scholarly journals SEVERE METHEMOGLOBINEMIA WITH UNKNOWN CAUSE – CASE REPORT

2020 ◽  
Vol 7 (3) ◽  
pp. 233-238
Author(s):  
Małgorzata Rak ◽  
Michał Dworzyński ◽  
Michał Dudek ◽  
Tomasz Ilczak ◽  
Dariusz Timler ◽  
...  
Keyword(s):  
Case Report ◽  
Nicotinamide Adenine Dinucleotide ◽  
Clinical Symptoms ◽  
A Priori ◽  
Cytochrome B5 ◽  
Etiological Factor ◽  
Toxic Compounds ◽  
Methemoglobin Level ◽  
Household Members ◽  
Medical Air

The aim: Methemoglobina is an oxidized form of hemoglobin, which normally doesn`t exceed 1%. It is stated that the amount of methemoglobin over 70% is fatal. The etiology vary, it might for instance be idiopathic, congenital or caused by toxic compounds. Material and methods: We analyzed the case of patient who had exceeded the fatal level of methemoglobin in a blood. Case report: Medical Air Rescue Team was dispatched to an 80-year-old patient who suddenly lost consciousness at home. Methemoglobin level was measured using Cobas b221 system and amounted to 75%. Given the patient’s advanced age, congenital causes of methemoglobinemia, such as deficiency of cytochrome-b5 reductase or nicotinamide adenine dinucleotide reductase (NADPH-MHb reductase) were excluded a priori. It seems that the only reason for the observed methemoglobinemia in the case of the examined patient was the acquired methemoglobinemia. The patient was treated with methylene blue with good results, her state improved soon. Despite a detailed interview, it was impossible to establish the etiological factor of methemoglobinemia. None of the household members exhibited clinical symptoms of poisoning with methemoglobinogenic substance. Although the methemoglobin level was potentially deadly, the patients survived. Conclusion: It should be stressed that it is not always possible to determine the etiological factor of the discussed disorders. Knowledge of the clinical picture of poisoning, as well as of the changes characteristic for poisoning and observable in laboratory, is extremely important, especially when it is not possible to determine the etiological factor of poisoning.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

CASE REPORT: RARE FORM OF HIRSCHPRUNG’S DISEASE

2020 ◽  
Vol 30 (5) ◽  
pp. 82-84
Author(s):  
Ilja Skalskis
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Clinical Symptoms ◽  
Hirschsprung Disease ◽  
Distal Colon ◽  
Total Colonic Aganglionosis ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
History Of ◽  
High Index Of Suspicion

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.

scholarly journals A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Victoria Blackabey ◽  
Olivia Kenyon ◽  
Rishi Talwar
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Clinical Symptoms ◽  
Symptomatic Relief ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Unusual Presentation ◽  
Sinus Surgery ◽  
Cancer Management ◽  
The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

scholarly journals Mood symptoms Associated with CADASIL Syndrome: A Case Report

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 144-144
Author(s):  
Asad Shaikh ◽  
Joel Idowu
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
Small Vessel Disease ◽  
Altered Mental Status ◽  
Hereditary Disease ◽  
African American Female ◽  
Psychiatric Disturbance ◽  
Rare Type ◽  
Parietal Lobes

AbstractObjectiveTo discuss the psychiatric symptoms that are associated with CADASIL syndrome Abstract Cerebral:Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare type of hereditary disease involving the small cerebral vessels. The clinical symptoms are various and include recurrent ischemic strokes, migraine with aura, seizures with epilepsy, psychiatric problems such as mood disturbances, and progressive cognitive decline leading to dementia. This disease needs awareness amongst the psychiatrists even though it is discussed much more in neurology literature. Psychiatric symptoms are seen in 20–41% of patients with CADASIL syndrome (1, 2). Psychiatric symptoms are actually the initial presentation in 15% of the cases. (3) The psychiatric disturbance most reported are mood disturbances (9–41%) especially depression. Here a 42-year-old African American female was brought to the hospital emergency room after she was found wandering in the streets. Psychiatry was consulted for altered mental status. Upon evaluation by the psychiatric consult service she was only oriented to person, depressed, anxious and complaining of headaches. Initial CT scan showed marked small vessel disease and old lacunar infarcts in the basal ganglia and right corona radiata. Magnetic Resonance Imaging (MRI) of the brain showed acute infarcts in the right posterior frontal and right parietal lobes along with old infarcts. Her symptoms and findings on imaging were consistent with CADASIL syndrome. Once the diagnosis was confirmed and prior records were obtained patient was resumed on an antidepressant and anxiolytic.ConclusionThe purpose of this case report was to discuss psychiatric symptoms associated with CADASIL syndrome. Although there has been research showing a relationship between vascular disease and depression, a review of the literature suggests that there needs to be more research done to explore other psychiatric disturbances that may be seen with this syndrome. Psychiatric symptoms that are untreated can have the potential to further impact the quality of life therefore psychiatrists need to be aware of this syndrome in order to treat these patients promptly.References1 https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0778-8 2 http://dx.doi.org/10.32474/OJNBD.2018.01.000101 3 https://pdfs.semanticscholar.org/47f6/5952ee3c5dcf2a61345f704914b17fa8dc0d.pdf

scholarly journals Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Roopashri Rajesh Kashyap ◽  
Gopakumar R. Nair ◽  
Subhas Babu Gogineni
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Head And Neck ◽  
Clinical Symptoms ◽  
Neck Region ◽  
Ethmoid Sinus ◽  
Ossifying Fibroma ◽  
Head And Neck Region ◽  
Aggressive Form ◽  
Aggressive Tumors

Ossifying fibromas form a part of the spectrum of fibro-osseous lesions of the jaws. They are rare, benign, nonaggressive tumors that are commonly seen in head and neck region. This paper presents the case of a 40-year-old female patient presented with minimal clinical symptoms, diagnosed to be suffering from aggressive form of ossifying fibroma of maxilla involving the maxillary sinus and ethmoid sinus. This paper emphasizes the importance of computed tomography in diagnosing such unapparent aggressive tumors.

scholarly journals Chilaiditi Syndrome: A Case Report Highlighting the Intermittent Nature of the Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Esha M. Kapania ◽  
Christina Link ◽  
Joshua M. Eberhardt
Keyword(s):  
Case Report ◽  
Complete Resolution ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Delayed Diagnosis ◽  
Spontaneous Resolution ◽  
Radiographic Evidence ◽  
Case Presentation ◽  
Chilaiditi Syndrome

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.

scholarly journals Gejala Klinis dan Pemeriksaan Penunjang pada Neonatus Terinfeksi COVID-19

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jason Rampengan ◽  
Johnny Rompis ◽  
Valentine Umboh
Keyword(s):  
Cohort Study ◽  
Case Report ◽  
Literature Review ◽  
Observational Study ◽  
Ct Scan ◽  
Clinical Symptoms ◽  
Ground Glass Opacity ◽  
Google Scholar ◽  
Ground Glass ◽  
Laboratory Examinations

Abstract: COVID-19 is spreading at an extremely rapid rate and can affect all age groups, albeit, information about clinical symptoms and laboratory examinations of COVID-19 I in neonates is still quite limited. This study was aimed to determine the clinical symptoms, radiographic examinations especially CT-scans, and laboratory tests that could appear in neonates suffering from COVID-19. This was a literature review study using three databases, namely Pubmed, Clinical Key, and Google Scholar. The keywords used were Covid-19 / SARS-CoV-2 AND Neonatus AND sign and symptoms AND laboratory. The selection based on inclusion and exclusion criteria, obtained 15 case report studies, three retrospective studies, one observational study, and one cohort study. The review revealed that the most frequent clinical features that appeared were fever (54.8%), dyspnoea (35.4%), and cough (29%). Meanwhile, for CT-Scan radiographs, there were 14 of 31 neonates (45.2%) did not show any abnormalities or normal. The most frequent abnormal image was ground glass opacity (GGO) (29%). Among laboratory examinations, lymphopenia was the most common abnormality (32.2%). Moreover, leukocytosis, leukopenia, thrombocytopenia, increased PCT, AST, etc. could also occur. Of all the reviewed literatures, there were no death cases of neonates died due to COVID-19. In conclusion, fever, dyspnea, cough, and lymphopenia are the most common findings as well as GGO in the CT-Scan radiograph.Keywords: COVID-19, neonates Abstrak: COVID-19 menyebar dengan sangat pesat dan dapat menjangkiti semua kelompok usia namun informasi mengenai gejala klinis dan pemeriksaan laboratorium terhadap kelompok neonatus masih terbatas. Penelitian ini bertujuan untuk mengetahui gambaran klinis, pemeriksaan radiografi khususnya CT-Scan, dan pemeriksaan laboratorium yang bisa muncul pada neonatus dengan COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, Clinical Key, dan Google Scholar. Kata kunci yang digunakan yaitu Covid-19/ SARS-CoV-2 AND Neonatus AND sign and symptom AND laboratory. Hasil seleksi berdasarkan kriteria inklusi dan ekslusi mendapatkan 15 penelitian case report, tiga retrospective study, satu observational study, dan satu cohort study. Hasil kajian menunjukkan bahwa gambaran klinis yang paling sering muncul ialah demam (54,8%), sesak (35,4%), dan batuk (29%). Pemeriksaan radiografi CT-Scan, neonatus yang tidak menunjukkan kelainan (normal) terdapat pada 14 dari 31 neonatus diamati (45,2%), sedangkan kelainan yang sering muncul ialah ground glass opacity/GGO (29%). Pada pemeriksaan laboratorium, limfopenia merupakan kelainan tersering (32,2%), sedangkan leukositosis, leukopenia, trombositopenia, peningkatan PCT, AST, dll juga bisa terjadi. Dari semua literatur yang dikaji, tidak ditemukan kasus kematian neonatus akibat COVID-19. Simpulan penelitian ini ialah gambaran klinis yang paling sering muncul pada neonatus ialah demam, sesak, dan batuk, limfopenia, dan GGO pada CT-Scan.Kata kunci: COVID-19, neonatus

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