scholarly journals A Rare Case of Pericardial Tuberculoma with Impending Tamponade in a 52-Year Old Woman: A Case Report

2021 ◽  
Author(s):  
Clement `C Kabakama ◽  
Zahra Daudi Khan ◽  
Pilly Chillo ◽  
Amos Rodger Mwakigonja
Keyword(s):  
Heart Failure ◽  
Ct Scan ◽  
Rare Case ◽  
Mediastinal Mass ◽  
Rare Complication ◽  
Clinical Signs ◽  
Extra Pulmonary Tuberculosis ◽  
History Of ◽  
Extra Pulmonary ◽  
The Right

Pericardial tuberculoma is a rare complication of tuberculous pericarditis. It may mimic a compressive mediastinal mass, often misinterpreted as a mediastinal tumour. Since, it arises from the pericardium, pericardial tuberculoma invariably compresses structures of the heart and may present with features of either-sided heart failure depending on the side of the compression. Hereby, the authors present a case of a 52-year-old woman with progressive difficulty in breathing and symptoms of right-sided heart failure as well as clinical signs of impending cardiac tamponade following a history of extra-pulmonary tuberculosis. Echocardiogram examination revealed a mass compressing the right side of the heart but was inconclusive of the mass origin. CT Scan of the chest showed a mass arising from the pericardium. The mass was later surgically excised. Histopathology confirmed pericardial tuberculosis and a diagnosis of a pericardial tuberculoma was reached. Patient’s heart failure symptoms regressed after surgery and she was discharged to continue with anti-tuberculosis regime. This report discusses the inclusion of pericardial tuberculoma in the differential diagnoses of cardiac compressing masses, particularly in tuberculosis endemic areas and emphasise on prompt CT Scan imaging when echocardiogram is inconclusive.

scholarly journals Metallic embolus to the brain in a patient with mechanical heart valves: an extremely rare complication

2019 ◽  
Vol 12 (8) ◽  
pp. e230653 ◽  
Author(s):  
Shazib Sagheer ◽  
Abu Baker Sheikh ◽  
Jon J Hallstrom ◽  
Veena Raizada
Keyword(s):  
Ct Scan ◽  
Heart Valves ◽  
Rare Complication ◽  
Replacement Surgery ◽  
Mechanical Valves ◽  
Rheumatic Valve Disease ◽  
History Of ◽  
The Right ◽  
The Brain ◽  
Paroxysmal Positional Vertigo

A 46-year-old man with a medical history of rheumatic valve disease underwent mitral and aortic valve replacements with On-X and CarboMedics Top Hat supra-annular mechanical valves, respectively. Seven months after the valve replacement surgery, the patient presented with dizziness. A CT scan of the brain was done as part of a thorough workup of dizziness. The CT scan revealed a small metallic density in the M2 branch of the right middle cerebral artery. The metallic density was believed to be a metallic embolus that originated from the mechanical valves or the suturing material, that is, Cor-Knot fastener. Although in our case, the dizziness was believed to be the result of benign paroxysmal positional vertigo, through this case, we aim to highlight this extremely rare structural complication of mechanical valves. This complication can have serious and potentially fatal consequences such as embolic component-related stroke or another organ infarction.

Suspected Iatrogenic Paradoxical Embolization in a Cat

2005 ◽  
Vol 41 (3) ◽  
pp. 193-197 ◽  
Author(s):  
Henry W. Green ◽  
Daniel F. Hogan
Keyword(s):  
Heart Failure ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Right Atrium ◽  
Diagnostic Testing ◽  
Clinical Signs ◽  
Thromboembolic Complications ◽  
History Of ◽  
Exercise Induced ◽  
The Right

A cat was evaluated for a 5-year history of progressive, episodic, exercise-induced cyanosis and panting. Diagnostic testing demonstrated tetralogy of Fallot with predominant right-to-left shunting and right-sided heart failure. Following diagnostic catheterization, the cat developed clinical signs consistent with systemic arterial thromboembolization and was euthanized. Necropsy findings included multiple thrombi within the right atrium and ventricle, and thromboemboli within the terminal aorta and right common carotid artery, a condition most consistent with iatrogenic paradoxical embolization secondary to diagnostic catheterization. Paradoxical embolization and thromboembolic complications of diagnostic catheterization are discussed.

scholarly journals A rare case of high-grade serous ovarian epithelial carcinoma presenting as an isolated cystic mediastinal mass: a case report and brief review of the literature

2010 ◽  
Vol 92 (5) ◽  
pp. e57-e58
Author(s):  
Marco Scarci ◽  
Rizwan Attia ◽  
Tom Routledge ◽  
Juliet King
Keyword(s):  
Rare Case ◽  
Cystic Lesion ◽  
Mediastinal Mass ◽  
High Grade ◽  
Review Of The Literature ◽  
Right Thoracotomy ◽  
Ovarian Epithelial Carcinoma ◽  
History Of ◽  
The Right ◽  
Primary Presentation

A 70-year-old woman presented with a 2-year history of increasing breathlessness. Computed tomography (CT) of the chest confirmed a well-defined cystic lesion abutting the mediastinum in the right hemi thorax measuring 8 × 6 cm. She underwent a right thoracotomy to excise the cystic lesion. Biopsies for histology demonstrated metastatic serous ovarian epithelial carcinoma. We report a very unusual primary presentation of ovarian epithelial carcinoma as a single cystic mediastinal mass. We also include a brief review of the literature.

A rare case of tuberculous spinal arachnoiditis

2018 ◽  
Vol 5 (3) ◽  
pp. 1134 ◽  
Author(s):  
Suman Chaudhary ◽  
Ankit Chaurasia ◽  
Gunjan Kela Mehrotra ◽  
Kewalkishore Arora ◽  
Yogesh Patel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pulmonary Tuberculosis ◽  
Rare Case ◽  
Rare Complication ◽  
Extra Pulmonary Tuberculosis ◽  
Nutritional Anemia ◽  
Spinal Arachnoiditis ◽  
Extra Pulmonary ◽  
Cns Tuberculosis

Central nervous system tuberculosis represents approximately 10% of extra pulmonary tuberculosis. However, spinal tuberculous arachnoiditis is a rare complication of CNS tuberculosis that can result in severe peripheral neurological deficit. We are reporting a case of 7-year-old male child of disseminated tuberculosis (pulmonary and spinal arachnoiditis) with nutritional anemia. We aim to illustrate the difficulties in the diagnosis and management of this potentially curable disease by reviewing the literature.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

Immune-Mediated Neutropenia in a Miniature Poodle

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Benjamin Brunson
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Tertiary Referral Center ◽  
Immune Mediated ◽  
Specialized Equipment ◽  
History Of ◽  
Light Sedation ◽  
The Right

ABSTRACT A 10 yr old spayed female toy poodle was presented to a tertiary referral center for a 10 day history of waxing and waning lethargy, vomiting, diarrhea, and anorexia. An immune-mediated neutropenia (IMN) was suspected to be the underlying cause of her clinical signs. A bone marrow aspirate was obtained from the chostochondral junction of the 11th and 12th ribs on the right side and provided a definitive diagnosis of IMN. A positive response to therapy and repeat blood work further confirmed the diagnosis. Obtaining bone marrow aspirates from the chostochondral junction is a safe, cheap, and reliable method of diagnosing IMN and can be performed in the private practice setting with light sedation and minimal need for specialized equipment.

scholarly journals Otitis with Aspergillus niger in a patient with SARS-CoV-2 and multiple comorbidities

2021 ◽  
Vol 24 (3) ◽  
pp. 137-140
Author(s):  
Andreea Florentina Stoenescu ◽  
◽  
Geta Vancea ◽  
Dana Ispas ◽  
Nicoleta Voicu-Pârvu ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Acute Onset ◽  
Suppurative Otitis Media ◽  
Vein Thrombosis ◽  
Significant Incidence ◽  
Lower Lung ◽  
History Of ◽  
The Right

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.

scholarly journals SUN-934 A Rare Case of Hyperparathyroidism - Parathyroid Carcinoma, Atypical Adenoma, or Both?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Petra Krutilova ◽  
Harjyot Sandhu ◽  
Michael Salim ◽  
Janice L Gilden ◽  
Paula Butler
Keyword(s):  
Parathyroid Carcinoma ◽  
Rare Case ◽  
Parathyroid Tissue ◽  
Needle Aspiration ◽  
Mitotic Rate ◽  
Fluid Replacement ◽  
Cancer Center ◽  
Subtotal Parathyroidectomy ◽  
History Of ◽  
The Right

Abstract Introduction: Parathyroid carcinoma (PC) is a rare endocrine malignancy. It accounts for <1% cases of primary hyperparathyroidism (PHPT). We present a rare case of concurrent PC and atypical parathyroid adenoma (PA). Case presentation: A 72-year-old woman presented with 1-week history of generalized weakness, confusion, and auditory hallucinations. Her medical history was significant for PHPT known for 5 years, CAD and CHF. The patient appeared mildly volume depleted and was tachycardic (105/min). The rest of her physical exam was unremarkable. Calcium (Ca) was 15.1 mg/dL (8.4–10.2 mg/dL) and intact PTH 451.9 pg/mL (12–88 pg/mL). Her condition improved with aggressive fluid replacement, pamidronate, and cinacalcet. A sestamibi scan revealed increased uptake of bilateral parathyroid tissue. Fine needle aspiration (FNA) revealed PA. Surgical treatment was postponed for control of cardiac comorbidities. One month later, she presented again with symptomatic hypercalcemia. Her Ca was 16.1 md/dL and PTH 761.5 pg/mL. Initial medical management was followed by subtotal parathyroidectomy – three masses were removed (one on the right and two on the left). Final pathology revealed PC within the left parathyroid, the others were consistent with hypercellular parathyroid tissue. One month later, the patient underwent left hemithyroidectomy, right parathyroidectomy, and central neck dissection. PTH level dropped to 2.4 pg/mL and Ca level was 7.6 mg/dL after surgery. She was discharged home on Ca and vitamin D supplements. Pathology was sent to a referral cancer center and revealed PC vs. atypical PA within the right parathyroid. Discussion: PC is a rare endocrine malignancy. Further, there are not many cases of synchronous PC and PA or multifocal PC. Diagnosing PC preoperatively is challenging since it shares overlapping characteristics with PA. Patients with malignancy commonly present with larger tumor size, higher level of Ca (>14.6 mg/dL), and PTH (5-fold higher than the upper limit of normal). Our patient had a history of multiple admissions due to symptomatic HC. She had no palpable neck masses on exam. Her initial FNA was consistent with PA. Hence, we presumed that her hypercalcemia was caused by PA. Establishing a definitive diagnosis of PC by frozen sections intraoperatively is difficult. Histopathologic findings of atypical cells, high mitotic rate, and cellular invasions can suggest the diagnosis, though they are often negative. Even postoperatively, pathologists often disagree on cytologic interpretation. However, differentiating PA and PC is important since earlier and more aggressive treatment is needed to reduce the morbidity and mortality in case of malignancy.

scholarly journals Unusual coexistence of first and second branchial fistulas: clinical case and review of the literature

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094430
Author(s):  
Danqing Liu ◽  
Guangqi Li ◽  
Jun Qiu ◽  
Jianyan Wang ◽  
Genwang Pei
Keyword(s):  
Clinical Signs ◽  
Preoperative Imaging ◽  
Review Of The Literature ◽  
False Positive Diagnosis ◽  
Fistula Recurrence ◽  
History Of ◽  
Physical Examinations ◽  
Missed Diagnosis ◽  
The Right

Branchial fistulas are uncommon in the clinical setting. The coexistence of first and second branchial fistulas has not been previously reported. We herein describe a 12-year-old girl who presented with a 2-year history of repeated swelling and purulence behind the right earlobe and neck. According to the patient’s physical and auxiliary examination findings, she was diagnosed with coexisting first and second branchial fistulas, both of which were completely removed by surgery. No clinical signs of fistula recurrence were present at the patient’s 20-month postoperative follow-up. Ipsilateral coexisting first and second branchial fistulas are very rare; thus, a false-positive diagnosis can easily occur if the doctor does not carefully perform specialized physical examinations. Surgery is an effective method for treating this condition. Adequate preoperative imaging preparation is imperative to ensure the most effective course of treatment. The purpose of this article is to improve clinicians’ awareness of this disease, thereby effectively reducing the rates of missed diagnosis and recurrence.

scholarly journals Rare Case of Servelle Martorelle Syndrome

2014 ◽  
Vol 10 (4) ◽  
pp. 91-94
Author(s):  
A Bhatnagar ◽  
M Deshpande
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Rare Case ◽  
Prompt Treatment ◽  
Congenital Vascular Malformation ◽  
History Of ◽  
The Right ◽  
Scapular Region

Servelle Martorelle Syndrome is a congenital vascular malformation associated with soft tissue hypertrophy and bony hypoplasia. This rarely involves whole of an extremity, with involvement of part of limbs reported in literature. We present a case of a twelve year boy who presented to the Department of Plastic Surgery SGPGIMS in April 2011 ,with history of circumferential soft tissue hypertrophy involving whole of left upper limb, scapular region and axilla since birth. The entire left upper limb length was lesser than the right upper limb. Hence this is a very rare case of Servelle Martorelle Syndrome having extensive limb involvement at a very young age. Highlighted is the role of conservative treatment and close follow-up to understand the natural history of the diseases, with prompt treatment of complications. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11011 Kathmandu Univ Med J 2012;10(4):91-94

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