RETROSPECTIVE ANALYSIS OF ACUTE LYMPHADENITIS OF THE MAXILLOFACIAL REGION AND NECK IN CHILDREN

2021 ◽  
pp. 134-139
Author(s):  
Маргарита Александровна Агапова ◽  
Дмитрий Юрьевич Харитонов ◽  
Ирина Владимировна Корытина ◽  
Анна Владимировна Подопригора
Keyword(s):  
Differential Diagnosis ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Hematological Parameters ◽  
Temperature Curve ◽  
Hospital Treatment ◽  
Maxillofacial Region ◽  
Clinical Forms ◽  
The Face ◽  
Life Threatening

Дети с острыми формами лимфаденитов челюстно-лицевой области составляют большую часть пациентов поликлиник и профильных стационаров. Зачастую они имеют недооцененную клиническую картину, общее состояние, распространенность и динамику острого воспалительного процесса, требуя хирургического вмешательства. Допущенные ошибки приводят к удлинению сроков лечения и иногда угрозе для жизни. Для раннего выявления показаний для госпитализации и помощи практикующим врачам в алгоритме действий проведен анализ случаев острых лимфаденитов лица и шеи в детском возрасте. На основе ретроспективных данных осуществлена систематизация лимфаденитов челюстно-лицевой области по клиническим формам и распределении частоты встречаемости, возрасту, анатомической принадлежности, выделены основные изменения гематологических показателей. Определена корреляция температурной кривой, этиологические причины возникновения лимфаденитов и основные микробиологические возбудители гнойных форм лимфаденитов лица и шеи у детей. На основании полученных данных нами разработаны и предложены критерии дифференциальной диагностики разных клинических форм лимфаденита, что поможет врачу с постановкой предварительного диагноза, или дифференциальной диагностике, на этапе поликлиники или на догоспитальном приёме. Данные критерии помогут сократить сроки лечения детей в стационаре и не допустить развития тяжелых осложнений Children with acute forms of lymphadenitis of the maxillofacial region make up the majority of patients in polyclinics and specialized hospitals. They often have an underestimated clinical picture, general condition, prevalence and dynamics of an acute inflammatory process, requiring surgical intervention. Mistakes lead to lengthening of treatment and sometimes life-threatening. For early detection of indications for hospitalization and assistance to practitioners in the algorithm of actions, an analysis of cases of acute lymphadenitis of the face and neck in childhood was carried out. On the basis of retrospective data, the systematization of lymphadenitis of the maxillofacial region by clinical forms and distribution of frequency of occurrence, age, anatomical affiliation was carried out, the main changes in hematological parameters were highlighted. The correlation of the temperature curve, the etiological causes of the occurrence of lymphadenitis and the main microbiological pathogens of purulent forms of lymphadenitis of the face and neck in children were determined. Based on the data obtained, we have developed and proposed criteria for the differential diagnosis of various clinical forms of lymphadenitis, which will help the doctor with a preliminary diagnosis, or differential diagnosis, at the stage of the polyclinic or at the pre-hospital admission. These criteria will help to shorten the period of hospital treatment for children and prevent the development of severe complications

Hemoperitoneum in a Peritoneal Dialysis Patient: Ruptured Ectopic Pregnancy

2018 ◽  
Vol 38 (6) ◽  
pp. 455-456 ◽  
Author(s):  
Orly F. Kohn ◽  
Sandra Culbertson ◽  
Yolanda T. Becker
Keyword(s):  
Differential Diagnosis ◽  
Peritoneal Dialysis ◽  
Ectopic Pregnancy ◽  
Dialysis Patient ◽  
Surgical Intervention ◽  
Peritoneal Dialysis Patient ◽  
Dialysis Patients ◽  
Childbearing Age ◽  
Life Threatening ◽  
High Index Of Suspicion

Hemoperitoneum is a well-recognized complication in female peritoneal dialysis (PD) patients of childbearing age. Bloody effluent is commonly of minor nature, presenting during menstruation or midcycle, resolving after a few rapid exchanges without a need for further intervention. One must remain vigilant, however, and consider a broader differential diagnosis when hemoperitoneum is persistent or severe, as it indicates a serious and potentially life-threatening etiology. We report 2 episodes of hemoperitoneum in a PD patient occurring more than 1.5 years apart, with different underlying etiologies. The more dramatic second episode was due to a ruptured ectopic pregnancy, a condition which had not been reported as a cause of hemoperitoneum in dialysis patients to date and requires a high index of suspicion and prompt surgical intervention.

scholarly journals Evaluation of dynamics of inflammatory process in patients with flegmones of shell-facial plants

2019 ◽  
Vol 41 part 1 (2) ◽  
pp. 25-28
Author(s):  
V. A. Malanchuk ◽  
A.V. Sidoryako
Keyword(s):  
Inflammatory Process ◽  
Inflammatory Diseases ◽  
Hospital Treatment ◽  
Specific Patient ◽  
Regional Administration ◽  
Process Dynamics ◽  
Group I ◽  
Life Threatening ◽  
Purulent Wound ◽  
Clinical Measurements

Modern and glance at the methods of diagnosis and treatment of patients with odontogenic inflammatory diseases of the maxillofacial area and neck was and remains one of the pressing problems that are frequent complications that lead to disorders in the tooth-jaw system, and can be a direct life-threatening ill. Purpose of the study. To increase the effectiveness of treatment of phlegmon of maxillofacial area and neck due to the active evaluation of the dynamics of the inflammatory process comparing a specific patient with standard indicatorschanges in the limits of edema of infiltration. Materials and methods. We carried out diagnostics and complex treatment of 120 patients with odontogenic phlegmons, who were in hospital treatment. The patients were divided into 2 groups: group I – 60 patients, treatment of which was carried out by the traditional method. Group II – 60 patients, modern treatment methods regional administration of attibiotics, vacuum drainage of purulent wound and plasmolifting at the stage of reparation, were added to their standard therapy. Conclusions: The proposed method is simple, reliable and does not require expensive equipment and makes it possible to predict the development of the disease only by clinical measurements of the volume of inflammation. Keywords: maxillofacial area, phlegmon, autoplasma, platelets, evaluation of the inflammatory process dynamics.

scholarly journals Bilateral Synchronous Granulomatous Orchitis in a Patient with Erectile Disfunction: Clinical and Pathologic Study of the Case

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
M. Rodriguez Peña ◽  
D. Moreno
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Male Patient ◽  
Leydig Cells ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Testicular Tumor ◽  
Histological Findings ◽  
Loss Of Libido ◽  
Histopathologic Analysis

A 50-year-old male patient presented with erectile failure and loss of libido. In the physical examination, there were stone-hard indurations in his bilateral testes. The ultrasonographic study demonstrated multiple hypoechoic areas in the testes and normal epididymis. Since the lesion was presumed as malignancy, bilateral inguinal exploration was performed and intraoperative frozen biopsies were studied and diagnosed as inflammatory process. Nevertheless, we decided to perform left orchiectomy to a deeper histopathologic analysis which revealed granulomatous orchitis, mastocytosis, and severe depletion of Leydig cells at the testicular interstitium. Differential diagnosis between testicular tumor and granulomatous orchitis is very difficult in any examination except by histological findings. Bilateral cases of this pathology are relatively rare, but it is necessary to distinguish them from the testicular tumor before surgical intervention to avoid an unnecessary orchiectomy.

scholarly journals Differential diagnosis and effective therapy for sore throat

2021 ◽  
pp. 166-171
Author(s):  
A. L. Guseva ◽  
M. L. Derbeneva
Keyword(s):  
Differential Diagnosis ◽  
Antibiotic Therapy ◽  
Sore Throat ◽  
Surgical Intervention ◽  
Streptococcal Pharyngitis ◽  
Retropharyngeal Abscess ◽  
Jugular Vein Thrombosis ◽  
Adequate Treatment ◽  
Vein Thrombosis ◽  
Life Threatening

Sore throat is a common complaint, which can be caused by a typical viral pharyngitis, or it can be rooted in a life-threatening disease such as epiglottitis or inflammation of the cellular spaces in the throat and neck. The doctor should take a closer look at a patient with a sore throat, immediately make a differential diagnosis and prescribe adequate treatment, including surgical intervention, if necessary.The article discusses the most common causes of a sore throat, including various types of pharyngitis, paratonsillar abscess, parapharyngeal abscess, retropharyngeal abscess, epiglottitis.Viral pharyngitis has a favourable prognosis, resolves without intervention and complications, but bacterial and fungal pharyngitis have a more severe course. Streptococcal pharyngitis caused by group A в-hemolytic streptococcus holds a dominant position in bacterial etiology and requires the use of antibiotic therapy. The differential diagnosis of streptococcal pharyngitis is based on the modified Centor scores in the routine clinical practice. Antibiotic therapy for streptococcal pharyngitis includes a 10-day course of unprotected penicillins. If a patient has an allergic reaction to penicillins, it is recommended to use clindamycin or clarithromycin. The surgical intervention combined with intramuscular or intravenous antibiotic therapy is recommended for the treatment of purulent processes in the cellular spaces of the neck. These diseases can have life-threatening complications, which include neurological damage, the spread of purulent process in the mediastinum with the development of mediastinitis, laryn-geal stenosis, sepsis, necrotizing fasciitis, jugular vein thrombosis and erosion of the carotid artery. The third generation cephalosporins and protected penicillins are recommended for the treatment of epiglottitis, and respiratory fluoroquinolones are used, if a patient has a history of allergic reactions to penicillins. In severe cases with symptoms of stenosis, intubation can be performed in addition to the use of antibiotics.

Chest pain, breathlessness, and fatigue

2020 ◽  
pp. 3276-3284
Author(s):  
Jeremy Dwight
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Emergency Department ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Past Medical History ◽  
Diagnostic Challenge ◽  
The Face ◽  
Life Threatening ◽  
The Individual

The symptoms of chest pain, breathlessness, and fatigue present a frequent diagnostic challenge in the outpatient and acute medical departments, as well as the emergency department. They have a broad differential diagnosis that includes several life-threatening pathologies. The cardiovascular history routinely includes assessment of risk factors and those aspects of the patient’s past medical history that make cardiovascular disease more likely. The presence of numerous risk factors may, on occasion, prompt the physician to proceed to further investigation even in the face of a relatively unconvincing history. Most diagnoses are made on the basis of patient history, and the physician is always compelled to return to the initial history and examination to put the findings of any investigations into context and to plan therapy appropriate for the individual patient.

Aspects of orthodontic protocol in cleft lip and palate patients

2020 ◽  
Vol 20 (2) ◽  
pp. 137-142
Author(s):  
O. V. Dudnik ◽  
Ad. A. Mamedov ◽  
O. I. Admakin ◽  
A. A. Skakodub ◽  
Y. O. Volkov ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Comprehensive Approach ◽  
Maxillofacial Region ◽  
Indirect Methods ◽  
Indirect Bonding ◽  
The Face ◽  
Direct And Indirect Methods

Relevance. Cleft lip and palate is one of the severe malformations of the face and jaw, requiring a comprehensive approach to the rehabilitation of the patients, including doctors of various specialties, one of which is orthodontists. A feature of orthodontic treatment is difficulty of fixing bracket systems, as well as lowering the level of oral hygiene, caused by deformation and displacement of fragments of the maxillofacial region.Purpose. Improving the effectiveness of orthodontic treatment and hygiene of the oral caviti in patients with cleft lip and palate in permanent bite period.Materials and methods. A comparison was made of the effetctiveness of fixing brackets systmes with direct and indirect bonding techniques and the effectiveness of oral hygiene during orthodontic treatment using irrigators.Results. The results of the study showed a difference in the effectiveness of using direct and indirect methods of fixing bracket systems in patients with cleft and palate. The use of irrigators as additional means of oral hygiene has demonstrated a positive dynamic of hygiene indices.Conclusions. Results of the study demonstrate the advantages of fixation the brackets by indirect bonding and use additional hygiene products irrigator for improving of oral hygiene.

A Serological Storm

1970 ◽  
Vol 9 (2) ◽  
Author(s):  
Bertha Wong MD ◽  
Maria Bagovich MD ◽  
Ivan Blasutig PhD ◽  
Simon Carette MD MPhil
Keyword(s):  
Differential Diagnosis ◽  
Hepatitis C Virus ◽  
Immune System ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Clinical Context ◽  
Autoantibody Profile ◽  
Life Threatening ◽  
Clinically Significant ◽  
Sensory Polyneuropathy

This article describes a patient presenting with a sensory polyneuropathy and multiple autoantibodies, leading to the diagnosis of hepatitis C virus (HCV) infection. His widely positive autoantibody profile in the absence of clinically significant rheumatic disease illustrates the importance of interpreting autoimmune serology in the appropriate clinical context and the concept of HCV being a non-specific activator of the immune system. In addition, it highlights the importance of considering untreated HCV infection in the differential diagnosis of rheumatic complaints, particularly if the workup reveals multiple autoantibodies, as HCV is a potentially severe and life-threatening disease, which can be appropriately managed with effective antiviral therapy.

scholarly journals The bowel and beyond: extracolonic findings from CT colonography

2021 ◽  
Author(s):  
Gerard Lambe ◽  
Peter Hughes ◽  
Louise Rice ◽  
Caoimhe McDonnell ◽  
Mark Murphy ◽  
...  
Keyword(s):  
Ct Colonography ◽  
Surgical Intervention ◽  
Potential Significance ◽  
Age And Gender ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Extracolonic Findings ◽  
The Difference ◽  
Clinically Significant ◽  
And Gender

AbstractCT colonography has emerged as the investigation of choice for suspected colorectal cancer in patients when a colonoscopy in incomplete, is deemed high risk or is declined because of patient preference. Unlike a traditional colonoscopy, it frequently reveals extracolonic as well as colonic findings. Our study aimed to determine the prevalence, characteristics and potential significance of extracolonic findings on CT colonography within our own institution. A retrospective review was performed of 502 patients who underwent CT colonography in our institution between January 1, 2010 and January 4, 2015. Of 502 patients, 60.63% had at least one extracolonic finding. This was close to other similar-sized studies (Kumar et al. Radiology 236(2):519–526, 2005). However, our rate of E4 findings was significantly higher than that reported in larger studies at 5.3%(Pooler et al. AJR 206:313–318, 2016). The difference may be explained by our combination of symptomatic/screening patients or by the age and gender distribution of our population. Our study lends support to the hypothesis that CT colonography may be particularly useful in identifying clinically significant extracolonic findings in symptomatic patients. CT colonography may allow early identification of extracolonic malignancies and life-threatening conditions such as an abdominal aortic aneurysm at a preclinical stage when they are amenable to medical or surgical intervention. However, extracolonic findings may also result in unnecessary investigations for subsequently benign findings.

Toxoplasma Appendicitis: A Once-in-a-Lifetime Diagnosis!

2017 ◽  
Vol 26 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Anisha M. Fernandes ◽  
Maheshkumar M. Lakhe ◽  
Sanjay A. Pai
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Muscularis Propria ◽  
Immunocompromised Patients ◽  
Lymphoid Follicles ◽  
Negative Results ◽  
Immunosuppressed Patients ◽  
Life Threatening

Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were reactive lymphoid follicles with histiocytes in the submucosa and tachyzoites in the muscularis propria. Immunohistochemistry confirmed the diagnosis of toxoplasma appendicitis. Serological evaluation yielded negative results. Retrospective review of the history revealed that the patient was on long-term immunosuppressive therapy with methotrexate. The patient was treated with sulfamethoxazole-trimethoprim and is asymptomatic at 7-month follow-up. Toxoplasma appendicitis must be considered in the differential diagnosis of appendicitis in immunosuppressed patients.

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