scholarly journals Congenital Dermal Sinus: case series and the consequences of late diagnosis and treatment

2020 ◽  
Vol 2 (3(September-December)) ◽  
pp. e622020
Author(s):  
Alick Durão Moreira ◽  
Antonio Bellas ◽  
Marcelo Sampaio Poousa ◽  
Rafaeldos Santos Mitraud Mitraud ◽  
Tatiana Protzenko

Introduction:Congenital Dermal Sinuses (CDS) are rare closed dysraphisms that can present throughout the extent of the neuroaxis. They occur due to a failure of the disjunction of the neuroectoderm and cutaneous ectoderm in a focal point during 3-4 week of embryogenic development. The prevalence of CDS of all types has been estimated to be 1 in 2,500 live births, most commonly localized in the lumbar region. More than half of the cases are associated with dermoid or epidermoid tumors. Clinical presentation of CDS usually consists in cutaneous stigmas like dimples, which has the potential to be diagnosed at birth. However, the majority of patients are diagnosed older and after complications such as meningitis, abscess, osteomyelitis, rupture of an associated epi/dermoid cyst. Once suspected the patient should be submitted to an image study with CT scan and/or MRI, and surgical consultation. Complete exeresis is the definitive treatment. Case report: we present 3 cases of CDS, including an extremely rare case of frontonasal location, to illustrate the extent of the disease and the importance of early diagnosis and treatment. All of the 3 cases presented with complications, requiring surgical treatment and long term antibiotic therapy. Conclusion: Although well reported in the literature, CDS are usually diagnosed after complications. The knowledge of clinical presentation, early diagnosis and treatment are essential to prevent its life threatening complications. 

2021 ◽  
Vol 10 (39) ◽  
pp. 3505-3507
Author(s):  
Srinivas Naik ◽  
Sourya Acharya ◽  
Gajendra Agrawal ◽  
Chetan Rathi ◽  
Sunil Kumar

Congenital heart disease (CHD) often poses a great diagnostic challenge for physicians. Despite antenatal diagnostic tests advancing to a great level, accurate diagnosis and treatment of congenital heart diseases is mandatory. These diseases range from mild to severe life-threatening scenarios sometimes having vague presentations making diagnosis even more difficult. Early diagnosis and treatment are usually lifesaving.1 Congenital heart diseases can often be classified as cyanotic and acyanotic based on clinical presentation. After birth, fetal structures like foramen ovale, ductus venosus and ductus arteriosus are no longer required for survival and they begin to close.2 Persistence of such structures after birth is a sign of congenital heart diseases. High mortality contributing diseases which require prompt intervention include hypoplastic left heart syndrome (HLHS), coarctation of aorta (COA), interrupted aortic arch (IAA), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), critical aortic stenosis (AS) pulmonary atresia (PA) and tricuspid atresia (TA).3 They contribute to significant mortality amongst neonatal age groups. Recognition of congenital heart diseases based on clinical fractures like cyanosis, tachycardia, tachypnoea, irritability, refusal to feed stabilisation and prompt referral to tertiary cardiac centre are critical to improve outcomes in neonates with CHDs, seizures, murmur etc is diagnostically challenging but lifesaving. Life-threatening CHDs may perhaps present with cyanosis, respiratory distress, shock or collapse; all of these are also frequent clinical presentation of various respiratory problems or sepsis in newborn. Early diagnosis and prompt treatment are the only life saving measures.


2020 ◽  
Author(s):  
A. van Steenis ◽  
M. Fumagalli ◽  
M. C. Kruit ◽  
C. M. P. C. D. Peeters-Scholte ◽  
L. S. de Vries ◽  
...  

AbstractTimely detection of severe infratentorial hemorrhage in neonates is crucial, especially in case of life-threatening brain stem compression and/or acute obstructive hydrocephalus, which need lifesaving neurosurgical intervention. Although the detection of infratentorial hemorrhage by ultrasound scanning is often considered as difficult, the use of additional acoustic windows and recognition of characteristic ultrasound features facilitate early diagnosis. In this case series, we report on newborns with severe, symptomatic infratentorial hemorrhage detected primarily by cranial ultrasound. We demonstrate the characteristic ultrasound features present in all cases and discuss how ultrasound diagnosis contributed to early diagnosis and treatment.


Author(s):  
Kimberly A. Kripps ◽  
Leighann Sremba ◽  
Austin A. Larson ◽  
Johan L.K. Van Hove ◽  
Hoanh Nguyen ◽  
...  

2021 ◽  
Vol 14 (2) ◽  
pp. 98-104
Author(s):  
Andrea Cunningham ◽  
Dipali Patel ◽  
Zahra Sheriteh

This case series describes a number of different treatment modalities used in the management of impacted mandibular second molars (MM2s). A variety of cases is used to illustrate a number of ways in which these teeth can be managed, and to demonstrate that each case should be managed on an individual basis, taking into account the overall malocclusion. The importance of early diagnosis and management is highlighted throughout. CPD/Clinical Relevance: This case series highlights the difficulties and challenges in managing patients who present with impacted lower second molars (MM2s), and the importance of early diagnosis and treatment.


2010 ◽  
Vol 79 (3) ◽  
pp. 497-508 ◽  
Author(s):  
Filip Konečný

In veterinary medicine, thrombo-embolism (TE) is an under-appreciated medical condition that requires immediate recognition. Since TE is multifactorial and its mode of presentation may vary, veterinarians face great difficulties in making a definitive diagnosis in a timely manner. In addition, most of the underlying conditions that give rise to TE are life-threatening and an aggressive diagnostic and therapeutic approach is required. Not only does the diagnosis and treatment of this condition require the collaboration of many specialties, the costs of therapy can be excessive with a high risk of recurrence. As such, owners have to be thoroughly informed before the therapy commences. While TE has been well-characterized in humans and is associated with significant morbidity and mortality, little information of similar quality is available in veterinary medicine. In addition, TE in animals is distinct from its human counterpart and we cannot simply adapt what is known from human clinical trials. With the promise of improvements in imaging modalities that improve our diagnostic capabilities, the window of opportunity to treat TE increases. This article focuses on aetiology, clinical presentation, diagnosis, and treatment of dogs and cats affected by TE.


2018 ◽  
Vol 132 (9) ◽  
pp. 827-831 ◽  
Author(s):  
K Mahawerawat ◽  
P Kasemsiri

AbstractBackgroundAlthough melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.ObjectivesTo report the clinical presentation and management of melioidosis in the head and neck.MethodA retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.ResultsMedical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35–88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47–98.80).ConclusionCareful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.


2021 ◽  
Vol 104 (3) ◽  
pp. 506-511

Ventricular arrhythmias are usually well controlled with medical management, cardiac implantable electronic devices, or catheter ablation. However, the refractory ventricular tachycardia or fibrillation (VT/VF) is life threatening and challenging. The authors reported a case series of left stellate ganglion blocks (LSGB) in patients with refractory VT/VF, who failed pharmacological treatment and multiple traditional cardiac interventions. Five patients underwent six LSGB. Four patients had significant decreased in ventricular arrhythmia burden. Among the responders, the LSGB suppressed significant VT/VF for three to seven days. Blocks did not only temporary suppress ventricular arrhythmia, but also stabilized the condition and served as a bridge to definitive treatment such as EP ablation or heart transplantation. There was no significant hemodynamic change or devastating side effects. The outcome from the present case series suggested that LSGB could be an effective treatment and a lifesaving intervention frintractable VT/VF. Keywords: Stellate ganglion block, Refractory ventricular tachycardia, Sympathectomy


2020 ◽  
Vol 43 (4) ◽  
pp. 418-422
Author(s):  
Mohan Nair ◽  
Pranav Bhagirath ◽  
Rajesh Gothi ◽  
Gautum Singal ◽  
Pritam Kitey ◽  
...  

2012 ◽  
Vol 28 (6) ◽  
pp. 320-323 ◽  
Author(s):  
Colleen Ryan

Appendicitis is a surgical emergency that can mimic many other abnormalities. Early diagnosis is critical to reduce the risk of perforation and potentially life-threatening complications. The use of sonography has proven to aid in accurately diagnosing an inflamed appendix without adversely affecting the rate of perforation. However, the accuracy of sonography is highly operator dependent. This case demonstrates the classic clinical presentation of appendicitis with the incorporation of sonographic findings to support the diagnosis.


2017 ◽  
Vol 5 (20) ◽  
pp. 54
Author(s):  
Teryn Perkins ◽  
Kenneth Iwuji ◽  
Phumpattra Chariyawong ◽  
Leigh Ann Jenkins

Takotsubo cardiomyopathy is a transient cardiomyopathy predominantly characterized byleft ventricular hypokinesis and wall motion abnormalities, usually apical ballooning during thesystolic phase of heart contraction. The clinical presentation may closely mimic acute coronarysyndrome. The majority of the cases are diagnosed in post-menopausal Caucasian women.The exact mechanism of takotsubo cardiomyopathy is unknown. To avoid complications andmortality, early diagnosis and treatment are important.


Sign in / Sign up

Export Citation Format

Share Document