OTO MASTOIDITIS AND SEPTIC CEREBRAL VENOUS THROMBOSIS

2021 ◽  
pp. 44-45
Author(s):  
Moses. P Moorthy ◽  
AV Srinivasan ◽  
Shifa Begum ◽  
K. Prasanthi
Keyword(s):  
Female Child ◽  
Low Molecular Weight ◽  
Tympanic Cavity ◽  
Mri Brain ◽  
History Of ◽  
Hrct Temporal Bone ◽  
Local Examination ◽  
Air Cells ◽  
Mastoid Air Cells ◽  
Csf Examination

11 yr old female child, admitted with history of fever, left ear pain, swelling behind the left ear of 5 days duration, for which she was treated by a nearby doctor. After 1 week the child had left ear discharge, headache, neck pain, recurrent episodes of vomiting. On general examination she is thin built, febrile, toxic and dehydrated. On local examination she had ear discharge, swelling behind the left ear. On neurological examination, she had neck stifness. Routine blood investigations including, CBC, LFT, RFT were normal. On CSF examination Protein-188 mg%,Sugar- 16 mg%,Cell count-165 cells/cumm,85% were Neutrophils. Aural swab C/S showed growth of Klebsiella sensitive to Amikacin, Ciprooxacin, Piperacillin / Tazobactum and Cotrimoxazole. ENT opinion was in favour of doing Mastoidectomy. HRCT Temporal bone showed complete opacication of external auditory canal, tympanic cavity and mastoid air cells with a possibility of lling up with pus. MRI BRAIN showed Left mastoid and postauricular abscess, mastoiditis, ventriculitis, venulitis with thrombosis of left transverse and sigmoid sinuses. Patient was treated with parenteral piperacillin tazobactum, Ciprooxacin, Amikacin, Metronidazole, Mannitol, Dexamethasone and Low molecular weight heparin.Patient improved in 3 weeks.Ear discharge dried up, mastoid abscess subsided, and the child became active and ambulant

scholarly journals Bilateral Inflammatory Aural Polyps: A Manifestation of Samter's Triad

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Robert Brobst ◽  
Nichole Suss ◽  
Stephanie Joe ◽  
Miriam Saadia-Redleaf
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Unusual Case ◽  
History Of ◽  
Samter’S Triad ◽  
The Right ◽  
Inflammatory Changes ◽  
Air Cells ◽  
Middle Ear Cleft ◽  
Mastoid Air Cells

We report an unusual case of bilateral inflammatory aural polyps in a patient with Samter's triad. This 52-year-old patient had a history of chronic rhinosinusitis with sinonasal polyps, asthma, and aspirin sensitivity, with progressive right-sided hearing loss, otorrhea, and aural fullness. She was found to have bilateral aural polyps, with the larger obstructing lesion on the right. A computed tomography supported these findings and revealed bilateral opacification of the middle ear cleft and mastoid air cells. An initial right tympanomastoidectomy was performed with the specimen histologically resembling a typical sinonasal polyp. We speculate that this patient's middle ear polyposis is secondary to the inflammatory changes of Samter's triad. This has not been described previously in the literature.

Neglected woman with hyperemesis gravidarum leading to Wernicke encephalopathy

2020 ◽  
Vol 13 (12) ◽  
pp. e238545
Author(s):  
Papa Dasari ◽  
Smitha Priyadarshini
Keyword(s):  
Grey Matter ◽  
Hyperemesis Gravidarum ◽  
Intravenous Fluids ◽  
State Of Health ◽  
Wernicke Encephalopathy ◽  
Periaqueductal Grey ◽  
Mri Brain ◽  
Good State ◽  
Periaqueductal Grey Matter ◽  
History Of

A teenage primigravida at 13 weeks of gestation presented with hyperemesis gravidarum of 45 days and a history of giddiness and inability to walk due to involuntary movements of limbs and eyes since 2 days. She was treated with intravenous fluids, thiamine and antiemetics. MRI brain showed hyperintensities in bilateral dorsomedial thalami, periaqueductal grey matter in T2-weighted and FLAIR images. A diagnosis of Wernicke encephalopathy was made and she was managed in intensive care unit and received injection thiamine as per the guidelines and her weakness and ataxia improved over 3 weeks and she was discharged at 17 weeks of pregnancy in good state of health.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals Predictive factors of epilepsy outcome in a sample of Egyptian pre-elderly and elderly population

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Steven Emil Gerges ◽  
Mahmoud Hemeda El Rakawy ◽  
Naglaa Mohammed El Khayat ◽  
Yousry Abo Elnaga Abdelhamid ◽  
Ahmed Mohammed Hazzou ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Elderly Population ◽  
Laboratory Data ◽  
The Elderly ◽  
Medical Comorbidities ◽  
Mri Brain ◽  
Group Data ◽  
History Of ◽  
Eeg Changes ◽  
International League

Abstract Background Elderly people with epilepsy are large, but neglected group. Data on the predictive factors for recurrent seizures in the elderly population are inconclusive or are not known for the majority of patients. This is especially true for the Egyptian population as no specific study was concluded to address this issue before. Objectives The aim of this study was to detect the predictive factors of epilepsy outcome in a sample of Egyptian aged population. Materials and methods A total of 100 patients aged 50 years or older with epilepsy diagnosed according to International League Against Epilepsy (ILAE) latest definition were included in the study and followed up for 6 months as regards seizure control. All participants were prospectively evaluated for epidemiological, clinical, radiological, electrodiagnostic, and laboratory data. Results The outcome was statistically significant affected in relation to absence of medical comorbidities (P = 0.037), seizure etiology (P = 0.007), history of status epilepticus (P <  0.001), MRI brain findings (P = 0.005), EEG changes (P <  0.001), Ca (P = 0.01), and Mg level (P = 0.046). Conclusion We conclude that aged Egyptian epileptic population with no medical comorbidities, normal MRI brain, or normal EEG can be predicted to have good outcome of their epilepsy while patients with post stroke epilepsy, abnormal MRI brain, and abnormal EEG, with low serum Ca or Mg level can be predicted to have poor outcome.

Correlation between tympanometry volume and three-dimensional computed tomography mastoid volumetry in tympanoplasty candidates

2021 ◽  
pp. 1-5
Author(s):  
L Epprecht ◽  
L Qingsong ◽  
N Stenz ◽  
S Hashimi ◽  
T Linder
Keyword(s):  
Computed Tomography ◽  
Tympanic Membrane ◽  
Cell Volume ◽  
Radiation Injury ◽  
Three Dimensional ◽  
Non Invasive ◽  
Tympanic Membrane Perforations ◽  
Computed Tomography Scans ◽  
Air Cells ◽  
Mastoid Air Cells

Abstract Objective Ventilation of the middle ear and mastoid air cells is believed to play an important role in the pathogenesis of chronic ear disease. Traditionally, ventilation is assessed by computed tomography. However, this exposes patients to cumulative radiation injury. In cases with a perforation in the tympanic membrane, tympanometry potentially presents a non-invasive alternative to measure the ventilated middle-ear and mastoid air cell volume. This study hypothesised that total tympanometry volume correlates with ventilated middle-ear and mastoid air cell volume. Method Total tympanometry volume was compared with ventilated middle-ear and mastoid air cell volume on computed tomography scans in 20 tympanic membrane perforations. Results There was a high correlation between tympanometry and computed tomography volumes (r = 0.78; p < 0.001). A tympanometry volume more than 2 ml predicted good ventilation on computed tomography. Conclusion These results may help reduce the need for pre-operative computed tomography in uncomplicated cases with tympanic membrane perforations.

scholarly journals Subacute Sclerosing Panencephalitis manifesting as Bell’s palsy and bilateral macular necrotizing retinitis: an atypical presenting feature

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lagan Paul ◽  
Tanya Jain ◽  
Manisha Agarwal ◽  
Shalini Singh
Keyword(s):  
Subacute Sclerosing Panencephalitis ◽  
Clinical History ◽  
Neurological Complications ◽  
Bell’S Palsy ◽  
Ocular Involvement ◽  
Bell's Palsy ◽  
Diagnostic Challenge ◽  
Bladder Control ◽  
Mri Brain ◽  
History Of

Abstract Background Subacute sclerosing panencephalitis (SSPE) is a potentially lethal complication of measles infection. Neurological complications take years to manifest after primary viral infection of brain and can lead to blindness in some individuals. Findings A 13-year-old female patient with history of Bell’s palsy 2 months prior, presented with rapidly progressing necrotizing retinitis in both eyes. Soon after, she was unable to walk, developed myoclonic jerks, altered sensorium and loss of bowel and bladder control. Her clinical history, CSF IgG measles antibody analysis, MRI brain and EEG findings confirmed the diagnosis of SSPE. Conclusion SSPE in our case presented as Bell’s palsy and sudden painless diminution of vision due to ocular involvement, and developed full blown disease within 2 months. SSPE can present as a diagnostic challenge and warrants early identification and referral for timely diagnosis and management.

Basal ganglia echogenicity in preterm infants: A case series

2020 ◽  
pp. 1-5
Author(s):  
S. Harvey ◽  
S. Ryan ◽  
A. Tarrant ◽  
M. King ◽  
B. Hayes
Keyword(s):  
Basal Ganglia ◽  
Clinical Course ◽  
Case Series ◽  
Abnormal Development ◽  
Cranial Ultrasound ◽  
Perinatal Factors ◽  
Mri Brain ◽  
Developmental Progress ◽  
Cognitive Delay ◽  
History Of

BACKGROUND: Damage to the basal ganglia and thalamus (BGT) can be caused by multiple perinatal factors and may be associated with movement disorders, cognitive delay and visual difficulties. Changes in BGT structure, seen as echogenicity on ultrasound, are difficult to objectively quantify. The aetiology, clinical relevance and developmental outcomes of BGT echogenicity are poorly understood. We aimed to gain a better understanding of the natural history of BGT echogenicity in a preterm population. METHODS: Retrospective review of clinical course, neuroimaging and development in infants born <32weeks gestation over 5 years with evidence of BGT echogenicity. RESULTS: BGT echogenicity was reported in 18/650 infants (2.7%). Echogenicity appeared at a median of 8 days (2–45 days) and resolved on pre-discharge ultrasound in 50%. Thirteen infants had a term corrected MRI brain with abnormal BGT signal seen in 3 infants (23%). All 3 infants had persisting echogenicity on discharge ultrasound. No infant with echogenicity resolution on ultrasound had changes on term MRI. 14 infants had developmental progress available at 1 year corrected. Abnormal development was reported in four children of whom one had BGT changes on term MRI. Two children with persistent BGT changes but an otherwise normal MRI had reported normal neurodevelopment. CONCLUSION: BGT echogenicity is relatively common on routine ultrasound and resolves in the majority of infants by term corrected. This review suggests that at term corrected, normal cranial ultrasound may obviate the need for MRI where no other concerns exist. BGT echogenicity did not appear to independently influence neurodevelopment.

Canal wall cholesteatoma following canalplasty

2009 ◽  
Vol 123 (10) ◽  
pp. 1174-1176 ◽  
Author(s):  
M Martinez Del Pero ◽  
N Donnelly ◽  
N Antoun ◽  
P Axon
Keyword(s):  
Late Complication ◽  
Canal Wall ◽  
Ear Canal ◽  
Early Complications ◽  
Cartilage Reconstruction ◽  
Air Cells ◽  
And Cartilage ◽  
Mastoid Air Cells

AbstractIntroduction:Bony canalplasty is a common otological procedure performed to widen a narrow ear canal. The aim of this report is to describe two unusual patients who presented with a canal wall cholesteatoma many years after bony canalplasty.Cases:Two patients, aged 28 and 52 years, are presented. Both underwent canalplasty, 14 and 17 years before re-presenting with cholesteatoma evident through posterior canal wall defects. Both patients underwent exploration of the mastoid cavities and cartilage reconstruction of the canal walls. There was no recurrence at 24 and three month follow-up examinations (variously), hearing was preserved in both cases, and the patients suffered no early complications.Conclusions:The most frequent long-term complication of canalplasty is re-stenosis of the external auditory canal. The importance of sealing any inadvertently opened mastoid air cells, in order to avoid the late complication reported, is emphasised.

scholarly journals Diagnosing RCVS Without the CV

2015 ◽  
Vol 6 (3) ◽  
pp. NP1-NP4 ◽  
Author(s):  
Nuri Jacoby ◽  
Ulrike Kaunzner ◽  
Marc Dinkin ◽  
Joseph Safdieh
Keyword(s):  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Multiple Risk Factors ◽  
Mri Brain ◽  
Cerebral Vasoconstriction ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Occipital Lobes ◽  
The Brain

This is a case of a 52-year-old man with a past medical history of 2 episodes of coital thunderclap headaches as well as recent cocaine, marijuana, and pseudoephedrine use, who presented with sudden, sharp, posterior headache associated with photophobia and phonophobia. His initial magnetic resonance imaging (MRI) of the brain, magnetic resonance angiography (MRA) of the head, and magnetic resonance venography (MRV) of the head were all normal as well as a normal lumbar puncture. Given the multiple risk factors for reversible cerebral vasoconstriction syndrome (RCVS), the patient was treated for suspected RCVS, despite the normal imaging. Repeat MRI brain 3 days after hospital admission demonstrated confluent white matter T2 hyperintensities most prominent in the occipital lobes, typical of posterior reversible encephalopathy syndrome (PRES). Repeat MRA of the head 1 day after discharge and 4 days after the abnormal MRI brain showed multisegment narrowing of multiple arteries. This case demonstrates that RCVS may present with PRES on MRI brain and also exemplifies the need to treat suspected RCVS even if imaging is normal, as abnormalities in both the MRI and the MRA may be delayed.

scholarly journals Butterfly vertebra: a case report

2017 ◽  
Vol 31 (1) ◽  
pp. 80-84 ◽  
Author(s):  
D. Adam ◽  
D. Iftimie ◽  
Gina Burduşa ◽  
Cristiana Moisescu
Keyword(s):  
Vertebral Fracture ◽  
Diagnostic Procedures ◽  
Spinal Pain ◽  
Benign Condition ◽  
Thoracic Spinal ◽  
Schmorl’S Nodes ◽  
History Of ◽  
Epidural Fat ◽  
Vertebral Bodies ◽  
Local Examination

Abstract Background and importance: Butterfly vertebra is an uncommon congenital spinal anomaly, which can be easily mistaken for vertebral fracture, infection or tumor. Clinical presentation: We report the case of a 20-year-old male patient with a 3-year history of intermittent mid-thoracic spinal pain. Local examination showed a mild thoracic kyphoscoliosis. Neurological examination was normal. Computer tomography revealed the presence of a T6 butterfly vertebra associated with morphological anomalies in adjacent vertebral bodies and T6-T9 Schmorl’s nodes. MRI scan confirmed the diagnosis and additionally showed a mild spinal stenosis caused by apparent posterior epidural fat hypertrophy. The patient was treated with painkillers and physical therapy. Conclusion: Butterfly vertebra is a benign condition. Once diagnosed, additional diagnostic procedures are not necessary. Neurosurgeons must be aware of this congenital anomaly that should not be confused with a vertebral fracture.

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