scholarly journals Multiple Clinical Findings on The Tongue: Variants of Normal or Pathologic Condition? (A Case Report)

2021 ◽  
Vol 24 (2) ◽  
pp. 55-59
Author(s):  
Yurina Alhayu ◽  
Febrina Rahmayanti ◽  
Ambar Kusuma Astuti

Various normal and pathologic findings might occasionally be found on the tongue and might confuse some patients and clinician due to its atypical presentation. This case report aimed to present a case report of multiple oral findings related to variants of normal and pathological findings on the tongue: geographic tongue, fissured tongue, and central papillary atrophy. A 53-year-old male patient came to Universitas Indonesia Dental Hospital for a dental check-up. Objective examination in the tongue showed depapilated areas surrounded by keratinized lining in the ventral and lateral left and right area of the tongue, multiple fissures in all over the dorsum of the tongue, and an ovoid redness area in the middle of 2/3 posterior dorsum part of the tongue. All those findings were asymptomatic. Those clinical findings were diagnosed as geographic tongue, fissured tongue, and central papillary atrophy. This case presents unique multiple variants of normal and pathological findings in the tongue. It is important to an oral health professional to have knowledge and ability to determine normal anatomy, variants of normal and pathological lesions. Patients should be informed and educated about oral mucosa normal variations and related clinical findings so they would not develop unnecessary anxiety. Keywords: central papillary atrophy, fissured tongue, geographic tongue, normal variations

2017 ◽  
Vol 21 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Katherine Y Wu ◽  
Amanda L Treece ◽  
Pierre A Russo ◽  
Jessica W Wen

Alagille syndrome is a multisystem disorder classically involving the liver, heart, vertebrae, facial features, and the eyes. In this case report, we document a case of Alagille syndrome with an atypical clinical and histopathologic presentation and subsequent identification of a novel JAG1 missense mutation. This case highlights that there may be both atypical clinical and pathologic findings in mutation-proven Alagille syndrome and that the diagnosis of Alagille syndrome should be considered in cases of ongoing bile duct damage in the setting of early-onset jaundice, cholestasis, hepatosplenomegaly, posterior embryotoxon in the eyes, and butterfly vertebrae.


2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Erin M. Kunz ◽  
Bebu Ram

Glomus tumors are rare and benign vascular soft-tissue masses commonly found subungually in the foot. A glomus tumor typically manifests with a classic triad of pain, point tenderness, and cold sensitivity. This case report describes an atypical presentation of a glomus tumor in the soft tissue of the rearfoot in a 77-year-old man in the setting of urosepsis. The mass had enlarged progressively for 6 months. Originally misdiagnosed as a hemangioma based on magnetic resonance imaging and clinical appearance, an excisional biopsy was performed. The lesion was subsequently diagnosed histopathologically as a glomus tumor. This article discusses the statistics of glomus tumor and discusses the importance of the need to recognize the symptoms and clinical findings of both typical and atypical presentation of this abnormality in differentiation and differential treatment and risk management of benign and malignant soft-tissue masses.


2021 ◽  
Vol 5 (4) ◽  
pp. 459-462
Author(s):  
Andrew Tadych ◽  
David Catano ◽  
April Brill

Introduction: Septic arthritis is a destructive form of acute arthritis that requires expeditious recognition. as delayed treatment yields significant morbidity and mortality. Case Report: A 40-year-old male presented to the emergency department with right elbow pain. Examination revealed tachycardia, swelling, redness, tenderness, and decreased range of motion of the right humeroulnar joint. Synovial fluid analysis was consistent with an inflammatory etiology, but blood and joint cultures ultimately revealed Haemophilus influenzae. Discussion: This case highlights the importance of trusting clinical findings over laboratory evidence in patients with suspected septic arthritis.


2020 ◽  
Vol 11 (3) ◽  
pp. 546-552
Author(s):  
José Ignacio Vela ◽  
Clément Jean Arthur Marie Passabosc ◽  
José Antonio Buil Calvo

Classical clinical findings of multiple evanescent white dot syndrome (MEWDS) include multiple, small white dots scattered throughout the posterior pole, foveal granularity, posterior vitreous cells, and mild optic disc swelling. We describe the case of a 35-year-old man who was admitted to our department with an unusual presentation of MEWDS at the early onset of the disease. A unilateral circumpapillary retinal white spot was observed. Spectral domain optical coherence tomography demonstrated irregularities of the retinal pigment epithelium and disruptions of the outer retinal layers around the optic nerve without other abnormalities. A few days later, the lesion spread centrifugally from the peripapillary region and along the vascular arcades. This distinctive appearance in an early stage of the disease may suggest a disorder other than MEWDS, which can lead to a misdiagnosis and unnecessary treatment.


2002 ◽  
Vol 41 (01) ◽  
pp. 37-41 ◽  
Author(s):  
S. Shung-Shung ◽  
S. Yu-Chien ◽  
Y. Mei-Due ◽  
W. Hwei-Chung ◽  
A. Kao

Summary Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation.


2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.


Author(s):  
Shweta Sharma ◽  
Bharat Sharma ◽  
Shantnu Chauhan ◽  
Mir Aziz ◽  
Nalin Chugh ◽  
...  

Author(s):  
Raul-Ciprian Covrig ◽  
Jasmina Petridou ◽  
Ulrich J. Knappe

AbstractBrucellosis is a frequent zoonosis in some regions of the world and may cause various symptoms. Neurobrucellosis is a rare but serious complication of the infection. Our case report describes the course of neurobrucellosis in a patient who had received a ventriculoperitoneal shunt in his native country 13 years prior to diagnosis of brucellosis. He initially presented to us with symptoms of peritonitis, which misled us to perform abdominal surgery first. After the diagnosis of neurobrucellosis was confirmed and appropriate antibiotics were initiated, the symptoms soon disappeared. Although the ventriculoperitoneal shunt was subsequently removed, the patient did not develop a symptomatic hydrocephalus further on. This case displays the challenges in diagnosing an infection that occurred sporadically in Europe and may be missed by currently applied routine microbiological workup. Considering the political context, with increasing relocation from endemic areas to European countries, it is to be expected that the cases of brucellosis and neurobrucellosis will rise. Brucellosis should be considered and adequate investigations should be performed.


2021 ◽  
pp. 112067212199767
Author(s):  
Iva Krolo ◽  
Aida Kasumović ◽  
Ivana Radman ◽  
Pavao Pavić

Purpose: Ocular features of Alport syndrome include anterior lenticonus, posterior polymorphous corneal dystrophy, and fleck-and-dot retinopathy in most cases. Keratoconus in such patients has been rarely mentioned in previous studies. To our knowledge, this is the first report of corneal cross-linking for halting the progression of keratoconus in a patient with Alport syndrome. Case report: A 22-year-old male was referred for his initial corneal topography, after he was already prescribed with rigid gas-permeable contact lenses. Alport syndrome was diagnosed in his infancy and gene COL4A5 mutation was confirmed. Ophthalmological evaluation confirmed keratoconus. One-year follow-up showed a progression on his right eye and standard corneal cross-linking was performed. Stabilization of the disease marked by normalization in visual function and corneal tomography values was noticed 1 year after the procedure. Conclusions: When diagnosing ocular clinical findings of Alport syndrome, keratoconus should be considered. Standard corneal cross-linking protocol can halt its progression.


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