scholarly journals Primary Cutaneous Cryptococcosis: A Rare Masquerading Presentation of Cryptococcus Infection

2021 ◽  
Author(s):  
Tanisha Bharara ◽  
Shalini Upadhyay ◽  
Mohinder Pal Singh Sawhney ◽  
Manisha Khandait
Keyword(s):  
Health Care Cost ◽  
Pigeon Droppings ◽  
Life Threatening ◽  
History Of ◽  
Uncommon Condition ◽  
Decaying Wood ◽  
Avian Excreta ◽  
Immunocompromised Hosts ◽  
Portal Of Entry ◽  
Cutaneous Cryptococcosis

The yeast, Cryptococcus is widely present in the environment. Its main portal of entry is the respiratory tract. Clinical and experimental evidences indicate that cryptococcosis is usually a reactivation of a dormant infection. They have been recovered from soil contaminated with avian excreta, especially pigeon droppings and from decaying wood, fruits, vegetables and dust. Cryptococcusmay be found on skin of healthy subjects without causing any manifestation but it is known to cause life threatening infection in immunocompromised hosts. Primary Cutaneous Cryptococcosis (PCC) is an uncommon condition which is characterised by localised cryptococcal skin eruptions without dissemination to internal organs. Clinicians are aware of the typical presentation of cryptococcal infections occurring mostly in immunocompromised patients. Rare manifestations like PCC may go unnoticed leading to prolonged morbidity and health care cost. The present article is a case report of PCC in a 39-year-old immunocompetent male who presented with two months history of scattered erythematous indurated papules and plaques on his right foot, arm and abdominal region developed after having suffered minor injury at the cement factory. The patient was started on fluconazole to which he responded well.

scholarly journals Acquired Factor XI Inhibitor Presenting as Spontaneous Bilateral Subdural Hematoma in an Elderly Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Natale Vazzana ◽  
Luca Scarti ◽  
Chiara Beltrame ◽  
Antonella Picchi ◽  
Gianni Taccetti ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Coagulation Factors ◽  
Spontaneous Bleeding ◽  
Autoimmune Conditions ◽  
Life Threatening ◽  
History Of ◽  
Uncommon Condition ◽  
High Degree ◽  
History Of Cancer ◽  
Mucocutaneous Bleeding

Development of autoantibodies against coagulation factors is an uncommon bleeding disorder associated with cancer, autoimmune conditions, pregnancy, or no apparent disease. Spontaneous FVIII inhibitors are the most frequently encountered; those against FXI have been only anecdotally reported. We report a case of acquired FXI inhibitor presenting as fatal intracranial spontaneous bleeding in an elderly patient with history of cancer and previous transfusions. Few cases of acquired FXI inhibitor have been reported in association with connective tissue disease, cancer, or surgery. Bleeding includes mucocutaneous bleeding, postsurgical hemorrhage, or life-threatening events. Treatment consists of arresting the bleeding and inhibitor eradication. High degree of suspicion is essential to promptly diagnose and treat this uncommon condition.

Reconstruction of a Previously Repaired Aortic Valve Destroyed by Infective Endocarditis: Case Report

2016 ◽  
Vol 8 (3) ◽  
pp. 408-410
Author(s):  
Tomas Chalela ◽  
Viktor Hraska
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Case Report ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Congenital Heart ◽  
Congenital Aortic Stenosis ◽  
Life Threatening ◽  
History Of ◽  
Uncommon Condition

Infective endocarditis (IE) is an uncommon condition among patients with congenital heart disease, however it can be life threatening. The usual management includes replacement of the affected valve, especially in patients with aortic valve compromise, and is even more common in previously repaired valves. In this case report, we describe the successful reconstruction of an aortic root destroyed by IE, in a patient with history of ballooning of a congenital aortic stenosis.

Severe Thyrotoxicosis (Thyroid Storm) With Liver Failure

2007 ◽  
Vol 6 (1) ◽  
pp. 30-32
Author(s):  
Victor Oguntolu ◽  
Keyword(s):  
Liver Failure ◽  
Thyroid Disease ◽  
Hepatic Dysfunction ◽  
Severe Form ◽  
Thyroid Storm ◽  
Prior History ◽  
Life Threatening ◽  
History Of ◽  
Background History ◽  
Uncommon Condition

Thyroid storm is a severe form of thyrotoxicosis. It is an uncommon condition but can be life-threatening. Most often it is seen in patients with a background history of thyroid disease and most cases are complicated with multi-organ involvement, mainly respiratory, cardiovascular, hepatic and renal. The association of severe thyrotoxicosis with severe hepatic dysfunction has been rarely reported. This case describes a 34-year-old male without a known prior history of thyroid disease who presented with severe liver failure.

scholarly journals Right Heart Thrombus and Pulmonary Embolism in Patients with Life-Threatening Bleeding: Management of a Complex Condition

2021 ◽  
Author(s):  
Enrico Bentivegna ◽  
Michelangelo Luciani ◽  
Valerio Spuntarelli ◽  
Giorgio Sesti ◽  
Flavia Del Porto ◽  
...  
Keyword(s):  
Therapeutic Strategy ◽  
Bleeding Risk ◽  
Right Heart ◽  
Bleeding Management ◽  
Critical Situation ◽  
Haemodynamic Parameters ◽  
Complex Patients ◽  
Life Threatening ◽  
Uncommon Condition ◽  
In Transit

AbstractRight heart thrombus (RHT) in transit is an uncommon condition associated with high mortality. Increased use of echocardiography has allowed an easier detection of RHT; however, there is no consensus about the most appropriate management of this critical situation. Therapeutic strategy should be decided according to patient’s haemodynamic parameters, clinical data, and bleeding risk. This paper, referring to the most current evidences, underlines the difficulty to establish the best therapeutic strategies in RHT among complex patients as there are no relevant guidelines. In some conditions, multidisciplinary management is the best way to find the most correct therapy despite the bad prognosis.

scholarly journals Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 205
Author(s):  
Nicola Tarantino ◽  
Domenico G. Della Rocca ◽  
Nicole S. De Leon De La Cruz ◽  
Eric D. Manheimer ◽  
Michele Magnocavallo ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Individual Factors ◽  
Substantial Part ◽  
Arrhythmogenic Substrate ◽  
Life Threatening ◽  
History Of ◽  
Anatomic Distribution ◽  
Artery Disease ◽  
Surveillance Analysis

A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete’s age, and the operator’s expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

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.

929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Oyende ◽  
J Jackman
Keyword(s):  
White Cell Count ◽  
General Surgeon ◽  
High Dose ◽  
General Anaesthetic ◽  
Microbiological Analysis ◽  
Reactive Protein ◽  
Affected Tissue ◽  
Life Threatening ◽  
History Of ◽  
High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

scholarly journals Anaphylactic Death: A New Forensic Workflow for Diagnosis

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 117
Author(s):  
Massimiliano Esposito ◽  
Angelo Montana ◽  
Aldo Liberto ◽  
Veronica Filetti ◽  
Nunzio Di Nunno ◽  
...  
Keyword(s):  
Clinical History ◽  
Rapid Onset ◽  
Mean Value ◽  
Laryngeal Edema ◽  
Tryptase Level ◽  
Antibody Staining ◽  
Life Threatening ◽  
History Of ◽  
Immunohistochemical Techniques

Anaphylaxis is a life-threatening or fatal clinical emergency characterized by rapid onset, and death may be sudden. The margin of certainty about the diagnosis of anaphylactic death is not well established. The application of immunohistochemical techniques combined with the evaluation of blood tryptase concentrations opened up a new field of investigation into anaphylactic death. The present study investigated eleven autopsy cases of anaphylactic death, carried out between 2005 and 2017, by the Departments of Forensic Pathology of the Universities of Foggia and Catania (Italy). An analysis of the medical records was carried out in all autopsies. Seven autopsies were carried out on males and four on females. Of the eleven cases, one showed a history of asthma, one of food ingestion, two of oral administration of medications, six did not refer any allergy history, and one subject was unknown. All cases (100%) showed pulmonary congestion and edema; 7/11 (64%) of the cases had pharyngeal/laryngeal edema and mucus plugging in the airway; only one case (9%) had a skin reaction that was found during external examination. Serum tryptase concentration was measured in ten cases, and the mean value was 133.5 µg/L ± 177.9. The immunohistochemical examination using an anti-tryptase antibody on samples from the lungs, pharynx/larynx, and skin site of medication injection showed that all cases (100%) were strongly immunopositive for anti-tryptase antibody staining on lung samples; three cases (30%) were strongly immunopositive for anti-tryptase antibody staining on pharyngeal/laryngeal samples; and eight cases (80%) were strongly immunopositive for anti-tryptase antibody staining on skin samples. We conclude that a typical clinical history, blood tryptase level >40 µg/L, and strongly positive anti-tryptase antibody staining in the immunohistochemical investigation may represent reliable parameters in the determination of anaphylactic death with the accuracy needed for forensic purposes.

scholarly journals Polymeric Nanocarriers: A Transformation in Doxorubicin Therapies

Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2135
Author(s):  
Kamila Butowska ◽  
Anna Woziwodzka ◽  
Agnieszka Borowik ◽  
Jacek Piosik
Keyword(s):  
Drug Delivery ◽  
Wide Spectrum ◽  
Stimuli Responsive ◽  
First Line ◽  
Medical Expenses ◽  
Polymeric Nanocarriers ◽  
Essential Properties ◽  
Life Threatening ◽  
History Of ◽  
Cancerous Cells

Doxorubicin, a member of the anthracycline family, is a common anticancer agent often used as a first line treatment for the wide spectrum of cancers. Doxorubicin-based chemotherapy, although effective, is associated with serious side effects, such as irreversible cardiotoxicity or nephrotoxicity. Those often life-threatening adverse risks, responsible for the elongation of the patients’ recuperation period and increasing medical expenses, have prompted the need for creating novel and safer drug delivery systems. Among many proposed concepts, polymeric nanocarriers are shown to be a promising approach, allowing for controlled and selective drug delivery, simultaneously enhancing its activity towards cancerous cells and reducing toxic effects on healthy tissues. This article is a chronological examination of the history of the work progress on polymeric nanostructures, designed as efficient doxorubicin nanocarriers, with the emphasis on the main achievements of 2010–2020. Numerous publications have been reviewed to provide an essential summation of the nanopolymer types and their essential properties, mechanisms towards efficient drug delivery, as well as active targeting stimuli-responsive strategies that are currently utilized in the doxorubicin transportation field.

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