scholarly journals Fatality Case in a Tuberculous Meningoencephalitis Patient Coinfected with COVID-19

2022 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Badrul Munir ◽  
Benny Arie Pradana ◽  
Widodo Mardi Santoso ◽  
Ria Damayanti ◽  
Catur Ari Setianto ◽  
...  

: Tuberculous meningoencephalitis (TBM) is the most severe, life-threatening form of tuberculosis that contributes to as much as 5% of cases of extrapulmonary tuberculosis. Emerging at the end of 2019, COVID-19 has been shown to affect various organs, including the brain. In this case report, a 21-year-old woman diagnosed with TBM, being in the intensive phase of tuberculous therapy, came with dysphagia and dysphonia as new complaints felt one day before admission accompanied by a positive meningeal sign, diplopia, and cephalgia, which became heavier after previously getting better. Cough and fever followed this complaint two days before admission. About the laboratory results, the PCR was positive for COVID-19, and CT scans showed increased leptomeningeal enhancement when compared with CT scan one month earlier. The patient received intravenous dexamethasone, anti-tuberculosis drugs, phenytoin, aspirin, oseltamivir, and hydroxychloroquine. The patient died four days after being hospitalized due to respiratory failure. This case report shows the coinfection of COVID-19 and TBM resulting in a poor tuberculosis treatment response and outcome.

Author(s):  
Mojtaba Ahmadinejad ◽  
Pouria Chaghamirzayi

Background: Laryngeal fractures are one of the complications of direct damage to the neck, which can lead to airway obstruction and life-threatening conditions. Other causes of laryngeal fractures include injuries during fights, sports injuries, hangings, and iatrogenic causes. In this study, we introduce a child with a laryngeal fracture following an accidental hanging. Case Report: A 9-year-old girl was presented to the emergency department with respiratory distress and inability to speak after being hanged by her scarf. We secured the cervical spine with a hard collar and provided two intravenous (IV) lines. Then, the patient was transferred to the radiology department to perform cervical and thoracic computerized tomography (CT) scans. In the cervical CT scan, the fracture of laryngeal cartilage was detected. We repaired the fracture by prolene sutures. Then the patient was transferred to the intensive care unit (ICU) ward. After 2 days, she was transferred to ward and discharged without any complications. Conclusion: The cervical trauma is a critical condition that must be managed carefully and urgently. For the rapid diagnosis of possible damage, imaging is necessary. Among all modalities, CT scan is the best choice for detection of the vertebral injuries and airway competence in emergent conditions.


JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119


2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Chen ◽  
Yonghong Zhong ◽  
Na Li ◽  
Huijie Wang ◽  
Yanbin Tan ◽  
...  

Abstract Background In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. Methods A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5–21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria). Results Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy. Conclusions Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.


2016 ◽  
Vol 02 (02) ◽  
pp. e42-e45
Author(s):  
Zhenpeng Liu ◽  
Xianzeng Hou ◽  
Xiaoyong Fan ◽  
Yuanyuan Hu ◽  
Guangcun Liu

Background Transorbital intracranial penetrating injury is rare. Damage caused by a huge metallic foreign body is very critical and life-threatening. Method We report an extremely rare case of transorbital intracranial penetrating metal strip (a car windshield wiper), which has not previously been reported in the literature. Results Emergency craniotomy was performed; the object was removed successfully, and the patient's life was saved. Conclusion With the life-threatening penetrating brain injury caused by a huge foreign body, prompt surgical treatment and comprehensive postoperative treatment are important to save patients' lives.


2019 ◽  
Vol 29 (3) ◽  
pp. 614-618
Author(s):  
Rutger C.C. Hengeveld ◽  
Bianca E. Olofsen ◽  
Edmée C. van Dongen-Lases ◽  
Peter A. Leenhouts ◽  
Victor F.H.A. Hakkenberg van Gaasbeek ◽  
...  

Introduction: Phlebotomy is an error-prone process in which mistakes are difficult to reveal. This case report describes the effect on laboratory results originating from a blood sample collected in close proximity to an intravenous catheter. Materials and methods: A 69-year-old male patient was referred to the Emergency department where pneumonia was suspected. Phlebotomy was performed to collect blood samples to assess electrolytes, renal function, liver function, infection and haematological parameters. Results: The laboratory analysis showed reduced potassium and calcium concentrations. To prevent life-threatening cardiac failure the clinician decided to correct those electrolytes. Remarkably, the electrocardiogram showed no abnormalities corresponding to hypokalaemia and hypocalcaemia. This observation, in combination with an overall increase in laboratory parameters with the exception of sodium and chloride, led to the suspicion of a preanalytical error. Retrospectively, an intravenous catheter was inserted in close proximity of the puncture place but no continuous infusion was started prior to phlebotomy. However, the intravenous catheter was flushed with sodium chloride. Since potential other causes were excluded, the flushing of the intravenous catheter with sodium chloride prior to phlebotomy was the most probable cause for the deviating laboratory results and subsequently for the unnecessary potassium and calcium suppletion. Conclusion: This case underlines the importance of caution in the interpretation of laboratory results obtained from specimens that are collected in the proximity of an intravenous catheter, even in the absence of continuous infusion.


2015 ◽  
Vol 44 (2) ◽  
pp. 181
Author(s):  
Maja Bogdan ◽  
Vlasta Zujić Atalić ◽  
Ivan Hećimović ◽  
Dubravka Vuković

<p><strong>Objective</strong>. The aim of this report was to describe the occurrence of a bacterial brain abscess in a healthy individual, without any predisposing condition. <strong>Case report</strong>. A thirteen-year old boy was admitted to the Department of Neurosurgery after the onset of vomiting, headache and dizziness. A neurological deficit was detected during the physical examination so urgent magnetic resonance imaging of the brain was performed, revealing an intrahemispheric, right positioned solitary expansive mass with ring enhancement. Purulent material was obtained during osteoplastic craniotomy with total extirpation of the brain abscess. Aggregatibacter aphrophilus and Bacteroides uniformis were isolated. The patient’s general condition improved and the neurological deficit subsided as a result of the prompt recognition and treatment of this life threatening condition. <strong>Conclusion</strong>. To achieve a favourable clinical outcome, prompt recognition and surgical treatment of a brain abscess are of primary importance,followed by administration of appropriate antimicrobial therapy. To our best knowledge, this is the first report of this combination of microorganisms as the cause of a brain abscess.</p>


Author(s):  
David Breuskin ◽  
Ralf Ketter ◽  
Joachim Oertel

Abstract Background Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy. Methods We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain. The authors recall the incident and the technique of the pen removal. Results Large surgical exposure of the pen trajectory was considered too traumatic. Therefore, we opted to remove the pen and have an immediate postoperative computed tomography (CT) scan. Due to its fragility, the pen case could only be removed with a screwdriver, inserted into the case. Post-op CT scan showed a small bleeding in the right peduncular region, which was treated conservatively. The patient was transferred back to intensive care unit and woken up the next day. She lost visual function on her right eye, but suffered from no further neurologic deficit. Conclusion Surgical management of removal of intracranial foreign bodies is no routine procedure. Although some would favor a large surgical exposure, we could not think of an approach to do so without maximum surgical efforts. We opted for a minimal surgical procedure with immediate CT scan and achieved an optimal result. We find this case to be worth considering when deciding on a strategy in the future.


Author(s):  
David L Brody

A concussion is a traumatic brain injury, but not an immediately life threatening one. A traumatic brain injury occurs when a sudden force is applied to the brain from outside. But not every force causes a concussion. In fact, most do not. The scalp, skull, and dura do a pretty good job protecting our brains from most of what happens to us on a daily basis. A traumatic brain injury means that the force applied to the brain caused a disruption in the brain’s structure, an impairment of the brain’s function, or both. A CT scan or an MRI scan may be negative, but this does not mean that there has not been a concussion. Traumatic brain injury, especially concussion, is a clinical diagnosis, not based on any lab test or scan. Typically, patients with concussion have Glasgow Coma Scale between 13 and 15.


2021 ◽  
Vol 17 (2) ◽  
pp. 163
Author(s):  
Feda Makkiyah

Abstract: Dual energy scan was performed to differentiate any collection associated with calsium. Case report. This 23 year old man showed severe hyperuricemia and mid thoracic pain and MRI showed collection over posterior epidural thecal sac over T3 until T9. Dual energy CT scan was performed to assess uric acid crystal over thoracic region. The CT result was negative. He was treated over intravenous antibiotic and pain medication. His pain improved  progressively and laboratory results  showed towards normal  value and he was discharged on day twelveth. Conclusion. This case report showed the comprehensive diagnostic tool to yield out the aetiology of  thoracal epidural collection, despite negative result. Keywords: Hyperuricemia, abcess, mid thoracic, dual energy, CT scan


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