Cervical spinal tuberculosis combined with brucellosis

Introduction: In some developing countries, tuberculosis and brucellosis, which are commom causes of spinal infections, are still common infectious diseases. However, co-occurrence of spinal tuberculosis and brucellosis is rare. Methodology: We report a case a 47-year-old male engaged in aquaculture with a medical history of numbness, weakness, fever, and night sweats in both upper limbs for about 10 days. Serum agglutination test (SAT) for Brucella revealed brucella infection. Cervical computed tomography (CT) scan and magnetic resonance imaging (MRI) suggested C6, C7 vertebral destruction and corresponding segmental nerve compression. Based on preoperative clinical symptoms and auxiliary examination, brucellar spondylitis was first suspected. According to the postoperative pathological examination, the patient was finally diagnosed as cervical spinal tuberculosis combined with brucellosis. Results: The preoperative symptoms of the patient decreased significantly after surgery, and the patient recovered and leaved hospital within two weeks of starting treatment. At the 6-month follow-up, the patient's clinical symptoms completely disappeared, and all laboratory tests returned to normal. Conclusion: Cervical spinal tuberculosis combined with brucellosis is a relatively rare condition. In areas with high rates of tuberculosis and brucellosis, we should conduct comprehensive examinations to avoid misdiagnosis and missed diagnosis.

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Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease

Multiple Sclerosis Journal ◽

10.1177/1352458509106214 ◽

2009 ◽

Vol 15 (8) ◽

pp. 918-927 ◽

Cited By ~ 52

Author(s):

A Siva ◽

S Saip ◽

A Altintas ◽

A Jacob ◽

BM Keegan ◽

...

Keyword(s):

Multiple Sclerosis ◽

Demyelinating Disease ◽

Clinical Symptoms ◽

Tertiary Care ◽

Similar Rate ◽

Randomized Controlled Studies ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Mri Study

Background Natural history of patients with incidentally discovered lesions that fulfill magnetic resonance imaging (MRI) criteria for multiple sclerosis (MS) in the absence of objective clinical symptoms suggestive of central nervous system (CNS) inflammatory-demyelinating disease is not well defined. Objective We evaluated the risk of developing symptomatic MS in patients with radiologically uncovered asymptomatic possible inflammatory-demyelinating disease (RAPIDD). Methods We identified and longitudinally followed a cohort of 22 patients from two tertiary care MS centers: Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey, and Mayo Clinic, Rochester, Minnesota, after an initial MRI study fulfilling the Barkhof–Tintore MRI criteria completed for other reasons unrelated to MS. Results Eight of 22 patients developed an objective clinical symptom consistent with a CNS inflammatory-demyelinating syndrome and fulfilled dissemination in space and time criteria for definite MS. Median age at the time of diagnosis of MS was 44.8 years (range 28.3–71.4 years). Time taken for the development of definite MS was studied by survival analysis. Cumulative event rates were; 12 months: 9%, 24 months: 15%, 36 months: 30.4%, and 60 months: 44.6%. Six of 22 patients were followed beyond 60 months. Two of these six patients developed MS later (at 66 and 112 months, respectively). Three patients remained asymptomatic despite follow-up of 10 years. Conclusions Patients with RAPIDD develop MS at a similar rate to treated patients (and less frequently than placebo groups) with clinically isolated syndromes from prior randomized controlled studies. Some patients with RAPIDD continue to have radiological evolution of subclinical disease without MS symptoms despite long follow-up periods.

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Rare Etiology of Odynophagia in a Female Adolescent

Case Reports in Gastroenterology ◽

10.1159/000513801 ◽

2021 ◽

pp. 352-358

Author(s):

Anastasios Koutsoumourakis ◽

Asterios Gagalis ◽

Maria Fotoulaki ◽

Maria Stafylidou

Keyword(s):

Antiviral Treatment ◽

Healing Process ◽

Rare Condition ◽

Female Adolescent ◽

Mucosal Barrier ◽

Esophageal Mucosa ◽

Intact Immune System ◽

History Of ◽

Orolabial Herpes

Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. omeprazole 40 mg two times a day, and acyclovir 5% cream four times a day. After 8 days of admission, the patient was discharged. A follow-up esophagogastroduodenoscopy was performed 7 weeks after discharge, and the results revealed that the esophageal mucosa had a normal appearance. The effect of antiviral treatment against HE remains unknown in these patients. Nevertheless, it is believed to accelerate the healing process in individuals with esophageal mucosal barrier damage. To the best of our knowledge, this case of a female adolescent with an intact immune system is the sixth case of herpes simplex esophagitis to be reported in the literature.

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Intravascular Glomus Tumor of the Forearm Causing Chronic Pain and Focal Tenderness

Case Reports in Orthopedics ◽

10.1155/2014/619490 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Sang Ki Lee ◽

Dae Geon Song ◽

Won Sik Choy

Keyword(s):

Chronic Pain ◽

Glomus Tumor ◽

Rare Condition ◽

Surgical Excision ◽

Vascular Tumor ◽

Glomus Tumors ◽

Contrast Magnetic Resonance ◽

History Of ◽

Subcutaneous Layer ◽

Magnetic Resonance Imaging Mri

Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition.Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI) showed a mass measuring 5 × 3 × 2 mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient’s symptoms were completely resolved postoperatively.Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis.

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A rare case of cavernous hemangioma accompanied with diffuse hepatic hemangiomatosis

Surgical Case Reports ◽

10.1186/s40792-020-01023-4 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Takuji Ota ◽

Toshiya Kamiyama ◽

Takuya Kato ◽

Takayuki Hanamoto ◽

Kunihiro Hirose ◽

...

Keyword(s):

Oral Contraceptives ◽

Cavernous Hemangioma ◽

Contraceptive Use ◽

Careful Examination ◽

Pathological Examination ◽

Surgical Removal ◽

Adjacent Area ◽

Oral Contraceptive Use ◽

History Of ◽

Magnetic Resonance Imaging Mri

Abstract Background Hepatic cavernous hemangioma (CH) is the most common hepatic benign tumor. Most cases are solitary, asymptomatic, and found incidentally. In symptomatic cases with rapidly growing tumors and coagulopathy, surgical treatment is considered. In rare cases, diffuse hepatic hemangiomatosis (DHH) is reported as a comorbidity. The etiology of DHH is unknown. Case presentation A 29-year-old female patient had a history of endometriosis treated with oral contraceptives. Hepatic CH was incidentally detected in the segment IVa of the liver according to the Couinaud classification. Follow-up computed tomography (CT) and ultrasound sonography showed the growth of the lesion and formation of multiple new lesions near the first. Enhanced CT and magnetic resonance imaging (MRI) revealed that the new lesions were different from CH. Although oral contraceptives were stopped, all lesions grew in size. Malignancy and possibility of rupture of these tumors were considered due to the clinical course, and we opted for surgical removal of the tumors. Left liver lobectomy and cholecystectomy were performed. Surgical findings were small red spot spreading and a mass in segment IV of the liver. Pathological examination revealed a circumscribed sponge-like tumor with diffuse irregular extension to the adjacent area. Both of the lesions consisted of blood-filled dilated vascular spaces lined by flat endothelium without atypia. The diagnosis was hepatic CH with DHH. The patient was discharged on postoperative day 12 uneventfully. Conclusion We report the successful resection of CH with DHH. The case findings suggest a relationship between oral contraceptive use and enlargement of CH and DHH. Although DHH has been poorly understood, a few previously published cases reported DHH occurrence in patients using oral contraceptives. In such cases, the decision to perform surgical resection should be made after careful examination.

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Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i3.5897 ◽

2021 ◽

Author(s):

Zahra Tavoli ◽

Ali Montazeri

Keyword(s):

Renal Agenesis ◽

Primary Diagnosis ◽

Case Presentation ◽

Uterus Didelphys ◽

Future Fertility ◽

History Of ◽

Ohvira Syndrome ◽

Obstructed Hemivagina ◽

Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

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Chondrosternal Arthritis in Infant: An Unusual Entity

Case Reports in Orthopedics ◽

10.1155/2014/652539 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

Athina Nikolarakou ◽

Dana Dumitriu ◽

Pierre-Louis Docquier

Keyword(s):

Clinical Symptoms ◽

Therapeutic Option ◽

White Blood Cells ◽

Laboratory Data ◽

C Reactive Protein ◽

Reactive Protein ◽

History Of ◽

Local Tenderness ◽

Wait And See

Primary arthritis of chondrosternal joint is very rare and occurs in infants less than 18 months of age. Presentation is most often subacute but may be acute. Child presents with a parasternal mass with history of fever and/or local signs of infection. Clinical symptoms vary from a painless noninflammatory to a painful mass with local tenderness and swelling, while fever may be absent. Laboratory data show low or marginally raised levels of white blood cells and C-reactive protein, reflecting, respectively, the subacute or acute character of the infection. It is a self-limiting affection due to the adequate immune response of the patient. Evolution is generally good without antibiotherapy with a progressive spontaneous healing. A wait-and-see approach with close follow-up in the first weeks is the best therapeutic option.

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Non traumatic spinal epidural haematoma

Acute Medicine Journal ◽

10.52964/amja.0787 ◽

2019 ◽

Vol 18 (4) ◽

pp. 255-258

Author(s):

Naureen Abdul Khalid ◽

◽

Nainal Shah ◽

Keyword(s):

Magnetic Resonance Imaging ◽

Trauma Surgery ◽

Epidural Haematoma ◽

Rare Condition ◽

Sudden Onset ◽

Resonance Imaging ◽

Spinal Epidural Haematoma ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Spinal Epidural

Spinal epidural haematoma is a rare condition, which may be due to trauma, surgery, epidural catheterisation or disorders of coagulation. We report a case of 60 year old lady who was on warfarin for Atrial fibrillation (AF) presented with history of non-traumatic sudden onset pain in both legs and difficulty in walking. Magnetic resonance imaging (MRI) spine demonstrated epidural haematoma which was treated conservatively. Another dilemma was anticoagulation for AF. We examine the options to manage such case.

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A case of retroperitoneal tumor – clinical and therapeutic considerations

ARS Medica Tomitana ◽

10.1515/arsm-2016-0034 ◽

2016 ◽

Vol 22 (3) ◽

pp. 203-207

Author(s):

R. Osman ◽

V. Sarbu ◽

S. Osman

Keyword(s):

Rare Condition ◽

Surgical Excision ◽

Retroperitoneal Tumor ◽

Lumbar Pain ◽

Pathological Examination ◽

Nerve Sheath Tumor ◽

Abdominal Girth ◽

Computed Tomographic ◽

Appropriate Treatment ◽

History Of

Abstract Introduction: The aim of this paper is to present a case of rare retroperitoneal tumor. Material and Methods. A 72 year old man presented with six month history of abdominal girth, lumbar pain and occasional episodes of constipation was admitted in our clinic. A computed tomographic abdominal scan revealed a retroperitoneal solid mass. Surgical exploration performed later displayed solid and well delimited mass throughout retroperitoneal space followed by excision of lesion and multiple drainages. Microscopic pathological examination was benign nerve sheath tumor. Conclusion. These tumors are characteristically firm, smooth, and asymptomatic. They range in size from 1-2 mm to over 20 cm. Awareness of this indolent and rare condition is an important prerequisite for early diagnosis and appropriate treatment. Surgical excision can usually be accomplished by enucleating of the tumor without damage to the adjacent nerve.

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Intramedullary spinal cysticercosis simulating a conus medullaris tumor: case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000100033 ◽

2006 ◽

Vol 64 (1) ◽

pp. 149-152 ◽

Cited By ~ 12

Author(s):

José Fernando Guedes-Corrêa ◽

Ricardo Caratta Macedo ◽

Rafael Pereira Vaitsman ◽

Jorge Gomes de Mattos ◽

Jovita Marques Agra

Keyword(s):

Spinal Cord ◽

Daily Living ◽

Conus Medullaris ◽

Acute Onset ◽

Pathological Examination ◽

Low Back ◽

The Central Nervous System ◽

Intradural Extramedullary ◽

Magnetic Resonance Imaging Mri

Cysticercosis is an endemic condition in many developing countries. Although it is the most common parasitic disease of the central nervous system, cysticercal involvement of the spinal cord is rare. It may occur as intradural extramedullary, intramedullary, intramedullary associated with intradural-extramedullary or as the vertebral presentation. We report the case of a 53-year-old woman who presented with low back pain of acute onset and no other symptoms. Magnetic resonance imaging (MRI) showed an intramedullary cyst of the conus medullaris region which, at pathological examination, was diagnosed as a cysticercal cyst. She refused anticysticercal agents and steroids postoperatively. After an eight-year follow-up, the patient performs the activities of her daily living with no difficulties, and annual spinal MRIs show no residual signs of the disease. Clinical, pathofisiological, diagnostic and therapeutic aspects of spinal cord intramedullary cysticercosis are discussed.

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A Longitudinal Study of Atlanto-Dens Relationships in Asymptomatic Individuals with Down Syndrome

PEDIATRICS ◽

10.1542/peds.89.6.1194 ◽

1992 ◽

Vol 89 (6) ◽

pp. 1194-1198 ◽

Cited By ~ 1

Author(s):

Siegfried M. Pueschel ◽

Francis H. Scola ◽

John C. Pezzullo

Keyword(s):

Down Syndrome ◽

Clinical Symptoms ◽

Age Groups ◽

Atlantoaxial Instability ◽

History Of ◽

Child Development Center ◽

Asymptomatic Individuals ◽

Development Center ◽

Over Time

This study was designed to investigate the natural history of atlantoaxial instability in individuals with Down syndrome and to determine whether significant changes in C1-C2 relationship are taking place over time. Although more than 400 patients with Down syndrome who are presently followed at the Child Development Center had cervical spine radiographic examinations in the past, only 141 patients who had serial radiological examinations and whose radiographs were available for reevaluation participated in this study. The results of our investigations revealed that there were only minor changes (1 to 1.5 mm) of atlanto-dens interval measurements over time in 130 (92%) patients with Down syndrome. Eleven patients (8%) had changes of atlanto-dens interval measurements between 2 and 4 mm over time; however, none of these patients had any clinical symptoms. The analyses of data obtained from several subgroups (males and females, various age groups, and patients with and without atlantoaxial instability) did not show any significant changes of atlanto-dens interval measurements of successively obtained radiographs. Our recommendations for and rationale of routine screening for atlantoaxial instability and follow-up examinations are discussed in detail.

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