scholarly journals Neurologic Disorder Masquerading as Postpregnancy Progression of Keratoconus

2012 ◽  
Vol 1 (3) ◽  
pp. 205-208
Author(s):  
Samaresh Srivastava ◽  
Vardhaman P Kankariya ◽  
Rohit Shetty ◽  
Sharon D’Souza ◽  
Viraj Vasavada ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Index ◽  
Field Analysis ◽  
Postpartum Women ◽  
Neurologic Disorder ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
High Index Of Suspicion ◽  
Ophthalmologic Disorders

ABSTRACT A 28-year-old woman with bilateral stable keratoconus for 2 years came with a complaint of recent blurring of vision 4 weeks postpartum. Her best-corrected visual acuity had dropped by three lines in the right eye and two lines in the left eye with the same manifest refraction. Corneal topography and Scheimpflug imaging revealed mild progression of the keratoconus, but not enough to explain the drop in visual acuity. However, fundus examination revealed temporal disk pallor in both eyes. Visual field analysis revealed classic bitemporal hemianopia. Subsequently, magnetic resonance imaging (MRI) of brain was performed which revealed a pituitary macroadenoma with pituitary apoplexy that was impinging on the pons. Based on these findings, urgent neurosurgery was performed, and the patient regained her visual acuity and fields 2 weeks later. Neuro-ophthalmologic disorders should always be kept as a differential diagnosis in pregnant and postpartum women. A high index of suspicion from the ophthalmologist can often avert life-threatening problems. Key message Neuro-ophthalmologic disorders can masquerade as a variety of clinical presentations in pregnant and postpartum women. A high index of suspicion from the ophthalmologist can often avert life-threatening problems. How to cite this article Shetty R, D’Souza S, Kankariya VP, Srivastava S, Vasavada V, Wadia K. Neurologic Disorder Masquerading as Postpregnancy Progression of Keratoconus. Int J Kerat Ect Cor Dis 2012;1(3):205-208.

scholarly journals Second trimester Abdominal Pregnancy: A Case Report in a Resource Limited Setting

2021 ◽  
Vol 8 (2) ◽  
pp. 1-4
Author(s):  
Jimah B Bashiru ◽  
Keyword(s):  
Abdominal Ultrasound ◽  
High Index ◽  
Emergency Laparotomy ◽  
Abdominal Pregnancy ◽  
Resource Limited ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with very high feto-maternal morbidity and mortality. Diagnosis and management can pose difficulties in low-resource centres. High index of suspicion is vital in making a prompt diagnosis. Case Presentation: A 23year old, gravida 2, para 1, who presented with a two-day history of severe abdominal pain was referred from a satellite clinic. Abdominal ultrasound scan revealed a live 18week 5day intra-abdominal pregnancy. Emergency laparotomy showed an intact gestational sac at the superior aspect of the uterus with massive hemoperitoneum. The placenta was attached to the right ovary, omentum, and fimbriae of the right fallopian tube. Conclusion: Abdominal pregnancy is a rare occurrence and requires a high index of suspicion for prompt diagnosis. Massive hemoperitoneum can be life threatening and prompt surgical intervention is key in saving the life of the mother.

scholarly journals Undiagnosed Case of Klippel-Trenaunnay Syndrome Presenting as Extensive Heterotrophic Ossification and Flexion Deformity of Right Lower Limb Requiring Amputation : A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 938-941
Author(s):  
Kushal Gautam ◽  
Sangharsha Thapa ◽  
Anu Radha Twayana ◽  
Lokendra Chhantyal ◽  
Puskar Poudel ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Recurrent Infection ◽  
Flexion Deformity ◽  
Life Threatening ◽  
Clinical Triad ◽  
Chronic Severe Pain ◽  
The Right ◽  
High Index Of Suspicion ◽  
Asymptomatic Disease ◽  
Variable Presentation

Klippel-Trenaunnay Syndrome is a rare disease characterized by a clinical triad of capillary malformation, soft tissue and bony hypertrophy, and atypical varicosity. This syndrome ranges from asymptomatic disease to life-threatening bleeding, embolism, and deformities. Management includes early diagnosis, prevention, and treatment of complications. We present a case of a 43-year-old male presenting with pain, swelling and deformity of the right leg for 30 years. On examination, diffusely enlarged tender right limb with several dark patchy discolorations, multiple tortuous vessels were found. Right leg X-ray showed heterotrophic ossification and distortion of ankle joint. Due to chronic severe pain, recurrent infection, contracture and flexion deformity of right leg, the patient underwent above knee amputation. This case focuses on the variable presentation and multiple problems faced by patients with Klippel-Trenaununay Syndrome as they get diagnosed late and shows the importance of high index of suspicion for early diagnosis and prevention of complications.

scholarly journals Case report: Recovery after large intramyocardial dissecting haematoma of the ventricular septum—a rare complication of myocardial infarction

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
David Lovasz ◽  
Daniele Camboni ◽  
Judith Zeller ◽  
Christof Schmid
Keyword(s):  
Myocardial Infarction ◽  
Plaque Rupture ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Ventricular Septum ◽  
Feasible Option ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Background Intramyocardial dissecting haematoma is a rare and potentially life-threatening complication of myocardial infarction (MI). Only a few isolated cases have been reported so far. Case summary We report the case of a patient with a large, obstructing intramyocardial haematoma of the ventricular septum following MI due to plaque rupture of the right coronary artery (RCA) and following successful coronary intervention. The clinically inapparent haematoma was discovered during routine echocardiography and confirmed by both computed tomography (CT) and magnetic resonance imaging (MRI). With non-surgical treatment, the patient remained clinically stable. Repeated echocardiography showed gradual regression of the haematoma. Follow-up echocardiography 3 months after the initial diagnosis demonstrated no evidence of septal haematoma. Discussion This report suggests that even large intramyocardial haematoma may recede without operative intervention. Echocardiography, CT, and MRI are all helpful in quantifying the size of the haematoma. The appropriate management should be patient-oriented, depending on clinical stability and progression of the haematoma. Conservative treatment in clinically stable patients suffering from septal haematoma following MI and coronary intervention can be a feasible option.

Cardiac Tamponade: atypical presentations after cardiac surgery Ravikirti & R Karadi

2012 ◽  
Vol 11 (2) ◽  
pp. 93-96
Author(s):  
◽  
Rangaprasad Karadi ◽  
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Tamponade ◽  
High Index ◽  
Atypical Presentation ◽  
Diagnosis And Management ◽  
Early Access ◽  
Life Threatening ◽  
Atypical Presentations ◽  
High Index Of Suspicion

We present two cases of cardiac tamponade presenting in the aftermath of cardiac surgery. We have briefly discussed the aetiology, presentation, diagnosis and management of the condition with emphasis on its atypical presentation in postoperative patients. A high index of suspicion and early access to echocardiography is necessary for prompt recognition and treatment of this life threatening emergency.

Life-threatening cardiac hypertrophy associated with dexamethasone treatment of bronchopulmonary dysplasia

1996 ◽  
Vol 6 (4) ◽  
pp. 337-340
Author(s):  
Keith J. Gallaher ◽  
Braxton Strickland ◽  
Kimberly Pickett ◽  
Jan M. Carter
Keyword(s):  
Cardiac Hypertrophy ◽  
Bronchopulmonary Dysplasia ◽  
Steroid Therapy ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Causal Link ◽  
High Index ◽  
Dexamethasone Treatment ◽  
Life Threatening ◽  
High Index Of Suspicion

SummaryWe report the case of an infant who developed severe cardiac compromise due to hypertrophic obstructive cardiomyopathy that developed while he was being treated with dexamethasone for bronchopulmonary dysplasia. This case is illustrative, as previous reports have described steroid-induced hypertrophic obstructive cardiomyopathy as being transient and benign. In this infant, the hypertrophic obstructive cardiomyopathy, waxed, waned, waxed, and waned again during two courses of dexamethasone, thus strengthening a causal link with steroid therapy. A high index of suspicion of hypertrophic obstructive cardiomyopathy as the etiology of hypoperfusion in steroid-treated infants with bronchopulmonary dysplasia is important. Serial echocardiographic monitoring of these infants is helpful in identifying cardiac compromise.

Pharyngeal trauma in children – accidental and otherwise

1995 ◽  
Vol 109 (12) ◽  
pp. 1168-1175 ◽  
Author(s):  
P. M. J. Tostevin ◽  
L. J. Hollis ◽  
C. M. Bailey
Keyword(s):  
Parapharyngeal Space ◽  
Accurate Diagnosis ◽  
High Index ◽  
Accidental Injury ◽  
Pharyngeal Wall ◽  
Penetrating Wounds ◽  
Pharyngeal Perforation ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Non Accidental Injury

AbstractPharyngeal perforation is an uncommon injury in children. Most reported cases to date have been secondary to instrumentation or penetrating wounds. Laceration to the pharyngeal wall may introduce air, secretions and bacteria into the parapharyngeal space and mediastinum and consequently has potentially life-threatening sequelae. The management of these injuries is controversial. We present a series of four children who suffered pharyngeal trauma, accidentally and otherwise, and discuss their management.We recommend a high index of suspicion of pharyngeal injury in all cases of oropharyngeal trauma and overnight admission to hospital for observation until an accurate diagnosis has been established. Non- accidental injury of the child must be seriously considered in all cases.

scholarly journals Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Elamparidhi Padmanaban ◽  
Preethi Kannan ◽  
Umamageswari Amirthalingam ◽  
Sudhakar Pitchumani ◽  
Padma Rekha
Keyword(s):  
Case Report ◽  
High Mortality ◽  
Bronchopleural Fistula ◽  
Fatal Outcome ◽  
Lower Lobe ◽  
High Index ◽  
Central Type ◽  
Pulmonary Mucormycosis ◽  
The Right ◽  
High Index Of Suspicion

Abstract Background Bronchopleural fistula (BFF) is a fistulous communication between the trachea or bronchus and the pleural space. Central type of bronchopleural fistula is usually post-surgical. Infective cause for central bronchopleural fistula is rare. This case report encompasses an infective cause of central bronchopleural fistula, mucormycosis. Pulmonary mucormycosis is a rapidly progressive condition with high mortality. A high index of suspicion and timely intervention is required to alleviate fatal outcome. The present case is discussed in detail about the clinical presentation and diagnostic imaging of pulmonary mucormycosis presenting with central bronchopleural fistula. Case presentation Thirty-five years old diabetic male, presented with fever, productive cough, mild haemoptysis and chest pain for 10 days duration. The patient was pale on general examination and had decreased breath sound in the right suprascapular and interscapular areas with coarse crackles in the right infrascapular and infra-axillary areas. The laboratory investigations were unremarkable except for anaemia and raised blood glucose level. Sputum examination on potassium hydroxide (KOH) mount showed broad aseptate hyphae. There was a loculated right hydropneumothorax with collapsed lung in chest radiograph. Multi-detector computed tomography of the thorax revealed central type of bronchopleural fistula with the right main bronchus, consolidation of the middle lobe and superior segment of the right lower lobe with multiple internal thick-walled cavities. Right pneumonectomy was performed as the patient did not improve on medical management and showed worsening of symptoms. Histopathological examination was suggestive of mucormycosis. Conclusion Central bronchopleural fistula due to an infective aetiology is uncommon. However, mucormycosis should be considered as a differential diagnosis in cases of central bronchopleural fistula with the destroyed lung, especially in diabetic individuals. Hence, a high index of suspicion is necessary for early diagnosis and management as mucormycosis is a rapidly progressive disease with delay in treatment leading to high mortality.

scholarly journals An unusual presentation of brain metastasis: Multiple skull and parenchymal lesions masquerading as infective etiology

2017 ◽  
Vol 3 (3) ◽  
Author(s):  
Satyajeet Rath ◽  
Madhup Rastogi ◽  
Ajeet Kumar Gandhi ◽  
Animesh Agrawal ◽  
Harikesh Bahadur Singh
Keyword(s):  
Brain Metastasis ◽  
Primary Carcinoma ◽  
Resonance Imaging ◽  
Solid Malignancies ◽  
Magnetic Resonance Imaging Mri ◽  
Brain Parenchymal ◽  
The Right ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis ◽  
Infective Etiology

<p class="SectionHeading1">Brain metastasis is a common occurrence in many solid malignancies. The radiological diagnosis is often determined with magnetic resonance imaging (MRI). We report a case of a 60-year-old lady who had headaches for two months, followed by seizures. Her MRI showed multiple skull and brain parenchymal lesions simulating an infective etiology. Further investigations revealed a primary carcinoma of the right lung. The patient showed improvement in symptoms once chemotherapy was started. Brain metastases can masquerade as infective lesions and delay the diagnosis of malignancy. A high index of suspicion is required to allow a prompt diagnosis and treatment.</p>

scholarly journals Silent uterine rupture in second trimester: a differential diagnosis to remember

2020 ◽  
Vol 9 (7) ◽  
pp. 3081
Author(s):  
Rajlaxmi Mundhra ◽  
Anupama Bahadur ◽  
Kiran Kunwar ◽  
Juhi Mishra ◽  
Ankita Yadav ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Maternal Mortality ◽  
Uterine Rupture ◽  
Emergency Situation ◽  
High Index ◽  
Second Trimester ◽  
Life Threatening ◽  
High Index Of Suspicion

Spontaneous silent uterine rupture is a life-threatening emergency situation requiring immediate laparotomy. High index of suspicion is key to prevent maternal mortality as at times the presentation can be nonspecific. Authors herein present a case of spontaneous silent uterine rupture during second trimester of pregnancy wherein the diagnosis was initially missed. To the best of authors knowledge, only a few cases with spontaneous fundal second trimester uterine rupture have been recorded so far.

scholarly journals The challenges of a Lemierre’s syndrome in COVID-19 times

2020 ◽  
Vol 6 (12) ◽  
pp. 2299
Author(s):  
Vikram Kemmannu Bhat ◽  
Jino Johns Lalitha ◽  
Suhas Suresh Desai ◽  
Nidhi Mohan Sreedevi
Keyword(s):  
Jugular Vein ◽  
Subcutaneous Tissue ◽  
Bone Marrow Suppression ◽  
High Morbidity ◽  
Lemierre’S Syndrome ◽  
Chest Computed Tomography ◽  
Life Threatening ◽  
The Right ◽  
Lemierre's Syndrome ◽  
High Index Of Suspicion

<p>Lemierre’s syndrome is a type of necrotizing fasciitis of the head and neck that is an uncommon rapidly spreading infection involving the skin, subcutaneous tissue and the fascia leading to life-threatening complications like septicaemia, bone marrow suppression, disseminated intravascular coagulation and multi-organ failure. The management of this disease, especially in COVID-19 pandemic is a challenge as it is associated with high morbidity. A 46-year-old male presented to us with complaints of swelling in the neck with discoloration of skin in the neck and chest. Computed tomography (CT) scan of the neck revealed thrombosis of the right internal jugular vein (IJV) and diffuse abscesses on both sides of the neck. A high index of suspicion is required for the diagnosis of Lemierre’s syndrome in the absence of typical clinical features. The rapid, unpredictable dissemination of infection and occult thrombus within the IJV make both diagnosis and management a challenge especially, during COVID-19 times.</p>

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