scholarly journals Severe Intraoperative Anaphylaxis Related to Thymoglobulin during Living Donor Kidney Transplantation

Antibodies ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 43
Author(s):  
Muhammad I. Saeed ◽  
Ryan D. Nicklas ◽  
Vikas Kumar ◽  
Rajan Kapoor ◽  
Imran Y. Gani
Keyword(s):  
Anaphylactic Shock ◽  
Kidney Transplant Recipient ◽  
Rare Condition ◽  
Patient Characteristics ◽  
Successful Outcome ◽  
Donor Kidney ◽  
Life Threatening ◽  
History Of ◽  
Polyclonal Immunoglobulin ◽  
Donor Kidney Transplantation

Anaphylaxis secondary to thymoglobulin (anti-thymocyte globulin) is a rare condition that can be life threatening. Thymoglobulin is a rabbit-derived T-cell depleting polyclonal immunoglobulin. It is commonly used for induction immunosuppression and/or for treatment of acute rejection in renal transplantation. We report a case of a living kidney transplant recipient who developed intraoperative anaphylactic shock secondary to thymoglobulin. The patient had a history of pet rabbit exposure. This case report highlights the importance of prompt identification and management of intraoperative anaphylaxis, which is key to a successful outcome. Induction immunosuppression selection based on patient characteristics is important. Communication between the anesthesia team and surgeons played a key role in stopping the donor surgery.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Infratentorial subdural empyemas mimicking pyogenic meningitis

2013 ◽  
Vol 04 (02) ◽  
pp. 213-215 ◽  
Author(s):  
Anurag Gupta ◽  
Suman S Karanth ◽  
A Raja
Keyword(s):  
Surgical Intervention ◽  
Treatment Options ◽  
Rare Condition ◽  
Pyogenic Meningitis ◽  
Suppurative Otitis Media ◽  
Life Threatening ◽  
History Of ◽  
Associated Risk Factors ◽  
High Degree ◽  
Delay In Treatment

ABSTRACTInfratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill‑planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.

scholarly journals A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher B. Toomey ◽  
Andrew Gross ◽  
Jeffrey Lee ◽  
Doran B. Spencer
Keyword(s):  
Risk Factors ◽  
Vision Loss ◽  
Complement Fixation ◽  
Rare Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Blurry Vision ◽  
Systemic Symptoms ◽  
The Right

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision. A 48-year-old Hispanic female with poorly controlled HIV/AIDS in southern California presented with a three-week history of headache, nausea, vomiting, right eye blurry vision, and a one-day history of subjective fever. Examination of the right eye revealed vitritis and several large chorioretinal lesions scattered throughout the periphery and macula with optic disc pallor. Serum coccidioidomycoses complement fixation (CF) was positive (titers of 1 : 256). Neuroimaging revealed a new area of enhancement in the left anterior frontal lobe consistent with meningoencephalitis. The patient was treated with intravenous fluconazole and intravitreal voriconazole with resolution of systemic symptoms and vitritis but persistence of unilateral, severe chorioretinal scarring and vision loss. In conclusion, in spite of the rarity of intraocular coccidioidomycosis, one must carry a degree of suspicion for this vision- and life-threatening condition as a potential etiology of chorioretinitis in individuals with pertinent risk factors.

scholarly journals Exercise-Induced Anaphylaxis: A Case Report and Review of the Diagnosis and Treatment of a Rare but Potentially Life-Threatening Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Nathan T. Jaqua ◽  
Matthew R. Peterson ◽  
Karla L. Davis
Keyword(s):  
Anaphylactic Shock ◽  
Clinical History ◽  
First Episode ◽  
Intravenous Fluids ◽  
Allergy Clinic ◽  
Intravenous Methylprednisolone ◽  
Daily Exercise ◽  
Life Threatening ◽  
History Of ◽  
Exercise Induced

A 24-year-old male Marine with an uncomplicated medical history and a long history of strenuous, daily exercise presented to the emergency department after experiencing anaphylactic shock while running. Symptoms resolved following administration of intramuscular diphenhydramine, ranitidine, intravenous methylprednisolone, and intravenous fluids. On followup in the allergy clinic, a meticulous clinical history was obtained which elucidated a picture consistent with exercise-induced anaphylaxis. He had experienced diffuse pruritus and urticaria while exercising on multiple occasions over the last three years. His symptoms would usually increase as exercise continued. Prior to the first episode, he regularly exercised without symptoms. Exercise-induced anaphylaxis is a rare but potentially life-threatening syndrome that requires a careful clinical history and is a diagnosis of exclusion. Treatment is primarily exercise avoidance. Prophylactic mediations are inconsistently effective but are empirically used. Successful treatment with omalizumab was recently reported in a case of refractory exercise-induced anaphylaxis.

scholarly journals A Challenging diagnosis that eventually results in a life-threatening condition: Addison’s disease and adrenal crisis

2019 ◽  
Vol 12 (12) ◽  
pp. e231858
Author(s):  
Philippa Joersjö ◽  
Linda Block
Keyword(s):  
Rare Condition ◽  
Addison’S Disease ◽  
Actual Condition ◽  
Adrenal Crisis ◽  
Addison's Disease ◽  
Gradual Onset ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Delays In Diagnosis

A young man endures many years with classic symptoms of Addison’s disease due to difficulties in distinguishing this rare condition, whose features are non-specific and insidious in nature. With all facts on hand, the patient’s notable history of psychiatric disorders, namely depression, anxiety and social isolation, as well as signs of extreme fatigue and syncope may well have been caused by a gradual onset of primary adrenal insufficiency. Long delays in diagnosis are not uncommon, as in this case where the actual condition was identified just in time when the patient presented with a life-threatening cardiovascular collapse.

scholarly journals Efficacy of short term valganciclovir in a standard-dose for cytomegalovirus prophylaxis in living donor kidney transplantation: a single-center report

2019 ◽  
pp. 22-26
Author(s):  
Gokhan Ertugrul ◽  
Tumay Yanaral
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Standard Dose ◽  
Kidney Transplant Recipient ◽  
Short Term ◽  
Donor Kidney ◽  
Living Donor Kidney Transplantation ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney

 Immunosuppressive drugs predispose the kidney transplant recipient to reactivation of сytomegalovirus (CMV) infections. Prophylaxis given to these patients is very important for the prevention of opportunistic CMV infections. The objective of this study was to evaluate the short term and standard-dose valganciclovir prophylaxis for CMV infections in living donor kidney transplantation. Methods. This study is retrospective one. Between April 2014 and April 2019 100 patients after living donor kidney transplantation with results CMV PCR-DNA and prophylactic treatment were studied retrospectively at Medipol University Medical Faculty Hospital Organ Transplantation Department, Istanbul, Turkey. Results.The mean age was 38.3±15.6 years. 68 (68%) patients were males and 32 (32%) patients were females. All patients were treated with 900 mg daily and 90 days valganciclovir prophylaxis. Mean follow-up was 29.1±15 months. There were not detected CMV infections during the follow-up period. Conclusions: Short term and standard-dosevalganciclovir prophylaxis appears to be successful prevention CMV infections in living donor kidney transplantation.

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