A cutaneous tuberculosis mimic presented with recurrent soft tissue infection: A case report

2021 ◽  
Vol 9 (1) ◽  
pp. 30-30
Author(s):  
Abu Mansor Matardiah Nor Hashimah ◽  
Lim Ai Lee ◽  
Azman Ali Raymond
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Skin Diseases ◽  
Cutaneous Tuberculosis ◽  
Small Nodule ◽  
Right Hand ◽  
History Of ◽  
The Right ◽  
Work Up ◽  
Immunocompetent Patients

Recurrent cellulitis is one of the cutaneous tuberculosis mimickers. As the skin lesion can mimic other skin diseases, the diagnosis can easily be missed especially in immunocompetent patients without any other risk factors. We present a case of a 62-year-old lady with history of right hand extensor tenosynovitis presented with right hand and forearm swelling and pain, associated with fever. Clinically, her right hand and forearm were erythematous with a small nodule at the right elbow. She was treated for recurrent right upper limb cellulitis and thrombophlebitis complicated by septic shock needing several courses of antibiotics. However, she did not show any significant response to the treatment. Multiple septics work up were carried out and all were negative, except aspiration of her right elbow nodule was positive for Mycobacterium tuberculosis. Anti-tuberculous treatment was started but unfortunately, she succumbed due to nosocomial infection.

scholarly journals Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

Abstract Background Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. Conclusions We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

scholarly journals Non-uremic Calciphylaxis: A Rare and Late Adverse Reaction of Warfarin

2019 ◽  
Vol 14 (3) ◽  
pp. 246-248 ◽  
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Akash D. Patel ◽  
Jignesh C. Kaklotar ◽  
Greshaben R. Patel ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Inflammatory Markers ◽  
Metabolic Profile ◽  
Connective Tissue Diseases ◽  
Skin Ulcer ◽  
Wound Treatment ◽  
History Of ◽  
The Right ◽  
Work Up ◽  
Late Adverse Reaction

Background:Calciphylaxis is a complex dermatological lesion of micro vascular calcification that is typically presented as panniculitis with gangrenous painful lesions having uremic and non-uremic causes.Case Report:We present a case of a 48-year old male with a history of paroxysmal atrial fibrillation and hypertension taking amlodipine 5 mg and warfarin 5 mg daily for the last 26 months. The patient had a 6- months history of painful swelling followed by necrotic skin ulcer over the right leg. His remarkable examination findings were right leg tender ulcer with surrounding erythema and secondary sepsis. His hemogram, metabolic profile and connective tissue diseases work up were unremarkable except leucocytosis and raised inflammatory markers. His local part radiological and skin biopsy findings were suggestive of calciphylaxis.Results and Conclusion:In our case, warfarin and amlodipine were culprit drugs for the lesion, but Naranjo score (warfarin 7and amlodipine 1) speculate warfarin as a probable adverse reaction of warfarin. The lesion was cured with local wound treatment after discontinuation of warfarin. The physician should be aware of this rare cutaneous disorder of systemic origin for proper management.

A 76-year-old man with a five-day history of painful swelling of the right hand

JAMA ◽  
1983 ◽  
Vol 250 (11) ◽  
pp. 1441-1442
Author(s):  
J. M. Aronchick
Keyword(s):  
Right Hand ◽  
History Of ◽  
The Right

ICU treatment of acute kidney injury

2018 ◽  
Author(s):  
Matt Wise ◽  
Paul Frost
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Haematological Malignancy ◽  
Previous History ◽  
Kidney Injury ◽  
History Of ◽  
Nephrotoxic Drugs ◽  
Abdominal Compartment ◽  
Icu Treatment

Traditionally, the etiology of acute kidney injury (AKI) is considered in terms of prerenal, renal, and obstructive causes. However, this categorization is less useful in the ICU, where the etiology of AKI is usually multifactorial and often occurs in the context of multi-organ failure. Hypotension, nephrotoxic drugs, and severe sepsis or septic shock are the most important identifiable factors. Less frequently encountered causes include pancreatitis, abdominal compartment syndrome, and rhabdomyolysis. Primary intrinsic renal disease such as glomerulonephritis is extremely uncommon. A previous history of cirrhosis, cardiac failure, or haematological malignancy, and age >65 years, are important risk factors. This chapter covers symptoms, complications, diagnosis, investigations, prognosis, and treatment of renal failure in the ITU.

scholarly journals Simultaneous Hydatid Cysts of Both the Right Atrium and Right Ventricle

2007 ◽  
Vol 50 (3) ◽  
pp. 217-219
Author(s):  
Caner Arslan ◽  
Emir Cantürk ◽  
Egemen Duygu ◽  
Ahmet Kürsat Bozkurt
Keyword(s):  
Right Ventricular ◽  
Right Atrial ◽  
Hydatid Cysts ◽  
Hepatic Hydatid Cyst ◽  
History Of ◽  
Ischemic Attack ◽  
The Right ◽  
Work Up ◽  
Hepatic Hydatid ◽  
Fatal Complications

Hydatid disease in both chambers of the heart is very rare. Mobile right atrial and right ventricular hydatid cysts were diagnosed incidentally in the etiologic work up for a transient ischemic attack in a 77-year-old man with a history of a hepatic hydatid cyst operation. Transthoracic echocardiography was very successful in the diagnosis of both hydatid cysts. Transesophagial echocardiography and computed tomography confirmed the diagnosis. Both right atrial and right ventricular hydatid cysts were removed under cardiopulmonary bypass to prevent morbidities and potentially fatal complications.

scholarly journals SPINDLE CELL CARCINOMA OF LARYNX- A DISTINCT CLINICOPATHOLOGICAL AND HISTOLOGICAL ENTITY

2017 ◽  
Vol 3 (3) ◽  
Author(s):  
Muhammad Faisal ◽  
Arif Jamshed ◽  
Raza Hussain
Keyword(s):  
Risk Factors ◽  
Cell Carcinoma ◽  
Vocal Cord ◽  
Distant Metastasis ◽  
Spindle Cell ◽  
Spindle Cell Carcinoma ◽  
Treatment Result ◽  
Left Vocal Cord ◽  
History Of ◽  
The Right

Spindle cell carcinoma (SpCC) is a variant of squamous cell carcinoma with biphasic components and more aggressive behaviour. Its rarity and histopathological pattern pose a diagnostic challenge. Early diagnosis and treatment result in a decrease in local and distant metastasis. Case 1 is a 71-year-old female presented with hoarseness of voice and dyspnoea for 2 years without any risk factors. Fibre-optic laryngoscopy (FOL) revealed smooth polyp hanging from anterior two-third of the left vocal cord. Microlaryngoscopic excision revealed SpCC followed by post-operative radiotherapy and is currentlyalive. Case 2 is a 72-year-old male presented with worsening stridor for 2 years post-excision of laryngeal nodule and history of smoking and hookah use for >20 years. He developed dysphonia after a few months with fixed hard level 3 nodes at the right side. FOL showed a polypoid mass extending from the left vocal cord into the supraglottis. Fine-needle aspiration cytology of the neck swelling confirmed the diagnosis of SpCC. Computerised tomography (CT) chest/abdomen showed distant metastasis. Palliative radiotherapy was given, but the patient died after 3 months due to locoregional failure. Case 3 is a 35-year-old male presented with a history of hoarseness for 3 years with no risk factors. FOL showed a 1.2-cm polypoid growth on the right vocal cord. Total laryngectomy was performed and histopathology showed SpCC. Radiotherapy was given and the patient is alive without disease with regular follow-ups. Smoking and alcohol are thought to be the contributing factors causing this disease. Biphasic nature of the tumour requires pathological sampling for diagnostic confirmation. Surgery combined with radiotherapy has a better survival outcome. SpCC is a rare tumour with a tendency for locoregionalrecurrence. Surgery should remain the mainstay of treatment followed by post-operative radiotherapy for a better control.Key words: Larynx, radiotherapy, spindle cell carcinoma

scholarly journals Internal Carotid Dissection as the Cause of Stroke in Childhood

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Giulia Cinelli ◽  
Vitaliana Loizzo ◽  
Lisa Montanari ◽  
Ilaria Filareto ◽  
Elisa Caramaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Magnetic Resonance ◽  
Internal Carotid ◽  
Clinical Signs ◽  
Cervical Pain ◽  
Resonance Imaging ◽  
Cervical Trauma ◽  
History Of ◽  
Associated Risk Factors ◽  
The Right

Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs’ risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with involuntary hypertonic closure of the right hand associated with transient difficulty for both fine movements of the right arm and speech. She had a history of minor cervical trauma occurring 20 days prior to our observation without other associated risk factors. Magnetic resonance imaging and magnetic resonance angiography showed ischemic lesions due to the left ICA dissection. Treatment with both acetylsalicylic acid and levetiracetam allowed recanalization of the ICA associated with the resolution of clinical signs. Our clinical case suggests that the ICA dissection must be suspected early whenever a child manifests mild neurologic deficits after a cervical trauma, especially if they are associated with headache and/or cervical pain. Moreover, the management of ICA dissection must be improved.

scholarly journals A case of recurring Amaurosis Fugax

2019 ◽  
pp. 85-87
Author(s):  
Y. Suthahar ◽  
J. Blackwell ◽  
G. Zachariah ◽  
V. Umachandran
Keyword(s):  
Risk Factors ◽  
Visual Loss ◽  
Sudden Onset ◽  
Vascular Risk ◽  
Amaurosis Fugax ◽  
Anti Platelet Therapy ◽  
History Of ◽  
Ct Head ◽  
The Right ◽  
Hospital Manager

WW a 43 year old Caucasian Hospital Manager, first presented in July 08 complaining of transient mono-ocular visual loss in the right eye.  She described sudden onset loss of vision – ‘like a curtain coming across the vision’.  She then proceeded to have similar symptoms in the left eye.  There was no history of a subsequent headache. The episode would between 30 seconds and 10 minutes and could occur up to 10 times a day. At times, the attack was also associated with some left arm numbness.  She was initially reviewed by Dr Vu [ Stroke Consultant] who diagnosed Amaurosis Fugax and started her on standard anti-platelet therapy  [combination of Aspirin and Dypyridamole].  She had very little in terms of vascular risk factors [nil hypertensive, minimal alcohol and a life-long non-smoker with a fasting cholesterol 3.12]. Her PMH history consisted of Gilberts’ Syndrome and endometriosis. She also suffered a DVT following a hysterectomy. Her initial investigations of a CT head and carotid duplex were normal.

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.

The Likeness of an Author

2019 ◽  
pp. 101-132
Author(s):  
Niv Allon
Keyword(s):  
Significant Role ◽  
Three Dimensional ◽  
Close Inspection ◽  
Eighteenth Dynasty ◽  
Right Hand ◽  
Military Background ◽  
History Of ◽  
The Right

This chapter shifts to three-dimensional art and studies scribal statues. It traces back the history of this statuary motif through time, studying changes in the texts inscribed on the statue and the gesture of the right hand. Analyzing these elements, the chapter investigates the relationships between statue, patron, and text. A close inspection of this statuary motif reveals a growing emphasis on the act of writing and a reinterpretation of the literacy act. Focusing on the Eighteenth Dynasty patrons who commissioned such statues once again suggests that men of military background like Haremhab play a significant role in disseminating images of literacy through their self-representation.

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