scholarly journals Cryptococcal empyema treated with tube thoracostomy and intrapleural fibrinolysis

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Akshay Kohli ◽  
Ashutosh Sachdeva ◽  
Edward M. Pickering
Keyword(s):  
Underlying Disease ◽  
Tube Thoracostomy ◽  
Pleuritic Chest Pain ◽  
First Case ◽  
Breath Sounds ◽  
Severe Underlying Disease ◽  
History Of ◽  
Dornase Alpha ◽  
The Right ◽  
Repeat Imaging

A 55-year old woman with a history of relapsed T-cell ALL presented with right pleuritic chest pain and decreased breath sounds over the right hemithorax. Imaging of the chest showed loculated effusions. Tube thoracostomy was performed with intrapleural application of alteplase and dornase alpha over a 3-day period. Repeat imaging demonstrated a marked decrease in the volume of the effusion. In most prior published cases of pleural cryptococcosis, surgical drainage was required in addition to prolonged antifungal agents. More than 50% of patients with cryptococcal infection have severe underlying disease or immunodeficiency state making them high risk for surgery. This is the first case to our knowledge of cryptococcal empyema successfully treated with tube thoracostomy and intrapleural fibrinolysis.

scholarly journals Recurrent Self-Induced Nontraumatic Orbital Emphysema Causing Orbital Compartment Syndrome with Optic Nerve Dysfunction

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Compartment Syndrome ◽  
Valsalva Manoeuvre ◽  
First Case ◽  
Orbital Emphysema ◽  
History Of ◽  
Nerve Dysfunction ◽  
The Right ◽  
Needle Decompression

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.

Laparoscopic surgical approach for the treatment of piriformis syndrome: Intrapelvic decompression technique

2021 ◽  
pp. 228402652110456
Author(s):  
Ahmet Kale ◽  
Gülfem Başol ◽  
Elif Cansu Gündoğdu ◽  
Emre Mat ◽  
Gazi Yıldız ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Decompression Surgery ◽  
Piriformis Syndrome ◽  
First Case ◽  
Cutaneous Allodynia ◽  
Pelvic Nerves ◽  
Uncommon Disease ◽  
History Of ◽  
Vas Scores ◽  
The Right

Introduction: Piriformis syndrome is an uncommon disease resulting from the piriformis muscle’s compression of the sciatic nerve. Pain and numbness in the buttocks and down the leg are the most common symptoms. This study analyzes the laparoscopic surgical treatment of piriformis syndrome. Methods: We report three cases of piriformis syndrome diagnosed in our hospital. The first case was a 40 years old woman with a 7-year history of intermittent low back pain and sciatica on her right side. Hyperesthesia and cutaneous allodynia were observed in the right sciatic nerve dermatome. The second case was a 30 years old woman with a 2-year history of sciatica on her left side. The third case was a 30 years old woman with a 2-year history of sciatica on her right side. All the patients underwent laparoscopic decompression surgery, which was performed to release the sciatic nerve or sacral nerve roots. Results: The patients were reexamined at the postoperative 3rd and 6th months. Their visual analog scale (VAS) scores were found to be decreased from 10/10, 9/10, and 7/10 to 0/10, 1/10, and 0/10, respectively. Conclusion: Due to the very few cases in the literature, pelvic piriformis syndrome is an exclusively clinical diagnosis. If the sciatica is refractory to conservative treatments, laparoscopic exploration and decompression surgery of the pelvic nerves and piriformis muscle could be an option.

scholarly journals Spontaneous Thrombosis of a Middle Meningeal Arteriovenous Fistula With Subsequent Pseudoaneurysm Formation: Case Report and Review of Literature

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Pouya Nazari ◽  
Pedram Golnari ◽  
Madhav Sukumaran ◽  
Ali Shaibani ◽  
Michael C Hurley ◽  
...  
Keyword(s):  
Unusual Case ◽  
Middle Meningeal Artery ◽  
Complete Healing ◽  
Spontaneous Thrombosis ◽  
Pseudoaneurysm Formation ◽  
Arteriovenous Fistulas ◽  
History Of ◽  
The Right ◽  
Repeat Imaging

ABSTRACT BACKGROUND AND IMPORTANCE Middle meningeal artery (MMA) pseudoaneurysms and middle meningeal arteriovenous fistulas (MMAVFs) are rarely reported after head injury. We report an unusual case of delayed MMA pseudoaneurysm formation after spontaneous thrombosis of an MMAVF, and review existing literature on MMAVF treatment and results. CLINICAL PRESENTATION A 59-yr-old male presented with a 5-d history of worsening left-sided headaches, followed by nausea, lethargy, and difficulty with speech. Non-contrast computed tomography demonstrated a left temporal intraparenchymal hemorrhage (IPH) and an acute left-sided subdural hematoma (SDH). Cerebral angiography found abnormal shunting between the right MMA and the right sphenoparietal sinus, consistent with an MMAVF. During the course of admission, the patient's neurological condition deteriorated requiring craniotomy for evacuation of SDH and IPH. Given the presumed incidental nature of the contralateral MMAVF, conservative management was recommended. Follow-up imaging 2 mo after surgery revealed spontaneous thrombosis of the right MMAV. Repeat imaging 5 mo later revealed an MMA pseudoaneurysm at the prior fistulous site, which was subsequently embolized with Onyx, occluding the pseudoaneurysm and the MMA both proximal and distal to the pseudoaneurysm. CONCLUSION Spontaneous thrombosis of an MMAVF is rare and only seen in 13.1% of cases. However, subsequent delayed formation of an MMA pseudoaneurysm has not been described. Our case therefore demonstrates that MMAVF thrombosis may not indicate complete healing of the underlying injury to the MMA, and suggests the need for continued follow-up of such lesions despite initial apparent resolution.

scholarly journals Aorta–bal kamra tunnel sikeres sebészi kezelése modern noninvazív képalkotó diagnosztika alapján

2015 ◽  
Vol 156 (28) ◽  
pp. 1140-1143
Author(s):  
István Hartyánszky ◽  
Márta Katona ◽  
Krisztina Kádár ◽  
Asztrid Apor ◽  
Sándor Varga ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Postoperative Management ◽  
Left Ventricular ◽  
Aortic Sinus ◽  
First Case ◽  
History Of ◽  
Dimensional Echocardiography ◽  
Aortic Orifice ◽  
Three Dimensional Echocardiography ◽  
The Right

Aortico-left ventricular tunnel is a rare congenital cardiac defect, which bypasses the aortic valve via the paravalvar connection from the aorta to the left ventricle. The authors report the history of a 14-year-old boy with aortico-left ventricular tunnel in whom the aortic orifice arose from the right aortic sinus and was closed by a pericardial patch. The diagnosis was confirmed by combined two-dimensional and real time three-dimensional echocardiogram and magnetic resonance imaging. This is the first case, in which these complex diagnostic imaging methods have been used in the pre- and postoperative management of this defect. Optimally the new transthoratic three-dimensional echocardiography would be needed to define the anatomy and functional consequences of the aortico-left ventricular tunnel and in the postoperative follow-up. Orv. Hetil., 2015, 156(28), 1140–1143.

scholarly journals Mesothelioma in two sheep with pericardial effusion and ascites

2020 ◽  
Vol 8 (1) ◽  
pp. e001031
Author(s):  
Nicola Fletcher ◽  
Camilla Brena ◽  
Amanda Carson ◽  
Mark Wessels ◽  
Tobias Floyd
Keyword(s):  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Domestic Animals ◽  
Diagnostic Pathology ◽  
First Case ◽  
Clinical Presentations ◽  
Rare Tumours ◽  
Microscopic Features ◽  
History Of ◽  
The Right

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in two sheep submitted to Animal and Plant Health Agency’s diagnostic pathology service with diverse clinical presentations. The first case was a 2-year-old ewe with a history of sudden death that had a nodular mass in the wall of the right auricle and marked pericardial effusion and ascites. The second case was a 3-year-old ewe with a history of recumbency which had a papillary mass in the peritoneal cavity and marked ascites. A diagnosis of mesothelioma in both cases was confirmed by immunohistochemistry for cytokeratin and vimentin. These cases highlight the diverse presenting signs that can be present with mesothelioma, and this tumour should be considered as a differential diagnosis in sheep with peritoneal, pericardial or pleural effusion at gross postmortem.

Symptomatic solitary xanthogranuloma occupying the cavernous sinus

2001 ◽  
Vol 94 (2) ◽  
pp. 322-326 ◽  
Author(s):  
Kazumichi Yamada ◽  
Masaki Miura ◽  
Haruhiko Miyayama ◽  
Naohiko Furuyoshi ◽  
Jun Matsumoto ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Middle Meningeal Artery ◽  
Magnetic Resonance Images ◽  
Superior Orbital Fissure ◽  
Content Type ◽  
First Case ◽  
History Of ◽  
Mixed Pattern ◽  
The Right ◽  
Field Defect

✓ The authors report the first case of a solitary xanthogranuloma of the cavernous sinus without systemic manifestation. A 43-year-old woman experienced decreased visual acuity on the right side in association with papilledema and a visual field defect. She was alert and no other neurological sign was observed. She had no family history of hyperlipoproteinemia and no cutaneous and/or systemic xanthomatous lesions. Skull x-ray films showed an enlarged right superior orbital fissure. Computerized tomography revealed a low-density oval mass 2 × 3 cm in diameter in the right cavernous region that was compressing the right optic nerve in the lateral to medial direction. This mass exhibited isointensity on T1-weighted and mixed-pattern hyperintensity on T2-weighted magnetic resonance images with diffuse contrast enhancement. Cerebral angiography demonstrated fine staining in the margin, originating from the right middle meningeal artery. These neuroimaging findings closely mimicked those associated with trigeminal neuroma. The lesion was partially removed via a right-sided zygomatic approach, and her symptoms improved. Clinical characteristics and histopathological features of this rare case are discussed.

scholarly journals Lifelong Idiopathic Unilateral Diaphragmatic Paralysis With Recurrent Pneumonia: A Case Report

2020 ◽  
Vol 10 (1) ◽  
pp. 26743
Author(s):  
Khosrow Agin ◽  
Akram Sabkara ◽  
Farzaneh Sadat Mirsafai Rizi ‎ ◽  
Bita Dadpour ◽  
Maryam Vahabzadeh ◽  
...  
Keyword(s):  
Primary Diagnosis ◽  
Diaphragmatic Paralysis ◽  
Recurrent Pneumonia ◽  
Emergency Center ◽  
Diabetes Mellitus Type Ii ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right

A 50-year-old woman was admitted to the emergency center with dyspnea, cough, and fever symptoms. She had a medical history of diabetes mellitus type II, rheumatoid arthritis, as well as several admission records due to aspiration pneumonia. The primary diagnosis was diabetic ketoacidosis and pneumonia. Normal breath sounds were reduced on the lower posterior right side of the thorax. A standard chest x-ray and lung Computed Tomography (CT) scan revealed collapse consolidation in the Right Lower Lobes (RLL) and Right Middle Lobes (RML). We here presented a case of unilateral diaphragmatic paralysis with a history of recurrent pneumonia.

scholarly journals Polylactic Acid Implant for Cranioplasty with 3-dimensional Printing Customization: A Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 151-155
Author(s):  
Tedy Apriawan ◽  
Khrisna Rangga Permana ◽  
Ditto Darlan ◽  
Muhammad Reza Arifianto ◽  
Fitra Fitra ◽  
...  
Keyword(s):  
Case Report ◽  
3D Printing ◽  
Polylactic Acid ◽  
Cost Effective ◽  
Skull Defect ◽  
3 Dimensional ◽  
First Case ◽  
Good Cosmetic ◽  
History Of ◽  
The Right

BACKGROUND: Cranioplasty is aimed to restore the structure and function of the lost portion of the skull defect. Many materials can be used for cranioplasty, such as the bones of the patient (autograft), the bones of other patients (allograft), bones of animals (xenograft), or synthetic materials such as acrylic or titanium mesh. These materials are quite expensive and sometimes require complex processes. Manual shaping of material for cranioplasty is also quite time-consuming and prone to cause esthetic dissatisfaction. The author will discuss the case of using polylactic acid (PLA) implant with 3-dimensional (3D) printing customization as a cheap and accurate cosmetic solution for cranioplasty procedures. CASE REPORT: We report 2 cases of skull defect underwent cranioplasty. The first case, female, 20-year-old, had a history of severe traumatic brain injury (TBI) and epidural hematoma. She underwent decompression craniotomy on the left frontotemporoparietal region of her skull. The second case, male, 46-year-old, had a history of spontaneous intracerebral hemorrhage due to arteriovenous malformation (AVM). He underwent decompression craniotomy on the right frontotemporoparietal region of her skull. Both the data of computerized tomography (CT) scan were reconstructed to get 3D model of skull defect. Prosthesis was made by 3D printer accordingly using PLA as material. There was no complication reported postoperatively and cosmetic satisfaction was obtained on both cases. CONCLUSION: The use of PLA implant with 3D printing customization was proved to be cost-effective and good cosmetic satisfaction with no complication reported following cranioplasty procedure.

scholarly journals Sequential Mycoplasma pneumoniae pneumonia and Chromobacterium violaceum skin abscess in a pediatric patient

2017 ◽  
Vol 11 (08) ◽  
pp. 656-661 ◽  
Author(s):  
Weizhen Guo ◽  
Iris Wai Sum Li ◽  
Xi Li ◽  
Hua Xu ◽  
Dongrong Lu ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Pediatric Patients ◽  
Community Acquired Pneumonia ◽  
Chromobacterium Violaceum ◽  
Respiratory Pathogen ◽  
First Case ◽  
History Of ◽  
The Right ◽  
Super Infection ◽  
Mycoplasma Pneumoniae Pneumonia

Mycoplasma pneumoniae is a common atypical respiratory pathogen causing community-acquired pneumonia in children. Co-infection with other respiratory viruses is common in pediatric patients but super-infection with bacteria other than Streptococcus pneumoniae and Haemophilus influenzae is rare. The first case of Chromobacterium violaceum infection incubated during and manifested after pneumonia caused by Mycoplasma pneumoniae in a 12-month old girl without any known history of immunodeficiency is here reported. The patient developed fever with redness and swelling over the middle phalanx of the right hand index finger which progressed to the formation of skin abscess. Following a course of intravenous meropenem and surgical drainage of the skin abscess, the patient fully recovered and was discharged.

scholarly journals Multiple myeloma associated with IgA lambda gammopathy and multiple myeloma oncogene 1 in a Yorkshire terrier

2018 ◽  
Vol 63 (No. 4) ◽  
pp. 187-192
Author(s):  
S. Kim ◽  
E. Son ◽  
S. Lee ◽  
S. Lee ◽  
H. Kim ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Weight Bearing ◽  
Serum Biochemistry ◽  
First Case ◽  
History Of ◽  
Immunofixation Electrophoresis ◽  
The Right ◽  
Yorkshire Terrier

An eight-year-old spayed female Yorkshire terrier was presented with a one-month history of conspicuous weight-bearing lameness in the right hindlimb, mild anorexia, intermittent vomiting and marked polydipsia and polyuria. Radiographs revealed circular radiolucent foci of variable size in the skeleton. Haematological and serum biochemistry examination revealed mild leucopoenia with severe neutropaenia, mild non-regenerative anaemia, moderate thrombocytopoenia, moderate hyperglobulinaemia, mild hypoalbuminaemia, mild azotaemia and moderate hypercalcaemia. Quantification of serum immunoglobulins revealed elevated IgA and IgG. Serum protein electrophoresis showed a broad appearance with a β-region spike. Plasma cells accounted for 7.6% of the cells in the bone marrow. Serum immunofixation electrophoresis (IFE) revealed IgA lambda gammopathy. Immunohistochemistry in the bone marrow was diffusely positive for multiple myeloma oncogene 1 (MUM-1) and CD20. To our knowledge, this is first case report of multiple myeloma associated with IgA lambda gammopathy confirmed via IFE and immunohistochemical expression of MUM-1 in a dog.

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