Occurrence of Polymelia in a Female Child

Two distinct and potentially deceitful cases of neurologic melioidosis are reported. Case 1: A 39-year-old alcoholic and uncontrolled diabetic male presented with cough, fever, and left focal seizures with secondary generalization. An magnetic resonance imaging (MRI) brain scan revealed a small peripherally enhancing subdural collection along the interhemispheric fissure suggestive of minimal subdural empyema. Blood culture grew Burkholderia pseudomallei. Patient was diagnosed with disseminated bacteraemic melioidosis with subdural empyema. He was successfully treated with ceftazidime-cotrimoxazole-doxycycline. Case 2: A 45-year-old male presented with left lower limb weakness, difficulty in passing urine and stool, and back pain radiating to lower limbs. Neurological examination revealed flaccid left lower limb with absent deep tendon reflexes and plantar reflex. Spinal MRI showed T2 hyperintensity from D9 to L1 suggestive of demyelination. Patient was treated with high dose methylprednisolone. By day 3 of steroid treatment, lower limb weakness progressed. Subsequent MRI showed extensive cord hyperintensity on T2 weighted sequence extending from C5 to conus medullaris consistent with demyelination. Cerebrospinal fluid (CSF) culture grew B. pseudomallei, and the patient was given meropenem-cotrimoxazole. After three weeks of parenteral treatment, the lower limbs remained paralyzed. Patient was discharged on oral cotrimoxazole-doxycycline. Conclusions: Melioidosis should be considered as a differential in focal suppurative central nervous system (CNS) lesions, meningoencephalitis, or encephalomyelitis in endemic areas. CNS infections must be ruled out prior to steroid administration. The role of corticosteroids in demyelinating CNS melioidosis has been refuted. This is a rare documentation of effect of unintentional corticosteroid treatment in melioidosis.

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A RARE CASE OF MAY- THURNER SYNDROME

10.36106/gjra/8100743 ◽

2021 ◽

pp. 17-19

Author(s):

B. Santhi ◽

Manigandan Manigandan ◽

Nishok Nishok

Keyword(s):

Iliac Artery ◽

Lower Limb ◽

Rare Case ◽

Common Iliac Artery ◽

Iliac Vein ◽

Common Iliac Vein ◽

Middle Aged ◽

Unique Case ◽

Left Common Iliac Vein ◽

Left Lower Limb

May-Thurner syndrome (MTS) is a venous outow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic.We report a unique case of a 25 -year-old male who presented with MTS-related multiple varicosities in left lower limb.

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Spondylodiscitis and early diagnosis: a case report

10.5327/1516-3180.146 ◽

2021 ◽

Author(s):

Mariana Moreira Soares de Sa ◽

Emanuelle Ferreira Barreto ◽

Marina Soares Vilela ◽

Roberta Kelly Netto Vinte Guimarães ◽

Vanessa Alves Lobato ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Case Report ◽

Early Diagnosis ◽

Lower Limb ◽

Clinical Case ◽

Lower Limbs ◽

Lumbosacral Spine ◽

Low Back ◽

Left Lower Limb

Context: Spondylodiscitis is a term that includes vertebral osteomyelitis, spondylitis and discitis. Among the vertebrae, the most affected are the lumbar (45%), followed by the thoracic (35%). Adults present themselves progressively, with a predominant complaint of low back pain and pain on palpation of the affected site, with significant limitation of movement due to muscle spasms. Report a clinical case with an emphasis on the possibility of early diagnosis and correct treatment aimed at the recovery of patients with neurological sequelae. Analysis of medical records in a patient admitted to the neurology ward of Santa Casa de Belo Horizonte. Clinical Case report: A.I.S. patient, 45 years old, with chronic low back pain due to asymmetry of the left lower limb. History of wear of the femoral head diagnosed in adolescence. Evolving for 2 months with progressive weakness in the lower limbs, associated with paresis and paresis in the left lower limb. He performed abdominal USG which showed hepatosplenomegaly with collateral circulation, increased caliber of the portal, splenic and superior mesenteric veins. Tomography of the lumbosacral spine with osteolytic lesions in the joints of L2-L3, L3-L4 and L4-L5., With almost total osteolysis of the L4 vertebral body, retropulsion of much later at this level, suggesting spondylodiscitis. The resonance of the lumbar spine performed with acute spondylodiscitis L2-L3 and L3-L4, compressing the roots of the equine tail with a comprehensive potential, remains as the emerging emerging roots. Liquid filling of the L3- L4 intervebral disc compatible with acute spondylodiscitis. Staphylococcus aureus and enterobacteria are responsible for more than half of the cases of non-tuberculosis. Conclusion: The diagnosis of discitis can be quite difficult, due to the rarity of the disease, the insidious symptoms and the high prevalence of low back pain in the general population. It is considered an important morbidity factor, as it causes an important neurological sequel. In addition, it points to the importance of differential diagnosis of low back pain in the population.

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Deep Vein Thrombosis of the Left Lower Limb in a 12 Year-Old Female Child with Ulcerative Colitis – Case Report

Polish Journal of Radiology ◽

10.12659/pjr.894529 ◽

2016 ◽

Vol 81 ◽

pp. 65-68

Author(s):

Elżbieta Krzesiek ◽

Urszula Zaleska- Dorobisz ◽

Barbara Iwańczak ◽

Andrzej T. Dorobisz

Keyword(s):

Ulcerative Colitis ◽

Deep Vein Thrombosis ◽

Case Report ◽

Lower Limb ◽

Female Child ◽

Vein Thrombosis ◽

Left Lower Limb ◽

Deep Vein

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Klippel–Trénaunay Syndrome and Developmental Coxa Vara in the Same Limb: A Case Report with a Review of the Literature

International Journal of Angiology ◽

10.1055/s-0041-1729921 ◽

2021 ◽

Author(s):

Balaji Zacharia ◽

Jittu Alex ◽

Ashwin Rajmohan

Keyword(s):

Lower Limb ◽

Lower Limbs ◽

Coxa Vara ◽

Port Wine ◽

Review Of The Literature ◽

Left Femur ◽

Port Wine Stains ◽

Left Lower Limb ◽

Klippel Trenaunay Syndrome

AbstractWe present a case of a 14-year-old girl who was first treated when she was 4 years old. She had progressive limping of the left lower limb from the age of 3 years. She was diagnosed to have developmental coxa vara of the left hip and treated by a subtrochanteric valgus osteotomy of the left femur. Later, she developed hypertrophy of the left upper and lower limbs. There were port-wine stains over the left lower limbs with multiple superficial varicosities. Her diagnosis was Klippel–Trénaunay syndrome (KTS). She is asymptomatic at the final follow-up. Both developmental coxa vara and KTS are rare conditions. We present this case to demonstrate the rarest combination of two rare conditions occurring in the same limb.

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An Extremely Rare Disconnection of the External Iliac Artery and Novel Collateral Remodeling in an Endometrial Stromal Sarcoma Woman

10.21203/rs.3.rs-575795/v1 ◽

2021 ◽

Author(s):

Shixuan Wang ◽

Ting Zhou ◽

Nan Yu ◽

Ronghua Liu

Keyword(s):

Iliac Artery ◽

Lower Limb ◽

External Iliac Artery ◽

Endometrial Stromal Sarcoma ◽

Lessons Learned ◽

Lower Limbs ◽

Arterial Blood Flow ◽

Stromal Sarcoma ◽

Arterial Blood ◽

Left Lower Limb

Abstract Background: Injury to the external iliac artery (EIA) can have serious consequences and can be extremely challenging for surgeons. Here, we report a patient with bizarre disconnection of the external iliac artery during a laparoscopic operation.Case presentation: On May 27, 2020, during a laparoscopic pelvic lymphadenectomy operation to treat endometrial stromal sarcoma, we encountered an unusual anatomy: abnormal disconnection of the left external iliac artery in a 26-year-old female patient. The proximal and distal ends of the left external iliac artery demonstrated old narrowing without active bleeding, and the distance between the two disconnected ends was more than 3 cm. The scenario was surprising to the entire staff in the operating theater. After a comprehensive assessment of skin temperature, arterial pulsation and arterial blood flow, a multidisciplinary team (MDT) determined that collateral circulation of the left lower limb had been established and could meet the blood supply of the lower limbs, which was also confirmed three times by computed tomography angiography (CTA) and Doppler ultrasound of the blood vessels in the abdomen and lower limbs. Eleven months after the operation, the patient had no obvious abnormality, and the daily activities of the left lower limb were not affected. Follow-up after treatment for the patient is still in progress.Conclusions: We describe the details of the whole case of disconnection of the external iliac artery. We hope to summarize the experience and lessons learned through this case and a relevant literature review to improve the safety and orderliness of our future clinical work.

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Congenital femoral deficiency: a rare case report

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20171741 ◽

2017 ◽

Vol 4 (3) ◽

pp. 1118

Author(s):

Sadashiva B Ukkali ◽

Khodaija Mahvish ◽

Nazeer Jeergal

Keyword(s):

Congenital Anomaly ◽

Lower Limb ◽

Rare Case ◽

Detailed History ◽

Rare Congenital Anomaly ◽

Male Baby ◽

Left Lower Limb ◽

Rare Case Report ◽

Type C ◽

Proximal Femoral Focal Deficiency

Proximal femoral focal deficiency (PFFD) is a rare congenital anomaly. We present a case of an isolated unilateral congenital femoral deficiency that was born locally. A full-term male baby was brought to us with a complaint of short left lower limb. Examination revealed short left lower limb with absence of thigh. Detailed history was obtained and he was examined clinically as well as radiologically. He was diagnosed as a case of PFFD of type C. Proper evaluation and its management accordingly can help the patient to lead a socially and economically productive life.

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A rare case of polydactyly with multiple defects

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200090 ◽

2020 ◽

Vol 7 (2) ◽

pp. 334

Author(s):

Sanjeev Kumar ◽

Pradeep Kumar Bansal ◽

Rohit Ishran ◽

Rajendra Kasana

Keyword(s):

Upper Limb ◽

Lower Limb ◽

Acute Gastroenteritis ◽

Rare Case ◽

Bardet Biedl Syndrome ◽

Delayed Onset ◽

Left Lower Limb ◽

Female Baby ◽

Obese Male ◽

Single Testis

Bardet-Biedl Syndrome (BBS) is a very rare genetically heterogenous disorder. Here is a case of 27 yr. old obese male presented with acute gastroenteritis with shock in our department. He had polydactyly in both upper limb and left lower limb, blindness since childhood, with difficult in learning and delayed onset of milestones. Patient’s sibling (younger brother 20-year-old) also had same problems since childhood and one female baby died within few days of birth. He was having single testis. Patient was managed conservatively. The available literature on this syndrome was reviewed.

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Cervical extradural metastasis from follicular carcinoma thyroid after 14 years post-thyroidectomy with Elsberg phenomenon

Romanian Neurosurgery ◽

10.33962/roneuro-2020-095 ◽

2020 ◽

pp. 557-560

Author(s):

Vijayan Pettakandy ◽

Shanavas Cholakkal ◽

Subrat Kumar Soren ◽

Harikrishnan S.

Keyword(s):

Upper Limb ◽

Lower Limb ◽

Thyroid Tissue ◽

Follicular Carcinoma ◽

Lower Limbs ◽

Sensory Loss ◽

Cervical Region ◽

Left Lower Limb ◽

Grade 3 ◽

Follicular Carcinoma Thyroid

Background. Follicular carcinoma thyroid usually metastasises to bone. Common sites of bone metastasis include skull and spine. Spinal metastasis are more common in the cervical region followed by dorsolumbar spine. Cervical extradural lesions present with progressive quadriparesis, sensory loss, dysautonomia, and respiratory distress. Typical Elsberg phenomenon in a cervical extradural lesion is rare. Elsberg phenomenon involves the involvement of ipsilateral upper limb, ipsilateral lower limb followed by contralateral lower limb and contralateral upper limb. Case presentation. We are reporting a case of 47-year-old lady presented with progressive quadriparesis of 1-month duration. Her weakness started in left upper limb followed by left lower limb, right lower limb and right upper limb weakness. She also had sensory loss below the level of C7. She had undergone near-total thyroidectomy for solitary thyroid nodule 14 years back and was on thyroid supplementation since then. Histopathology at that time was reported as follicular adenoma with Hashimoto thyroiditis. Her right upper limb power was grade 4- Left upper limb grade 1 right lower limb Grade 3, left lower limb grade 2 with hypertonia of both upper and lower limbs. She was evaluated with MRI Spine which showed a dumb bell-shaped extramedullary lesion involving the C5-C6 vertebra with significant cord compression and encasement of the left vertebral artery. USG neck showed left supraclavicular lymph node enlargement and small residual thyroid tissue in the left side of the thyroid. USG guided FNAC from the thyroid tissue and neck nodes were inconclusive. The patient underwent C4 and C5 laminectomy and subtotal excision from the cervical lesion. Histopathology was reported as metastasis from follicular carcinoma thyroid. Postoperatively patient limb power improved to grade 3 left upper and lower limbs and was discharged and later referred for radioiodine ablation Conclusion. Cervical extradural metastasis from follicular carcinoma thyroid can present with Elsberg syndrome even without any neck swelling even after decades of post thyroidectomy status for a benign aetiology. Laminectomy and decompression may lead to clinical improvement.

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A Rare Indication for Amputation

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-27-3-90 ◽

2016 ◽

Vol 27 (3) ◽

pp. 90-92

Author(s):

V.K. Sreekala

Keyword(s):

Lower Limb ◽

Road Traffic Accident ◽

Traffic Accident ◽

Road Traffic ◽

Skin Grafting ◽

Lower Limbs ◽

Degloving Injury ◽

Prosthetic Fitting ◽

Left Lower Limb ◽

The Right

Abstract A forty-two years old housewife came to the outpatient department. She met with a very bad road traffic accident in childhood resulting in a crush injury of left lower limb and a degloving injury on the right lower limb. She had undergone transtibial amputation on the left and skin grafting on the right lower limbs. The scar has been transformed into a large keloid. Now she is ambulant with patellar tendon bearing prosthesis on the left side and a rocky hard, heavy, insensate right lower limb with a grotesque appearance. She requests amputation and prosthetic fitting on the right side.

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