium syndrome, confirmed COVID-19 with sepsis, malnutrition, hypercoagulation, grade III decubitus ulcer, suspected dementia, immobilization, total dependence. The patient admitted to the isolation ward. The patient had meropenem 500 mg every 12 hours, anticoagulants and favipiravir according to the dose and parenteral nutrition. Conclusion. Patients with COVID-19 who present with delirium, either as a primary symptom or presenting symptoms or signs, have a worse outcome. Delirium relationship with comorbid factors can increase mortality and morbidity in the elderly with COVID-19.

scholarly journals Corneal erforation casused by eyelid margin trichilemmal carcinoma: A case report

2019 ◽  
Author(s):  
Liying Zhang ◽  
Zhirong Lin ◽  
Huping Wu
Keyword(s):  
Rare Case ◽  
The Elderly ◽  
Corneal Perforation ◽  
Slit Lamp ◽  
Blurred Vision ◽  
Eyelid Margin ◽  
Case Presentation ◽  
Adnexal Tumor ◽  
History Of

Abstract Background: Trichilemmal carcinoma (TLC) is a rare malignant adnexal tumor predominantly affecting the scalp, eyelids, neck and face of the elderly. Here, we firstly report a rare case of corneal perforation caused by TLC grown in eyelid margin. Case presentation: A 68-year-old female presented with two months history of unprovoked redness, pain and blurred vision in the left eye. On slit-lamp examination, a 1×2mm aseptic corneal perforation embedded by iris prolapsed was noted. After excluding other causes through examinations and case history inquiry, we speculated that the severe MGD and subsequent BKC might be the cause. In order to prevent the ulcer enlargement and intraocular infection, the patient was treated with penetrating keratoplasty immediately. However, a terrible phenomenon has aroused our concern that several small nodules gradually developed on the eyelid margin, accompanied with bleeding, burst and madarosis postoperatiely. The biopsy revealed the eyelid was involved by TLC and then the lesionectomy was performed immediately. There was no evidence of local recurrence and metastasis during 1 year follow-up. Conclusions: The involvement of eyelid margin by TLC, and subsequent BKC and corneal perforation were very rare and it has not been reported yet. The concomitant BKC can be gradually healed after rectifying eyelid margin by total excision of TLC. It is very important to offer careful follow-up to all patients.

scholarly journals Hypertrophic Osteoarthropathy: A Secondary Manifestation of Malignant Melanoma

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Shiva Malaty ◽  
Aditya Gupta
Keyword(s):  
Metastatic Melanoma ◽  
Plain Film ◽  
Hypertrophic Osteoarthropathy ◽  
Imaging Studies ◽  
Case Presentation ◽  
Rare Finding ◽  
Presenting Symptoms ◽  
Lung Malignancies ◽  
History Of

Background. Hypertrophic osteoarthropathy (HOA) is a rare finding in the setting of metastatic melanoma. A majority of cases of secondary HOA involve lung malignancies. Evaluation of presenting symptoms such as polyarthralgia and clubbing followed by review of imaging studies are diagnostic steps for HOA. Case Presentation. We present a 60-year-old female with a history of metastatic melanoma who presented with bilateral and symmetric polyarthralgia and clubbing. A plain film radiograph demonstrated periosteal thickening involving the metacarpals and proximal phalanges as well as the distal radius and ulna, consistent with HOA. The patient was treated with nonsteroidal anti-inflammatory agents for supported care. Conclusion. HOA may be a secondary manifestation of metastatic melanoma. Recognition and supportive care of this condition may lead to improved quality of life for patients.

scholarly journals Denture Impaction Causing an Upper Esophageal Diverticulum

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Shireen Samargandy ◽  
Hani Marzouki ◽  
Talal Al-Khatib ◽  
Mazin Merdad
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
The Elderly ◽  
Barium Swallow ◽  
Diagnostic Challenge ◽  
Case Presentation ◽  
History Of ◽  
Endoscopic Diverticulotomy ◽  
Tomography Scan ◽  
Rule Out

Background. Dentures are a common cause of inadvertent foreign body ingestion particularly in the elderly. Due to their radiolucent nature, they often present a diagnostic challenge to care providing physicians. Case Presentation. A 66-year-old female presented to our otolaryngology clinic with a 2-year history of dysphagia. Her physical examination was unremarkable. Computed tomography scan of the neck and barium swallow suggested Zenker diverticulum. She was planned for endoscopic diverticulotomy; however, during surgery, a foreign body was incidentally found and retrieved, which was a partial lower denture. The diverticulum resolved thereafter, and the patient's symptoms abated. Conclusion. The authors recommend evaluating the esophagus endoscopically first in cases of upper esophageal diverticular formation, even when planning an open repair approach, to rule out any concealed foreign bodies.

Infant critical head injury could be a remote cause of middle-aged cerebral amyloid angiopathy

2019 ◽  
Author(s):  
Keisuke Tachiyama ◽  
Masahiro Nakamori ◽  
Yuki Hayashi ◽  
Hayato Matsushima ◽  
Eiji Imamura ◽  
...  
Keyword(s):  
Cerebral Amyloid Angiopathy ◽  
The Elderly ◽  
Amyloid Angiopathy ◽  
Resonance Imaging ◽  
Middle Aged ◽  
Case Presentation ◽  
Csf Analysis ◽  
History Of ◽  
Lobar Hemorrhage ◽  
Cerebral Amyloid

Abstract Background Cerebral amyloid angiopathy (CAA) is a sporadic condition in the elderly and is associated with Alzheimer’s disease. The younger cases, however, may have a history of traumatic brain injury (TBI) during infancy. Case Presentation We present a case of a 37-year-old man who had cerebral lobar hemorrhage. Magnetic resonance imaging revealed several lobar microbleeds, which along with the asymptomatic, lobar hemorrhages increased every year. At the age of 40 years, he developed mild cognitive impairment. Cerebrospinal fluid (CSF) analysis revealed a markedly decreased level of amyloid β42. Moreover, he had a subdural hematoma during infancy. Thus, we diagnosed him with CAA, which was related to the TBI at infancy. Conclusion TBI at infancy can be a remote cause of middle-aged CAA and dementia. This was supported by the low Aβ42 level in the CSF analysis.

Hoarding disorders: Two different clinical presentations

2017 ◽  
Vol 41 (S1) ◽  
pp. S746-S746
Author(s):  
A. Samico ◽  
D. Mota ◽  
Â. Venâncio ◽  
L. Ribeiro
Keyword(s):  
Age Of Onset ◽  
Health Hazard ◽  
The Elderly ◽  
Psychiatric Facility ◽  
Obsessive Compulsive ◽  
Her Family ◽  
Compulsive Disorder ◽  
History Of ◽  
Competing Interest ◽  
Clinical Cases

IntroductionHoarding disorders (HD) have increasingly become a public health hazard. It usually emerges during two broad life periods: in early age-of-onset is usually associated with obsessive-compulsive disorder (OCD); in the elderly, it can be due to psychiatric and organic disorders, unrelated to OCD.ObjectivesOur objective is to increase medical awareness and to highlight that both young and elderly people may suffer from this condition.AimsThe aim of this presentation is to address HD and its different presentations.MethodsPresentation of two clinical cases of HD and pathology revision.ResultsA 30-year-old woman was hoarding litter, food and several items in a systematic way, become aggressive when her family tried to clean the house and was admitted several times in a psychiatric facility for cleanliness of her house. She had a history of depressive symptoms and severe OCD, with obsessive thoughts and several verification behaviors. A 78-year-old woman, with history of cerebral vascular disease, was self-neglected, living in a filthy home, with hoarding of litter and many worthless objects in a disorganized way, become aggressive after her relatives try to enter her house and refused to get help of any kind. Later on, she was admitted in a psychiatric facility and diagnosed with vascular dementia.ConclusionsTimely diagnosis and proper management of these two variations of HD will allow more advanced studies in this matter and more effective pharmacological and psychotherapeutic treatments. These clinical cases reinforce the importance of practical guidelines for appropriate approach of these patients with complex and multidimensional needs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Recognizing Aphemia and How to Differentiate From Aphasia in the Era of Telemedicine

2021 ◽  
pp. 194187442199054
Author(s):  
Brittany M. Kasturiarachi ◽  
Balaji Krishnaiah
Keyword(s):  
Clinical Skill ◽  
Precentral Gyrus ◽  
Case Presentation ◽  
Her Family ◽  
Clinical Syndromes ◽  
History Of ◽  
Intimate Knowledge ◽  
Pars Opercularis ◽  
Pure Motor

Background: Aphemia, or pure motor mutism, is a phenomenon that has been reported previously in the literature and typically is associated with small infarcts in the inferior dominant precentral gyrus, pars opercularis, or inferior perirolandic gyrus. Clinically, it is important to distinguish aphemia from aphasia syndromes. Telemedicine is becoming more prevalent and involving neurologists across the country. This is an important consideration when addressing aphemic patients as many mistakes can be made during a virtual exam clouding a patient’s clinical picture. Case Presentation: Our patient is a 61-year-old female with a past medical history of hypertension, diabetes, and an old right frontoparietal stroke without any residual deficits. She presented after her family stated that she “quit speaking” for about seven hours. Initial neurological evaluation was done via telemedicine due to the COVID-19 pandemic and was pertinent for decreased consciousness, inability to answer either orientation question, a right facial droop, and aphasia. Later it was found that the patient exhibited a pure motor mutism rather than aphasia and had an MRI lesion in the left inferior precentral gyrus. Conclusion: Differentiating aphemia from aphasia is an important clinical skill for a neurologist to foster especially in the era of telemedicine. An intimate knowledge of the parts of a speech exam are vital in directing emergency staff during stroke evaluation. Additionally, distinguishing these clinical syndromes has implications with respect to prognosis and long-term rehabilitation.

scholarly journals Rhino-orbital mucormycosis in COVID-19 patients—a new threat?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Sandeep Singh Awal ◽  
Som Subhro Biswas ◽  
Sampreet Kaur Awal
Keyword(s):  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Paranasal Sinuses ◽  
Correct Diagnosis ◽  
Antifungal Drugs ◽  
Intracranial Extension ◽  
Imaging Findings ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
History Of

Abstract Background Coronavirus disease 2019 (COVID-19) is known to be associated with a myriad of viral, fungal, and bacterial co-infections. Rhino-orbital mucormycosis is a rare angio-invasive fungal infection which has shown a rising trend in the setting of COVID-19. Case presentation We describe the imaging findings in 3 cases of rhino-orbital mucormycosis in patients with history of COVID-19. All cases had varying involvement of paranasal sinuses extending into the orbital compartment while case 3 had intracranial extension of infection. Conclusions Rhino-orbital mucormycosis can have aggressive necrosis of the involved paranasal sinuses and orbits with or without cerebral extension. Hence, the correct diagnosis is imperative as prompt antifungal drugs and surgical debridement can significantly reduce mortality and morbidity.

scholarly journals Aplasia - Congenital Lung Abnormality with Non-Development

2012 ◽  
Author(s):  
Catherine Rivera ◽  
Douglas Gardenhire
Keyword(s):  
Lung Tissue ◽  
Left Lung ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Class Iii ◽  
Obstructive Pulmonary Disease ◽  
Case Presentation ◽  
Lung Abnormalities ◽  
History Of

The following case presentation is of a 75-year-old male who presented to the emergency department with chronic obstructive pulmonary disease (COPD) exacerbation, secondary to pneumonia, and a history of a congenital left lung abnormality with non-development. Since the first report by de Pozzis in 1673, more than 200 cases of lung abnormalities with non-development have been recorded.1,2 The first proposed classification of underdevelopment of the lung was introduced by Schneider in 1912: Class I Agenesis - total absence of bronchus and lung, Class II Aplasia - rudimentary bronchus without lung tissue, and Class III Hypoplasia - bronchial hypoplasia and variable but reduced amount of lung tissue.1,2 The rarity of reports and applicable literature involving congenital lung abnormalities with non-development in the elderly, such as pulmonary aplasia, prompted this case presentation.

scholarly journals Acute bilateral myopia induced by Triplixam: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ruta Jaruseviciene ◽  
Ginte Sirvydyte
Keyword(s):  
Adverse Effect ◽  
Ciliary Body ◽  
Volume Effect ◽  
Systemic Hypertension ◽  
Blurred Vision ◽  
Idiosyncratic Reaction ◽  
Case Presentation ◽  
Common Drug ◽  
History Of ◽  
Choroidal Effusion

Abstract Background Side effects of the systemic drugs used to treat eyes are not common. Triplixam is used to treat systemic hypertension and contains amlodipine, indapamide and perindopril arginine as active ingredients which might have induced the sudden myopia. The transient myopia with objective findings disappeared after the discontinuation of the drug. Case presentation A 33-year-old male presented to the emergency department with a history of blurred vision in both eyes. Development of myopia, lens thickening, choroidal effusion and retinal striae at the macula with the increase in macular thickness was observed in both eyes. These symptoms cleared completely after the drug was discontinued. Myopisation could have been caused by lens thickening and changing its refractive index as a result of allergic or idiosyncratic reaction of the ciliary body. Retinal striae may be caused by the volume effect of the choroidal effusion. Conclusion Our report describes the adverse effect of Triplixam, probably resulting from its ingredient indapamide. Although indapamide is a common drug used in the treatment of systemic hypertension, it is important for cardiologists, general practitioners and other physicians to be aware of the possible adverse effect of Triplixam.

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