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Sample records for causing dysphonia case

  1. CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF WINDSTROKE-CAUSED DYSPHAGIA-DYSPHONIA SYNDRONE

    Institute of Scientific and Technical Information of China (English)

    HAN Jianhua; DONG Yingli; ZHANG Ru

    2002-01-01

    Objective: To observe the therapeuticeffect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp-acupunoture in the treatment of wind stroke. Methods: A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp-point Dingzhongxian (MS 5), Dingnie Houxiexian (MS 7), Dingpangxian Ⅱ (MS 9) and Dingnie Qianxiexian (MS 6). Before and after acupuncture treatment, clinical symptoms of dysphagia and dysphonia were compared, and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter. Results: Following two courses (4 weeks) of scalp-acupuncture treatment, of the 38 cases, 23 had their dysphagia and dysphonia cured (60.5%), 10 (25.3%) had remarkable improvement, 3(7.9% ) experienced improvement and 2 (5.3%) had no apparent changes. Simultaneously, MBFS of ACA, MCA and PCA increased significantly in comparison with that of pre-treatment (P < 0.01 ). Additionally, results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain. Conclusion: Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating cerebral blood flow.

  2. Psychogenic spasmodic dysphonia: a case study with expert opinions.

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    Sapir, S

    1995-09-01

    Spasmodic (spastic) dysphonia (SD) is considered by some to be a neurologic syndrome and by others a symptom complex of multiple etiologies, neurologic and psychogenic. A case of a 26-year-old female psychiatric nurse with psychogenic SD (PSD) is presented. The dysphonia was alleviated within one session of voice therapy. Psychogenic etiology was established by the author, based on three diagnostic criteria--symptom incongruity, symptom reversibility, and symptom psychogenicity. Seven nationally recognized voice experts listened to audio-recorded samples of the patient's pre- and posttherapy voice during conversational speech. The experts agreed that the dysphonia was psychogenic and characterized it as staccato-like speech, effortful phonation, and interrupted flow of speech; six characterized it with intermittent voice arrests (voice stoppages); five with hoarse-harsh voice; and four with waxing and waning, strained-strangled phonation. These are often described as salient features of SD. Nevertheless, the experts disagreed among themselves as to whether the dysphonia was characteristic of SD and should be labeled as such. The author argues that as long as the voice characteristics and pathophysiologic findings that constitute SD are not well delineated, and as long as the diagnosis of SD is based on symptoms alone, patients with psychogenic or poorly understood voice disorders are likely to be misdiagnosed with organic (neurologic) SD and thus subjected to undue medical treatment. The author also argues that the debate over the etiology of SD can be resolved if SD is considered a neurologic syndrome, PSD a nonorganic phonatory disorder that mimics the syndrome, and if the voice symptoms and pathophysiologic characteristics of SD are well defined and agreed on.

  3. CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF EINDSTROKE—CAUSED DYSKPHAGIA—DYSPHONIA SYNDRONE

    Institute of Scientific and Technical Information of China (English)

    韩舰华; 董颖丽; 等

    2002-01-01

    Objective:To observe the therapeutic effect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp-acupuncture in the treatment of wind strokek.Methods:A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp-point Dingzhougxian (MS 5),Dingnie Houxiexian (MS 7),Dingpangxian Ⅱ (MS 9) and Dingnie Qianxiexian (MS 6).Before and after acupuncture treatment,clinical symptoms of dysphadia and dyskphonia sere compared,and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA),middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter.Results:Following two courses (4 weeks) of scalp-acupuncture treatment,of the 38 cases,23 had their dysphagia and dyskphonia cured (60.5%),10 (25.3%) had remarkable improvement,3(7.9%) experienced improvement and 2(5.3%) had no apparent changes.Simultaneously.MBFS of ACA,MCA and PCA increased significantly in comparison with that of pre-treatment (P<0.01).Additionally,results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain.Conclusion:Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating carebral blood flow.

  4. Spasmodic dysphonia.

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    Schaefer, S D; Freeman, F J

    1987-02-01

    Few speech disorders have been more controversial as to etiology and treatment as spasmodic dysphonia. This article reviews the historical background and origins of spasmodic dysphonia theories and the legacy of their implications on the current treatment of afflicted patients. The evolution and impact of "organic theories" is discussed and a personal perspective on the central nervous system investigations performed by the authors is briefly elucidated and their practical experience in managing spasmodic dysphonia patients is offered for the reader's consideration.

  5. Dysphonia as the primary complaint in a case of myasthenia gravis: diagnosis and speech therapy.

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    Nemr, Nair Kátia; Simões-Zenari, Marcia; Ferreira, Tainá Soares; Fernandes, Heloisa Regina; Mansur, Letícia Lessa

    2013-01-01

    Myasthenia gravis is an autoimmune disease, manifested by progressive muscular weakness and fatigue. There are frequent ocular and bulbar symptoms, among them, dysphonia. This article reports a case of dysphonia that contributed to the diagnosis of myasthenia gravis through a speech evaluation. The patient sought speech therapy with the ENT diagnosis of presbyphonia. The perceptual voice assessment and acoustic analysis pointed out respiration, glottal voice source and resonance affections. Considering that some of the data obtained from anamnesis and vocal assessments were not directly related to presbyphonia, the speech therapist discussed the case with the physician and they both concluded it was necessary to refer the patient to a neurological evaluation. The neurologist then raised the diagnostic hypotheses of myasthenia gravis and requested further examinations. The patient underwent speech therapy and drug treatment. A vocal reassessment, which occurred two months after the initial treatment, showed improvement in voice quality, with great impact on quality of life. This article shows the importance of detailed clinical speech evaluation and participation of a speech therapist in an interdisciplinary team.

  6. Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

    NARCIS (Netherlands)

    Lohmann, Katja; Wilcox, Robert A.; Winkler, Susen; Ramirez, Alfredo; Rakovic, Aleksandar; Park, Jin-Sung; Arns, Bjoern; Lohnau, Thora; Kasten, Meike; Brueggemann, Norbert; Hagenah, Johann; Schmidt, Alexander; Kaiser, Frank J.; Kumar, Kishore R.; Zschiedrich, Katja; Alvarez-Fischer, Daniel; Altenmueller, Eckart; Ferbert, Andreas; Lang, Anthony E.; Muenchau, Alexander; Kostic, Vladimir; Simonyan, Kristina; Agzarian, Marc; Ozelius, Laurie J.; Langeveld, Antonius P. M.; Sue, Carolyn M.; Tijssen, Marina A. J.; Klein, Christine; Groen, Justus

    2013-01-01

    Objective A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family. Methods Genome-wide linkage analysis was carried

  7. [Analysis of phonosurgical methods of treatment in spasmodic dysphonia].

    Science.gov (United States)

    Kosztyła-Hojna, Bożena; Berger, Greta; Zdrojkowski, Maciej

    2017-02-20

    Spasmodic dysphonia (SD) is rather a rare voice disorder. It is most often seen in woman aged 40-50. The disease is caused by deep emotional and neurological disorders of extrapyramidal system. Two main clinical forms of SD are distinguished: about 90% of cases - adductor spasmodic dysphonia and abductor spasmodic dysphonia roughly 10%. Conservative therapy does not always yield sufficient effects. Botulinum toxin - type A injections into the thyroarytenoid muscle are also used in therapy. Though results are temporary and reversible. Among phonosurgical methods thyroplasty type II according to Isshiki and tyroarytenoid muscle myectomy (TAM) should be also mentioned among phonosurgical methods. The aim of the work is to evaluate results of conservative and phonosurgical treatment of SD. Spasmodic dysphonia markedly restricts communication process of patients and public relations both social and occupational.

  8. [Dysphonia following glyphosate exposition].

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    Ptok, M

    2009-11-01

    Glyphosate is a commonly used nonselective herbicide which inhibits plant growth through interference with the production of essential aromatic amino acids. Toxicity for humans has been reported after suicidal ingestion. Here we describe a 26-year-old teacher who used glyphosate correctly but suffered from severe dysphonia after some hours. Laryngostroboscopy revealed decreased vocal fold mobility suggesting innervation impairment. The symptoms resolved spontaneously 6 weeks later and vocal fold mobility returned to normal. Glyphosate neurotoxicity has been discussed in the literature therefore, the dysphonia observed here may have been due to an intermittent neuropraxia of the laryngeal nerve. However, to our knowledge a similar case has not been reported in literature.

  9. [Dysphonia in children].

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    Nicollas, R; Giovanni, A; Triglia, J-M

    2008-06-01

    Dysphonia is a frequent reason for consultation in children. Most of the time, this presentation is the consequence of a vocal abuse, however, the physician has to be aware that an organic lesion, such as laryngeal papillomatosis can exist and so perform a flexible laryngoscopy. In case of laryngeal papillomatosis, surgery and several medical treatments will be proposed for a long time. In other cases, speech therapy, sometimes associated with surgery, will be performed.

  10. Consideration of genetic contributions to the risk for spasmodic dysphonia.

    Science.gov (United States)

    Sharma, Nutan; Franco, Ramon A

    2011-09-01

    Spasmodic dysphonia, a form of the neurologic condition known as dystonia, results from involuntary spasms of the larynx, producing interruptions of speech and changes in voice quality. The pathogenesis of spasmodic dysphonia is not well understood. However, several genetic mutations have been identified that cause different forms of dystonia. In some individuals, these genetic mutations result in spasmodic dysphonia, either with no other signs of dystonia or as part of a broader dystonia phenotype. Thus, research in the growing field of dystonia genetics may help to inform our understanding of the pathogenesis of spasmodic dysphonia.

  11. Diagnosis of spasmodic dysphonia manifested by swallowing difficulty in videofluoroscopic swallowing study.

    Science.gov (United States)

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun; Kim, Tae Uk

    2015-04-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.

  12. [Dysphonia in children and adolescents].

    Science.gov (United States)

    Fuchs, M; Meuret, S; Stuhrmann, N C; Schade, G

    2009-06-01

    Hoarseness is the leading symptom of dysphonia among children and adolescents. The incidence is evaluated internationally to be 6-25%. In an overview the hereditary and acquired organic and functional causes including secondary organic lesions of the vocal folds, the pathomechanisms and the symptoms typical for this age group are presented. In clinical routine, symptoms of dysphonia in children and adolescents should be consciously looked for and any long-term hoarseness should be examined by specialized physicians, even in this age group, using methods suitable to the age group and the developmental stage. When the appropriate indications are present all therapeutic options currently available should be taken into consideration. Furthermore, this paper provides information for the parents concerning the imminent phoniatric examination.

  13. Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

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    Paulauskienė Iveta

    2016-01-01

    Full Text Available Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis or functional (functional dysphonia, laryngeal conversion disorder, paradoxical vocal folds motion conditions. Rarely systemic diseases as amyloidosis, sarcoidosis, Wegener’s granulomatosis or tuberculosis can cause vocal dysfunction too. That is why laryngeal tuberculosis is often forgotten in case of persistent hoarseness. In this article, we present a case of a young previously healthy woman, complaining of persistent hoarseness with no other leading symptoms. Though endoscopic image suggested a malignancy, histology showed granulomatous lesion. Detailed examination revealed laryngeal and pulmonary tuberculosis resistant to rifampicin. Conclusion: Dysphonia can be the only one symptom of laryngeal tuberculosis. The disease should be taken into consideration when a patient complains of persistent hoarseness in order to avoid delays in treatment and spread of infection.

  14. Spasmodic dysphonia: description of the disease and associated neurologic disorders

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    Coelho, Marina Serrato

    2010-06-01

    Full Text Available Introduction: Spasmodic dysphonia (SD is a problem that affects speech and vocalization, one of the most devastating disorders of oral communication. It is characterized by vocal quality tensaestrangulada, harshly and / or interspersed with abrupt vocal attack and a great tension in the vocal tract. The etiology of spasmodic dysphonia is unclear. Some authors point to psychogenic causes, neurological or even unknown. Objective: To assess the prevalence of muscular dystonias and other neurological symptoms in patients with ED. Method: A retrospective study of 10 cases with diagnosis of ED for symptoms and neurological disorders associated. Results: There was a significant predominance of the disease in females (9:1. The average age of onset of symptoms was 32 years, ranging between 14 and 60 years. The mean disease duration was 10 years. Among the patients, 87.5% had a diagnosis of disorders of movement made by a neurologist, including orofacial dystonias (50%, essential tremor (50% and spastic paraparesis (12%. Conclusion: The presence of movement disorders followed almost all cases of spasmodic dysphonia. More studies are needed to clarify the pathophysiological basis of disease.

  15. Neurologic aspects of spasmodic dysphonia.

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    Rosenfield, D B; Donovan, D T; Sulek, M; Viswanath, N S; Inbody, G P; Nudelman, H B

    1990-08-01

    We discuss the etiology of 100 spasmodic dysphonia patients. Seventy-one patients had underlying essential tremor, 25 had Meige's syndrome, 12 were hypothyroid, and 27 had either a functional disturbance or focal dystonia. Six patients had intermittent breathy dysphonia. A large corpus of spasmodic dysphonia patients have organic neurolaryngeal disease.

  16. Current evidence for the organic etiology of spastic dysphonia.

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    Dedo, H H; Townsend, J J; Izdebski, K

    1978-01-01

    For over 100 years it has been universally assumed in the literature that spastic dysphonia is a functional or psychoneurotic voice disorder. In the last few years, new data have accumulated that support the concept that spastic dysphonia is caused by an organic, rather than a functional, abnormality. Histologic examination of segments of the recurrent laryngeal nerve removed from patients with spastic dysphonia has revealed myelin abnormalities in 30% of the nerves examined. Neurologic examination indicated brain stem or basal ganglia disturbances in some patients who had no apparent nerve disease.

  17. Dysphonia risk screening protocol

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    Katia Nemr

    2016-03-01

    Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

  18. Section four: laryngitis and dysphonia.

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    Hueston, William J; Kaur, Dipinpreet

    2013-12-01

    Acute laryngitis is most often caused by viral illnesses through direct inflammation of the vocal cords or from irritation due to postnasal drainage. Bacterial infections, such as acute epiglottitis, also can cause dysphonia but typically have other systemic symptoms as well as respiratory distress. Chronic laryngitis is characterized by symptoms lasting more than 3 weeks. Chronic vocal cord issues can be related to overuse or stress on the vocal cords resulting in nodules or polyps. Individuals in certain occupations, such as singers, school teachers, and chemical workers, are at greater risk of chronic laryngitis. The diagnostic approach to chronic laryngitis should include visualization of the vocal cords to rule out potential malignant lesions. For acute and chronic overuse symptoms, the best treatment is vocal rest. The use of antibiotics or decongestants should be discouraged.

  19. [Classification of dysphonia. Vocal dysfunction].

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    Crevier-Buchman, L; Monfrais-Pfauwadel, M C; Laccourreye, O; Menard, M; Brasnu, D

    1993-01-01

    A review of functional dysphonia is presented, pointing out the frequent association with organic dysphonia as a releasing or an aggravating factor. Each pathology is described with its psychopathological and histological features, its clinical and psychophysiological symptoms and its treatment, most of the time based on voice therapy.

  20. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on videolaryngoscopy

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    Keyvan Kiakojury

    2014-07-01

    Full Text Available Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action.   Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software.   Results: A total of 197 patients (mean age, 40.72 ±15.17 years participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes.   Conclusion:  Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.      

  1. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on videolaryngoscopy

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    Keyvan Kiakojury

    2014-07-01

    Full Text Available Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action.   Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software.   Results: A total of 197 patients (mean age, 40.72 ±15.17 years participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes.   Conclusion:  Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.

  2. Clinical evaluation of functional dysphonia.

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    Monday, L A

    1983-10-01

    Functional dysphonia is a voice impairment without any organic lesion of the phonating system. It may be classified into two categories: functional dysphonia itself where no lesions are found and functional laryngopathies where vocal cord lesions may be attributed to vocal abuse or misuse. The clinical evaluation of a dysphonic patient is performed in three steps: history taking, vocal evaluation, and examination. History taking helps the diagnosis and may be considered also as a therapeutic procedure. Vocal evaluation is oriented toward the voice itself and how it is produced. Then an ENT examination is performed with special attention to the larynx. In functional dysphonia, usually, everything looks normal but there may be signs of inflammation, hyperkinetism, hypokinetism, excessive laryngeal movements, etc. Functional laryngopathies include vocal nodules, laryngitis, polyps, and contact ulcer.

  3. Recurrent laryngeal nerve pathology in spasmodic dysphonia.

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    Bocchino, J V; Tucker, H M

    1978-08-01

    Since it was first described in 1871, spasmodic (spastic) dysphonia has been considered a disease of psychogenic origin. Unsupported theories of possible organic etiology have appeared sporadically in the literature. In 1976 sectioning of the recurrent laryngeal nerve for patients with this disease was reported with resultant improvement in voice production. This was attempted because the spasmodic dysphonic has, in effect, already compensated vocal cords bilaterally. It was reasoned, therefore, that if one of these was paralyzed the patient would immediately be converted to a state approximating that of well-compensated unilateral vocal cord paralysis which situation, as is well known, usually carries with it a fairly good voice. A controlled study to evaluate the efficacy of this surgical approach has been undertaken at the Cleveland Clinic during the past year. In an attempt to elucidate the possible organic etiology of spasmodic dysphonia, a section of nerve was removed in every case and examined by both light and electron microscopy. Special stains for myelin were also used on the light microscopy specimens. Demyelinization has been found in most of the cases examined by electron microscopy. Possible correlation between this disease entity and other cranial nerve syndromes of unknown etiology is noted. Such conditions as trigeminal neuralgia, glossopharyngeal neuralgia, belpharospasm, hemifacial spasm, and even possibly Bell's palsy may exhibit a similar etiology.

  4. [Clinical features of spastic dysphonia].

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    Vasilenko, Iu S; Golubev, V L; Debrianskaia, M B

    1995-01-01

    Clinical, neurological, endoscopic, psychological findings, questionnaire data on vegetative sphere, diaphragm x-ray, articulation test and Viene test system evidence obtained on 25 patients with phonic spasm confirm organic neurological nature of spastic dysphonia as focal muscular dystonia. This condition can be accompanied with tremor, rotatory, winking and writers' spasms, oromandibular dystonia. As indicated by positive treatment outcomes, combined treatment of phonic spasm with GABA-ergic drugs of clonazepam (antelepsin) and baclofen, orthophonic voice correction, physiotherapy is pathogenetically justified.

  5. Visual assessment of voice disorders in patients with occupational dysphonia

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    Bożena Kosztyła-Hojna

    2014-11-01

    Full Text Available [b]introduction[/b]. In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. [b]objective[/b]. The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG and digital stroboscopy (DS with a high resolution module. [b]material and methods[/b]. The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the ‘e’ vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany. Vocal folds vibrations were registered at the rate of 4,000 frames per second. [b]results[/b]. HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations. [b]conclusions[/b]. HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment.

  6. Visual assessment of voice disorders in patients with occupational dysphonia

    OpenAIRE

    Bożena Kosztyła-Hojna; Diana Moskal; Anna Kuryliszyn-Moskal; Ryszard Rutkowski

    2014-01-01

    [b]introduction[/b]. In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. [b]objective[/b]. The purpose of the study is assessment of the usefulness...

  7. Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

    OpenAIRE

    Paulauskienė Iveta; Mickevičienė Vaiva

    2016-01-01

    Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis) or functional (functio...

  8. A STUDY OF VOICE CHANGES IN SPASMODIC DYSPHONIA AFTER BOTULINUM THERAPY

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    Sanajeet Kumar

    2016-03-01

    Full Text Available BACKGROUND Spasmodic dysphonia is a neurological disorder, which can give the voice a strained quality. There is currently no cure for spasmodic dysphonia. The most common treatment for spasmodic dysphonia is the injection of botulinum toxin. METHODS Botulinum toxin A injection was performed in 10 patients with adductor spasmodic dysphonia. Voice handicap index scoring and voice analysis was done pre- and post-injection. Fundamental frequency, standard deviation of fundamental frequency, jitter, shimmer, mean phonation time and voice noise energy was studied in voice analysis. These voice parameters were measured from sustained phonation of vowel /a/. RESULTS Results of study indicated, a Spasmodic dysphonia patients had high mean values for voice handicap index score and all voice parameters. b All parameters were reduced significantly post botulinum therapy, but remained higher than their normal value. c All voice parameters except jitter showed strong positive correlation with voice handicap index in all domains. Jitter showed moderate positive correlation with total score, physical and emotional domain and strong positive correlation with functional domain. CONCLUSION Botulinum toxin A injection improves voice in cases of spasmodic dysphonia, significantly still post procedure voice does not return to normal.

  9. DIFFERENTIAL DIAGNOSIS OF ADDUCTOR SPASMODIC DYSPHONIA AND MUSCLE TENSION DYSPHONIA USING ACOUSTIC PARAMETERS

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    Swapna Sebastian

    2014-10-01

    Full Text Available Objective:The study aimed at differentiating Adductor Spasmodic Dysphonia (ADSD from Muscle Tension Dysphonia (MTD using acoustic measurements . Method: Perceptual as well as acoustic analysis of the voice was done on 12 patients of Adductor Spasmodic dysphonics and Muscle tension dysphonics each. The age of these patients ranged between 30 to 64 years . Results: Adductor spasmodic dysphonics statistically differed from muscle tension dysphonia in the acoustic parameters of voice break, harmonic to noise ratio, and jitter. The parameters which showed maximum significance of differences were voice break which was presented only by the adductor spasmodic dysphonics and harmonic to noise ratio which was affected in muscle tension dysphonia. Conclusion: Voice breaks were found to be more sensitive in discriminating adductor spasmodic dysphonia from muscle tension dysphonia in the present study. Percentage of voice break correlated with perceptual assessment of severity.

  10. Treatment of spastic dysphonia by recurrent laryngeal nerve section.

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    Barton, R T

    1979-02-01

    The problem of management of patients with spastic dysphonia has been complicated by a general resistance to speech therapy, psychotherapy, hypnotherapy, and drug therapy. Dedo introduced the concept of recurrent laryngeal nerve section in an attempt to eliminate the hyperfunction and excessive adduction of the vocal folds. Eleven patients were treated by RLN section with satisfactory results in 8 and some improvement in the other 3. The operation was found to be generally uncomplicated and required on average 4 days of hospitalization. Dedo's theory that spastic dysphonia is caused by a neurotropic viral-induced proprioceptive nerve deficit represents a new search for organic cause. His most recent report of finding unmyelinated fibres in one-third of the resected recurrent laryngeal nerves is of questionable significance. The evidence of deep emotional conflict and/or compulsive life-style is found in the majority of the patients, but the syndrome is not typical of an hysterical or conversion neurosis. Regardless of etiologic theory, RLN section is an effective treatment in selected, long-standing, and resistant instances of spastic dysphonia.

  11. Vocal dose in teachers: correlation with dysphonia.

    Science.gov (United States)

    Gama, Ana Cristina Côrtes; Santos, Juliana Nunes; Pedra, Elisângela de Fátima Pereira; Rabelo, Alessandra Terra Vasconcelos; Magalhães, Max de Castro; Casas, Estevam Barbosa de Las

    2016-04-01

    Teachers are professionals with high prevalence of dysphonia, whose main risk factors are the large work hours in classrooms with the presence of background noise. The purpose of the study was to calculate the phonation time and the cycle dose of teachers with dysphonia and teachers without voice disorders during the class. There were two groups analyzed: five teachers with functional dysphonia were the first group and five teachers without voice disorders were the second group. For the data was used the VoxLog® dosimeter and the parameters were: intensity; fundamental frequency; phonation time and cycle dose. The statistical analysis used ANOVA, Student's T-test, and Kruskal-Wallis test. Dysphonic teachers showed major values of phonation time and cycle dose compared with teachers without voice disorders. The dysphonia is related to extended period of speech time and greater exposure of the tissue of the vocal fold to phonotrauma.

  12. [Application of acoustic analysis of the voice to diagnosis and treatment of functional dysphonia].

    Science.gov (United States)

    Chernobel'skiĭ, S I

    2009-01-01

    Acoustic analysis of the voice was used to facilitate diagnosis and to objectively evaluate results of the treatment of psychogenic dysphonia (PD) in 20 women. The control group comprised 20 women showing no signs of laryngeal pathology. The following parameters were measure: jitter, shimmer, signal to noise ratio, and response in the voicing test. Other methods applied included laryngoscopy, videolaryngoscopy, and laryngostroboscopy. It was shown that hoarseness in patients with PD results from the disturbances of mechanisms controlling stability of phonation. This observation is confirmed by the results of the acoustic test. It is concluded that dysphonia confirmed in the acoustic test in the absence of organic changes in the larynx is caused by psychogenic factors. Acoustic analysis of the voice is indicated to objectively evaluate results of the treatment of psychogenic dysphonia.

  13. Dysphonia: medical treatment and a medical voice hygiene advice approach. A prospective randomised pilot study.

    Science.gov (United States)

    Pedersen, M; Beranova, A; Møller, S

    2004-07-01

    For many years all patients with dysphonia referred to in the literature as resulting from non-organic (functional) voice disorders were sent to speech therapy. Medical diagnoses were not taken into account. In our earlier Cochrane review on vocal cord nodules we discovered that evidence-based research in the area of benign voice disorders with dysphonia, and with or without slight benign swellings including nodules on the vocal cords, was lacking at that time. Therefore, a prospective randomised pilot study based on our Cochrane review has been made on dysphonic patients with non-organic (function provoked?) voice disorders as the basis for further evidence-based studies. Medical treatment was based on the scientific approach that once a micro-organic disorder caused by reflux, infection, allergy or environmental irritatants (e.g., dust or noise in the workplace) was discovered by very careful anamnesis and systematic objective routine analyses and was treated effectively, with documentation, the non-organic voice disorder disappeared, as, e.g., in the case of a diagnosis and treatment of helicobakter pylori. The reason is that the mucosal swelling/dysfunction of the vocal cords is secondary. In order to try to understand why the recommendation to all these patients for many years was only voice therapy, which the speech therapists "felt to be effective", updated voice-hygiene advice (for posture, accents of the diaphragm, intonation pattern and resonance) was given by experienced laryngologists, randomised with the updated medical diagnosis/therapy in order to elucidate what effect the training might have. No evidence-based studies in the literature document any effect. The crucial point seemed to be that doctors mostly did not examine any other diagnoses other than the "dysphonia" and did not dig down to any of the medical reasons when the vocal fold diagnosis of "non- organic disorders" was made. This should be changed in the future. This pilot study was based

  14. Cortical dysfunction of the supplementary motor area in a spasmodic dysphonia patient.

    Science.gov (United States)

    Hirano, S; Kojima, H; Naito, Y; Tateya, I; Shoji, K; Kaneko, K; Inoue, M; Nishizawa, S; Konishi, J

    2001-01-01

    The etiology of spasmodic dysphonia (SD) is still unknown. In the present study, cortical function of a 59-year-old male patient with adductor type SD was examined during phonation with positron emission tomography (PET). Magnetic resonance imaging showed no organic abnormality in the brain. However, PET showed remarkable activities during phonation in the left motor cortex, Broca's area, the cerebellum, and the auditory cortices, whereas the supplementary motor area (SMA) was not activated. The SMA is known to function for motor planning and programming and is usually activated in normal phonation. Several previous reports have shown that the damage of the SMA caused a severe disturbance of voluntary vocalization. In the present case, it was suggested that the functional deficit of the SMA might be related to SD.

  15. [Personality and coping with stress in patients with functional dysphonia].

    Science.gov (United States)

    Freidl, W; Egger, J; Friedrich, G

    1989-08-01

    The study was done to prove the etiopathogenetical power of some personality traits, proceeding life events, and strain effects when exposed to an experimental work-stress. 20 functional dysphonics, 14 individuals suffering from organic voice disorders and a group of 20 control persons were examined. The results show that the group of functional dysphonics produced a significant more positive self-evaluation regarding their personality with a clear tendency to restraint. Compared to the control group they showed a higher level of state anxiety in situations causing stress. Furthermore the influence of proceeding life events for the etiopathogenesis of functional dysphonia has become clear.

  16. Adductor spasmodic dysphonia and botulinum toxin treatment : The effect on well-being

    NARCIS (Netherlands)

    Langeveld, TPM; Luteijn, F; van Rossum, M; Drost, HA; De Jong, RJB

    2001-01-01

    Adductor spasmodic dysphonia (AdSD) is a controversial and enigmatic voice disorder. It is generally accepted that it has a neurologic, although undetermined, cause, and it is accompanied by much psychological and physical distress. In this prospective study, standardized psychometric tests were use

  17. Comparing health locus of control in patients with Spasmodic Dysphonia, Functional Dysphonia and Nonlaryngeal Dystonia.

    Science.gov (United States)

    Haselden, Karen; Powell, Theresa; Drinnan, Mike; Carding, Paul

    2009-11-01

    Locus of Control (LoC) refers to an individuals' perception of whether they are in control of life events. Health Locus of Control refers to whether someone feels they have influence over their health. Health Locus of Control has not been studied in any depth in voice-disordered patients. The objective of this study was to examine Health Locus of Control in three patient groups: (1) Spasmodic Dysphonia, (2) Functional Dysphonia and (3) a nondysphonic group with Nonlaryngeal Dystonia. LoC was measured and compared in a total of 57 patients using the Multidimensional Health Locus of Control Scales (diagnostic specific) Form C. Internal, Chance, and Powerful others LoC were measured and comparisons were made using one-way analysis of variance. Contrary to expectations Internal LoC was found to be significantly higher in the Functional Dysphonia group when compared to the other two groups. There was no significant difference between the groups in Chance or Powerful others LoC. The two organic groups, Spasmodic Dysphonia and Nonlaryngeal Dystonia, were more alike in Internal Health Locus of Control than the Functional Dysphonia group. The diagnostic nature of the groups was reflected in their LoC scores rather than their voice loss. These results contribute to the debate about the etiology of Spasmodic Dysphonia and will be of interest to those involved in the psychology of voice and those managing voice-disordered patients.

  18. Disfluency in Spasmodic Dysphonia: A Multivariate Analysis.

    Science.gov (United States)

    Cannito, Michael P.; Burch, Annette Renee; Watts, Christopher; Rappold, Patrick W.; Hood, Stephen B.; Sherrard, Kyla

    1997-01-01

    This study examined visual analog scaling judgments of disfluency by normal listeners in response to oral reading by 20 adults with spasmodic dysphonia (SD) and nondysphonic controls. Findings suggest that although dysfluency is not a defining feature of SD, it does contribute significantly to the overall clinical impression of severity of the…

  19. Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

    Science.gov (United States)

    Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

    2004-01-01

    This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

  20. Parkinson's disease detection based on dysphonia measurements

    Science.gov (United States)

    Lahmiri, Salim

    2017-04-01

    Assessing dysphonic symptoms is a noninvasive and effective approach to detect Parkinson's disease (PD) in patients. The main purpose of this study is to investigate the effect of different dysphonia measurements on PD detection by support vector machine (SVM). Seven categories of dysphonia measurements are considered. Experimental results from ten-fold cross-validation technique demonstrate that vocal fundamental frequency statistics yield the highest accuracy of 88 % ± 0.04. When all dysphonia measurements are employed, the SVM classifier achieves 94 % ± 0.03 accuracy. A refinement of the original patterns space by removing dysphonia measurements with similar variation across healthy and PD subjects allows achieving 97.03 % ± 0.03 accuracy. The latter performance is larger than what is reported in the literature on the same dataset with ten-fold cross-validation technique. Finally, it was found that measures of ratio of noise to tonal components in the voice are the most suitable dysphonic symptoms to detect PD subjects as they achieve 99.64 % ± 0.01 specificity. This finding is highly promising for understanding PD symptoms.

  1. Spasmodic dysphonia: let's look at that again.

    Science.gov (United States)

    Murry, Thomas

    2014-11-01

    G. Paul Moore influenced the study of spasmodic dysphonia (SD) with his 1960 publication that examined the neurological, medical, and vocal fold behavior in a group of patients with adductor spasmodic dysphonia (ADSD). This review of advances in the diagnosis and treatment of SD follows a time line of research that can be traced in part to the early work of Moore et al. This article reviews the research in ADSD over the past 50 plus years. The capstone events that brought SD to its present day level of management by laryngologists and speech-language pathologists are highlighted. A look to the future to understand more of the disorder is offered for this debilitating disorder.

  2. Recurrent laryngeal nerve histopathology in spastic dysphonia: a preliminary study.

    Science.gov (United States)

    Dedo, H H; Izdebski, K; Townsend, J J

    1977-01-01

    Spastic dysphonia is a severe voice disorder ordinarily described as psychogenic. Organic-neurologic changes secondary to central or peripheral nervous system involvement have also been postulated and led recently to the surgical treatment of spastic dysphonia by unilateral section of the recurrent laryngeal nerve (RLN). This study reports the histologic findings from these resections of the RLN from patients with an average 9.5 years duration of spastic dysphonia. Thirty percent of the RLNs examined demonstrated significant abnormalities as compared to age-matched controls. Although no reactive changes were noted by light microscopy, groups of fibers which did not stain for myelin or axons were found in RLNs from patients with spastic dysphonia. A preliminary ultrastructural study of these areas in one RLN revealed sheets of unmyelinated axons. These findings suggest an organic basis for spastic dysphonia at least in some patients.

  3. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on Videolaryngoscopy

    OpenAIRE

    Keyvan Kiakojury; Mehdi Dehghan; Fateme Hajizade; soraya khafri

    2014-01-01

    Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via...

  4. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on videolaryngoscopy

    OpenAIRE

    Keyvan Kiakojury; Mehdi Dehghan; Fateme Hajizade; soraya khafri

    2014-01-01

    Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via...

  5. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    OpenAIRE

    Seyyedeh Maryam Khoddami; Noureddin Nakhostin Ansari; Farzad Izadi; Saeed Talebian Moghadam

    2013-01-01

    The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physio...

  6. Proposta de modelo de atendimento multidisciplinar para disfonias relacionadas ao trabalho: estudo preliminar Multidisciplinary protocol proposal for professional dysphonia: preliminary study

    Directory of Open Access Journals (Sweden)

    Erica Ortiz

    2004-10-01

    multiple causes and its evaluation, ethiological conclusion and occupational reports aren't defined yet. AIM: In order to obtain a more accurate and comprehensive evaluation, a multidisciplinary protocol was elaborated to ensure proper medical scientific support. It consists of anamnesis, physical exam, laryngeal endoscopy, perceptive voice analysis and Voice Handicap Index application (VHI. STUDY DESIGN: Transversal historic cohort. MATERIAL E MÉTODO: In this preliminary study, the protocol was applied on 15 voice professionals with dysphonia. RESULTS: 13,3% with normal voice performance; 33,3% with functional dysphonia; 46% with organic dysphonia. Dysphonia was related to the voice-oriented job in 40% cases and it was ruled out in 46,6%. CONCLUSION: We concluded that the protocol is complete enough to help otolaryngologists evaluate this workers' category.

  7. Botulinum toxin therapy for abductor spasmodic dysphonia.

    Science.gov (United States)

    Woodson, Gayle; Hochstetler, Heidi; Murry, Thomas

    2006-03-01

    Botulinum toxin has been widely accepted as an effective therapy for controlling the symptoms of adductor spasmodic dysphonia (ADSD). Reported experience with botulinum treatment for abductor spasmodic dysphonia (ABSD) has been less impressive. Factors that may impair outcomes for ABSD include differences in the pathophysiology of ADSD and ABSD and limitation of maximal dose from airway restriction with posterior cricoarytenoid muscle (PCA) weakness. We report our experience with botulinum injection of the PCA with an asymmetric dose escalation protocol, based on clinical observations that in ABSD, abductor spasms are often stronger on one side, usually the left. The nondominant side was injected with 1.25 units. Dominant side dose began at 5 units, with step-wise increments of 5 units per week until one of three endpoints was reached: Elimination of breathy voice breaks, complete abductor paralysis of the dominant side, or airway compromise. Fourteen of 17 patients achieved good or fair voice, with dominant-side doses ranging from 10 to 25 units. Exercise intolerance limited PCA dose in two patients. One patient had persisting breathiness that improved with medialization thyroplasty. Asymmetric botulinum toxin injection into PCA muscles can suppress abductor spasm in patients with ABSD, but breathiness may persist, because of inadequate glottal closure.

  8. Behavioral management of pediatric dysphonia.

    Science.gov (United States)

    Hersan, R; Behlau, M

    2000-10-01

    Children's voice disorders may be functional or organic in cause and a thorough evaluation by the otolaryngologist and speech-language pathologist is necessary to obtain the proper diagnosis, to understand the underlying etiologic factors, and to prepare a plan of treatment that is appropriate for the child. Because voice disorders may be present with developmental communication problems, treatment must include all factors that affect growth and development of the child.

  9. Case to Cause: Back to the Future

    Science.gov (United States)

    Abramovitz, Mimi; Sherraden, Margaret S.

    2016-01-01

    This article reopens the historic debate about the roles of micro and macro practice in social work and encourages the profession to find ways to achieve a better balance between case and cause in education, practice, and research. To this end, it traces the history of the case versus cause debate including conceptual frameworks for rebalancing…

  10. Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

    Directory of Open Access Journals (Sweden)

    Svetel Marina

    2007-01-01

    Full Text Available Background/Aim. Spasmodic dysphonia (DS is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80−100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. Methods. The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12−16 units each. In our study we applied indirect technique originally developed by Hočevar and Pirtošek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. Results. The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index − (VHI that was rated as rather significant one (t = 3.562; p = 0.006. Conclusion. Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.

  11. Objective Voice Parameters and Self-Perceived Handicap in Dysphonia

    OpenAIRE

    Hummel, Christina; Scharf, Manuela; Schützenberger, Anne; Graessel, Elmar; Rosanowski, Frank

    2013-01-01

    Objective: This study focuses on the relation between objective voice quality and the self-perception of a voice handicap. Patients and Methods: The study group consisted of 86 German-speaking patients (51 women, 35 men) suffering from benign dysphonia. The test persons completed the German version of the Voice-Related Quality of Life (V-RQOL) Questionnaire without prior information about their diagnosis and underwent voice analysis with the Dysphonia Severity Index (DSI) being the parameter ...

  12. Defining the psychiatric role in spastic dysphonia.

    Science.gov (United States)

    Ginsberg, B I; Wallack, J J; Srain, J J; Biller, H F

    1988-03-01

    The authors evaluated 11 surgically-treated patients with spastic dysphonia, a phonation disorder of unclear etiology. The results indicate that the illness does not appear to be a somatoform disorder, but that stress may play a role in its expression, and that there may be secondary depression and anxiety. The experience of spastic dysphonics suggests that psychiatric treatments may be inappropriately applied to an illness without clear organic etiology, whereas, conversely, a proper psychiatric role may be rejected when effective medical or surgical treatment is available. The authors recommend that psychiatrists evaluating patients with illnesses of unclear etiology should be cautious in making a primary psychiatric diagnosis unless DSM-III criteria are met.

  13. [Personality and coping with stress in patients suffering from functional dysphonia].

    Science.gov (United States)

    Freidl, W; Friedrich, G; Egger, J

    1990-01-01

    The examination covers the personality of 20 functional dysphonics, 14 individuals suffering from organic voice disorders and a group of 20 control persons when exposed to stress and its working up. In examining the group of functional dysphonics a significant positive self-assessment regarding their personality with a clear tendency to restraint has become clear. In comparison with the control persons an intensified anxiety state in situations causing stress is the result. Thus the influence of life events has been shown to have an important effect on the etiopathogenesis of functional dysphonia.

  14. [Diagnosis of non-organic dysphonia in adult].

    Science.gov (United States)

    Crevier-Buchman, L; Tessier, Ch; Sauvignet, A; Brihaye-Arpin, S; Monfrais-Pfauwadel, M-Cl

    2005-01-01

    Non organic dysphonia or functional voice disorders are the consequence of a vocal misuse or overuse with inefficient oral communication. Any stage of voice production can be altered. A review of physiopathological, aerodynamic and biomechanical mechanisms will help to understand the onset of dysphonia. Organic lesions as a consequence of functional voice disorders are frequent but the link is not easy to establish. It is important to look for various physiologic, anatomic, environmental, behavioural and infectious factors that could induce or aggravate non organic dysphonia, as they can benefit from specific treatment. A thorough functional and organic assessment is the first step of the rehabilitation process, taking into account the patient's expectations about his voice handicap.

  15. [Functional dysphonia: relation with personality and ICD-10 criteria].

    Science.gov (United States)

    Carvajal, C; Sanfuentes, M T; Eva, P; Jara, C; Lolas Stepke, F

    1992-03-01

    The International Classification of Diseases, 10th. revision (ICD-10) in the category F45 defines the somatoform disorder as a mental disease characterized by the reiterative presentation of somatic symptoms in absence of an organic disease, or the somatic pathology being insufficient to explain the intensity of the symptoms as well as the discomfort and preoccupation of the patient. Fifteen female teachers with functional dysphonia were studied by means of a semistructured interview and psychometric evaluations. Considering dysphonia as the principal symptom, the most frequent diagnosis, in accordance with ICD-10 was "Other somatoform disorder" (F-45.8)(9/15). Five patients were diagnosed as motor dissociative disorder (F-44.4). All the patients had some abnormality of personality (5 with personality disorder and 10 with exacerbation of personality traits). The criteria of ICD-10 to classify the functional dysphonia as Somatoform disorder are discussed. It is suggested that certain personality traits are facilitators for somatization.

  16. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    Directory of Open Access Journals (Sweden)

    Seyyedeh Maryam Khoddami

    2013-01-01

    Full Text Available The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD. The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

  17. The assessment methods of laryngeal muscle activity in muscle tension dysphonia: a review.

    Science.gov (United States)

    Khoddami, Seyyedeh Maryam; Nakhostin Ansari, Noureddin; Izadi, Farzad; Talebian Moghadam, Saeed

    2013-11-04

    The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

  18. Osteonecrosis caused by Bisphosphonates: a clinical case

    Science.gov (United States)

    SPINELLI, D.; DE VICO, G.; BONINO, M.; BARLATTANI, A.; BOLLERO, P.; BARLATTANI, A.

    2010-01-01

    SUMMARY The osteonecrosis of the maxillares caused by bisphosphonates (OMB) either wrongly known or not reconised in earlier times became nowadays very important among the dentists and maxillo-facials surgeons because of the potential serious consequences that might bring in the oral cave of the patients, who are suffering already for their base condition. The goal of our work was to verify if a deep treatment and an attentive observation with a close follow-up can bring to the resolution of serious cases of ostenecrosis of the maxillares by bisphosphonantes. Although without a statistic value our case report put the basis for a chance to execute wider casistic studies. PMID:23285372

  19. Nonsurgical treatment of stylohyoid (Eagle) syndrome: a case report.

    Science.gov (United States)

    Taheri, Arman; Firouzi-Marani, Shahram; Khoshbin, Masoud

    2014-10-01

    Eagle syndrome is a rare condition caused by elongation of the styloid process or calcification of the stylohyoid ligament. Patients with Eagle syndrome typically present with dysphagia, dysphonia, cough, voice changes, otalgia, sore throat, facial pain, foreign body sensation, headache, vertigo, and neck pain. Here we report a case in which the patient initially presented with sore throat, left-sided facial pain, and cough. This case report provides a brief review of the diagnosis and nonsurgical management of this rare syndrome.

  20. Comparison of Perceptual Signs of Voice before and after Vocal Hygiene Program in Adults with Dysphonia

    Directory of Open Access Journals (Sweden)

    Seyyedeh Maryam khoddami

    2011-12-01

    Full Text Available Background and Aim: Vocal abuse and misuse are the most frequent causes of voice disorders. Consequently some therapy is needed to stop or modify such behaviors. This research was performed to study the effectiveness of vocal hygiene program on perceptual signs of voice in people with dysphonia.Methods: A Vocal hygiene program was performed to 8 adults with dysphonia for 6 weeks. At first, Consensus Auditory- Perceptual Evaluation of Voice was used to assess perceptual signs. Then the program was delivered, Individuals were followed in second and forth weeks visits. In the last session, perceptual assessment was performed and individuals’ opinions were collected. Perceptual findings were compared before and after the therapy.Results: After the program, mean score of perceptual assessment decreased. Mean score of every perceptual sign revealed significant difference before and after the therapy (p≤0.0001. «Loudness» had maximum score and coordination between speech and respiration indicated minimum score. All participants confirmed efficiency of the therapy.Conclusion: The vocal hygiene program improves all perceptual signs of voice although not equally. This deduction is confirmed by both clinician-based and patient-based assessments. As a result, vocal hygiene program is necessary for a comprehensive voice therapy but is not solely effective to resolve all voice problems.

  1. Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study

    Science.gov (United States)

    2016-01-01

    Objective To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). Methods Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. Results There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. Conclusion The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI. PMID:27606266

  2. Death caused by heat stroke: Case report

    Directory of Open Access Journals (Sweden)

    Savić Slobodan

    2014-01-01

    Full Text Available Introduction. Heat stroke is the most dangerous among numerous disorders caused by elevated environmental temperature. It is characterized by an increased body temperature of over 40°C, the dysfunction of the central nervous system and the development of multiple organ failure. The aim of this paper was to highlight problems in the clinical and post-mortal diagnosis of fatal heat stroke. Case Outline. A 20-year-old male was found unconscious on the street; on admission at the Emergency Center, Clinical Center of Serbia, Belgrade, he was in a coma. The body temperature of 40°C was maintained despite the applied therapy, meningeal signs were negative, tachycardia with gallop rhythm, hypotension, bleeding from the nose and mouth, and presence of skin bruises. Laboratory findings: highly elevated LDH and creatine kinase, elevated serum creatinine, AST, and signs of DIC. Lethal outcome occurred 6 hours after admission, and the case remained clinically unsolved. Autopsy showed signs of hemorrhagic diathesis, brain and pulmonary edema, and microscopic examination revealed general congestion, internal bleeding in various organs, cerebral edema, massive blood aspiration and pulmonary edema. Toxicological and bacteriological examinations were negative. Based on these findings and subsequently obtained data on the conditions at the workplace where the young man had a part-time job, it was concluded that the violent death was caused by heat stroke. Conclusion. Since heat stroke is associated with a high mortality rate and high incidence of serious and permanent organ damage in survivors, it is important to make the diagnosis of heat stroke as quickly as possible and apply appropriate treatment. Misdiagnosis of heat stroke, and consequently inadequate treatment, with a potential fatal outcome for the patient, can be the reason for blaming doctors for the legal offense of medical malpractice in failing to administer first aid.

  3. [Epidemiological survey of dysphonia in children at primary school entry].

    Science.gov (United States)

    Lecoq, M; Drape, F

    1996-01-01

    The study of 259 children in primary school revealed a prevalence of dysphonia of 10%, often undiagnosed, untreated or considered as benign. It would seem desirable to draw attention to this symptom, which may be an indication of organic pathology or of psychological problems, the early treatment of which may avoid later sequelae. It is sometimes necessary to allow a period for reflection in order to gain the cooperation of the child and his parents.

  4. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin

    NARCIS (Netherlands)

    Dejonckere, P. H.; Neumann, K. J.; Moerman, M. B. J.; Giordano, A.; Manfredi, C.; Martens, J.P.

    2012-01-01

    Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were perform

  5. Use of topical lidocaine in the treatment of muscle tension dysphonia.

    Science.gov (United States)

    Dworkin, J P; Meleca, R J; Simpson, M L; Garfield, I

    2000-12-01

    This investigation explored the potential usefulness of topical lidocaine in the treatment of muscle tension dysphonia. Three patients with this disorder, who were previously unresponsive to standard voice therapy, were treated with lidocaine. In each case, the outcome was prompt, clinically significant, and sustained. Persistently high-pitched and shrill vocal quality was converted to near normal voice patterns within 15 minutes after transcricothyroid membrane lidocaine injection. We suggest that this temporary and simple laryngeal and tracheal anesthetic technique may have helped to break the perverse cycle of hyperactive glottal and supraglottal muscle contractions evident in each of these patients during phonation efforts. We discuss the possible sensorimotor mechanism of action of this therapeutic technique.

  6. A Solitary Plasmocytoma Case Causing Horner Syndrome

    Directory of Open Access Journals (Sweden)

    Mustafa Vayvada

    2014-08-01

    Full Text Available Solitary plasmacytoma is a rare plasma cell tumour, when seen in the chest wall, it is important to diagnose since the treatment scheme and prognosis will vary, compared to primary malignant tumours of the chest wall. A 60-year-old male presented to our clinic with left shoulder pain radiating to the left axilla. Horner%u2019s syndrome symptoms were present, in further examination a chest wall mass located in the left upper lung lobe region was detected. Histopathologic diagnosis was solitary plasmocytoma via video-assisted thoracoscopy. The primary tumor of the rib malignancy causing Horner%u2019s syndrome is discussed with reference to the relevant literature.

  7. Diagnosis and management of ventricular dysphonia.

    Science.gov (United States)

    Von Hake, C P; Ganzman, I P; Mauer, T P

    1989-02-01

    Ventricular phonation may develop on a functional level, or it may occur as an alternative voice for the patient who has an organic disease of the true vocal folds. Three cases that represent iatrogenic, traumatic, and neurologic forms of the disorder are reported. Diagnosis, treatment, and guidelines for follow-up speech therapy are discussed.

  8. Adductor spasmodic dysphonia: Relationships between acoustic indices and perceptual judgments

    Science.gov (United States)

    Cannito, Michael P.; Sapienza, Christine M.; Woodson, Gayle; Murry, Thomas

    2003-04-01

    This study investigated relationships between acoustical indices of spasmodic dysphonia and perceptual scaling judgments of voice attributes made by expert listeners. Audio-recordings of The Rainbow Passage were obtained from thirty one speakers with spasmodic dysphonia before and after a BOTOX injection of the vocal folds. Six temporal acoustic measures were obtained across 15 words excerpted from each reading sample, including both frequency of occurrence and percent time for (1) aperiodic phonation, (2) phonation breaks, and (3) fundamental frequency shifts. Visual analog scaling judgments were also obtained from six voice experts using an interactive computer interface to quantify four voice attributes (i.e., overall quality, roughness, brokenness, breathiness) in a carefully psychoacoustically controlled environment, using the same reading passages as stimuli. Number and percent aperiodicity and phonation breaks correlated significanly with perceived overall voice quality, roughness, and brokenness before and after the BOTOX injection. Breathiness was correlated with aperidocity only prior to injection, while roughness also correlated with frequency shifts following injection. Factor analysis reduced perceived attributes to two principal components: glottal squeezing and breathiness. The acoustic measures demonstrated a strong regression relationship with perceived glottal squeezing, but no regression relationship with breathiness was observed. Implications for an analysis of pathologic voices will be discussed.

  9. Parry-Romberg syndrome (progressive hemifacial atrophy) with spasmodic dysphonia--a rare association.

    Science.gov (United States)

    Mugundhan, K; Selvakumar, C J; Gunasekaran, K; Thiruvarutchelvan, K; Sivakumar, S; Anguraj, M; Arun, S

    2014-04-01

    Parry-Romberg syndrome is a rare clinical entity characterised by progressive hemifacial atrophy with appearance of 'saber'. Various neurological and otorhinolaryngological disorders are associated with this syndrome. The association of Parry -Romberg syndrome with Spasmodic dysphonia has rarely been reported. A 37 year old female presented with progressive atrophy of tissues of left side of face for 10 years and change in voice for 1 year. On examination, wasting and atrophy of tissues including tongue was noted on left side of the face. ENT examination revealed adductor spasmodic dysphonia. We report the rare association of Parry -Romberg syndrome with spasmodic dysphonia.

  10. Empyema Caused by Clostridium bifermentans: A Case Report

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    Safa Edagiz

    2015-01-01

    Full Text Available A case of pneumonia with associated empyema caused by Clostridium bifermentans is described. C bifermentans is an anaerobic, spore-forming, Gram-positive bacillus. This organism is infrequently reported as a cause of infection in humans, and older publications tended to regard it as nonpathogenic. However, in more recent reports, C bifermentans has been documented as a cause of septic arthritis, osteomyelitis, soft tissue infection, abdominal infections, brain abscess, bacteremia and endocarditis. The present case is the third reported case of empyema caused by C bifermentans, and it serves to further define the spectrum of illness due to this uncommon organism.

  11. Esophageal tuberculosis; A rare cause of odynophagia: A case report

    Directory of Open Access Journals (Sweden)

    Khalid Hamid Changal

    2013-04-01

    Full Text Available We present a rare case of esophageal tuberculosis causing odynophagia. Tuberculosis of the esophagus is a rare condition, even in countries with a high incidence of tuberculosis (TB and studies estimate that it constitutes about 0.3% of gastrointestinal TB cases. The case emphasizes the diverse ways tuberculosis can present.

  12. Gastric perforation caused by Strongyloides stercoralis: a case report.

    Science.gov (United States)

    Oztürk, Gürkan; Aydınlı, Bülent; Celebi, Fehmi; Gürsan, Nesrin

    2011-01-01

    Strongyloidiasis is a parasitosis caused by the female nematode of the Strongyloides stercoralis. S. stercoralis causes a chronic infection that is asymptomatic in 50% of chronically infected patients, and it can also affect the stomach. Gastric involvement causes symptoms mostly mimicking gastritis. We report herein a case of gastric perforation in a 37-year-old woman, which was thought to be caused by S. stercoralis.

  13. [Diagnostics and therapy of dysphonia suitable for the ages and developmental stages of children and adolescents (part 2)].

    Science.gov (United States)

    Fuchs, M

    2008-02-01

    The incidence of dysphonia among children and adolescents is evaluated internationally at 6 % to 25 %. Nonetheless, hoarseness as a leading symptom among children is often insufficiently recognized by their parents/attachment figures, by the young patients themselves, and even by physicians. In an overview, the hereditary and acquired organic and functional causes - including secondary organic lesions of the vocal folds - their pathomechanisms and the symptoms typical for this age group are presented. For diagnostics suitable for these age groups and developmental stages, modern methods of laryngoscopy (including stoboscopy and real-time laryngoscopy), of functional diagnostics of vocal capacity and quality as well as anamnestic and psychometric procedures for the investigation of possible psychosomatic genesis are available. Frequent therapeutic measures are vocal hygienic counseling and psycho- and family dynamic therapies. Vocal exercise treatments are particularly employed for the consequences of laryngeal surgery and with voice techniques unfavorable as a precondition for increased vocal activity. Operative measures in the sound-producing areas of the vocal apparatus and in the framework of plastic reconstruction concentrate on the optimizing of vocal capacity and quality. In clinical routine, symptoms of dysphonia in children and adolescents should be consciously registered, and any long-term hoarseness, in this age group as well, should be examined by specialized physicians using the methods suitable to the age group and the developmental stage. When the appropriate indications are present, all of the therapeutic options currently available should be discussed.

  14. Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

    Science.gov (United States)

    Mor, Niv; Tang, Christopher; Blitzer, Andrew

    2016-09-01

    Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD.

  15. A Case of Fungal Arthritis Caused by Hansenula Anomala

    OpenAIRE

    Choi, Sung-Wook; Lee, Tong-Joo; Kim, Myung-Ku; Lee, Moon; Jung, Jae-Ho

    2010-01-01

    Hansenula anomala (H. anomaly) is part of the normal flora in the alimentary tract and throat. It has been reported to be an organism causing opportunistic infections in immunocompromised patients. However, cases of fungal arthritis caused by H. anomala are rare. We encountered a case of H. anomala arthritis in a 70-year-old man who was treated with an empirical antibiotic treatment and surgery under the impression of septic arthritis. However, the patient did not improve after antibiotic the...

  16. Sialadenitis caused by iatrogenic trauma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Woo; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2004-06-15

    A case of sialadenitis is presented in a patient with painful swelling of the right mouth floor. The condition was caused by trauma on the right mouth floor during dental treatment, which had happened 15 days before admission. On aspiration, mucous secretion was found and ultrasonography showed obstruction of duct. Histopathological studies and surgical investigation established a definite diagnosis of obstructive sialadenitis caused by ductal laceration. As surgical treatment sialodochoplasty was selected. The case and relevant considerations are discussed.

  17. Chronic diarrhea and pancolitis caused by paracoccidioidomycosis: a case report.

    Science.gov (United States)

    Bravo, Eduar A; Zegarra, Arturo J; Piscoya, Alejandro; Pinto, José L; de Los Rios, Raúl E; Prochazka, Ricardo A; Huerta-Mercado, Jorge L; Mayo, Nancy L; Tagle, Martin

    2010-01-01

    South American blastomycosis is a systemic micosis caused by infection with Paracoccidioides brasiliensis. The most frequently affected sites are the lower lip buccal mucous membrane, palate, tongue, sublingual region, lymph glands, and lungs. However, colonic involvement is not a common expression of Paracoccidioidomycosis. We report a case of chronic diarrhea and pancolitis caused by Paracoccidioidomycosis with fatal outcome.

  18. Chronic Diarrhea and Pancolitis Caused by Paracoccidioidomycosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Eduar A. Bravo

    2010-01-01

    Full Text Available South American blastomycosis is a systemic micosis caused by infection with Paracoccidioides brasiliensis. The most frequently affected sites are the lower lip buccal mucous membrane, palate, tongue, sublingual region, lymph glands, and lungs. However, colonic involvement is not a common expression of Paracoccidioidomycosis. We report a case of chronic diarrhea and pancolitis caused by Paracoccidioidomycosis with fatal outcome.

  19. A Case of Pneumonia Caused by Raoultella planticola.

    Science.gov (United States)

    Cho, Young Jun; Jung, Eun Jung; Seong, Ji Seok; Woo, Yong Moon; Jeong, Beom Jin; Kang, Yeong Mo; Lee, Eun

    2016-01-01

    Raoultella species are gram-negative, non-motile, aerobic bacilli that are primarily considered as environmental bacteria. Raoultella planticola is reportedly a rare cause of human infections. Also, the definite pathological mechanism of Raoultella planticola is currently unknown. We report a case of pneumonia caused by Raoultella planticola.

  20. Bacterial cholangitis causing secondary sclerosing cholangitis: a case report

    NARCIS (Netherlands)

    H.R. van Buuren (Henk); A.C.T.M. Depla (Annekatrien); P.C.J. ter Borg (Pieter)

    2002-01-01

    textabstractBACKGROUND: Although bacterial cholangitis is frequently mentioned as a cause of secondary sclerosing cholangitis, it appears to be extremely rare, with only one documented case ever reported. CASE PRESENTATION: A 48-year-old woman presented with an episode of acute bil

  1. Bacterial cholangitis causing secondary sclerosing cholangitis: A case report

    NARCIS (Netherlands)

    P.C.J. ter Borg (Pieter); H.R. van Buuren (Henk); A.C.T.M. Depla (Annekatrien)

    2002-01-01

    textabstractBackground: Although bacterial cholangitis is frequently mentioned as a cause of secondary sclerosing cholangitis, it appears to be extremely rare, with only one documented case ever reported. Case presentation: A 48-year-old woman presented with an episode of acute biliary pancreatitis

  2. A false case of infection caused by Dicrocoelium dendriticum

    Directory of Open Access Journals (Sweden)

    Cinzia Rossi

    2011-09-01

    Full Text Available We describe a false case of infection caused by Dicrocoelium dendriticum, a cosmopolite trematode that can infect human bile ducts but tends to live in cattle or other grazing mammals. Our aim is to stress the relevance of adequate diagnostic methods and of exact medical history in order to detect any possible clinical case.

  3. Suicidal death caused by electrocution: Two case reports

    Directory of Open Access Journals (Sweden)

    Nikolić Slobodan

    2004-01-01

    Full Text Available Suicides by electrocution are extremly rare in our country. In these cases, specific or characteristic external lesions caused through contact with conductors at the sites of entry and exit of the current, as well as general autopsy findings, and excluding the other possible causes of death, are important to elucidate them. Dilema if death was sucidal, homicidal or accidental in manner, could be solved through good police investigation, and properly explained circumstantial events. Herein, we reported two cases of suicidal deaths, caused by electrocution. In the first case, it was a male, age of 32, who wraped the electrical cord around his rists, and kiled himself by plugging it in. In second case, it was a female, age of 46, abused by her husband, who commited suicide by putting the switched hear-dryer into the water in bathtube.

  4. Cause of death conundrum with methadone use: a case report.

    Science.gov (United States)

    Letsky, Michael C; Zumwalt, Ross E; Seifert, Steven A; Benson, Blaine E

    2011-06-01

    Deaths caused by a methadone intoxication or overdose are becoming more frequent. We report a case involving a patient who had extremely high methadone blood concentrations but whose cause of death may have been unrelated to the drug. A 51-year-old woman was found deceased in bed by her daughter. At the scene were numerous bottles of methadone, with the chronic dosage of 240 mg 3 times a day. There was no history of prior suicide attempts, there were no reports of suicidal ideation having been voiced and there was no suicide note. At autopsy, there were no pills found in the stomach. Microscopic tissue examination revealed lobar pneumonia of the right lower lobe. Postmortem lung cultures grew out Streptococcus pneumoniae. Femoral blood contained methadone, 5.7 mg/L; EDDP, 2.1 mg/L; oxycodone, 0.017 mg/L; doxylamine, 0.022 mg/L; and ethanol, 13.0 mg/dL. The postmortem methadone concentration was consistent with her known dose, plausible pharmacokinetics and conditions of discovery. Various causes of death, such as a methadone-related arrhythmia from QTc prolongation or the contribution of methadone to the development of the pneumonia, cannot be ruled out and may well have caused or contributed to death, but the pneumonia was felt to be a competent cause of death. Ultimately, the most likely cause(s) of death, is a decision left to the individual medical examiner. This case is illustrative of the growing number of similar cases facing forensic pathologists. The cause of death cannot be solely based on drug concentrations and it may not be possible to come to a conclusion as to "the" cause of death and the forensic pathologist must be content with "a" cause of death.

  5. Migrated pharyngeal fish bone causing spondylodiscitis. Case report

    Directory of Open Access Journals (Sweden)

    Aluizio Augusto Arantes Júnior

    2014-03-01

    Full Text Available Ingestion of foreign bodies is a common problem seen at emergency rooms and frequently involves chicken and fish bones. There are few cases of migrated foreign bodies through the retropharynx causing infectious process in the area but no one, despite the proximity, causing spondylodiscitis. Perhaps such condition is attributed to the integrity of the longus colli fascia covering and protecting the cervical spine. We described the first case of spondylodiscitis due to a foreign body (saw-toothed fish bone that penetrated the longus colli fascia and carved into vertebral body C3.

  6. Case Report of Granulicatella adiacens as a Cause of Bacterascites

    Directory of Open Access Journals (Sweden)

    Molly C. Cincotta

    2015-01-01

    Full Text Available Granulicatella adiacens is a Gram-positive coccus, formerly grouped with nutritionally variant Streptococcus, often found as commensal bacteria of the human oral cavity, urogenital tract, and gastrointestinal tract. Prior case reports have demonstrated Granulicatella spp. as a pathogen that can cause bacteremia and infective endocarditis particularly of prosthetic valves and pacemaker leads. Here, we report on a unique case of Granulicatella adiacens bacterascites in a 50-year-old male.

  7. A case report of abdominal distention caused by herpes zoster

    Institute of Scientific and Technical Information of China (English)

    Su-Rong Zhou; Chuan-Yu Liu

    2012-01-01

    Gastrointestinal complications caused by herpes zoster are extremely rare.Here,we described a case of abdominal distention caused by herpes zoster.The patient was a 59-year-old female who suffered from unexplained paroxysmal and a burning pain on the right part of her waist and abdomen,accompanied by abdominal distention.Intestinal pseudo-obstruction was diagnosed by abdominal radiography.Distention of the right abdominal wall was still apparent after one month.In this report,we found that recovery from abdominal distention caused by herpes zoster is difficult and may require surgical intervention.

  8. Assessment of dysphonia due to benign vocal fold lesions by acoustic and aerodynamic indices: a multivariate analysis.

    Science.gov (United States)

    Cantarella, Giovanna; Baracca, Giovanna; Pignataro, Lorenzo; Forti, Stella

    2011-04-01

    The goal was to identify acoustic and aerodynamic indices that allow the discrimination of a benign organic dysphonic voice from a normal voice. Fifty-three patients affected by dysphonia caused by vocal folds benign lesions, and a control group were subjected to maximum phonation time (MPT) measurements, GRB perceptual evaluations and acoustic/aerodynamic tests. All analyzed variables except the airflow variation coefficient were significantly different between the two groups. The unique significant factors in the discrimination between healthy and dysphonic subjects were the aerodynamic indices of MPT and Glottal efficiency index, and the acoustic index Shimmer. These results show that a combination of three parameters can discriminate a voice deviance and highlight the importance of a multidimensional assessment for objective voice evaluation.

  9. Unexpected cause of malignant otitis externa: A rare case report

    Directory of Open Access Journals (Sweden)

    Abdulla Al-otaibi

    2011-01-01

    Full Text Available Malignant otitis externa is an uncommon infection affecting the ear canal and temporal bone. The most common causative organism is Pseudomonas aeruginosa. In this article, we report a malignant otitis externa caused by actinomycosis, a case never been reported before in the literature.

  10. A case of fungal arthritis caused by Hansenula anomala.

    Science.gov (United States)

    Choi, Sung-Wook; Lee, Tong-Joo; Kim, Myung-Ku; Lee, Moon; Jung, Jae-Ho

    2010-03-01

    Hansenula anomala (H. anomaly) is part of the normal flora in the alimentary tract and throat. It has been reported to be an organism causing opportunistic infections in immunocompromised patients. However, cases of fungal arthritis caused by H. anomala are rare. We encountered a case of H. anomala arthritis in a 70-year-old man who was treated with an empirical antibiotic treatment and surgery under the impression of septic arthritis. However, the patient did not improve after antibiotic therapy and surgery. Consequently, knee joint aspiration was performed again, which identified fungal arthritis caused by H. anomala. It was treated successfully with amphotericin B and fluconazole. When treating arthritis patients with diabetes, it is important to consider the possibility of septic arthritis by H. anomala and provide the appropriate treatment.

  11. Ileus caused by cholesterol crystal embolization: A case report.

    Science.gov (United States)

    Azuma, Shunjiro; Ikenouchi, Maiko; Akamatsu, Takuji; Seta, Takeshi; Urai, Shunji; Uenoyama, Yoshito; Yamashita, Yukitaka

    2016-03-28

    Cholesterol crystal embolization (CCE) is a rare systemic embolism caused by formation of cholesterol crystals from atherosclerotic plaques. CCE usually occurs during vascular manipulation, such as vascular surgery or endovascular catheter manipulation, or due to anticoagulation or thrombolytic therapy. We report a rare case of intestinal obstruction caused by spontaneous CCE. An 81-year-old man with a history of hypertension was admitted for complaints of abdominal pain, bloating, and anorexia persisting for 4 mo. An abdominal computed tomography revealed intestinal ileus. His symptoms were immediately relieved by an ileus tube insertion, and he was discharged 6 d later. However, these symptoms immediately reappeared and persisted, and partial resection of the small intestine was performed. A histopathological examination indicated that small intestine obstruction was caused by CCE. At the 12-mo follow-up, the patient showed no evidence of CCE recurrence. Thus, in cases of intestinal obstruction, CCE should also be considered.

  12. Leg Weakness Caused by Bilateral Piriformis Syndrome: A Case Report.

    Science.gov (United States)

    Moon, Hee Bong; Nam, Ki Yeun; Kwon, Bum Sun; Park, Jin Woo; Ryu, Gi Hyeong; Lee, Ho Jun; Kim, Chang Jae

    2015-12-01

    Piriformis syndrome (PS) is an uncommon neuromuscular disorder caused by the piriformis muscle (PM) compressing the sciatic nerve (SN). The main symptom of PS is sciatica, which worsens with certain triggering conditions. Because the pathophysiology is poorly understood, there are no definite diagnostic and therapeutic choices for PS. This case report presents a young woman who mainly complained of bilateral leg weakness. Electromyography revealed bilateral sciatic neuropathy and magnetic resonance imaging confirmed structural lesions causing entrapment of the bilateral SNs. After a laborious diagnosis of bilateral PS, she underwent PM releasing surgery. Few PS cases present with bilateral symptoms and leg weakness. Therefore, in such cases, a high level of suspicion is necessary for accurate and prompt diagnosis and treatment.

  13. Usefulness of acoustic studies on the differential diagnostics of organic and functional dysphonia.

    Science.gov (United States)

    Pruszewicz, A; Obrebowski, A; Swidziński, P; Demeńko, G; Wika, T; Wojciechowska, A

    1991-01-01

    Phoniatric and acoustic examinations were carried out in a group of 30 patients with dysphonia, including 15 with organic type and 15 with functional type. A complex phoniatric assessment offered the possibility to differentiate between these two groups of pathological voices. This was achieved also on the basis of acoustic analysis of the voice by extracting characteristics such as: formant frequency, Fo and its range, percentage of noise in the analysed verbal text, mean and maximum values of jitter. The possibility of differential diagnosis of these two different types of dysphonia in acoustic studies was confirmed by clinical examinations. The acoustic studies presented can be regarded as a new approach to a fast and sufficiently precise method in the screening diagnostics of dysphonia conditioned by growth of the vocal fold mass.

  14. Abnormal striatal dopaminergic neurotransmission during rest and task production in spasmodic dysphonia.

    Science.gov (United States)

    Simonyan, Kristina; Berman, Brian D; Herscovitch, Peter; Hallett, Mark

    2013-09-11

    Spasmodic dysphonia is a primary focal dystonia characterized by involuntary spasms in the laryngeal muscles during speech production. The pathophysiology of spasmodic dysphonia is thought to involve structural and functional abnormalities in the basal ganglia-thalamo-cortical circuitry; however, neurochemical correlates underpinning these abnormalities as well as their relations to spasmodic dysphonia symptoms remain unknown. We used positron emission tomography with the radioligand [(11)C]raclopride (RAC) to study striatal dopaminergic neurotransmission at the resting state and during production of symptomatic sentences and asymptomatic finger tapping in spasmodic dysphonia patients. We found that patients, compared to healthy controls, had bilaterally decreased RAC binding potential (BP) to striatal dopamine D2/D3 receptors on average by 29.2%, which was associated with decreased RAC displacement (RAC ΔBP) in the left striatum during symptomatic speaking (group average difference 10.2%), but increased RAC ΔBP in the bilateral striatum during asymptomatic tapping (group average difference 10.1%). Patients with more severe voice symptoms and subclinically longer reaction time to initiate the tapping sequence had greater RAC ΔBP measures, while longer duration of spasmodic dysphonia was associated with a decrease in task-induced RAC ΔBP. Decreased dopaminergic transmission during symptomatic speech production may represent a disorder-specific pathophysiological trait involved in symptom generation, whereas increased dopaminergic function during unaffected task performance may be explained by a compensatory adaptation of the nigrostriatal dopaminergic system possibly due to decreased striatal D2/D3 receptor availability. These changes can be linked to the clinical and subclinical features of spasmodic dysphonia and may represent the neurochemical basis of basal ganglia alterations in this disorder.

  15. Case report: Infective endocarditis caused by Brevundimonas vesicularis

    Directory of Open Access Journals (Sweden)

    Chen Tun-Chieh

    2006-12-01

    Full Text Available Abstract Background There are few reports in the literature of invasive infection caused by Brevundimonas vesicularis in patients without immunosuppression or other predisposing factors. The choice of antimicrobial therapy for bacteremia caused by the pathogen requires more case experience to be determined. Case presentation The case of a 40-year-old previously healthy man with subacute endocarditis proposed to be contributed from an occult dental abscess is described. The infection was found to be caused by B. vesicularis on blood culture results. The patient recovered without sequelae after treatment with ceftriaxone followed by subsequent ciprofloxacin therapy owing to an allergic reaction to ceftriaxone and treatment failure with ampicillin/sulbactam. Conclusion To our knowledge, this is the first report of B. vesicularis as a cause of infective endocarditis. According to an overview of the literature and our experience, we suggest that third-generation cephalosporins, piperacillin/tazobactam, and ciprofloxacin are effective in treating invasive B. vesicularis infections, while the efficacy of ampicillin-sulbactam needs further evaluation.

  16. Neurocysticercosis causing sudden death:a case report

    Institute of Scientific and Technical Information of China (English)

    Martinez Fernanda; Seley Celeste; Marchesi Liliana; Fontanarossa Victoria; Rodriguez Dominique; Troncoso Alcides

    2010-01-01

    We report an acute case of a native man from Bolivia suffered from cephalalgia which rapidly worsened and ended in his sudden and unexpected death. Magnetic resonance imaging (MRI) of the brain was obtained. Features demonstrated on brainMRI scan were consistent with a diagnosis of neurocysticercosis (NCC). An autopsy showed the presence of intraventricular Taenia solium (T. solium) cysts which caused blockage of cerebrospinal fluid and secondary hydrocephalus. Due to the increasing travel movements of people neurocysticercosis must be considered as a cause of unexplained sudden death.

  17. Retained drains causing a bronchoperitoneal fistula: a case report

    Directory of Open Access Journals (Sweden)

    Kieninger Alicia A

    2011-05-01

    Full Text Available Abstract Introduction Bronchoperitoneal fistulas are extremely rare. We present a case where retained surgical drains from a previous surgery resulted in erosion and fistula formation. This condition required an extensive surgical procedure and advanced ventilator techniques. Case presentation A 24-year-old African-American man presented to our Emergency Department with a one-week history of fever, dyspnea, cough, and abdominal pain. A computed tomography scan of his chest and abdomen revealed bilateral lower lobe pneumonia and two retained Jackson-Pratt drains in the right upper quadrant. He was taken to the operating room for drain removal, a right hemicolectomy, debridement of a duodenal injury, a Roux-en-y duodenojejunostomy, and an end ileostomy. He subsequently became increasing hypoxemic in the intensive care unit and a bronchoperitoneal fistula was diagnosed. He required high-frequency oscillatory ventilation followed by lung isolation, and was successfully resuscitated using these techniques. Conclusion To the best of our knowledge, this is the first known case report of a bronchoperitoneal fistula caused by retained surgical drains. This is also the first known report that details successful management of this condition with advanced ventilatory techniques. This case highlights the importance of follow-up for trauma patients since retained surgical drains have the potential to cause life-threatening complications. When faced with this condition, clinicians should be aware of advanced ventilatory methods that can be employed in the intensive care unit. In this case, these techniques proved to be life-saving.

  18. [THREE CASES OF DRUG-INDUCED PNEUMONIA CAUSED BY MESALAZINE].

    Science.gov (United States)

    Akiyama, Norimichi; Yokomura, Koshi; Nozue, Tsuyoshi; Abe, Takefumi; Matsui, Takashi; Suda, Takafumi

    2015-12-01

    We report three cases of drug-induced pneumonia caused by mesalazine. They were all diagnosed as ulcerative colitis and treated with mesalazine orally. Our three cases and literature review revealed that mesalazine-induced pneumonia resemble like eosinophilic pneumonia or organizing pneumonia and that have good prognosis with drug cessation or administration of corticosteroid. The patient of ulcerative colitis is increasing every year and it is anticipated that the patient with mesalazine-induced pneumonia may also increase. In the treatment of ulcerative colitis with mesalazine, we should pay attention with patient's cough or fever for early detection of drug-induced pneumonia.

  19. Methemoglobinemia Caused by Topical Teething Preparation: A Case Report

    Directory of Open Access Journals (Sweden)

    Ran D. Balicer

    2004-01-01

    Full Text Available Methemoglobinemia (MetHb remains an uncommon, but potentially fatal disorder. Benzocaine (ethyl aminobenzoate, a topical anesthetic, has been reported to cause acquired MetHb when used during endoscopic or other ambulatory procedures. Reports of severe MetHb following benzocaine-containing preparations in the community, however, are very rare. We discuss this entity by describing an unusual case of severe MetHb in a 5-year-old child, caused by unattended self-use of a benzocaine-containing, pain-relief gel for teething. This case story illustrates the potential lethal risk of over-the-counter topical anesthetics for pediatric use. We review the risks of this potentially deadly disorder and the associated diagnostic challenges. Physicians not familiar with this rare complication may face diagnostic dilemmas, as its presentation is often nonspecific and rapid treatment is essential to prevent life-threatening complications.

  20. A case of lipoma of parietal peritoneum causing abdominal pain.

    Science.gov (United States)

    Bang, Chang Seok; Kim, Yeon Soo; Baik, Gwang Ho; Han, Sang Hak

    2014-06-01

    Lipomas are common benign tumors of mature adipose tissue, enclosed by thin fibrous capsules. They can occur on any part of the body; however, peritoneal lipoma is extremely rare. We encountered a case of a 75-year-old man presenting with intermittent abdominal pain, who had undergone right hemicolectomy due to colon cancer. Abdominal computerized tomography showed a well-defined heterogenous fatty mass measuring 4.5 × 3.5 cm in size, suggesting fat necrosis located in the abdominal wall. Laparotomy showed a very large soft mass of peritoneum. Pathologically, the tumor was diagnosed as lipoma containing fat necrosis located in parietal peritoneum not fixed to any organs, but with small bowel adhesion. Due to its rare etiologic origin and obscure cause of development, we report on a case of lipoma of parietal peritoneum causing abdominal pain.

  1. Perianal abscess caused by Actinomyces: report of a case.

    Science.gov (United States)

    Magdeburg, R; Grobholz, R; Dornschneider, G; Post, S; Bussen, D

    2008-12-01

    Most anal abscesses are caused by anal fistula and invasion of the surrounding tissues by a mixed colonic flora. The treatment comprises excision of the abscess and. if appropriate, fistulectomy. Primary anorectal actinomycosis and perianal actinomycosis are very rare and are caused by Actinomyces, which is a ubiquitous microaerophilic bacterium. Here we report a case of perianal actinomycosis. The patient had a short history of painless perineal induration without fever or leucocytosis with normal routine blood tests. After excision sulphur granules drained from the cavity and the pathological investigations were indicative of perianal actinomycosis. Appropriate surgery and antibiotic treatment healed the perianal infection. After elimination of other diagnoses, e.g. Crohn's disease, tuberculosis and malignant growths, this rare case of perianal actinomycosis should be kept in mind in the differential diagnosis of a painless perianal mass.

  2. Lipoma causing Guyon's canal syndrome: a case report and review

    Directory of Open Access Journals (Sweden)

    Narayanathu Chellappantilla Sreekumar

    2014-12-01

    Full Text Available Compression of the ulnar nerve in Guyon's canal leads to Guyon's canal syndrome. Lipoma is a rare cause of such compressions with only 12 cases reported previously. We report a 55-year-old man who presented with swelling in the left hand with decreased sensation in the ring and little fingers. Magnetic resonance imaging revealed high signals in T1-weighted and T2-weighted images with suppression of the short T1 inversion recovery signal, suggestive of lipoma. On exploration a well-encapsulated, dumbbell-shaped, fatty tumor was seen in the hypothenar space and Guyon's canal. The tumor was enucleated in toto. At 6-month follow-up, the patient had fully regained sensation. A review of the literature is presented for similar cases where a lipoma was the cause of Guyon's canal syndrome.

  3. Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients.

    Science.gov (United States)

    van Esch, Babette F; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

    2017-02-01

    Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.

  4. Liver abscess caused by Ascaris lumbricoides: case report

    OpenAIRE

    Pinilla,Análida Elizabeth; Myriam Consuelo LÓPEZ; Ricaurte, Orlando; CASTILLO,Blanca; Murcia, Martha Isabel; Nicholls, Rubén Santiago; Duque, Sofía; OROZCO Luis Carlos

    2001-01-01

    A case is reported of a woman who lived in a rural area with a chronic illness that consisted of weight loss and abdominal pain in the epigastrium and upper right quadrant. The initial diagnosis was a mass in the liver, which was later, demonstrated, both by direct and histological examination, to be an abscess caused by Ascaris lumbricoides. Eggs of Ascaris lumbricoides and abundant Charcot-Leyden Crystals were found.

  5. Perforated duodenal diverticulum caused by Bezoar: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Jung; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Dept. of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2013-11-15

    Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

  6. A case of retropharyngeal abscess with spondylitis causing tetraplegia

    Directory of Open Access Journals (Sweden)

    Takeshi Kusunoki

    2012-04-01

    Full Text Available We report a case of retropharyngeal abscess with spondylitis causing tetraplegia. At a previous hospital, administration of antibiotics improved the inflammation findings. However, magnetic resonace imaging showed a remaining retropharyngeal abscess. This patient showed a disturbance of consciousness under this therapy. Therefore, he was admitted to our hospital and underwent a drainage operation. At 1 day after this operation, he recovered from the disturbance of consciousness.

  7. Altered sensation caused by peri-implantitis: a case report.

    Science.gov (United States)

    Kim, Jong-Eun; Shim, Ji-Suk; Huh, Jung-Bo; Rim, Jae-Suk; Lee, Jeong-Yol; Shin, Sang-Wan

    2013-07-01

    Frequently reported is a case wherein a lesion caused by periodontitis or periapical lesion in a natural tooth enlarged, invaded the inferior alveolar nerve canal, and induced paresthesia. Cases wherein paresthesia occurred because of peri-implantitis have been rarely reported. The patient in this case report had experienced transient paresthesia after implant placement and recovered normal sensation 3 months later. Thirteen years later, this patient visited the authors' hospital with paresthesia in the same region because the peri-implantitis progressed to the apex of the implant. One week after removal of the implant, sense recovery and pain relief started, and 15 days after removal, the paresthesia and pain completely disappeared. For patients who experience transient paresthesia and recovery owing to nerve damage caused by the placement of an implant in the mandibular molar or premolar area, or in patients in whom the implant is close to the inferior alveolar nerve canal or the mental nerve, the spread of inflammation caused by peri-implantitis can induce paresthesia.

  8. Necrotizing fasciitis caused by perforated appendicitis: a case report.

    Science.gov (United States)

    Hua, Jie; Yao, Le; He, Zhi-Gang; Xu, Bin; Song, Zhen-Shun

    2015-01-01

    Acute appendicitis is one of the most common causes of acute abdominal pain. Accurate diagnosis is often hindered due to various presentations that differ from the typical signs of appendicitis, especially the position of the appendix. A delay in diagnosis or treatment may result in increased risks of complications, such as perforation, which is associated with increased morbidity and mortality rates. Necrotizing fasciitis caused by perforated appendicitis is extremely rare. We herein report a case of 50-year-old man presenting with an appendiceal abscess in local hospital. After ten days of conservative treatment with intravenous antibiotics, the patient complained about pain and swelling of the right lower limb and computed tomography (CT) demonstrated a perforated appendix and gas and fluid collection extending from his retroperitoneal cavity to the subcutaneous layer of his right loin and right lower limb. He was transferred to our hospital and was diagnosed with necrotizing fasciitis caused by perforated appendicitis. Emergency surgery including surgical debridement and appendectomy was performed. However, the patient died of severe sepsis and multiple organ failure two days after the operation. This case represents an unusual complication of a common disease and we should bear in mind that retroperitoneal inflammation and/or abscesses may cause necrotizing fasciitis through lumbar triangles.

  9. [Case of hyperkalemia possibly caused by gabexate mesilate].

    Science.gov (United States)

    Doi, Tomoki; Kurahashi, Kiyoyasu; Goto, Takahisa

    2010-02-01

    We report a case of hyperkalemia in a recipient of living-related liver transplantation. The patient received a continuous infusion of gabexate mesilate at 60 mg x hr(-1) starting about 1 hr after the induction of anesthesia. The serum potassium concentration (K+) was increased from 4.53 mEq x l-(1) to 5.08 mEq x l(-1) within about 1 hr. Thereafter, a massive blood loss caused by an accidental damage of the portal vein necessitated rapid fluid therapy to maintain blood pressure. We observed an abnormal ECG recording including a wide QRS complex and a high T wave when about 30 units of leukocytes-reduced red cell concentrates had been transfused. Blood gas analysis showed high K+ (7.52 mEq x l(-1)) and metabolic acidosis (pH 7.167, base excess-12.5 mmol x l(-1)). We successfully controlled K+ with combination of therapies before causing any cardiac events to the patient. Gabexate mesilate is one possible cause of hyperkalemia in the present case because an increase in K+ was observed before transfusion, and transfusion might have augmented the effect. Gabexate mesilate is one of the protease inhibitors. Naphamostat mesilate, another protease inhibitor, is known to cause hyperkalemia by limiting potassium excretion from the kidney through an inhibition of Na/K-ATPase at the cortical collecting ducts. Although the mechanism by which gabexate mesilate causes hyperkalemia is unclear, it would be of benefit to use this drug cautiously, as it may cause hyperkalemia.

  10. Parkinsonism caused by adverse drug reactions: a case series

    Directory of Open Access Journals (Sweden)

    Agaba Emmanuel I

    2011-03-01

    Full Text Available Abstract Introduction Parkinsonism puts a high direct cost burden on both patient and caregiver. Several reports of drug-induced parkinsonism have been published, but to the best of our knowledge, there has not been any report of quinine or halothane inducing parkinsonism. Case presentation We describe two cases of parkinsonism possibly caused by adverse drug reaction to quinine in a 29-year-old black Nigerian woman and to halothane in a 36-year-old black Hausa (Nigerian man who received it as general anaesthesia for appendicectomy in our teaching hospital. Conclusion These are two unusual cases of parkinsonism caused by adverse drug reactions to high-dose quinine and to halothane as general anaesthesia. We consider that these two cases are important in bringing this potential side-effect to the attention of both pharmacologists and primary care physicians as these are two of the most commonly used medications in our clinics. We conclude that parkinsonism should be included among the adverse drug reactions to high-dose quinine and halothane general anaesthetic.

  11. Unusual cause of generalized osteolytic vertebral lesions: a case report

    Directory of Open Access Journals (Sweden)

    Nanda Sudip

    2007-06-01

    Full Text Available Abstract Background Vertebral sarcoidosis is an extremely rare form of osseous sarcoidosis. Although osseous sarcoidosis is almost always an incidental finding of sarcoidosis elsewhere in the body, vertebrae may be the primary disease site. Involvement of vertebrae is usually localized and sclerotic or lytic. Case presentation We describe a case of extensive asymptomatic vertebral involvement by sarcoid with osteolytic lesions. Making the diagnosis requires biopsy and ruling out other commoner causes of osteolytic vertebral lesions. Conclusion We report this case in the hope of expanding the knowledge of osseous sarcoidosis. Our patient was unique in that all involvement was axial with sparing of the peripheral skeleton, near absence of any other organ involvement, diffuse involvement of the whole spine and osteolytic bone lesions.

  12. A PULMONARY INFECTION CAUSED BY MYCOBACTERIUM PEREGRINUM– A CASE REPORT.

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    Tatina T. Todorova

    2015-12-01

    Full Text Available Mycobacterium peregrinum is a member of the group of rapidly growing Nontuberculous Mycobacteria (NTM. It can be found in high frequency in natural and laboratory environments and is considered to be uncommonrare pathogen for both immunocompetent and immunosuppressed individuals. Currently, pulmonary infections caused by Mycobacterium peregrinum are unusual and diagnosed only in limited number of cases. Here, we present a clinical case of elderly man (72 years with 1 month history of non-specific respiratory symptomatic. The patient was without underlying immunosuppressive condition or lung disease. Chest X-ray demonstrated persistent pleural effusion, opacities and cavitations in the right lobe. One of the sputum culturesgrewa rapidly growing mycobacterium and the isolated strain was found to be Mycobacterium peregrinumas identified by molecular genetic detection (PCR and DNA strip technology. To our knowledge, this is the third case in the world to report Mycobacterium peregrinumas a possible causative agent of pulmonary infection.

  13. Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task.

    Science.gov (United States)

    Sapienza, Christine M.; Walton, Suzanne; Murry, Thomas

    1999-01-01

    Acoustic phonatory events were identified in 14 women diagnosed with adductor spasmodic dysphonia (ADSD), a focal laryngeal dystonia that disturbs phonatory function, and compared with those of 14 age-matched women with no vocal dysfunction. Findings indicated ADSD subjects produced more aberrant acoustic events than controls during tasks of…

  14. Functional Dysphonia during Mental Imagery: Testing the Trait Theory of Voice Disorders

    Science.gov (United States)

    van Mersbergen, Miriam; Patrick, Christopher; Glaze, Leslie

    2008-01-01

    Purpose: Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. Method: Twelve participants with FD, 19 participants…

  15. Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

    Science.gov (United States)

    Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

    2009-01-01

    The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

  16. 功能性发声障碍的临床特征及预后分析%Clinical Characteristics and Prognosis of Functional Dysphonia

    Institute of Scientific and Technical Information of China (English)

    崔卫新; 徐文; 程丽宇

    2016-01-01

    目的:探讨功能性发声障碍的诱因、临床特征及预后。方法回顾性分析104例功能性发声障碍患者的临床资料和频闪喉镜检查结果,并对所有患者进行共鸣发声疗法和重音治疗法发声训练,治疗前后行VHI评估和GRBAS评分,分析疗效。结果104例中,无明显诱因34例(32.69%),诱发因素分别为上呼吸道感染29例(27.88%),情绪紧张22例(21.15%),用声过度10例(9.62%),其他因素9例(8.65%)。频闪喉镜检查见粘膜波正常43例(41.35%),黏膜波改变53例(50.96%,其中41例未引出黏膜波,12例黏膜波减弱),室带完全超越声带3例,不配合发声未引出黏膜波5例;发声时声门闭合不全65例(62.50%),声门上代偿性内收30例(28.85%),喉部挤压9例(8.65%)。随访67例,恢复正常53例(79.10%),其G评分、V H I评分均降为0分;6例发声明显好转但未完全恢复正常,G评分和VHI评分较治疗前降低;8例治疗后G评分和VHI评分无明显变化。结论功能性发声障碍诱因复杂,并非单一精神心理因素所致;喉镜检查多可见声带振动异常、声门闭合不良及声门上代偿;治疗可采取心理疏导、发声矫正和中医针灸相结合,多数患者预后较好。%Objective To investigate the cause ,clinical characteristics and prognosis of functional dysphonia . Methods The clinical data and the laryngostroboscopic examination of 104 patients with functional dysphonia were retrospectively analyzed .All the patients underwent the resonant therapy and the accent therapy ,and finished the voice handicap index (VHI) and GRBAS score before and after the treatment .Results Among the 104 patients ,34 cases (32 .69% ) had no apparent cause ,29 cases (27 .88% ) caused by upper respiratory tract infection ,22 cases (21 .15% ) by emotional tension ,10 cases (9 .62% ) by excessive

  17. Case of endogenous endophthalmitis caused by Streptococcus equisimilis

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    Shinsuke Suemori

    2010-08-01

    Full Text Available Shinsuke Suemori1, Akira Sawada1, Shinya Komori1, Kiyofumi Mochizuki1, Kiyofumi Ohkusu2, Hirofumi Takemura31Department of Ophthalmology, 2Department of Microbiology, 3Department of General and Cardiothoracic Surgery Gifu University Graduate School of Medicine, Gifu, JapanAbstract: We report a rare case of endogenous endophthalmitis caused by Streptococcus equisimilis. A 74-year-old woman with endocarditis developed endogenous endophthalmitis. The patient underwent emergency mitral valvuloplasty, and intravitreal and subconjunctival injections of vancomycin and meropenem. After the surgery, she was treated with topical antibiotics, ointment, intravenous gentamicin and intravenous penicillin G potassium. The causative organism was identified as S. equisimilis. S. equisimilis should be considered as a pathogen that can cause severe endogenous endophthalmitis.Keywords: endogenous endophthalmitis, group G Streptococcus, endocarditis, Streptococcus equisimilis

  18. [Allergy caused by sodium fluoride glycerin: a case report].

    Science.gov (United States)

    Ma, Jihong

    2012-04-01

    In recent years, though more and more ulcerations of oral mucosa caused by allergy to drug occurred clinically, allergy to sodium fluoride glycerin is extremely rare. A case of allergy to sodium fluoride glycerin occurred in Qianfoshan Campus Hospital of Shandong University. After treatment by sodium fluoride glycerin, there was mucosal edema, a large number of red miliary granules in buccal and palatal mucosa. After 3 hours, there were swallowing difficulties, but no breathing difficulties. Next day large ulcers of oral mucosa developed. The patient was cured 7 days after treatment. Fluoride-sensitive test result was positive.

  19. Urogenital Myiasis Caused by Psychoda Albipennis: A Case Report

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    Ersagun Karagüzel

    2015-12-01

    Full Text Available Urogenital myiasis is one of the parasitic diseases of the urinary system. We report a case of urogenital myiasis caused by Psychoda albipennis in a 64-year-old male patient. The patient who was admitted to our clinic with the complaints of dysuria and urinary discharge of larvae lasted for a month, brought along the larvae which were examined in the microbiology laboratory. The examination of larvae revealed that they were the fourth-stage larvae of the moth fly Psychoda albipennis. The patient, whose physical examination and laboratory investigations were normal, was treated with oral hydration, antiseptic and antibiotics.

  20. Aseptic Meningitis Caused by Lassa Virus: Case Series Report.

    Science.gov (United States)

    Okokhere, Peter O; Bankole, Idowu A; Iruolagbe, Christopher O; Muoebonam, Benard E; Okonofua, Martha O; Dawodu, Simeon O; Akpede, George O

    2016-01-01

    The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever. The 4 patients recovered fully following intravenous ribavirin treatment and suffered no neurologic complications.

  1. Case of megaloblastic anemia caused by intestinal taeniasis.

    Science.gov (United States)

    Vuylsteke, Peter; Bertrand, Celine; Verhoef, Gregor E G; Vandenberghe, Peter

    2004-07-01

    A 61-year-old eutrophic male was diagnosed with vitamin B12 deficiency and megaloblastic anemia. A modified Schilling test suggested intestinal malabsorption unrelated to intrinsic factor deficiency. Subsequent colonoscopy revealed the presence of a Taenia tapeworm. The anemia resolved within days under therapy with niclosamide and temporary vitamin B12 supplements. The present case suggests that, in addition to other well-known parasitic agents, e.g., Diphyllobothrium latum and Giardia lamblia, Taenia infestation can also be a cause of intestinal vitamin B12 malabsorption.

  2. [Espondilodiskitis caused by Kingella kingae in children: a case report].

    Science.gov (United States)

    Budnik, Isolda; Porte, Lorena; Arce, José D; Vial, Sergio; Zamorano, Juanita

    2011-08-01

    During the last years, spondilodiskitis due to Kingella kingae has been a new target of interest, since it is the second agent that causes non tuberculous espondilodiskitis in children, after Staphylococcus aureus. Its clinical presentation is very inespecific, sometimes with fever, abdominal or lumbar disconfort, nocturnal pain, altered walking and sedestation. Images, culture methods and PCR (polymerase chain reaction) can be helpful for diagnosis, although in an important percent of the cases, etiology cannot be determined. Although there are no established guidelines for treatment, before the suspicion, empiric antibiotic treatment should be started for good prognosis. We describe a case of a 3 year old boy, who had this disease and then a review about spondilodiskitis in childhood and microbiological aspects of Kingella kingae.

  3. Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report

    OpenAIRE

    Gülçin Bayramoğlu; Faruk Aydın; Gülay Karagüzel; Mustafa İmamoğlu; Ayşenur Ökten

    2014-01-01

    Vulvovaginitis caused by Shigella species (Shigella spp.) has rarely been reported. This paper describes two cases of prepubertal vulvovaginitis, presenting with a bloody and purulent vaginal discharge, separately caused by ampicillin-resistant Shigella flexneri and trimethoprim-sulfomethoxazoleresistant Shigella sonnei. Our conclusions are that Shigella spp. is the potential cause of vulvovaginitis in prepubertal girls in developing countries where these pathogens are endemic, and identifica...

  4. Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report

    OpenAIRE

    Bayramoğlu, Gülçin; Aydın, Faruk; Karagüzel, Gülay; İMAMOĞLU, Mustafa; Ökten, Ayşenur

    2012-01-01

    Vulvovaginitis caused by Shigella species (Shigella spp.) has rarely been reported. This paper describes two cases of prepubertal vulvovaginitis, presenting with a bloody and purulent vaginal discharge, separately caused by ampicillin-resistant Shigella flexneri and trimethoprim-sulfomethoxazoleresistant Shigella sonnei. Our conclusions are that Shigella spp. is the potential cause of vulvovaginitis in prepubertal girls in developing countries where these pathogens are endemic, and identifica...

  5. Reliability of speaking and maximum voice range measures in screening for dysphonia.

    Science.gov (United States)

    Ma, Estella; Robertson, Jennie; Radford, Claire; Vagne, Sarah; El-Halabi, Ruba; Yiu, Edwin

    2007-07-01

    Speech range profile (SRP) is a graphical display of frequency-intensity occurring interactions during functional speech activity. Few studies have suggested the potential clinical applications of SRP. However, these studies are limited to qualitative case comparisons and vocally healthy participants. The present study aimed to examine the effects of voice disorders on speaking and maximum voice ranges in a group of vocally untrained women. It also aimed to examine whether voice limit measures derived from SRP were as sensitive as those derived from voice range profile (VRP) in distinguishing dysphonic from healthy voices. Ninety dysphonic women with laryngeal pathologies and 35 women with normal voices, who served as controls, participated in this study. Each subject recorded a VRP for her physiological vocal limits. In addition, each subject read aloud the "North Wind and the Sun" passage to record SRP. All the recordings were captured and analyzed by Soundswell's computerized real-time phonetogram Phog 1.0 (Hitech Development AB, Täby, Sweden). The SRPs and the VRPs were compared between the two groups of subjects. Univariate analysis results demonstrated that individual SRP measures were less sensitive than the corresponding VRP measures in discriminating dysphonic from normal voices. However, stepwise logistic regression analyses revealed that the combination of only two SRP measures was almost as effective as a combination of three VRP measures in predicting the presence of dysphonia (overall prediction accuracy: 93.6% for SRP vs 96.0% for VRP). These results suggest that in a busy clinic where quick voice screening results are desirable, SRP can be an acceptable alternate procedure to VRP.

  6. Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia.

    Science.gov (United States)

    Kirke, Diana N; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

    2016-02-03

    Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions.

  7. Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report

    Directory of Open Access Journals (Sweden)

    Gülçin Bayramoğlu

    2012-03-01

    Full Text Available Vulvovaginitis caused by Shigella species (Shigella spp. has rarely been reported. This paper describes two cases of prepubertal vulvovaginitis, presenting with a bloody and purulent vaginal discharge, separately caused by ampicillin-resistant Shigella flexneri and trimethoprim-sulfomethoxazole-resistant Shigella sonnei. Our conclusions are that Shigella spp. is the potential cause of vulvovaginitis in prepubertal girls in developing countries where these pathogens are endemic, and identification of the bacteria and making antibiotic susceptibility testing in these cases should not be overlooked.

  8. Spontaneous retropharynegeal hematoma: A case report and literature overview

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Ji Hwa [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-02-15

    A spontaneous retropharyngeal hematoma is a rare condition with a difficult diagnostic. This disease may rapidly progress to an airway obstruction. The author reports about a case of a 56-year-old man with an acute onset of sore throat, dysphonia and dyspnea. A retropharyngeal high attenuated soft tissue density could be seen on the neck CT. A rapid improvement of the retropharyngeal abnormality was seen on the 3 days follow-up MR imaging. Signal changes caused by blood products which were visible on the MRI images suggested the diagnosis of retropharyngeal hematoma. The patient was conservatively managed.

  9. A Case of Apparent Contact Dermatitis Caused by Toxocara Infection

    Directory of Open Access Journals (Sweden)

    Rosanna Qualizza

    2014-01-01

    Full Text Available Infection from Toxocara species may give rise to a large array of clinical symptoms, including apparent manifestations of allergy such as asthma, urticaria/angioedema, and dermatitis. We report a case, thus far not described, of contact dermatitis attributed to nickel allergy but caused by Toxocara infection. The patient was a 53-year-old woman presenting from 10 years a dermatitis affecting head, neck, and thorax. Patch tests initially performed gave a positive result to nickel, but avoidance of contact with nickel did not result in recovery. The patient referred to our Allergy Service in 2010 because of dermatitis to feet. Patch testing confirmed the positive result for nickel, but expanding the investigation a positive result for IgG antibodies to Toxocara was detected by Western blotting and ELISA. Treatment with mebendazole achieved immediate efficacy on feet dermatitis. Then, two courses of treatment with albendazole resulted in complete regression of dermatitis accompanied by development of negative ELISA and Western blotting for Toxocara antibodies. This report adds another misleading presentation of Toxocara infection as apparent contact dermatitis caused by nickel and suggests bearing in mind, in cases of contact dermatitis not responding to avoidance of the responsible hapten and to medical treatment, the possible causative role of Toxocara.

  10. Otomastoiditis caused by Sphingomonas paucimobilis: case report and literature review

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    Gabriel Nuncio Benevides

    2014-09-01

    Full Text Available Sphingomonas paucimobilis is an aerobic Gram-negative bacillus that, although rare in humans, most commonly infects immunocompromised and hospitalized patients. Among the 59 pediatric cases of S. paucimobilis infection reported in the literature, the most common diagnosis involves isolated bacteremia. These cases are related to sporadic or epidemic infections. Death related to this infection occurred in only one case. The authors report a case of an 11-year-old boy with the diagnosis of Sphingomonas paucimobilis otomastoiditis and a thorough review of the literature on this infection in pediatrics. The patient presented a 20-day history of fever, otalgia, otorrhea, and progressive retroauricular swelling with protrusion of the left ear; despite 15 days of amoxicillin regimen. His past medical history included chronic bilateral otitis media, but no cause of immunosuppression was found. A brain computed tomography scan showed left otomastoiditisassociated with a large circumscribed fluid collection with deep involvement of the soft tissues of the temporal region, including the subperiosteal space. Blood tests showed neutrophilia and elevated C-reactive protein. Surgical manipulation of the cited collection drained a large amount of a fetid purulent secretion. Ceftazidime and clindamycin were empirically initiated. The outcome was favorable, with fever defervescence and resolution of the scalp deformation. Culture of the drained secretion was positive for S. paucimobilis. Ciprofloxacin was scheduled for a further 10 days after discharge. The follow-up showed complete recovery. As far as we know, this is the first case of S. paucimobilis otomastoiditis, complicated with subperiosteal abscess in an immunocompetent child. The authors call attention to the increasing number of reports on S. paucimobilis infection over the years, and therefore to the importance of this pathogen, which was previously underestimated.

  11. A Rare Case of Cranial Osteomyelitis Caused by Proteus Vulgaris

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    Hakan Uslu

    2011-03-01

    Full Text Available Osteomyelitis of the calvarial bones can cause serious complications such as brain abscess, due to the close proximity to adjacent brain structures. Development of the purulent secretion in surgery and traumatic scalp injuries must be considered as a possibility of osteomyelitis possibility. Generally gram positive, rarely gram negative bacteria and mix agents, can be isolated in infection. Especially chronic pyogenic osteomyelitis agents can be isolated from chronic infections such as tuberculosis. In cranial osteomyelitis diagnosis, radiological diagnosis has a very important place together with the clinical diagnosis. However, infection can usually show late findings radiologically. In treatment, antibiotic treatment is absolutely essential as well as removal of the infected part of the bone. Due to antibiotic treatment lasting between 6-12 weeks, organizing the antibiotic protocols according to the results of culture-antibiograms, which were provided from purulent secretions, has the most important role in the success of surgical treatment. In Proteus sp. infections, for choice of suitable treatment, determination of the type of bacteria is important. For exact diagnosis, histopathological examination of the bone tissue must be carried out. In this report, a case with cranial osteomyelitis caused by Proteus vulgaris which is a gram negative bacteria causing anaerobic infections and classified in the Enterobacteriaceae family is presented. The patient was treated with surgery and appropriate antibiotics. Early recognition of this condition, planning the best treatment strategy and taking precautions to prevent complications, is mandatory for a better outcome.

  12. A Rare Case of Pneumonia Caused by Shewanella putrefaciens

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    Rajshree Patel

    2012-01-01

    Full Text Available Shewanella putrefaciens is a gram-negative, nonfermentative, oxidase positive, motile bacillus that produces hydrogen sulphide. It is found widely in the nature especially in marine environments. In some very rare cases Shewanella putrefaciens can be a human pathogen. It can produce a wide variety of clinical syndromes including bacteremia as well as skin and soft tissue infections. However, pneumonia due to S. putrefaciens is rare; there are a total of 4 reported cases in the literature. We present a case of 63-year-old male who was presented to emergency room status after cardiac arrest, fell into sea water face down. On the second day of hospitalization, he was diagnosed to have pneumonia based on the clinical, radiological, and laboratory findings. Empirical antibiotic treatment with vancomycin and piperacillin/tazobactam combination was initiated. Gram-stained smear of endotracheal aspirate yielded gram-negative bacteria, and the isolate grown from endotracheal aspirate culture was identified as S. putrefaciens by Biomerieux API 20 NE technique. On review of the literature and according to culture and sensitivity results, therapy in our patient was changed to cefepime. Patient’s pneumonia improved with treatment with cefepime. We believe that our patient developed pneumonia evidently caused by S. putrefaciens, after near drowning in sea water. The pneumonia resolved after treatment with cefepime.

  13. Two cases of chronic radiodermatitis caused by cardiac catheterization

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    Ishikawa, Makiko; Soh, Inketsu; Sueki, Hirohiko; Iijima, Masafumi [Showa Univ., Tokyo (Japan). School of Medicine; Hayashi, Ken; Wakugawa, Motoshi

    1999-12-01

    Coronary angiography (CAG) and percutaneous transluminal coronary angioplasty (PTCA) associated with fluoroscopy and cineradiography deliver higher radiation doses than any other conventional methods and, as a result, expose patients to ionizing radiation. We herein report two cases of radiodermatitis caused by cardiac catheterization whose irradiation dose could be retrospectively calculated. One sixty-year-old female and one sixty eight-year-old female who had suffered from myocardial infarction and angina pectoris, respectively, developed erythematous plaques on the right submammary area and the lesions were initially diagnosed to be fixed drug eruptions. The lesions of submammary area gradually showed the findings of poikiloderma and finally demonstrated ulceration, however, we could not make an accurate diagnosis at that time, due to our lack of knowledge about these radiologic examinations. The cumulative irradiation dose of these cases was calculated to be 58.5 Gy and 45.5 Gy, respectively, and both cases were finally diagnosed to have chronic radiodermatitis as a result of cardiac catheterization. (author)

  14. "King archie, who was quite grouchy" - a vocal dysphonia health education project O rei Sebastião que era muito resmungão

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    Maria Rosário Dias

    2013-02-01

    Full Text Available PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

  15. "King archie, who was quite grouchy" - a vocal dysphonia health education project O rei Sebastião que era muito resmungão

    Directory of Open Access Journals (Sweden)

    Maria Rosário Dias

    2012-01-01

    Full Text Available PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

  16. [An operated case of a meningioma causing acute subdural hematoma].

    Science.gov (United States)

    Chonan, Masashi; Niizuma, Kuniyasu; Koyama, Shinya; Kon, Hiroyuki; Sannohe, Seiya; Kurotaki, Hidekachi; Midorikawa, Hiroshi; Sasaki, Tatsuya; Nishijima, Michiharu

    2013-03-01

    We report a rare case of a meningioma causing acute hematoma. A 67-year-old woman presented with sudden headache. No evidence of trauma was seen. CT demonstrated a subdural hematoma in the convexity of the fronto-temporal lobe. Magnetic resonance imaging showed marked signal heterogeneity in the convexity of the frontal lobe. One week later, the patient underwent hematoma evacuation and tumor resection including the attached dura mater. The histological diagnosis was meningothelial meningioma. The clot was connected directly to the tumor and the origin of the subdural hematoma was identified as the meningioma. Postoperative course was uneventful, and the headache improved. Meningiomas have a relatively benign course but rarely present with hemorrhage. Surgical exploration is the effective and recommended treatment.

  17. Acute Myocardial Infarction Caused by Filgrastim: A Case Report

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    Cemil Bilir

    2012-01-01

    Full Text Available Common uses of the granulocyte-colony stimulating factors in the clinical practice raise the concern about side effects of these agents. We presented a case report about an acute myocardial infarction with non-ST segment elevation during filgrastim administration. A 73-year-old man had squamous cell carcinoma of larynx with lung metastasis treated with the chemotherapy. Second day after the filgrastim, patient had a chest discomfort. An ECG was performed and showed an ST segment depression and negative T waves on inferior derivations. A coronary angiography had showed a critical lesion in right coronary arteria. This is the first study thats revealed that G-CSF can cause acute myocardial infarction in cancer patients without history of cardiac disease. Patients with chest discomfort and pain who are on treatment with G-CSF or GM-CSF must alert the physicians for acute coronary events.

  18. Localization fibrosing mediastinitis causing pulmonary infraction: A case report

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    Sur, Young Keun; Kim, Eun Young; Kang, Doo Kyoung; Park, Kyung Joo; Koh, Young Wha; Sun, Joo Sung [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2016-06-15

    A 44-year-old female patient visited our emergency room for hemoptysis and refractory chest wall pain of 2 months duration. She had no history of smoking or other medical conditions. Chest CT scan showed homogenously enhancing soft tissue mass without calcification at the left pulmonary hilum. Encasing and compression of the left lower pulmonary artery by the mass had resulted in pulmonary infarction in the left lower lobe. Laboratory tests for tuberculosis, fungus, and vasculitis were all negative. The patient underwent surgical biopsy and resection of infarcted left lower lobe that was histopathologically confirmed as fibrosing mediastinitis. Herein, we reported a rare case of surgically confirmed and treated localized fibrosing mediastinitis causing pulmonary infarction.

  19. A Case of Torsion of Gravid Uterus Caused by Leiomyoma

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    Gururaj Deshpande

    2011-01-01

    Full Text Available Uterine torsion during pregnancy is only sporadically reported in the literature. Here we present a case of leiomyoma causing uterine torsion in pregnancy and review the literature on etiology, diagnosis, and management. A 25-years-old primigravida with leiomyoma complicating pregnancy was admitted in our hospital with abdominal pain and uterine tenderness. She underwent emergency LSCS (lower segment cesarean section for fetal bradycardia. Intraoperatively, the uterus was rotated 180 degrees left to right. Inadvertent incision on the posterior wall was avoided by proper delineation of anatomy. Torsion was corrected by exteriorization of leiomyoma and uterus, and lower segment cesarean was carried out safely. Prompt recognition and management of this condition is necessary for better maternal and fetal outcome.

  20. Aseptic Meningitis Caused by Lassa Virus: Case Series Report

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    Peter O. Okokhere

    2016-01-01

    Full Text Available The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever. The 4 patients recovered fully following intravenous ribavirin treatment and suffered no neurologic complications.

  1. Candidiasis caused by Candida kefyr in a neonate: Case report

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    Weichert Stefan

    2012-03-01

    Full Text Available Abstract Background Systemic Candidia infections are of major concern in neonates, especially in those with risk factors such as longer use of broad spectrum antibiotics. Recent studies showed that also term babies with underlying gastrointestinal or urinary tract abnormalities are much more prone to systemic Candida infection. We report a very rare case of candidiasis caused by Candida kefyr in a term neonate. Case Presentation Renal agenesis on the left side was diagnosed antenatally and anal atresia postnatally. Moreover, a vesico-ureteral-reflux (VUR grade V was detected by cystography. The first surgical procedure, creating a protective colostoma, was uneventful. Afterwards our patient developed urosepsis caused by Enterococcus faecalis and was treated with piperacillin. The child improved initially, but deteriorated again. A further urine analysis revealed Candida kefyr in a significant number. As antibiotic resistance data about this non-albicans Candida species are limited, we started liposomal amphotericin B (AMB, but later changed to fluconazole after receiving the antibiogram. Candiduria persisted and abdominal imaging showed a Candida pyelonephritis. Since high grade reflux was prevalent we instilled AMB into the child's bladder as a therapeutic approach. While undergoing surgery (creating a neo-rectum a recto-vesical fistula could be shown and subsequently was resected. The child recovered completely under systemic fluconazole therapy over 3 months. Conclusions Candidiasis is still of major concern in neonates with accompanying risk factors. As clinicians are confronted with an increasing number of non-albicans Candida species, knowledge about these pathogens and their sensitivities is of major importance.

  2. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

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    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  3. An evaluation study of voice therapy in non-organic dysphonia.

    Science.gov (United States)

    Carding, P N; Horsley, I A

    1992-01-01

    Thirty patients diagnosed as suffering from non-organic dysphonia were assigned to one of three treatment groups: direct therapy, indirect and no treatment for a period of 8 weeks. Therapeutic outcome was evaluated by independent judges, patient self-evaluation, electrolaryngograph ratings and measures of fundamental frequency. The direct treatment group showed the most significant improvement in the return to normal voice functioning followed by the indirect treatment group. One patient in the control group showed improvement without any intervention. This study provides evidence in support of the effectiveness of both direct and indirect therapy in the treatment of non-organic dysphonia and raises questions concerning individual patient responses to these approaches.

  4. Is an organic/functional distinction psychologically meaningful in patients with dysphonia?

    Science.gov (United States)

    Millar, A; Deary, I J; Wilson, J A; MacKenzie, K

    1999-06-01

    Dysphonia (hoarseness) is a common clinical condition and, if persistent, patients are referred to otolaryngology clinics for clinical examination. During the examination, a clinical distinction is often made among three types of patients: (1) those with a clear organic basis for dysphonia (cancer, vocal cord palsy): (2) those with some degree of organic pathology; and (3) those with an apparently functional etiology. Functional patients are often characterized as having a psychogenic disorder. This study assessed the psychological validity of the functional category in 204 out-patients (aged 17 to 87 years) with persistent hoarseness of types (2) and (3). Following clinical examination, a consultant otolaryngologist categorized patients as having functional or organic etiology. Subjects were then compared on measures of personality and psychological distress. Dysphonic subjects showed marked psychological distress compared with norms, and reported significantly more previous psychosomatic symptoms than norms, but there were no differences in personality or psychological distress between organic and functional subgroups of dysphonics.

  5. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial

    OpenAIRE

    MacKenzie, K.; Millar, A; Wilson, J. A.; Sellars, C.; Deary, I. J.

    2001-01-01

    OBJECTIVES: To assess the overall efficacy of voice therapy for dysphonia. DESIGN: Single blind randomised controlled trial. SETTING: Outpatient clinic in a teaching hospital. Participants: 204 outpatients aged 17-87 with a primary symptom of persistent hoarseness for at least two months. INTERVENTIONS: After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to thi...

  6. Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports.

    Science.gov (United States)

    Baker, Janet

    2003-09-01

    Psychogenic dysphonia refers to loss of voice where there is insufficient structural or neurological pathology to account for the nature and severity of the dysphonia, and where loss of volitional control over phonation seems to be related to psychological processes such as anxiety, depression, conversion reaction, or personality disorder. Such dysphonias may often develop post-viral infection with laryngitis, and generally in close proximity to emotionally or psychologically taxing experiences, where "conflict over speaking out" is an issue. In more rare instances, severe and persistent psychogenic dysphonia may develop under innocuous or unrelated circumstances, but over time, it may be traced back to traumatic stress experiences that occurred many months or years prior to the onset of the voice disorder. In such cases, the qualitative nature of the traumatic experience may be reflected in the way the psychogenic voice disorder presents. The possible relationship between psychogenic dysphonia and earlier traumatic stress experience is discussed, and the reportedly low prevalence of conversion reaction (4% to 5%) as the basis for psychogenic dysphonia is challenged. Two cases are presented to illustrate the issues raised: the first, a young woman who was sexually assaulted and chose to "keep her secret," and the second, a 52-year-old woman who developed a psychogenic dysphonia following a second, modified thyroplasty for a unilateral vocal fold paresis.

  7. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin.

    Science.gov (United States)

    Dejonckere, P H; Neumann, K J; Moerman, M B J; Martens, J P; Giordano, A; Manfredi, C

    2012-04-01

    Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were performed on voices of 19 patients diagnosed with adductor spasmodic dysphonia (SD), before and after treatment with Botulinum toxin. The speech material consisted of 40 short sentences phonetically selected for constant voicing. Seven perceptual parameters (traditional and dedicated) were blindly rated by a panel of experienced clinicians. Nine acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals and validated with synthesized deviant voices. Patients also filled in a VHI-questionnaire. Significant improvement is shown by all three approaches. The traditional GRB perceptual parameters appear to be adequate for these patients. Conversely, the special acoustic analysis program is successful in objectivating the improved regularity of vocal fold vibration: the basic jitter remains the most valuable parameter, when reliably quantified. The VHI is well suited for the voice-related quality of life. Nevertheless, when considering pre-therapy and post-therapy changes, the current study illustrates a complete lack of correlation between the perceptual, acoustic, and self-assessment dimensions. Assessment of SD-voices needs to be tridimensional.

  8. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

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    Michael P Cannito

    2008-03-01

    Full Text Available Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age.Keywords: vocal aging, adductor spasmodic dysphonia, botulinum toxin, voice quality, speech fluency

  9. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study.

    Science.gov (United States)

    Simonyan, Kristina; Ludlow, Christy L

    2010-11-01

    Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and decreased activation extent in the basal ganglia, thalamus, and cerebellum during asymptomatic tasks. Increased activation intensity in SD patients was found only in the primary somatosensory cortex during symptomatic voice production, which showed a tendency for correlation with ADSD symptoms. Both SD groups had lower correlation of activation intensities between the primary motor and sensory cortices and additional correlations between the basal ganglia, thalamus, and cerebellum during symptomatic and asymptomatic tasks. Compared with ADSD patients, ABSD patients had larger activation extent in the primary sensorimotor cortex and ventral thalamus during symptomatic task and in the inferior temporal cortex and cerebellum during symptomatic and asymptomatic voice production. The primary somatosensory cortex shows consistent abnormalities in activation extent, intensity, correlation with other brain regions, and symptom severity in SD patients and, therefore, may be involved in the pathophysiology of SD.

  10. [Pseudothrombocytopenia caused by ethylenediaminetetraacetic acid (EDTA) (case report)].

    Science.gov (United States)

    Putarek, K; Vuk, T; Soldo, D; Sarlija, D; Grgicevic, D; Jaksić, B

    1997-01-01

    Pseudothrombocytopenia is a laboratory artefact that can introduce serious problems in diagnosis and treatment in patients with low platelet count. The most common reason for this artefact is in vitro platelet clumping in blood samples collected into ethilenediaminetetraacetic acid (EDTA) anticoagulant. The clumping activity is greater at temperatures less than 37 degrees C, and the EDTA concentrations required for clumping are 20 times below anticoagulant concentrations. In this article we described the case of a female patient with diagnosed EDTA induced pseudothrombocytopenia. The cause of incorrectly low platelet counts was proved by simultaneous analysis in blood samples collected into EDTA anticoagulant and into heparin as a control sample. Absences of incorrectly low platelet count in heparin sample and rapid decrease of platelet count in EDTA sample were noticed. Decrease in platelet count was accompanied by increase in the number of leukocytes, so called pseudoleukocytosis. Careful examination of blood film is necessary to establish correct diagnosis, promptly after the blood collection and approximately two hours later. It is important to verify formation of clumps two hours after the blood collection and also progressive reduction in the platelet count in EDTA sample. By blood assessment conducted in this concern it is possible to avoid severe misinterpretation in such patients.

  11. A Case of Onychomycosis Caused by Rhodotorula glutinis

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    Hatice Uludag Altun

    2014-01-01

    Full Text Available Rhodotorula spp. have emerged as opportunistic pathogens, particularly in immunocompromised patients. The current study reports a case of onychomycosis caused by Rhodotorula glutinis in a 74-year-old immunocompetent female. The causative agent was identified as R. glutinis based on the pinkish-orange color; mucoid-appearing yeast colonies on Sabouraud Dextrose Agar at 25°C; morphological evaluation in the Corn Meal-Tween 80 agar; observed oval/round budding yeast at 25°C for 72 hours; no observed pseudohyphae; positive urease activity at 25°C for 4 days; and assimilation features detected by API ID 32C kit and automated Vitek Yeast Biochemical Card 2 system. Antifungal susceptibility test results were as follows: amphotericin B (MIC = 0.5 µg/mL, fluconazole (MIC = 128 µg/mL, itraconazole (MIC = 0.125 µg/mL, voriconazole (MIC = 1 µg/mL, posaconazole (MIC = 0.5 µg/mL, anidulafungin (MIC = 0.5 µg/mL, and caspofungin (MIC = 16 µg/mL. Antifungal therapy was initiated with oral itraconazole at a dose of 400 mg/day; seven-day pulse therapy was planned at intervals of three weeks. Clinical recovery was observed in the clinical evaluation of the patient before the start of the third cure. Although R. glutinis has rarely been reported as the causative agent of onychomycosis, it should be considered.

  12. [Facial pain- a rare cause. Impacted lower third molars causing primarily "unclear" facial pain: a case report].

    Science.gov (United States)

    Gander, Thomas; Dagassan-Berndt, Dorothea; Mascolo, Luana; Kruse, Astrid L; Grätz, Klaus W; Lübbers, Heinz-Theo

    2013-01-01

    Orofacial pain often causes special difficulties to patients and dentists. Numerous differential diagnoses require the utilization of a coordinated diagnostic concept. Often, multiple causes lead to the need for a complex treatment plan. Impacted third molars are a potential cause of a variety of complications. Caries, pulp necrosis, and periapical infection are some of the infrequent causes of such pain. The presented case shows just such a constellation, resulting in primarily "unclear" orofacial pain. A diagnostic sequence generally leads to the correct diagnosis and thereby allows for fast and effective therapy. This shows how important structured diagnostics are, especially in cases of "unclear" pain.

  13. Disfonia organofuncional e queixas de distúrbios alérgicos e/ou digestivos Organic-functional dysphonia and complains off allergic and/or digestive disturbance

    Directory of Open Access Journals (Sweden)

    Carla Aparecida Cielo

    2009-09-01

    and digestive disturbance in patients with organic-functional dysphonia among the complains of allergic disturbance, digestive disturbance, and of both associated, the ones of allergic disturbance were significantly more frequent in patients with Organic-functional dysphonia. CONCLUSION: there is a relationship among the complains of allergic and/or digestive disturbance and the Organic-functional dysphonia, once that they are co-factors for causing dysphonia and larynx lesions. The high frequency concerning complaints of allergic disturbances in people with organic-functional dysphonia in this study can be linked with the weather in the south of Brazil.

  14. [Anaphylaxis caused by royal jelly].

    Science.gov (United States)

    Roger, A; Rubira, N; Nogueiras, C; Guspi, R; Baltasar, M; Cadahia, A

    1995-01-01

    Royal jelly is the food on which are fed and which causes them to develop into queen bees. It is claimed to have rejuvenating virtues for human beings. This report describes a 15-year-old atopic woman who presented, 15 minutes after the intake of royal jelly, local angioedema, generalised urticaria, dysphonia and bronchospasm. She was given antihistaminics and corticoesteroids and responded well. The ingested product contains royal jelly, lactose and potassium sorbate. No anaphylactic reactions to lactose and sorbates have been described previously. Prick test to common food allergens hymenoptera venoms and pollens were negative. RAST to meletin was also negative. Blood eosinophils were 600 and total IgE 465. Non-commercial prepared specific IgE to royal jelly was positive (0.8 KU/l). Prick by prick was positive to 1/10 dilution, being negative in controls (undiluted). No oral provocation test was performed due to the risk of anaphylaxis. No reported cases of royal jelly allergy were founded in a review of the medical literature. Concluding, it is the first described case of IgE anaphylactic reaction due to royal jelly.

  15. A Rare Case of Jejunal Diverticulosis Causing Mesenteric Volvulus

    OpenAIRE

    Reddi, Bhavani Rao; Konkena, Janardhan Rao; Bogarapu, Chaitanya Babu; Kollu, Srinu Babu; Neelam, Prasad

    2015-01-01

    Jejunal diverticulosis is a rare asymptomatic entity [1]. In literature, there are only few cases of jejunal diverticulosis where small gut volvulus is reported. The disease entity is important as it may masquerade as hemorrhage, obstruction, or perforation which are life threatening. We report a rare case of small bowel volvulus secondary to jejunal diverticulosis.

  16. Laryngotracheal mucormycosis: Report of a case.

    Science.gov (United States)

    Mattioni, Jillian; Portnoy, Joel E; Moore, Jaime Eaglin; Carlson, David; Sataloff, Robert T

    2016-01-01

    Airway mucormycosis is a deadly opportunistic infection that affects immunocompromised persons, particularly diabetics and those undergoing chemotherapy. Although it is typically a pulmonary or sinonasal infection, mucormycosis can affect the larynx and trachea, with devastating results. We report the case of a 46-year-old man with human immunodeficiency virus infection, hepatitis C infection, neurosyphilis, and recently diagnosed Burkitt lymphoma who presented with dysphonia and stridor after receiving one dose of intrathecal chemotherapy. Flexible laryngoscopy detected the presence of fibrinous material that was obstructing nearly the entire glottis. Surgical debridement revealed a firm mucosal attachment; there was little bleeding when it was removed. After debridement, the patient's dyspnea improved only to recur 2 days later. After an awake tracheotomy, laryngoscopy and bronchoscopy identified necrosis extending from the supraglottic area to the carina tracheae. Biopsies demonstrated hyphal architecture consistent with mucormycosis. Despite continued debridements, the fibrinous material reaccumulated. The patient was placed in hospice care; his airway remained patent, but he died from other causes several weeks after presentation. The management of airway mucormycosis is challenging and complex. Fungal airway infections should be considered in the differential diagnosis of an immunosuppressed patient who presents with dyspnea, dysphonia, and vocal fold immobility. Timely diagnosis and management are critical for a successful outcome, although the prognosis is poor if the infection is widespread, even with the best of efforts.

  17. An unusual cause for trismus caused by mandibular coronoid osteoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Vashishth, Shirin; Garg, Kanika; Patil, Prashant; Sreenivasan, Venkatraman [Dept. of Oral Medicine and Radiology, Subharati Dental College, Meerut (India)

    2013-03-15

    Osteoma is a dense bony proliferation of otherwise normal membranous bone. This tumor is essentially restricted to the craniofacial skeleton and is rarely diagnosed in other bones. The mandible and the paranasal sinuses are the most common sites, while the involvement of the coronoid process has been reported in only 6 cases so far. This report demonstrated a case of osteoma occurring at the mandibular coronoid process in a 26-year-old female patient. The patient was managed with surgical resection of the osteoma followed by physiotherapy.

  18. A case of isolated hepatic actinomycosis causing right pulmonary empyema

    Institute of Scientific and Technical Information of China (English)

    Gonenc Kocabay; Atahan Cagatay; Haluk Eraksoy; Betul Tiryaki; Aydin Alper; Semra Calangu

    2006-01-01

    @@ The clinical picture of actinomycosis was first described in 1878.1 Actinomvcosis agents are found in the natural flora of the oral cavity, upper gastrointestinal system and female genital systems.Actinomyces israelii is usually responsible for the infections and causes chronic suppurative and granulomatous infections.1 The most common disease form is cervicofascial infection.

  19. Acute pancreatitis caused by leptospirosis: Report of two cases

    Institute of Scientific and Technical Information of China (English)

    Ekrem Kaya; Adem Dervisoglu; Cafer Eroglu; Cafer Polat; Mustafa Sunbul; Kayhan Ozkan

    2005-01-01

    Two cases of acute pancreatitis with leptospirosis are reported in this article. Case 1: A 68-year-old woman,presented initially with abdominal pain, nausea, vomiting,and jaundice. She was in poor general condition, and had acute abdominal signs and symptoms on physical examination. Emergency laparotomy was performed, acute pancreatitis and leptospirosis were diagnosed on the basis of surgical findings and serological tests. The patient died on postoperative d 6. Case 2: A 62-year-old man, presented with fever, jaundice, nausea, vomiting, and malaise. Acute pancreatitis associated with leptospirosis was diagnosed,according to abdominal CT scanning and serological tests.The patient recovered fully with antibiotic treatment and nutritional support within 19 d.

  20. Prosopagnosia without apparent cause: overview and diagnosis of six cases.

    Science.gov (United States)

    Dobel, Christian; Bölte, Jens; Aicher, Mona; Schweinberger, Stefan R

    2007-08-01

    We compared six cases of congenital prosopagnosia to unimpaired participants using standardized test batteries, tailor-made experimental paradigms, and clinical questionnaires. Every prosopagnosic participant displayed deficits in recognizing famous faces and retaining novel faces over short periods of time. Other aspects of face perception such as judgment of emotional expression, speech reading and memory for faces and names were impaired to a lesser degree or only in single cases. No evidence was found for general visual deficits or social dysfunctions. Two of our six cases are first order relatives, and a further three report first-order relatives suffering from prosopagnosic symptoms. The results are in line with the idea of a genetic component to congenital prosopagnosia.

  1. Acquired Lymphangioma Circumscriptum Caused Macroglossia: A Case Report

    Directory of Open Access Journals (Sweden)

    Mahmut Sami Metin

    2015-03-01

    Full Text Available Lymphangioma circumscriptum (LC is a hamartomatous vascular malformation of lymphatic channels. The etiology is not fully understood. It is usually congenital. Lesions are characterized as thin-walled and grouped vesicles. Lesions are usually seen on proximal extremities, shoulder, axilla, abdomen and neck. They are rarely seen on genital and oral mucosa. Our case was 20 years old male suffering from growing, pain and burning of tongue for 2 months durations. There was a plaque consisted of grouped vesicles on tongue in dermatological examination. Biopsy was obtained. LC was diagnosed. We decided to report this case since acquired LC on tongue and macroglossi is very rare in literature.

  2. Spontaneous epigastric hernia causing gastric outlet obstruction: a case report.

    Science.gov (United States)

    Arowolo, O A; Ogundiran, T O; Adebamowo, C A

    2006-09-01

    Epigastric hernia, a rare form of ventral abdominal hernia, accounts for 0.4 - 1.5% of all abdominal wall hernias. It usually occurs in middle - aged individuals and is rarely large enough to admit more than a small amount of extra-peritoneal fat. In this case report, we present a 64 years old woman with 6 days history of sudden onset of painful epigastric swelling associated with acute gastric outlet obstruction. We did not find a previous report of a similar case in the medical literature.

  3. [Clitoral epidermoid cyst causing clitoromegaly. A rare case report].

    Science.gov (United States)

    Masson, V; Fiquet François, C; Rausky, J; Mazouz Dorval, S; Revol, M

    2014-04-01

    Clitoromegaly is uncommon. It is mostly congenital, hormonal or tumoral. Epidermoid cyst is rare. It can be the consequence of trauma, but in some situations the cyst can be non-traumatic. We report the case of a 53-year-old woman who presented a misdiagnosis of clitoromegaly due to hormonal condition. Surgical exploration has highlighted an epidermoid cyst. This observation underlines the importance to evoke a cystic origin for clitoral hypertrophy and encourages us to propose imaging (ultrasound, MRI) in case of etiological doubt. The preoperative diagnosis must be made to preserve vascularization and innervation of the clitoris.

  4. [Dermatophytic pseudomycetoma: report of a case caused by Trichophyton tonsurans].

    Science.gov (United States)

    Moraes, M A; Machado, A A; Medeiros Filho, P; Reis, C M

    2001-01-01

    A case of dermatophytic pseudomycetoma, in a patient with a history of recurrent lesions in the scalp, for over two years, is reported. Histopathological examination of the affected tissues revealed the mycelial aggregates or pseudogranules characteristic of the disease. Cultures of fresh tissues samples detected a fungus identified as Trichophyton tonsurans. Additional examinations failed to demonstrate lesions of tinea capitis, a probable source of the deep infection. Dermatophytic pseudomycetoma is an extremely rare form of dermatophytosis, and the rarity of such cases is the motive for the present communication.

  5. Second Fatal Case of Infective Endocarditis caused by Gemella bergeriae

    Directory of Open Access Journals (Sweden)

    Aijan Ukudeeva

    2017-03-01

    Full Text Available Our case illustrates a fatal course of infection with Gemella bergeriae endocarditis that was complicated by cardiogenic shock due to perforation of the mitral valve with severe mitral regurgitation, extension of infection into the myocardium adjacent to the mitral valve, and coronary sinus thrombosis.

  6. Transient feelings of compulsion caused by hemispheric lesions: three cases.

    OpenAIRE

    1988-01-01

    There was strong evidence of a neurological explanation for transient feelings of compulsion reported by three patients. In at least two cases the mechanism was epileptic. The frontal lobe was implicated in all three. A feeling of compulsion, divorced from action, has rarely if ever been reported in epilepsy or other neurological disorders.

  7. Root Cause Assessment for a Manufacturing Industry: A Case Study

    Directory of Open Access Journals (Sweden)

    R. Kalantri

    2013-03-01

    Full Text Available Root-cause identification for quality related problems are key issues for manufacturing processes. It has been a very challenging engineering problem particularly in a multistage manufacturing, where maximum number of processes and activities are performed. However, it may also be implemented with ease in each and every individual set up and activities in any manufacturing process. Kaizen is aimed towards reduction in different types of losses i.e. Failure Loss/ Breakdown Loss, Minor stoppage, idling loss, Setup and adjustment loss etc. So as to improve quality and productivity.In this report, root-cause identification methodology has been adopted to eliminate the rejection of product manufactured by the enterprise and improving the life of product. Brainstorming and other Root Cause Assesmenttools have been used to find out the reasons of tube failure and vibration in tubular strander. Solutions of these problems have also given in this report. Kaizen activities have reduced the time consumed in daily activities of cleaning, lubricating, inspection etc. A detailed study has illustrated the effectiveness of the proposed methodology.

  8. Osteomyelitis pubis caused by Kingella kingae in an adult patient: Report of the first case

    OpenAIRE

    Wilmes Dunja; Omoumi Patrick; Squifflet Jean; Cornu Olivier; Rodriguez-Villalobos Hector; Yombi Jean

    2012-01-01

    Abstract Background Kingella kingae is the second most common pathogen causing paediatric arthritis and is described to be the causative bacteria in some paediatric osteomyelitis. Its microbiological detection is particularly difficult due to its slow growing. To our best knowledge this is the first case description of osteomyelitis pubis caused by this microorganism. Case presentation We report the unusual case of pubic osteomyelitis with soft tissue abcess caused by Kingella kingae in an ad...

  9. Analysis of cases caused by acute spider bite

    Institute of Scientific and Technical Information of China (English)

    Zihni Sulaj; Gentian Vyshka; Amarda Gashi

    2015-01-01

    We performed a retrospective study of 176 patients in the University Hospital Center of Tirana (Albania), during the period 2001-2011, admitted with the diagnosis of a suspected spider bite. Three fatalities were registered during this decade covered from our study, with a clinical picture of marked hypertension, tachycardia and acute cardiac failure leading to death within a minimum of 25 hours and a maximum of 42 hours from the occurrence. Out of the total of 176 patients, we had 59% (104 cases) females, and 41% males. The overwhelming majority of the patients lived in rural areas (155 of the cases); extremities were mostly affected from the bites. A summary of clinical signs and a brief review of the available literature are made in the results and discussion section of this paper. Authors advocate that special precautions should be taken especially in severe forms of interesting autonomous nerve system, with aggressive fluid resuscitation, supportive therapy and close monitoring of vital signs.

  10. Acute chemical pneumonitis caused by nitric acid inhalation: case report

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Hyung Shim; Lee, In Jae; Ko, Eun Young; Lee, Jae Young; Kim, Hyun Beom; Hwang, Dae Hyun; Lee, Kwan Seop; Lee, Yul; Bae, Sang Hoon [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2003-06-01

    Chemical pneumonitis induced by nitric acid inhalation is a rare clinical condition. The previously reported radiologic findings of this disease include acute permeability pulmonary edema, delayed bronchiolitis obliterans, and bronchiectasis. In very few published rare radiologic reports has this disease manifested as acute alveolar injury; we report a case of acute chemical pneumonitis induced by nitric acid inhalation which at radiography manifested as bilateral perihilar consolidation and ground-glass attenuation, suggesting acute alveolar injury.

  11. A catheter related sepsis case caused by Pantoea agglomerans

    Directory of Open Access Journals (Sweden)

    Fadime Yılmaz

    2015-04-01

    microorganism was sensitive to piperacillin-tazobactam, so, patient's therapy was not changed. After treatment, when the general condition of the patient healed, he was discharged by ending antibiotics on the sixteenth day. This case report, is intended to call attention to the risk of the growth of catheter-associated sepsis and antibioterapi are lated to P. agglomerans which is rarely seen on immunocompromised patients.

  12. A rare case of human trypanosomiasis caused by Trypanosoma evansi

    Directory of Open Access Journals (Sweden)

    Powar R

    2006-01-01

    Full Text Available Human trypanosoma infections like the ones seen in Africa and South America are unknown in India. The only exception in literature is of two documented cases of a self-limiting febrile illness, being attributed to Trypanosoma lewisi like parasites. We are reporting an unusual case of trypanosomiasis from the rural parts of Chandrapur district in Maharashtra. An adult male farmhand who used to practice veterinary medicine also, presented with history of febrile episodes on and off since five months and drowsiness before admission to this Institute. Though routine blood and other investigations were within normal limits, the peripheral smear showed a large number of trypanosomes which morphologically resembled the species Trypanosoma evansi , the aetiological agent of surra - a form of animal trypanosomiasis. A battery of assays covering the spectrum of parasitology, serology, and molecular biology confirmed the infecting parasite to be T. evansi . Failure to demonstrate the central nervous system (CNS involvement, as evidenced by the absence of parasite in cerebrospinal fluid (CSF advocated the use of suramin - the drug of choice in early stage African trypanosomiasis without any CNS involvement. Suramin achieved cure in our patient. The case is being reported because of its unique nature as the patient was not immunocompromised and showed infestation with a parasite which normally does not affect human beings.

  13. Scalp Haematoma in Cerebral Palsy Case due to Unknown Cause - A Rare Case Report

    Science.gov (United States)

    Singh, Dharamjit Singh Jitsweer

    2016-01-01

    Incidences of cerebral palsy (CP) in children are not quite common even though it is the most common motor disorder in children. Further quality of life in CP cases is not so good in young adult stages and has to face certain problems. However scalp haematoma formation in CP patient without injury to head is rarely been reported. The case is being reported for the first time from Malaysia. We report on a unique case of scalp haematoma in an 18-year-old girl of known CP patient with unknown cause. No history of trauma or fall with any of the focal neurological signs or symptoms was found. Clinical examination showed soft boggy swelling of 8 x 10 cm size, involving most of scalp and upper face. CT - scan showed scalp haematoma with right orbital extraconal lesion. She underwent incision and drainage of scalp lesion; consequently around 100 ml of clotted blood came out. At follow-up she was doing well. PMID:27504347

  14. First case of infectious endocarditis caused by Parvimonas micra.

    Science.gov (United States)

    Gomez, Carlos A; Gerber, Daniel A; Zambrano, Eduardo; Banaei, Niaz; Deresinski, Stan; Blackburn, Brian G

    2015-12-01

    P. micra is an anaerobic Gram-positive cocci, and a known commensal organism of the human oral cavity and gastrointestinal tract. Although it has been classically described in association with endodontic disease and peritonsillar infection, recent reports have highlighted the role of P. micra as the primary pathogen in the setting of invasive infections. In its most recent taxonomic classification, P. micra has never been reported causing infectious endocarditis in humans. Here, we describe a 71 year-old man who developed severe native valve endocarditis complicated by aortic valvular destruction and perivalvular abscess, requiring emergent surgical intervention. Molecular sequencing enabled identification of P. micra.

  15. Sildenafil: Can Cause Acute Ischaemic Stroke? A Case Report

    Directory of Open Access Journals (Sweden)

    Zeynep Özözen Ayas

    2015-12-01

    Full Text Available Sildenafil is an inhibitor of phosphodiesterase type-5 (PDE-5, is used for erectile dysfunction. There is not enough information about its effects on the central nervous system Headache, nasal congestion, facial flushing, nausea are the most common side effects. However, neurological complications such as third cranial nerve palsy, transient global amnesia, seizures, cerebral hemorrhage, and infarction are less commonly observed. We present a case of a 60-year-old man with acute ischaemic stroke, which we considered to be interrelated to sildenafil intake. Clinicians must be aware of the possibility of neurological side effects when the patient use sildenafil.

  16. Cat-scratch disease causing atypical granulomatous conjunctivitis: case report

    OpenAIRE

    Alexandre Hassler Príncipe de Oliveira; Carlos Alberto Pires Pereira; Luciene Barbosa de Sousa; Denise de Freitas

    2004-01-01

    Relatamos caso de paciente do sexo feminino, brasileira, 23 anos, residente na Alemanha, que cursou com quadro de conjuntivite granulomatosa bilateral crônica, sem acometimento ganglionar, não responsiva a tratamento tópico. A pesquisa laboratorial confirmou diagnóstico de conjuntivite por Bartonella henselae. O caso demonstra que a ausência de acometimento ganglionar não exclui o diagnóstico de doença da arranhadura do gato.We report a case of a 23-year-old female patient, Brazilian, residen...

  17. Uncommon Cause of Acute Adrenal Failure - Case Report

    Directory of Open Access Journals (Sweden)

    Tariq

    2010-12-01

    Full Text Available Adrenomyeloneuropathy is a rare X-linked inherited disorder of peroxisomes characterized by accumulation of very-long-chain fatty acids (VLCFA in the central and peripheral nervous system, adrenal glands and testes, leading to dysfunction of these organs and systems (1. Here, we report a case of adrenomyeloneuropathy presenting initially as acute adrenal crisis, which progressed rapidly within one year to variant neurological manifestations, dementia, sensory, motor and psycho-intellectual dysfunction, and generalized spasticity. Turk Jem 2010; 14: 103-5

  18. Analysis of cases caused by acute spider bite

    Directory of Open Access Journals (Sweden)

    Zihni Sulaj

    2015-08-01

    Full Text Available We performed a retrospective study of 176 patients in the University Hospital Center of Tirana (Albania, during the period 2001–2011, admitted with the diagnosis of a suspected spider bite. Three fatalities were registered during this decade covered from our study, with a clinical picture of marked hypertension, tachycardia and acute cardiac failure leading to death within a minimum of 25 h and a maximum of 42 h from the occurrence. Out of the total of 176 patients, we had 59% (104 cases females, and 41% males. The overwhelming majority of the patients lived in rural areas (155 of the cases; extremities were mostly affected from the bites. A summary of clinical signs and a brief review of the available literature are made in the results and discussion section of this paper. Authors advocate that special precautions should be taken especially in severe forms of interesting autonomous nerve system, with aggressive fluid resuscitation, supportive therapy and close monitoring of vital signs.

  19. Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

    Science.gov (United States)

    Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

    2015-09-01

    Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time.

  20. Effective dysphonia detection using feature dimension reduction and kernel density estimation for patients with Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Shanshan Yang

    Full Text Available Detection of dysphonia is useful for monitoring the progression of phonatory impairment for patients with Parkinson's disease (PD, and also helps assess the disease severity. This paper describes the statistical pattern analysis methods to study different vocal measurements of sustained phonations. The feature dimension reduction procedure was implemented by using the sequential forward selection (SFS and kernel principal component analysis (KPCA methods. Four selected vocal measures were projected by the KPCA onto the bivariate feature space, in which the class-conditional feature densities can be approximated with the nonparametric kernel density estimation technique. In the vocal pattern classification experiments, Fisher's linear discriminant analysis (FLDA was applied to perform the linear classification of voice records for healthy control subjects and PD patients, and the maximum a posteriori (MAP decision rule and support vector machine (SVM with radial basis function kernels were employed for the nonlinear classification tasks. Based on the KPCA-mapped feature densities, the MAP classifier successfully distinguished 91.8% voice records, with a sensitivity rate of 0.986, a specificity rate of 0.708, and an area value of 0.94 under the receiver operating characteristic (ROC curve. The diagnostic performance provided by the MAP classifier was superior to those of the FLDA and SVM classifiers. In addition, the classification results indicated that gender is insensitive to dysphonia detection, and the sustained phonations of PD patients with minimal functional disability are more difficult to be correctly identified.

  1. Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

    Directory of Open Access Journals (Sweden)

    Abiola Jesuloba

    2009-10-01

    Full Text Available Abstract Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale, length of response and duration of complications (breathiness, cough, dysphagia and total voice loss. Injections were performed under electromyography (EMG guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.

  2. Biofouling in water systems--cases, causes and countermeasures.

    Science.gov (United States)

    Flemming, H-C

    2002-09-01

    Biofouling is referred to as the unwanted deposition and growth of biofilms. This phenomenon can occur in an extremely wide range of situations, from the colonisation of medical devices to the production of ultra-pure, drinking and process water and the fouling of ship hulls, pipelines and reservoirs. Although biofouling occurs in such different areas, it has a common cause, which is the biofilm. Biofilms are the most successful form of life on Earth and tolerate high amounts of biocides. For a sustainable anti-fouling strategy, an integrated approach is suggested which includes the analysis of the fouling situation, a selection of suitable components from the anti-fouling menu and an effective and representative monitoring of biofilm development.

  3. Pseudocyst in Omentum caused by Abdominal Tuberculosis : Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, So Yeon; Kim, Hyun Jin; Park, Soo Youn; Choi, Hyun Joo; Hwang, Seong Su; Cha, Eun Suk; Park, Young Ha [Catholic University of Korea, St.Vincent' s Hospital, Suwon (Korea, Republic of)

    2006-06-15

    A 25-year-old woman presented with abdominal discomfort and weight loss. Sonography demonstrated a well defined, anechoic, cystic mass with posterior acoustic enhancement, internal thin septations, and a peripheral hypoechoic solid portion that had no increased blood flow on Doppler ultrasound. Contrast-enhanced CT revealed a cystic omental mass with internal thin septations and an enhancing solid portion which appeared as the hypoechoic solid portion on ultrasonography. A pathologic specimen demonstrated a pseudocyst containing serous fluid with gelatinous material. The solid component at the peripheral portion of the pseudocyst indicated caseous necrosis with multinucleated giant cells. This histologic finding was consistent with tuberculosis and supported the final diagnosis of omental pseudocyst caused by tuberculous peritonitis. Therefore, intraperitoneal pseudocyst with tuberculosis should be considered in the differential diagnosis of an intraperitoneal cystic mass in a young adult

  4. Management on tsunami causing posttraumatic stress disorder: a case report.

    Science.gov (United States)

    Jarusuraisin, Ngamwong; Kesornsukon, Kanch

    2005-11-01

    On December 26, 2004, tsunamis hit Southeast Asia and caused serious damage and loss of lives. In Thailand, six provinces (Ranong, Phang-Nga, Phuket, Krabi, Trang, and Satun) were impacted. The present study reports the psychiatric assessments such as Thai GHQ-60 and IES. It also reports management techniques of both cognitive behavior therapy and medication. Those were provided to a Thai female patient who was 54 years old. The patient responded to treatment quickly because of early management. The tsunami victim with Posttraumatic Stress Disorder (PTSD) is not an individual. A mass of people who faced or witnessed the tsunami are vulnerable to get PTSD any time during 6 months after trauma. These early management techniques are useful and practical for a mass of victims and survivors.

  5. Sacral Fracture Causing Neurogenic Bladder: A Case Report

    Directory of Open Access Journals (Sweden)

    Tatsuro Sasaji

    2012-01-01

    Full Text Available A 76-year-old man presented with a Denis Zone III sacral fracture after a traffic accident. He also developed urinary retention and perineal numbness. The patient was diagnosed with neurogenic bladder dysfunction caused by the sacral fracture. A computed tomogram (CT revealed that third sacral lamina was fractured and displaced into the spinal canal, but vertebral body did not displace. The fracture lines began at the center of lamina and extended bilateraly. The fracture pattern was unique. The sacrum was osteoporosis, and this fracture may be based on osteoporosis. We performed laminectomy to decompress sacral nerve roots. One month after surgery, the patient was able to urinate. Three months after surgery, his bladder function recovered normally. One year after surgery, he returned to a normal daily life and had no complaints regarding urination. One-year postoperative CT showed the decompressed third sacrum without displacement.

  6. [A case of gingival myiasis caused by Wohlfahrtia magnifica].

    Science.gov (United States)

    Çetın Özdemır, Eda; Ekşi, Fahriye; Şenyurt, Süleyman Ziya; Üstün, Kemal; Karaoğlan, İlkay; Ercıyas, Kamile

    2014-07-01

    Myiasis is an infestation of living or dead tissue of humans and animals by diptera larvae. Gingival myiasis is a rare pathology and is mainly associated with poor oral hygiene, alcoholism, senility, suppurative lesions, mouth breathing, mental retardation and hemiplegia. Myiasis is most common during summer since the fly population increases during this season. Mostly it occurs in farmers and people who live in tropical climates. Gingival myiasis in humans in Turkey is limited to only a few cases. According to our literature research, this is the first case of gingival myiasis produced by larvae of Wohlfahrtia magnifica in a Turkish adult. According to our best knowledge, it is also the first gingival myiasis case that one of the causative larva had grown to the adult stage in Turkey. A 43 years old male patient who perceived the presence of live maggots in his mouth was referred to our clinic. Clinical findings of gingival myiasis were observed. The patient had no history of systemic disease but oral hygiene was poor. Clinical and radiographic examination indicated that he had chronic periodontitis. Before the dental treatment seven larvae and during the scalling five larvae were elevated from the gingival sulcus. The body of the larvae composed of 12 segments and they were 8-10 mm in length. One of the larvae which was sent to the microbiology laboratory were placed into sheep liver to resume life and the other larvae were placed into 70% alcohol solution. After 9-10 days, the larva which was placed in the liver became pupa. Approximately 15 days later, the pupa became an adult fly. The larvae were identified as the second stage larvae of Wohlfahrtia magnifica. Treatment consisted of removal of the maggots from the gingival sulcus, followed by scaling and oral hygiene instruction. Non-surgical periodontal treatment was applied and the patient was followed-up for 3 months. After non-surgical periodontal treatment, patient didn't accept the flap operation. The

  7. The Consequences of Spasmodic Dysphonia on Communication-Related Quality of Life: A Qualitative Study of the Insider's Experiences

    Science.gov (United States)

    Baylor, C.R.; Yorkston, K.M.; Eadie, T.L.

    2005-01-01

    The purpose of this study was to explore the biopsychosocial consequences of spasmodic dysphonia (SD) as experienced by people with SD. Qualitative research methods were used to investigate the insider's perspective of living with SD. Six adults with SD participated in face-to-face phenomenological interviews. The results are summarized in a model…

  8. Xanthogranulomatous cholangitis causing obstructive jaundice: A case report

    Institute of Scientific and Technical Information of China (English)

    Susumu Kawate; Susumu Ohwada; Hayato Ikota; Kunihiro Hamada; Kenji Kashiwabara; Yasuo Morishita

    2006-01-01

    This article reports the case of a 34-year-old woman with xanthogranulomatous cholangitis who developed obstructive jaundice. Microscopically, the bile duct was surrounded and narrowed by a xanthogranulomatous lesion, but no xanthogranulomatous cholecystitis was seen. Although percutaneous cholangiograms done via the transhepatic biliary drainage showed smooth narrowing of the upper to middle bile duct, the cytology of bile was diagnosed as class V adenocarcinoma.Therefore, right extended hepatectomy and extrahepatic bile duct resection were performed. The differentiation of benign and malignant strictures at the hepatic hilum is often difficult. Xanthogranulomatous cholangitis is one possible diagnosis of a bile duct stricture. Precise review of all the preoperative information is required to make a correct diagnosis.

  9. Mandibular prognathism caused by acromegaly - a surgical orthodontic case.

    Science.gov (United States)

    Gosau, Martin; Vogel, Corinna; Moralis, Antonios; Proff, Peter; Kleinheinz, Johannes; Driemel, Oliver

    2009-01-01

    A 22-year-old man presented for orthodontic surgery because of mandibular prognathism. Clinical symptoms suggested acromegaly, and diagnosis was verified by an endocrinologist as well as by radiograph. Bilateral mandibular prognathism often represents the first and most striking physical characteristic of acromegaly; usually, it is also the main reason why patients seek help from orthodontists or maxillo-facial surgeons. This case report recapitulates the clinical and histopathological findings in pituitary growth hormone (GH) adenomas and emphasises their importance in surgical orthodontic planning. Mandibular prognatism, macroglossia and abnormal growth of hands and feet represent strong indicators for the diagnosis of acromegaly. This disease and its complications not only affect the entire body but increase mortality if the pituitary gland tumour remains untreated.

  10. [Acetaminophen (paracetamol) causing renal failure: report on 3 pediatric cases].

    Science.gov (United States)

    Le Vaillant, J; Pellerin, L; Brouard, J; Eckart, P

    2013-06-01

    Renal failure secondary to acetaminophen poisoning is rare and occurs in approximately 1-2 % of patients with acetaminophen overdose. The pathophysiology is still being debated, and renal acetaminophen toxicity consists of acute tubular necrosis, without complication if treated promptly. Renal involvement can sometimes occur without prior liver disease, and early renal manifestations usually occur between the 2nd and 7th day after the acute acetaminophen poisoning. While therapy is exclusively symptomatic, sometimes serious metabolic complications can be observed. The monitoring of renal function should therefore be considered as an integral part of the management of children with acute, severe acetaminophen intoxication. We report 3 cases of adolescents who presented with acute renal failure as a result of voluntary drug intoxication with acetaminophen. One of these 3 girls developed severe renal injury without elevated hepatic transaminases. None of the 3 girls' renal function required hemodialysis, but one of the 3 patients had metabolic complications after her acetaminophen poisoning.

  11. Mandibular prognathism caused by acromegaly – a surgical orthodontic case

    Directory of Open Access Journals (Sweden)

    Proff Peter

    2009-08-01

    Full Text Available Abstract A 22-year-old man presented for orthodontic surgery because of mandibular prognathism. Clinical symptoms suggested acromegaly, and diagnosis was verified by an endocrinologist as well as by radiograph. Bilateral mandibular prognathism often represents the first and most striking physical characteristic of acromegaly; usually, it is also the main reason why patients seek help from orthodontists or maxillo-facial surgeons. This case report recapitulates the clinical and histopathological findings in pituitary growth hormone (GH adenomas and emphasises their importance in surgical orthodontic planning. Mandibular prognatism, macroglossia and abnormal growth of hands and feet represent strong indicators for the diagnosis of acromegaly. This disease and its complications not only affect the entire body but increase mortality if the pituitary gland tumour remains untreated.

  12. Clostridium difficile causing acute renal failure: Case presentation and review

    Institute of Scientific and Technical Information of China (English)

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  13. Nasopharyngeal polyp causing sensory disturbances: a case report

    Science.gov (United States)

    Sabeh, Abrar Majed; Ahmed, Iffat Mirza

    2016-01-01

    Nasopharyngeal polyps are benign abnormal mucosal protrusions associated with nasal and pharyngeal mucosa. They are commonly found in all age groups with various symptoms. This paper presents a case of a 52-year-old male who presented with constant numbness over the dental midline and extending along the right side of the maxilla for the past few weeks. The patient also reported difficulty in breathing, especially lying down. After a comprehensive head and neck examination, including muscle palpation and temporomandibular joint examination, all within normal limits, a CNS lesion was suspected. A cranial nerve screening examination disclosed hyposensitivity in the area of teeth # 7 to 10. A panoramic radiograph demonstrated right sinus abnormality. We determined the need for additional diagnostic testing, including cone beam computed tomography, which showed a thickened sinus membrane with a polypoid structure (extending posterior from the right inferior concha into the oropharynx). The patient was referred to an ear, nose, and throat (ENT) specialist for further evaluation. The ENT diagnosis was a nasal polyp, and the patient was prescribed a steroid spray to be used three times daily. On follow-up, the patient’s symptoms were reduced from constant numbness to intermittent “fading sensation” with no breathing difficulties lying down. Ancillary diagnostic testing, such as Cone Beam CT, is useful and may be required for the diagnosis of sensory disturbances in the Orofacial region. PMID:27279994

  14. Chronic mastitis in cows caused by Streptococcus dysgalactiae: Case report

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    Cojkić Aleksandar

    2015-01-01

    Full Text Available Mastitis in dairy cows is an economically important disease because it makes up 38% of all diseases that occur in intensive cattle breeding. Mastitis affects milk production, either temporarily or permanently, depending on the course of infection and type of pathogen agent. Regular and timely therapy of mastitis based on the application antimicrobials, apart from prophylaxis, is very important for good health of breeding stock. This paper presents the case of repeated mastitis in a cow, Holstein-Friesian breed, 5 years old, which did not respond to antibiotic therapy. Milk samples from each separate quarter of the udder were collected under aseptic conditions and sent to the laboratory for further bacteriological tests, for isolation and identification of pathogens, as well as to test pathogen resistance to some antibiotics. On the basis of bacteriological examinations, there was confirmed the presence of Streptococcus dysgalactiae, which showed sensitivity to ampicillin, cloxacillin and augmentin, intermediate resistance to tetracycline and resistance to kotrimeksazol.(cotrimoxazole-proveriti [Projekat Ministarstva nauke Republike Srbije, br. TR 31085

  15. Giant prolactinoma causing cranio-cervical junction instability: a case report.

    Science.gov (United States)

    Zaben, Malik J A; Harrisson, Stuart E; Mathad, N V

    2011-12-01

    Prolactinomas are common secretory pituitary tumours, usually managed with dopamine agonists. There have previously been case reports of rarer giant prolactinomas causing invasion of surrounding structures. We describe a case report of an exceptionally aggressive giant prolactinoma that eroded the occipital condyles causing cranio-cervical joint instability mandating surgical fixation.

  16. Bartholinitis caused by Streptococcus pneumoniae : Case report and review of literature

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    Parvathi S

    2009-04-01

    Full Text Available Most of the Bartholin′s gland abscesses have been thought to be caused by colonizing micro-organisms of the perineal region. We encountered an interesting case of acute Bartholins abscess caused by Streptococcus pneumoniae in a primigravida. The abscess was incised and drained. The patient was treated with Cefuroxime. This case is presented for its rarity.

  17. [Scorpionism causing severe acute flaccid paralysis. Case report].

    Science.gov (United States)

    Villa-Manzano, Alberto I; Vázquez-Solís, Ma Guadalupe; Zamora-López, Xochitl Xitlalli; Arias-Corona, Fernando; Palomera-Ávila, Francisco Miguel; Pulido-Galaviz, Carlos; Pacifuentes-Orozco, Adán

    2016-01-01

    Introducción: el alacranismo es un problema de salud pública en diversas regiones del mundo, siendo México el país que tiene mayor número de casos. Las manifestaciones clínicas oscilan desde sintomatología local hasta cuadros graves con repercusiones a nivel cardiovascular, respiratorio y neurológico, e incluso la muerte. No existen reportes de parálisis flácida como una manifestación del cuadro clínico por picadura del alacrán del género Centruroides, familia Buthidae, especie altamente tóxica, endémica y causante de altos índices de morbimortalidad en nuestra región. Caso clínico: documentamos un caso de alacranismo grave, provocado por escorpión de la familia Buthidae del género Centruroides, que causó parálisis flácida aguda, posterior a resolución de otras manifestaciones severas. Solo existe un reporte de caso de alacranismo que produce parálisis flácida aguda en la literatura médica, pero relacionado con el escorpión de la familia Parabuthus, endémico de Sudáfrica, el cual no es endémico en México. Conclusiones: conocer esta complicación, nueva para nuestra región, permitirá maximizar esfuerzos para diagnosticar y manejar oportunamente esta entidad con la aplicación temprana de faboterápico específico y soporte vital avanzado.

  18. Ileo-ileal Intussusception in an Adult Caused by Vanek's Tumour: A Rare Case Report.

    Science.gov (United States)

    Teli, Bhavuray; Cp, Madhu; S, Sudhir; Mv, Shreeharsha

    2013-12-01

    Adult intussusception is relatively rare in patients with bowel obstructions. Adult invagination is mostly caused by benign tumours. Intussusceptions caused by inflammatory fibroid polyps (IFPs) are uncommon. IFPs are rare, localized, non-neoplastic lesions originating in the submucosa of the gastrointestinal tract. We are reporting a rare case of intestinal obstruction caused by an ileo-ileal intussusception, caused by an IFP, a rare but peculiar and always benign tumour.

  19. Non-organic dysphonia. II. A comparison of subglottal pressures in normal and pathological voices.

    Science.gov (United States)

    Gramming, P

    1989-01-01

    In previous investigations, typical phonetogram differences have been revealed between healthy and pathological voices: the average maximum and minimum sound pressure levels that a patient suffering from non-organic dysphonia can produce at different fundamental frequencies deviate significantly from the corresponding values for a healthy voice. The subglottal pressure, being the primary tool for regulating the sound pressure level of voice, was estimated from the oral pressure during the voiceless stop/p/in 10 female and 10 male subjects with normal voices and in 10 female and 10 male non-organic dysphonic patients. In loud phonation, the female patients had significantly lower values than the female healthy subjects, while no corresponding significant difference was seen between the male subjects. In soft phonation, the male patients had significantly higher values than the normal healthy subjects, while the females showed no significant difference.

  20. Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia.

    Science.gov (United States)

    Gandhi, Sachin; Remacle, Marc; Mishra, Prasun; Desai, Vrushali

    2014-12-01

    Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

  1. Comparison of cepstral coefficients to other voice evaluation parameters in patients with occupational dysphonia

    Directory of Open Access Journals (Sweden)

    Ewa Niebudek-Bogusz

    2013-12-01

    Full Text Available Background: Special consideration has recently been given to cepstral analysis with mel-frequency cepstral coefficients (MFCCs. The aim of this study was to assess the applicability of MFCCs in acoustic analysis for diagnosing occupational dysphonia in comparison to subjective and objective parameters of voice evaluation. Materials and Methods: The study comprised 2 groups, one of 55 female teachers (mean age: 45 years with occupational dysphonia confirmed by videostroboscopy and 40 female controls with normal voice (mean age: 43 years. The acoustic samples involving sustained vowels "a" and four standardized sentences were analyzed by computed analysis of MFCCs. The results were compared to acoustic parameters of jitter and shimmer groups, noise to harmonic ratio, Yanagihara index evaluating the grade of hoarseness, the aerodynamic parameter: maximum phonation time and also subjective parameters: GRBAS perceptual scale and Voice Handicap Index (VHI. Results: The compared results revealed differences between the study and control groups, significant for MFCC2, MFCC3, MFCC5, MFCC6, MFCC8, MFCC10, particularly for MFCC6 (p < 0.001 and MFCC8 (p < 0.009, which may suggest their clinical applicability. In the study group, MFCC4, MFCC8 and MFCC10 correlated significantly with the major objective parameters of voice assessment. Moreover, MFCC8 coefficient, which in the female teachers correlated with all eight objective parameters, also showed the significant relation with perceptual voice feature A (asthenity of subjective scale GRBAS, characteristic of weak tired voice. Conclusions: The cepstral analysis with mel frequency cepstral coefficients is a promising tool for evaluating occupational voice disorders, capable of reflecting the perceptual voice features better than other methods of acoustic analysis. Med Pr 2013;64(6:805–816

  2. Acupuncture Treatment of Facial Paralysis Caused by Craniocerebral Trauma in 50 Cases

    Institute of Scientific and Technical Information of China (English)

    赵建平

    2003-01-01

    @@ Cooperating with doctors in the Department of Brain Surgery, the author have treated 50 cases of facial paralysis caused by craniocerebral trauma in recent 3 years. The results are reported as follows.

  3. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

    Directory of Open Access Journals (Sweden)

    Senthil Sirisha

    2010-01-01

    Full Text Available The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  4. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

    OpenAIRE

    Senthil Sirisha; Garudadri Chandrasekhar; Rao Harsha; Maheshwari Rajat

    2010-01-01

    The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC) due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  5. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: a case series.

    Science.gov (United States)

    Senthil, Sirisha; Garudadri, Chandrasekhar; Rao, Harsha B L; Maheshwari, Rajat

    2010-01-01

    The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC) due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  6. First Cases of Cutaneous Leishmaniasis Caused by Leishmania (Viannia) naiffi Infection in Surinam

    NARCIS (Netherlands)

    P.P.A.M. van Thiel; T. van Gool; P.A. Kager; A. Bart

    2010-01-01

    Cutaneous leishmaniasis in Surinam is generally caused by infection by Leishmania guyanensis. We report three cases of infection with Leishmania (Viannia) naiffi, a Leishmania species not described from Surinam before. Treatment with pentamidine proved to be effective

  7. Subluxation of the Cricoarytenoid Joint After External Laryngeal Trauma: A Rare Case and Review of the Literature.

    Science.gov (United States)

    Friedlander, Eviatar; Pascual, Paula Martínez; Da Costa Belisario, Julia; Serafini, Daniel Poletti

    2017-03-01

    Cricoarytenoid joint subluxation is rare condition. There are <200 cases reported in the English literature. The most frequent cause of this condition is a traumatic tracheal intubation which account for approximately 80 % of all cases. The most common symptoms are dysphonia and pain of the anterior region of the neck which appear after upper airway manipulation or cervical trauma. In this report we present a well-documented case of a 31 year old male that was referred to the outpatient clinic because of acute dysphonia and pain that appeared immediately after receiving a blow of a soccer ball. Diagnosis was suspected after patient reported the acute onset of symptoms after the traumatic event along with findings in flexible fiberoptic laryngoscopy and videostroboscopy. A CT scan of the larynx was done where the injury of the left cricoarytenoid joint was seen. The patient was informed of the condition and was given the option of surgical reduction or speech therapy. Speech therapy was done for 3 month and the patient was satisfied with the result, although the anatomical abnormality persisted. We reviewed the literature and we discuss the diagnosis process and possible treatment options.

  8. A case of peritoneal dialysis-associated peritonitis caused by Sphingomonas paucimobilis

    Directory of Open Access Journals (Sweden)

    Jae Un Lee

    2013-06-01

    Full Text Available Sphingomonas paucimobilis is an aerobic Gram-negative bacillus found in soil and water. Knowledge regarding the role of this infectious agent is limited because it is rarely isolated from human material. Furthermore, it is an unusual pathogen in cases of peritoneal dialysis (PD-associated peritonitis. The clinical courses and outcomes of peritonitis caused by S. paucimobilis are variable. Whereas some patients were cured with appropriate antibiotic therapy, others required catheter removal. Cases of PD-associated peritonitis caused by S. paucimobilis have been reported worldwide, and there was a case report of coinfection with S. paucimobilis and Chryseobacterium indologenes in Korea. However, there has been no case caused by S. paucimobilis as a single pathogen. We report a case of PD-associated peritonitis due to S. paucimobilis in which the patient recovered after catheter removal.

  9. Meningitis caused by Filobasidium uniguttulatum: case report and overview of the literature.

    NARCIS (Netherlands)

    Pan, W.; Liao, W.; Hagen, F.; Theelen, B.; Shi, W.; Meis, J.F.G.M.; Boekhout, T.

    2012-01-01

    Cryptococcal meningitis is mainly caused by Cryptococcus neoformans and Cryptococcus gattii, but occasionally other Cryptococcus species and phylogenetically related species are involved. Herein, we present a case of cryptococcal meningitis from China, which was caused by an azole and flucytosine re

  10. The Causes of Churn in the Telecommunication Industry: A Single, Exploratory Case Study on Kenyan Carriers

    Science.gov (United States)

    Halim, Joseph

    2015-01-01

    This single explorative case study investigated the causes of churn in the telecommunication industry in Kenya, narrowed down to include only the capital city of Nairobi. The question of this dissertation was split into three sub-questions. The first sub-question investigated the behavioral patterns of customers causing churn. The second…

  11. Lateral sided snapping elbow caused by a meniscus: two case reports and literature review.

    Science.gov (United States)

    Kang, Shin-Taek; Kim, Tae-Ho

    2010-06-01

    Lateral sided snapping elbow is an unusual condition, and it is apt to be misdiagnosed as lateral epicondylitis. The causes of lateral sided snapping elbow have been attributed to intraarticular loose bodies, instability, synovial plicae and torn annular ligament. We report our experiences for treating lateral sided snapping elbow caused by a meniscus in the radio-humeral joint. In the present cases, the cause of snapping was detected using double contrast arthrogram under fluoroscopic control, and histology revealed that it was a meniscus. Complete removal of the meniscus allowed immediate relief of the symptom, and there was no recurrence in both cases.

  12. [A case of metastatic rectal cancer with fulminant hepatitis caused by XELOX therapy].

    Science.gov (United States)

    Kemmochi, Takeshi; Suzuki, Yuta; Yoneda, Masataka; Ito, Yasuhiro; Ohkubo, Yusuke; Egawa, Tomohisa; Nagashima, Atsushi; Shimokawa, Reiko; Makino, Hiroyuki; Yamamuro, Wataru

    2014-11-01

    We report a case of fulminant hepatitis that was caused by XELOX therapy administered for metastatic rectal cancer. A 69- year-old man with metastatic rectal cancer received 4 courses XELOX therapy. He was subsequently admitted to our hospital with general fatigue. Shenzhen flapping and altered consciousness were noticed on the fifth day of hospitalization. A liver biopsy was subsequently performed. The patient was diagnosed with liver failure due to sinusoidal obstruction syndrome caused by oxaliplatin. This case provides valuable information as there are only a few reports of fulminant hepatitis caused by oxaliplatin.

  13. Isolated oculomotor nerve palsy caused by cavernous sinus dural arteriovenous fistula: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [The Catholic Univ. of Korea, Suwon (Korea, Republic of); Kim, Bum Soo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-10-15

    Cavernous dural arteriovenous fistula (DAVF), which usually presents with conjunctival injection, proptosis, loss of visual acuity, and ophthalmoplegia, is a rare cause of ophthalmoplegia. Thus, it may be overlooked when the typical symptoms are lacking. There have been some cavernous DAVF case reports presenting with isolated oculomotor, abducens and trochlear nerve palsy. We report a patient presenting with isolated oculomotor palsy, caused by cavernous DAVF, which was treated by transvenous coil embolization. This case suggests that cavernous DAVF should be considered in the differential diagnosis of isolated oculomotor nerve palsy and for which case - selective angiography and embolization may be helpful in reaching a diagnosis and providing a guide for optimal treatment.

  14. Dermatophytosis caused by Microsporum gypseum in infants: report of four cases and review of the literature*

    Science.gov (United States)

    Souza, Beatriz da Silva; Sartori, Débora Sarzi; de Andrade, Carin; Weisheimer, Edna; Kiszewski, Ana Elisa

    2016-01-01

    Dermatophytosis caused by Microsporum gypseum is rare, especially in infants, with few published cases. Diagnosis in this age group is frequently delayed. We review the literature and report 4 new cases of tinea of glabrous skin caused by M. gypseum mimicking eczema in infants. Considering new and previously reported cases, half of patients were exposed to sand, emphasizing the importance of this transmission vehicle in this age group. In conclusion, although rare, dermatophytosis by M. gypseum should be part of the differential diagnosis of inflammatory dermatosis in infants. A clinical suspicion and the availability of culture are keys to the diagnosis. PMID:28099610

  15. Rapidly expanding lung abscess caused by Legionella pneumophila in immunocompromised patients: a report of two cases.

    Science.gov (United States)

    Miyara, Takayuki; Tokashiki, Kaori; Shimoji, Tsutomu; Tamaki, Kazunori; Koide, Michio; Saito, Atsushi

    2002-02-01

    We describe two cases of lung abscess caused by Legionella pneumophila in immunocompromised patients. The first case had been treated initially with 60 mg prednisolone for ulcerative colitis, and L. pneumophila serogroup 1 was isolated from sputum samples after cavitation of the lung lesion. The second case was diagnosed as plasma cell lymphoma at post-mortem examination. L. pneumophila serogroup 5 was isolated from the contents of lung abscess, together with Enterococcus faecium and Prevotella intermedia in the post-mortem examination. Lung abscess caused by Legionella is unusual. Here, we discuss the difficulty of diagnosis of legionellosis in patients with unusual chest radiographic findings.

  16. Osteomyelitis pubis caused by Kingella kingae in an adult patient: Report of the first case

    Directory of Open Access Journals (Sweden)

    Wilmes Dunja

    2012-10-01

    Full Text Available Abstract Background Kingella kingae is the second most common pathogen causing paediatric arthritis and is described to be the causative bacteria in some paediatric osteomyelitis. Its microbiological detection is particularly difficult due to its slow growing. To our best knowledge this is the first case description of osteomyelitis pubis caused by this microorganism. Case presentation We report the unusual case of pubic osteomyelitis with soft tissue abcess caused by Kingella kingae in an adult patient of 66 years with a history of end-stage renal disease and breast carcinoma. Diagnosis was based on imaging and the microorganism was isolated from Computed Tomography-guided aspiration of synovial fluid. The infection resolved completely after twelve weeks of treatment with oral amoxicillin. Conclusion This case description highlights the importance in osteoarticular infections of systematic inoculation of synovial liquid in BACTEC vials to optimise the detection of causative organisms, which can necessitate specific treatments.

  17. Endometrioid Endometrial Carcinoma Indirectly Caused by Pituitary Prolactinoma:A Case Report

    Directory of Open Access Journals (Sweden)

    Kimihiro Nishino

    2013-01-01

    Full Text Available We present the case of a 44-year-old nulliparous woman who experienced irregular menstrual cycles for about 10 years and developed both pituitary prolactinoma and endometrioid endometrial carcinoma. In premenopausal women, hyperprolactinemia causes hypogonadism by inhibiting secretion of gonadotropin-releasing hormone and thus suppressing luteinizing hormone levels, which can cause menstrual disorders ranging from amenorrhea, oligomenorrhea and chronic anovulatory cycle to short luteal phase of the menstrual cycle. A chronic anovulatory menstrual cycle is the most common cause of long-term exposure of the endometrium to endogenous estrogen without adequate opposition from progestins, which can lead to endometrioid endometrial carcinoma. In this case, pituitary prolactinoma may have caused the chronic anovulatory cycle and indirectly led to the endometrioid endometrial carcinoma. In patients for whom the cause of irregular menstruation and chronic anovulatory cycle is suspected to be hyperprolactinemia, explorations of both the hypophysis and endometrium are essential.

  18. Endometrioid endometrial carcinoma indirectly caused by pituitary prolactinoma: a case report.

    Science.gov (United States)

    Nishino, Kimihiro; Niwa, Yuri; Mizutani, Teruyuki; Shimizu, Ken; Hayashi, Kazumasa; Chaya, Jyunya; Kato, Noriko; Yamamuro, Osamu

    2013-01-01

    We present the case of a 44-year-old nulliparous woman who experienced irregular menstrual cycles for about 10 years and developed both pituitary prolactinoma and endometrioid endometrial carcinoma. In premenopausal women, hyperprolactinemia causes hypogonadism by inhibiting secretion of gonadotropin-releasing hormone and thus suppressing luteinizing hormone levels, which can cause menstrual disorders ranging from amenorrhea, oligomenorrhea and chronic anovulatory cycle to short luteal phase of the menstrual cycle. A chronic anovulatory menstrual cycle is the most common cause of long-term exposure of the endometrium to endogenous estrogen without adequate opposition from progestins, which can lead to endometrioid endometrial carcinoma. In this case, pituitary prolactinoma may have caused the chronic anovulatory cycle and indirectly led to the endometrioid endometrial carcinoma. In patients for whom the cause of irregular menstruation and chronic anovulatory cycle is suspected to be hyperprolactinemia, explorations of both the hypophysis and endometrium are essential.

  19. An unusual case of duodenal perforation caused by a blister pack: A case report and literature review

    OpenAIRE

    Si-Yuan Yao; Yugo Matsui; Souichi Shiotsu

    2015-01-01

    Introduction: Ingestion of foreign bodies is a relatively common clinical problem. Blister packs have been known to be a causative agent of gastrointestinal perforation. We report a rare case of duodenal perforation caused by a blister pack, which was complicated by retroperitoneal abscess and having a poor outcome. Presentation of case: A 72 year-old man with a history of dementia presented to the emergency department with a 2-day history of backache. Upon radiological findings, perforate...

  20. Ochronosis as an unusual cause of valvular defect: a case report

    Directory of Open Access Journals (Sweden)

    Steverding Dietmar

    2009-11-01

    Full Text Available Abstract Introduction Alkaptonuria (also known as ochronosis is a genetic disorder characterised by the accumulation of homogentisic acid deposits in connective tissue. In rare cases, ochronosis can cause valvular heart disease. Case presentation We present the case of a 68-year-old Caucasian man with alkaptonuria-associated degenerative valvular defects with aortic, mitral and tricuspid valve insufficiency. The patient did not have any cardiac complaints and was referred to our clinic for evaluation of a conspicuous new heart murmur. Conclusion This case report shows that early diagnosis of cardiovascular ochronosis gives us the opportunity to use conservative treatment to slow down the progression of valvular dysfunction.

  1. Post-prandial reactive hypoglycaemia and diarrhea caused by idiopathic accelerated gastric emptying: a case report

    Directory of Open Access Journals (Sweden)

    Balan Kottekkattu

    2011-05-01

    Full Text Available Abstract Introduction The majority of cases of post-prandial reactive hypoglycemia are considered idiopathic. Abnormalities of B-cell function and glucose regulation by insulin and glucagon have been postulated as causes but associated gastrointestinal dysfunction has not been reported. We report the first case of accelerated gastric emptying associated with post-prandial reactive hypoglycemia, abdominal bloating and diarrhea. We consider that gastric dysmotility is an important cause of this condition as treatment of the underlying abnormal gastric emptying allows effective control of symptoms. Case presentation A 20-year-old Caucasian woman presented with post-prandial fatigue, sweating, nausea, faintness and intermittent confusion, which had led to pre-syncope and syncope on occasions. She also experienced marked abdominal bloating and diarrhea over the same period. These episodes responded to oral administration of sweet drinks. Her symptoms were ameliorated by modification of her diet. Conclusion This is an original case report of the association of idiopathic accelerated gastric emptying with post-prandial reactive hypoglycemia and diarrhea. Family physicians, endocrinologists and gastroenterologists often consult patients with a constellation of post-prandial symptoms, which are considered to be idiopathic in most cases. This case indicates that gastric dysmotility might be the primary cause of these symptoms in some patients and, if found, offers a therapeutic target which in our case was successful.

  2. Inflammatory pseudotumor in the liver and right omentum caused by pelvic inflammatory disease: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Hyuk Jun; Kim, Seong Hoon [Dept. of Radiology, Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2015-08-15

    Inflammatory pseudotumor can develop in any part of the human body. It is one of the most important tumor-mimicking lesions that require differential diagnosis. There are various causes of inflammatory pseudotumor, one of which is infection and its resultant inflammation. Pelvic inflammatory disease (PID) often causes perihepatitis, which is called Fitz-Hugh-Curtis syndrome. In Fitz-Hugh-Curtis syndrome, bacteria spread along the right paracolic gutter, causing inflammation of the right upper quadrant peritoneal surfaces and the right lobe of the liver. We experienced a case of PID with accompanying inflammatory pseudotumor in the liver and the right omentum. This case identically correlates with the known intraperitoneal spreading pathway involved in Fitz-Hugh-Curtis syndrome, and hence, we present this case report.

  3. Human bacterial arthritis caused by Streptococcus zooepidemicus: report of a case.

    Science.gov (United States)

    Friederichs, Jan; Hungerer, Sven; Werle, Regina; Militz, Matthias; Bühren, Volker

    2010-09-01

    Septic arthritis caused by Streptococcus zooepidemicus is a rare event in humans. Of the four cases reported in the literature, only two patients had direct animal contact, and the portal of entry remained unclear in all cases. We report herein the case of a patient who suffered a purulent arthritis of the left shoulder caused by S. zooepidemicus, successfully treated in our department. A diagnostic FDG-PET-CT scan ruled out other foci of infection, but detected a hyperkeratotic plantar chronic soft tissue lesion of the left foot, acquired in a paragliding accident 10 years earlier. The fact that the patient habitually took care of his horses barefoot in boots, identifies the cutaneous portal of entry as most likely. To our knowledge this is the first report of a septic arthritis caused by S. zooepidemicus where a cutaneous entry route is described.

  4. Pulmonary Infection Caused by Achromobacter xylosoxidans in a Patient with Carcinoma of Epiglottis: A Rare Case.

    Science.gov (United States)

    Roy, Priyamvada

    2014-05-01

    Achromobacter xylosoxidans is an aerobic, motile, oxidase and catalase positive, non-fermenting, gram negative bacillus. It is an opportunistic pathogen which is responsible for various nosocomial and community-acquired infections. However, there are only very few reports of pulmonary infections caused by this bacterium in cancer patients. We are presenting a case of a patient with carcinoma of epiglottis, who developed pulmonary infection caused by Achromobacter xylosoxidans. According to the available literature, this is the first case of pulmonary infection caused by Achromobacter xylosoxidans, which was detected in a cancer patient in India. Since Achromobacter xylosoxidans demonstrates resistance to many classes of antimicrobials, vigilant and efficient microbiological work-ups and surveillances are needed, to diagnose infections caused by this rare pathogen in clinical settings.

  5. Simultaneous Larva Migrans and Larva Currens Caused by Strongyloides stercoralis: A Case Report

    OpenAIRE

    Liliam Dalla Corte; Mariana Vale Scribel da Silva; Paulo Ricardo Martins Souza

    2013-01-01

    Strongyloidiasis is an infectious disease caused by the Strongyloides stercoralis larvae, which penetrate the skin, go through the lymphatic circulation, and migrate to the lungs before reaching the intestines. They mature and may cause cutaneous strongyloidiasis, known as larva currens because of the quick migratory rate of the larva. The authors describe a case in which the larvae did not follow their natural lymph route, and after penetrating into the intertriginous area, they migrated to ...

  6. Staphylococcal abscess caused by trauma with a rosebush aculeus (Plantae, Rosaceae): apropos of a case*

    OpenAIRE

    2013-01-01

    Cutaneous abscess is a localized collection of pus in the dermis and subcutaneous tissue usually caused by trauma. The authors report the case of a 30-year-old male patient, gardener, that presents an ulcerated plaque in the third right finger, caused by an aculeus plant wound. The examination of the lesion's exudate ruled out the existence of fungi and showed the presence of Staphylococcus aureus. The authors emphasize the sporotrichosis as an important differential diagnosis, especially in ...

  7. Seizures caused by pyridoxine (vitamin B6) deficiency in adults: A case report and literature review

    OpenAIRE

    2014-01-01

    Pyridoxine (vitamin B6) deficiency is a recognised cause of intractable seizures in neonates. However, pyridoxine deficiency related seizures in adults were rarely reported. This article reports a case of a 79 year old lady who suffered from new-onset seizures and was successfully treated with vitamin B6. The patient had chronic renal disease and weight loss due to anepithymia following a pelvic fracture. This article also reviews literatures of seizures caused by pyridoxine deficiency in adu...

  8. Nosocomial pneumonia caused by carbapenem-resistant Raoultella planticola: a case report and literature review.

    Science.gov (United States)

    Xu, M; Xie, W; Fu, Y; Zhou, H; Zhou, J

    2015-04-01

    Raoultella planticola is a rare opportunistic pathogen usually invaded immunocompromised patients and sometimes even causes fatal infections. Recently, there is growing concern about the emergence of carbapenem resistance in this species. Here, we describe one case of hospital-acquired pneumonia due to a carbapenem-resistant R. planticola (CRRP) co-producing Klebsiella pneumoniae carbapenemase and extended-spectrum β-lactamase. A literature review was performed to indicate the microbiological and clinical features of infections caused by CRRP.

  9. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review.

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

    2011-01-01

    Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  10. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tarush Rustagi

    2011-01-01

    Full Text Available Brown-Séquard's syndrome (BSS is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  11. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

    2011-01-01

    Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. PMID:23259105

  12. Rare case of entero-enteric intussusception caused by small bowel metastasis from a cardiac liposarcoma

    Institute of Scientific and Technical Information of China (English)

    Gustavo Gomez; Mohammad Bilal; Paul Klepchick; Kofi Clarke

    2016-01-01

    Primary cardiac liposarcoma is exceedingly rare and its metastatic potential varies based on the actual tumor subclass. Intestinal intussusception is also an uncommon cause of abdominal pain and bowel obstruction in adults and it usually generates at a malignant lead point in this age group. We report a case of a primary cardiac dedifferentiated liposarcoma in a pregnant woman causing small bowel seeding leading to bowel intussusception.

  13. Purulent Pericarditis Caused by Streptococcus Milleri Strains; the Gained Experience from Nine Reported Cases

    Directory of Open Access Journals (Sweden)

    Ilias A. Kouerinis

    2015-12-01

    Full Text Available Bacterial pericarditis caused by Streptococcus Milleri Group (SMG strains is a particularly exceptional pathology. All the eight previous reported cases were under the care of medical teams and the seven existed reports in medical journals were more or less from this perspective. Herein, we reported a unique case of a pericardial-cutaneous fistula resulting from a recurrent purulent pericardial effusion caused by SMG strains, which had been treated with open surgical drainage two months before. A thorough review of the surgical treatment options and the results has also been presented.

  14. A COMMON PATHOLOGY, A RARE CAUSE – A CASE REPORT OF CANDIDIAL GASTRIC PERFORATION

    Directory of Open Access Journals (Sweden)

    Sujata Singla

    2017-07-01

    Full Text Available Peritonitis due to peptic ulcer perforation is a frequently encountered surgical emergency. Intake of non steroidal anti inflammatory drugs (NSAIDs, Helicobacter pylori infection and neoplastic etiology are the common causes documented. Uncommonly peptic perforation can be due to fungal infection. If it occurs; it is associated with significantly increased morbidity and mortality. This case report emphasize on considering fungal infection as etiology of gastric perforation, even when other common causes like NSAIDs intake are present. An early diagnosis can prevent fatal complications like shock, fever, wound complications and multiorgan failure. Knowledge of such case reports can help a surgeon in dealing with common pathology but rare etiology.

  15. Cubital tunnel syndrome due to heterotrophic ossification caused by radial head fracture: A case report

    Directory of Open Access Journals (Sweden)

    Seyitali Gumustas

    2014-04-01

    Full Text Available Compression of the ulnar nerve in the cubital tunnel is the second most common nerve entrapment syndrome in the upper extremity after carpal tunnel syndrome. Although various etiologies have been described, heterotrophic ossification is rarely seen. Heterotrophic ossification should be kept in mind as a cause of ulnar nerve entrapment after elbow trauma. Early diagnosis and surgical intervention are important in such cases before completion of the maturation phase. We report a case of heterotrophic ossification due to elbow trauma that caused cubital tunnel syndrome. [Hand Microsurg 2014; 3(1.000: 24-28

  16. Ulceration Caused by a Small Alkaline Battery: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fatih Tekin

    2017-03-01

    Full Text Available Small alkaline or lithium-ion batteries, which are commonly referred to as watch batteries or button cells, may cause potentially dangerous organ injuries and tissue damage if swallowed. This condition, which is commonly seen in children, may cause damage, particularly in the respiratory and gastrointestinal tracts, as well as in the nose, external ear canal, and middle and inner ears. Ulceration due toxin contact is a very rare condition. In this study, we present the case of an 18-month-old male who swallowed a cell which caused damage in the medial femoral area after harmlessly passing through the entire gastrointestinal tract. The battery caused skin necrosis with the contribution of the electrolytic effect of stool in a diaper is an infrequent case and avoidable with only the parents' attention. Usually, swallowing watch batteries does not cause any symptoms or findings, and it easily excreted in stool. However, serious injuries and even deaths in cases involving the nasal cavities, outer and inner ear, esophagus, stomach, intestines, and neighboring organs have been reported in the literature. It is important to acknowledge the negative consequences and signs and symptoms of such conditions, and note that the battery may stick to body parts such as genital, medial femoral, anal, and intergluteal regions that remain in the diaper-covered area and may cause skin ulcerations due to the electrolytic characteristics of the stool.

  17. Middle ear osteoma causing progressive facial nerve weakness: a case report

    OpenAIRE

    Curtis, Kate; Bance, Manohar; Carter, Michael; Hong, Paul

    2014-01-01

    Introduction Facial nerve weakness is most commonly due to Bell’s palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. Case presentation We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery...

  18. A Case of Ventilator-Associated Pneumonia Caused by Ewingella americana : First Report from Turkey

    Directory of Open Access Journals (Sweden)

    Kenan Ecemiş

    2014-09-01

    Full Text Available Ewingella americana is a very rare cause of serious infections, especially in immunocompromised patients. We report a case of ventilator-associated pneumonia (VAP in an intensive care unit patient, who was treated successfully with ceftriaxone. To the best of our knowledge, this is the first case of VAP due to Ewingella americana in the English literature.J Microbiol Infect Dis 2014; 4(3: 118-120

  19. Four cases of pediculosis caused by Pthirus pubis Linnaeus, 1758 (Diptera: Anoplura) from peninsular Malaysia.

    Science.gov (United States)

    Pakeer, O; Jeffery, J; Mohamed, A M; Ahmad, F; Baharudin, O

    2007-12-01

    Four cases of pediculosis, two in adults and two in children, caused by the crab-louse, Pthirus pubis Linnaeus, 1758 (Diptera: Anoplura) is reported from peninsular Malaysia. This is the second report of the problem to be documented from the country. Although P. pubis is closely associated with genital hairs, it is, however, also found to occur on the eyelashes, eyebrows, hairs of the body, head and axilla. The few reported cases of pthiriasis probably do not reflect the true situation.

  20. Septic arthritis caused by Brucella melitensis in urban Shenzhen, China: a case report

    OpenAIRE

    Wong, Tak Man; Lou, Nan; Jin, Wentao; Leung, Felix; To, Michael; Leung, Frankie

    2014-01-01

    Abstract Introduction: Brucellosis is a systemic infectious disease which is still a challenging medical problem in rural areas such as northern China. It rarely occurs in urban areas such as Shenzhen in southern China. Osteoarticular involvements are frequently seen in brucellosis, and rarely is arthritis the only clinical presentation. We report a case of hip septic arthritis caused by Brucella melitensis in an urban area of Shenzhen, China. Case presentation: A 29-year-old Chinese wom...

  1. Ascariasis as a cause of hepatic abscess: A report of 3 cases.

    Science.gov (United States)

    Chauhan, V; Thakur, S; Rana, B

    2015-01-01

    We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

  2. Secondary infertility caused by the retention of fetal bones after an abortion: a case report

    OpenAIRE

    Kramer Hannah MC; Rhemrev Johann PT

    2008-01-01

    Abstract Introduction Unwanted contraception through prolonged retention of fetal bone is a rare cause of secondary infertility. It is usually associated with a history of abortion, either spontaneous or induced. Case presentation We describe a case of intrauterine retention of fetal bone diagnosed 8 years after the termination of a pregnancy. The patient had no complaints of pain, irregular vaginal bleeding or discharge. A hysteroscopy was performed and irregular structures were removed. The...

  3. Pseudomyxoma peritonei caused by ruptured intraductal papillary mucinous neoplasm of the pancreas: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Sun; Lee, Hae Kyung; Lee, Min Hee; Yi, Boem Ha; KIm, Hee Kyung; Jung, Jun Chul; Cha, Jang Gyu [Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2014-05-15

    Pseudomyxoma peritonei (PMP) is an uncommon disease characterized by the seeding of mucin-secreting tumor cells throughout the abdomen and accumulation of mucin in the abdominal and pelvic cavities. Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are defined as pancreatic neoplasms that accumulate mucin within dilated ducts. Only a few cases of pancreatic IPMNs are associated with extra-pancreatic mucin and lead to PMP. This manuscript describes an unusual case of PMP caused by ruptured pancreatic IPMN.

  4. Neglected Fournier's Gangrene Caused by Acinetobacter baumannii: A Rare Case Report

    Science.gov (United States)

    Emre, Arif; Sertkaya, Mehmet; Duman, Yakup; Kale, Ilhami Taner

    2016-01-01

    Fournier's gangrene, rare but life threatening disease, is characterized by an acute necrotic infection of the scrotum, penis, or perineum. Fournier's gangrene is a mixed infection caused by both aerobic and anaerobic bacteria. Fournier's gangrene caused by multidrug resistant Acinetobacter baumannii have been reported rarely. The mainstay of treatment is prompt recognition and a combination of antibiotics with radical debridement. We describe a case of a 56-year-old male patient presenting with neglected Fournier's gangrene caused by Acinetobacter baumannii. Many treatment modalities including broad-spectrum antibiotics, aggressive debridement, negative pressure wound therapy, diversion colostomy, and partial-thickness skin grafts were applied to save the patient's life. PMID:27725892

  5. Interstitial nephritis caused by HIV infection by itself: a case report.

    Science.gov (United States)

    Doi, Asako; Iwata, Kentaro; Hara, Shigeo; Imai, Yukihiro; Hasuike, Toshikazu; Nishioka, Hiroaki

    2016-01-01

    Interstitial nephritis is a common cause of renal dysfunction. It is primarily caused by drugs, infections, or autoimmune disorders. Patients with human immunodeficiency virus (HIV) infection can develop interstitial nephritis, although it typically occurs because of the aforementioned etiologies and not as a direct consequence of HIV infection. Interstitial lesions may occur in patients with HIV-associated nephropathy (HIVAN). However, interstitial nephritis without the glomerular injuries characteristic of HIVAN, and without the risk factors described earlier, is very rare. Here, we describe a rare case of interstitial nephritis that was likely caused directly by HIV infection and not by other etiologies.

  6. Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

    Science.gov (United States)

    Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

    2015-01-01

    Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD.

  7. Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia.

    Science.gov (United States)

    Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Yanagida, Saori; Nishizawa, Noriko; Oridate, Nobuhiko; Fukuda, Satoshi; Homma, Akihiro

    2017-02-22

    Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

  8. Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability.

    Science.gov (United States)

    Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

    2014-02-07

    The purpose of this study was to compare cortical inhibition in the hand region of the primary motor cortex between subjects with focal hand dystonia (FHD), adductor spasmodic dysphonia (AdSD), and healthy controls. Data from 28 subjects were analyzed (FHD n=11, 53.25 ± 8.74 y; AdSD: n=8, 56.38 ± 7.5 y; and healthy controls: n=941.67 ± 10.85 y). All subjects received single pulse TMS to the left motor cortex to measure cortical silent period (CSP) in the right first dorsal interosseus (FDI) muscle. Duration of the CSP was measured and compared across groups. A one-way ANCOVA with age as a covariate revealed a significant group effect (p<0.001). Post hoc analysis revealed significantly longer CSP duration in the healthy group vs. AdSD group (p<0.001) and FHD group (p<0.001). These results suggest impaired intracortical inhibition is a neurophysiologic characteristic of FHD and AdSD. In addition, the shortened CSP in AdSD provides evidence to support a widespread decrease in cortical inhibition in areas of the motor cortex that represent an asymptomatic region of the body. These findings may inform future investigations of differential diagnosis as well as alternative treatments for focal dystonias.

  9. Correlation between female sex and allergy was significant in patients presenting with dysphonia.

    Science.gov (United States)

    Lauriello, M; Angelone, A M; Businco, L Di Rienzo; Passali, D; Bellussi, L M; Passali, F M

    2011-06-01

    Aim of the present study was to investigate the prevalence of allergy in patients affected by both organic and/or functional vocal fold disorders. The secondary aim was to assess the correlation between sex and allergy in dysphonic patients. A retrospective chart review was performed on dysphonic patients. A total of 76 patients underwent fiberoptic endoscopy to assess the objective picture. Logistic regression analyses have been conducted to assess the association between sex and the outcome variables. The laryngoscopic examination revealed the presence of poor glottic closure in 32.9%, hyperkinesias in 11.8%, redness in 11.84%, polyps in 5.3%, oedema in 3.95%, vocal fold hypertrophy in 5.3%, nodules in 42.1%, cordectomy in 2.6%. Allergic rhinitis was present in 56.6%, milk intolerance in 13.2%, asthma in 9.2%, atopic dermatitis in 3.9%, drugs intolerance in 11.8%. A total of 76.32% patients presenting with dysphonia were allergic. A statistically significant association was found between female sex and presence of allergy. In conclusion, allergy testing should be performed routinely on female professional voice users. Mild respiratory disorders must be taken into serious consideration in female professional voice users, who may primarily complain of vocal dysfunction rather than upper and lower respiratory diseases.

  10. The effectiveness of voice therapy for patients with non-organic dysphonia.

    Science.gov (United States)

    Carding, P N; Horsley, I A; Docherty, G J

    1998-08-01

    Forty-five patients diagnosed as having non-organic dysphonia were assigned in rotation to one of three groups. Patients in one group received no treatment and acted as a control group. Patients in the other two groups received a programme of either 'indirect' therapy or 'direct with indirect' therapy, respectively. A self-report questionnaire of vocal performance, observed ratings of voice quality, and computer-derived acoustic measurements (signal-to-noise ratio, pitch perturbation and amplitude perturbation) were carried out on all patients before and after treatment to evaluate the changes in voice quality over time. There was a significant difference between the three groups on the self-report questionnaire, voice quality ratings and pitch perturbation measurements (P = < 0.05). Thirteen out of 15 control patients showed no significant change on any of the measures. Seven patients who received indirect treatment showed significant improvement in voice quality following treatment. Fourteen out of 15 patients who received direct treatment showed significant improvement in voice quality.

  11. Evaluation of voice quality in adductor spasmodic dysphonia before and after botulinum toxin treatment.

    Science.gov (United States)

    Langeveld, T P; van Rossum, M; Houtman, E H; Zwinderman, A H; Briaire, J J; Baatenburg de Jong, R J

    2001-07-01

    In this prospective study, the efficacy of botulinum toxin (Botox) injections in patients with adductor spasmodic dysphonia (AdSD) was assessed by 3 different modalities: perceptual and acoustic analyses and subjective self-assessment. This was done by comparing AdSD patients' pretreatment and posttreatment values and comparing these values with those of normal control speakers. In contrast to most other studies, the posttreatment status was defined as the optimal voice quality as judged by the patient. The aim of the study was to assess to what extent Botox injections actually improve voice quality and function. The AdSD subjects rated a significantly improved voice quality and function after Botox treatment. However, the results were never within normal limits. Perceptually, the characteristic and severely impaired AdSD voice improved, but another "type" of pathological voice was detected after Botox treatment. Acoustic analyses demonstrated a significant improvement, as well. Nevertheless, the "optimally" treated AdSD voice still remained significantly deviant as compared to normal voice production. Currently, Botox injection is the therapy of first choice for AdSD. Although significant improvement could be measured in our study perceptually, acoustically, and subjectively, the optimal voice that was achieved never fully matched normal voice quality or function.

  12. A rare case of mucormycosis of median sternotomy wound caused by Rhizopus arrhizus

    Directory of Open Access Journals (Sweden)

    Chawla R

    2007-01-01

    Full Text Available We describe a case of mucormycosis of median sternotomy wound caused by Rhizopus arrhizus . The patient, a known diabetic and a case of coronary artery disease underwent coronary artery bypass surgery. In the postoperative period, patient developed infection of the median sternotomy wound, from which R. arrhizus was isolated on culture. Patient succumbed in spite of being treated with surgical debridement and amphotericin B. To the best of our knowledge, this is the first reported case of mucormycosis of median sternotomy wound from India.

  13. An uncommon cause of seizures in children living in developed countries: neurocysticercosis -a case report

    Directory of Open Access Journals (Sweden)

    Denegri Federica

    2011-01-01

    Full Text Available Abstract Neurocysticercosis represents an important cause of seizures in children in endemic countries, such as Latin America, Asia and sub-Saharan Africa, while in Europe, especially in Italy, the cases of neurocysticercosis are anectodal. We report the case of a 6 year old boy, born and lived for four years in Cameroon, who presented a right emiconvulsion. The diagnosis was neurocysticercosis. This case accentuates the need to consider neurocysticercosis in a child presenting with non febrile seizures, mainly if he emigrated from an area of high prevalence or if he had long-term stay in endemic regions.

  14. A rare case of allergic bronchopulmonary mycosis caused by Alternaria alternata.

    NARCIS (Netherlands)

    Chowdhary, A.; Agarwal, K.; Randhawa, H.S.; Kathuria, S.; Gaur, S.N.; Najafzadeh, M.J.; Roy, P.; Arora, N.; Khanna, G.; Meis, J.F.G.M.

    2012-01-01

    A rare case of allergic bronchopulmonary mycosis (ABPM), caused by Alternaria alternata, is reported in an immunocompetent resident of Delhi. Her complaints included a generalized, urticarial skin rash and occasional pain in the right lower chest. Her differential count showed eosinophils, 22%; abso

  15. Two cases of severe sepsis caused by Bacillus pumilus in neonatal infants

    NARCIS (Netherlands)

    Kimouli, Maria; Vrioni, Georgia; Papadopoulou, Magdalini; Koumaki, Vasiliki; Petropoulou, Dimitra; Gounaris, Antonios; Friedrich, Alexander W.; Tsakris, Athanassios

    2012-01-01

    Bacillus pumilus is an environmental contaminant that has been rarely associated with clinical infections. Here, two cases of severe sepsis caused by B. pumilus are described in two full-term neonates; one in a female infant with no factors predisposing her to infection and the other in a male infan

  16. A Case of Infective Endocarditis and Pulmonary Septic Emboli Caused by Lactococcus lactis

    Science.gov (United States)

    Habib, Adib; Asli, Nazih; Geffen, Yuval; Miron, Dan; Elias, Nael

    2016-01-01

    Infective endocarditis is a rare condition in children with normal hearts. We present here a case of previously healthy eleven-year-old girl with infective endocarditis and pulmonary septic emboli caused by a very rare bacterial etiology (Lactococcus lactis). Identification of this pathogen was only made by polymerase chain reaction.

  17. [Clinical case of the month. Cardiac complications of acromegaly: a rare cause of dilated cardiomyopathy].

    Science.gov (United States)

    Devoitille, A; Beckers, A; Piérard, L A

    2012-04-01

    Acromegaly is a disease characterized by chronic growth hormone hypersecretion. Cardiovascular complications represent the main cause of death. We present here a rare case of dilated cardiomyopathy whose diagnosis revealed an acromegaly. This will provide the opportunity to review an uncommon disease and its recently reassessed prevalence.

  18. Tatumella ptyseos causing severe human infection: report of the first two Brazilian cases

    Directory of Open Access Journals (Sweden)

    Paulo Sérgio Gonçalves da Costa

    2008-10-01

    Full Text Available Tatumella ptyseos is the type species of the Tatumella genus (Enterobacteriaceae. This fermentative Gram-negative rod has only rarely been reported as a cause of human infections; there is very little information about it in the medical literature. We report here the first two Brazilian cases of T. ptyseos infections, both evolving to severe sepsis.

  19. Keratitis caused by the recently described new species Aspergillus brasiliensis: two case reports

    Directory of Open Access Journals (Sweden)

    Vágvölgyi Csaba

    2010-02-01

    Full Text Available Abstract Introduction Human infections caused by Aspergillus brasiliensis have not yet been reported. We describe the first two known cases of fungal keratitis caused by Aspergillus brasiliensis. Case presentations A 49-year-old Indian Tamil woman agricultural worker came with pain and defective vision in the right eye for one month. Meanwhile, a 35-year-old Indian Tamil woman presented with a history of a corneal ulcer involving the left eye for 15 days. The fungal strains isolated from these two cases were originally suspected to belong to Aspergillus section Nigri based on macro- and micromorphological characteristics. Molecular identification revealed that both isolates represent A. brasiliensis. Conclusion The two A. brasiliensis strains examined in this study were part of six keratitis isolates from Aspergillus section Nigri, suggesting that this recently described species may be responsible for a significant proportion of corneal infections caused by black Aspergilli. The presented cases also indicate that significant differences may occur between the severities of keratitis caused by individual isolates of A. brasiliensis.

  20. Insidious manifestation of pyogenic liver abscess caused by Streptococcus intermedius and Micrococcus luteus: a case report.

    Science.gov (United States)

    Ioannou, Antreas; Xenophontos, Eleni; Karatsi, Alexandra; Petrides, Christos; Kleridou, Maro; Zintilis, Chrysostomos

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora.

  1. Causes and consequences of personal financial management in the case of larger and structural charitable donations

    NARCIS (Netherlands)

    Wiepking, P.; Bekkers, R.H.F.P.

    2010-01-01

    We study causes and consequences of financial management in households in the specific case of charitable giving. We test hypotheses using couples in the Giving in the Netherlands Panel Study (n = 1,101). We find that more relationship specific investments lead to deciding on charitable giving as on

  2. Cutaneous phaeohyphomycosis caused by Exophiala dermatitidis: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Mei Chen

    2016-01-01

    Full Text Available We report a case of cutaneous phaeohyphomycosis caused by Exophiala dermatitidis. An adult male presented with a 1 month history of erythematous swelling and ulcer on the right forearm. E. dermatitidis was identified from the lesion through microscopic examination, in vitro culture, cutaneous biopsy and molecular analysis. He was treated with oral itraconazole (400 mg/day and showed improvement.

  3. Cutaneous phaeohyphomycosis caused by Exophiala dermatitidis: A case report and literature review.

    Science.gov (United States)

    Chen, Mei; Zhang, Jingdong; Dong, Zhengbang; Wang, Fei

    2016-01-01

    We report a case of cutaneous phaeohyphomycosis caused by Exophiala dermatitidis. An adult male presented with a 1 month history of erythematous swelling and ulcer on the right forearm. E. dermatitidis was identified from the lesion through microscopic examination, in vitro culture, cutaneous biopsy and molecular analysis. He was treated with oral itraconazole (400 mg/day) and showed improvement.

  4. OTORHINOLARYNGOLOGIC CAUSES OF CLAUDE-BERNARD-HÖRNER SYNDROME: THREE CASES REPORT

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    R. de la Fuente Cañibano

    2010-01-01

    Full Text Available The syndrome of Claude-Bernard-Hörner is caused by the sinpatical injury of thebranches ascending innervation of the stellate ganglion and the iris smooth muscle eyelid. His triad is the presence of ptosis, myosis and enoftalmos. It may be accompanied by anhidrosis, pupillary dilation heterocromía delayed in the congenital case.

  5. An unusual ulcer: A case of cutaneous mucormycosis caused by Rhizopus oryzae

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    Bradley J. Gardiner

    2015-03-01

    Full Text Available Mucormycoses are high-mortality infections feared by clinicians worldwide. They predominantly affect immunocompromised hosts and are associated with a spectrum of disease. We describe a case of cutaneous mucormycosis caused by Rhizopus oryzae in a patient with multiple risk factors cured with complete surgical excision and a short course of antifungal therapy.

  6. De Quervain disease caused by abductor pollicis longus tenosynovitis: a report of three cases.

    Science.gov (United States)

    Maruyama, Masahiro; Takahara, Masatoshi; Kikuchi, Noriaki; Ito, Kazuo; Watanabe, Tadayoshi; Ogino, Toshihiko

    2009-01-01

    De Quervain disease is caused by a stenosing tenosynovitis in the first dorsal compartment, and the main aetiology is extensor pollicis brevis (EPB) tenosynovitis. We encountered three cases in which EPB tenosynovitis was absent and abductor pollicis longus (APL) tenosynovitis was confirmed during operation. In the treatment of de Quervain disease, APL tenosynovitis should be paid as much attention as EPB tenosynovitis.

  7. Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature.

    Science.gov (United States)

    Subhani, Shaik; Patnaik, Amar N; Barik, Ramachandra; Nemani, Lalita

    2016-09-01

    Stenotrophomonas maltophilia is known for nosocomial habitat. Infective endocarditis due to this organism is rare and challenging because of resistance to multiple broad-spectrum antibiotic regimens. Early detection and appropriate antibiotic based on culture sensitivity reports are the key to its management. We report the diagnosis, treatment, and outcome of two cases of infective endocarditis caused by S. maltophilia.

  8. Urosepsis caused by Globicatella sanguinis and Corynebacterium riegelii in an adult: case report and literature review.

    Science.gov (United States)

    Matsunami, Masatoshi; Matusnami, Masatoshi; Otsuka, Yoshihito; Ohkusu, Kiyofumi; Sogi, Misa; Kitazono, Hidetaka; Hosokawa, Naoto

    2012-08-01

    We report an extremely rare case of urosepsis caused by Globicatella sanguinis and Corynebacterium riegelii coinfection in a 94-year-old Japanese man with nephrolithiasis. Prompt identification of this coinfection is important so that effective antimicrobial coverage can be initiated.

  9. OTORHINOLARYNGOLOGIC CAUSES OF CLAUDE-BERNARD-HÖRNER SYNDROME: THREE CASES REPORT

    OpenAIRE

    R. de la Fuente Cañibano; A. Muñoz Herrera

    2010-01-01

    The syndrome of Claude-Bernard-Hörner is caused by the sinpatical injury of thebranches ascending innervation of the stellate ganglion and the iris smooth muscle eyelid. His triad is the presence of ptosis, myosis and enoftalmos. It may be accompanied by anhidrosis, pupillary dilation heterocromía delayed in the congenital case.

  10. Hemosuccus pancreaticus as a rare cause of gastrointestinal bleeding: a report of two cases.

    Directory of Open Access Journals (Sweden)

    Ghodratollah Maddah

    2015-05-01

    Full Text Available Pancreatic diseases are known to be associated with complications such as pseudocyst and abscess. A pseudoaneurysm associated with pancreatitis may develop as well. The pseudoaneurysm may rupture into various parts of the gastrointestinal tract; the peritoneal cavity, or the retroperitoneum. We report two cases of Hemosuccus pancreaticus admitted to our center in the past five years. One case was associated with acute pancreatitis, and another case was associated with chronic pancreatitis. A pseudocyst was found in two cases. Both were successfully managed by emergency surgery. So, Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding with difficult diagnosis, and surgery is the effective treatment for the patient with severe bleeding. However in cases with no life-threatening bleeding angiography and embolization can be performed.

  11. Budd-chiari syndrome caused by diaphragmatic hernia of the liver: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jae Min; Yoon, Jung Won; Kim, Jae Wook; Chung, Woo Kyoung; Chung, Hee Sun; Kim, Joo Hyung; Choi, Jun Ho; Kim, Seung Ho [Armed Forces Capital Hospital, Seongnam (Korea, Republic of)

    2007-01-15

    Budd-Chiari syndrome is an uncommon disorder, and it is caused by obstruction of the hepatic venous out-flow or inferior vena cava above the hepatic vein. It may result from a large number of conditions, including primary congenital obstructions of the hepatic veins or inferior vena cava by webs or bands. Secondary causes include trauma, polycythemia vera, chronic leukemia, pregnancy, tumors and use of oral contraceptives. No definitive etiologic factors have been identified in two thirds of all cases. We recently experienced a case of Budd-Chiari syndrome caused by diaphragmatic hernia in 21-year-old man. Postoperative follow up CT showed normal venous flow after reintroduction of the liver into the abdominal cavity and closure of the diaphragm defect.

  12. Serious brain injury coexisting with multiple injuries caused by traffic accidents in 69 cases

    Institute of Scientific and Technical Information of China (English)

    张浚; 张鹤飞; 等

    1999-01-01

    Objective To explore the speciality,diagnosis,cure principle of serious brain injury coexisting with nultiple injuries caused by traffic accidents.Methods To analyze the clinic data of 69 cases of serious rain injury combined by oter parts of injuries caused by traffic accidents received from January 1998 to April 1999.Results This type of injury took up 11.5 percent of brain injuries in the same term and 33.6 percent of serious brain injuries.The specialities of the injury are that most of them were pedestrians crashed by vehicles.Coesisting injuries including chest injury and limb fractures accounted for a large part.The brain injury usally presented profound disturbance of consciousness,being dangerous and complicated,and a high ISS value.After treatment 13 cases died,9 cases was heavily crippled,11 cases lightly crippled,and 36 cases recovered.The death was usually caused by brain injury.Conclusions Road traffic accidents increased substantially every year.Most of them are related with violating drive rules and regulations.It is important to decrease the road traffic accidents by strengthening propaganda on traffic safety and traffic management.The main principles for salvage should emphasize the importance of pre-hospital emergency rescue and the accurate diagnosis rate,especially the distinction between coma and shock.The priority should be put on those injuries threatening to life.

  13. A rare cause of abdominal lymphadenopathy--tularemia: report of two pediatric cases.

    Science.gov (United States)

    Gülhan, Belgin; Tezer, Hasan; Kanık-Yüksek, Saliha; Kılıç, Selçuk; Senel, Emrah

    2014-01-01

    Tularemia caused by Francisella tularensis occurs worldwide in the northern hemisphere, with great variation in geographic and temporal occurrence. It generally presents as an acute febrile disease with the major clinical presentations including the six classic forms of tularemia: ulceroglandular, glandular, oculoglandular, oropharyngeal, typhoidal, and pneumonic. In contrast to European countries, where the ulceroglandular form is more prominent, the oropharyngeal form is the most common presentation in Turkey. We present rare cases of oropharyngeal tularemia in a 16-year-old boy and nine-year-old girl. To the best of our knowledge, these are the firstly described abdominal lymphadenopathy cases from Turkey. The second case was admitted with erythema nodosum, and abdominal lymphadenopathy was detected during the investigation. Excisional lymph node biopsy revealed abdominal tularemia. It is necessary to consider tularemia in the differential diagnosis of abdominal lymphadenopathy in tularemia regions. We also conclude that oropharyngeal tularemia can cause lymphadenopathy in any part of the gastrointestinal tract.

  14. Case of a cerebral abscess caused by Porphyromonas gingivalis in a subject with periodontitis

    Science.gov (United States)

    Grisar, Koenraad; Maes, Honorine; Politis, Constantinus

    2017-01-01

    We report the case of a 65-year-old man presenting with generalised seizures after developing a right frontal brain abscess. Stereotactic aspiration and subsequent matrix assisted laser desorption/ionisation time-of-flight analyzer (MALDI-TOF) spectrometry revealed Porphyromonas gingivalis as the only causative anaerobe microorganism. Secondary incision and drainage was required due to neurological deterioration with increased dimensions of the abscess, intracranial pressure and formation of a subdural occipitoparietal empyema. Oral imaging was positive for apical periodontitis of multiple elements; therefore, the remaining dentition was removed. Targeted antibiotic treatment included intravenous ceftriaxone and ornidazole. The patient was discharged to our revalidation unit 59 days after admission to make a full recovery. To the best of our knowledge, this is the sixth reported case of P. gingivalis causing an intracranial abscess and the third case of a true intracerebral parenchymal abscess caused by this bacterium. PMID:28228396

  15. Oesophagobronchial fistula caused by varicella zoster virus in a patient with AIDS: a unique case

    Science.gov (United States)

    Moretti, F; Uberti-Foppa, C; Quiros-Roldan, E; Fanti, L; Lillo, F; Lazzarin, A

    2002-01-01

    Human herpesvirus oesophagitis in human immunodeficiency virus positive patients is caused by cytomegalovirus and herpes simplex virus; no cases of oesophagitis and oesophagobrochial fistula as a result of varicella zoster virus (VZV) have been reported to date. This report describes the case of a patient with a 2–3 mm deep oesophageal ulcer whose viral culture was positive for VZV. The patient was treated with acyclovir with resolution of the symptomatology. After the end of the induction treatment, because of the onset of fever and fits of coughing during eating, the patient underwent oesophagography, which showed an ulcer with an oesophagobronchial fistula in the middle and lower third of the oesophagus. This case report stresses the role of VZV infection as a possible cause of oesophagobronchial fistula, a rare but benign condition in patients with AIDS. PMID:11986352

  16. Inferior alveolar nerve paresthesia caused by endodontic pathosis: a case report and review of the literature.

    Science.gov (United States)

    Giuliani, M; Lajolo, C; Deli, G; Silveri, C

    2001-12-01

    Sensory disturbances such as anesthesia, hypoesthesia, hyperesthesia, and paresthesia may be present in the oral cavity, stemming from many local and systemic factors. Paresthesia of the inferior alveolar nerve is quite rare because of the unique anatomy of this nerve. Among other effects, periapical lesions can damage the nerve, resulting in paresthesia of its innervated area. Only a few cases of paresthesia caused by these lesions are reported in the literature. In this report we present a case of paresthesia of the right inferior alveolar nerve; discuss the anatomy, pathobiology, and etiology; and suggest that a periapical lesion affecting the lower right second molar (No. 31) may have been the cause. The routine x-rays (intraoral and panorex) and the axial and cross-sectional tomographs of the mandible by means of computed tomography contribute to making this case a good example of nerve injury.

  17. CASE OF SUBACUTE THYROIDITIS PRESENTING AS THE CAUSE OF PYREXIA OF UNKNOWN ORIGIN

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    Faiz

    2015-10-01

    Full Text Available : Pyrexia of unknown origin (PUO is not infrequently a diagnostic dilemma for clinicians. Endocrine causes of PUO are rare. The endocrine disorder likely to present as PUO is subacute thyroiditis. Subacute thyroiditis usually occurs in middle-aged women as viral prodrome, classic symptoms of thyrotoxicosis, and an elevated erythrocyte sedimentation rate. The patient may have abrupt onset of fever and chills with complaints of thyroid pain, or only low-grade fever with poorly characterized anterior neck pain. We present a case of PUO in a 40-year-old male who had fever for more than two month. Despite an extensive evaluation, the patient had persistent fever and no cause was found, with the exception of subacute thyroiditis. The fever resolved from the fifth day of treatment with low-dose steroid (Prednisolone, 10mg per day. This case illustrates that subacute thyroiditis should be considered in cases of FUO.

  18. Bilateral Facial Paralysis Caused by Temporal Bone Fracture: A Case Report

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    Ghiasi

    2016-02-01

    Full Text Available Introduction Although bilateral facial nerve palsy is a rare condition, its etiology is more detectable than the unilateral type. A temporal bone fracture is one cause of bilateral facial nerve palsy, contributing in 3% of the cases. Case Presentation Here, we report the case of a 35-year-old man complaining of bilateral incomplete eye closure, two weeks after a closed head injury caused by a motor vehicle accident. Conclusions The high resolution computed tomography findings revealed a bilateral temporal bone fracture line, which extended to the fallopian canal. With regard to treatment, near complete recovery was obvious after two weeks of treatment with oral corticosteroids. Overall, bilateral facial palsy is hard to diagnose; therefore, clinical suspicion and the early detection of facial nerve injuries is necessary for good nerve recovery in temporal bone fractures.

  19. Rhinologic headache caused by mucosal contact with a surgical solution. A case report

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    Ignacio ALCALÁ-RUEDA

    2016-03-01

    Full Text Available Introduction and objective: Rhinologic headache caused by mucosal contact is a difficult definition condition with good response to surgical approach. Description: We present a case of a 31 year-old male with rhinologic headache criteria. We decided to offer a surgical approach, successfully. Discussion: Rhinologic headache is included in the group of “Headache caused by disorders of the nasal mucosa, turbinates or septum”. There is no agreement about its cause because the prevalence of mucosal nasal contact is similar in patients with and without facial pain. There is evidence in the resolution of facial pain with a surgical approach. Conclusions: Despite the evidence of success in the surgical approach, some doubts still persist about the causes of this entity.

  20. Seizures caused by pyridoxine (vitamin B6) deficiency in adults: A case report and literature review.

    Science.gov (United States)

    Tong, Yisha

    2014-05-01

    Pyridoxine (vitamin B6) deficiency is a recognised cause of intractable seizures in neonates. However, pyridoxine deficiency related seizures in adults were rarely reported. This article reports a case of a 79 year old lady who suffered from new-onset seizures and was successfully treated with vitamin B6. The patient had chronic renal disease and weight loss due to anepithymia following a pelvic fracture. This article also reviews literatures of seizures caused by pyridoxine deficiency in adults. Seizures caused by vitamin B6 deficiency in adults may result from dietary deficiency, liver disease, pregnancy and certain medications and can be easily treated by vitamin B6 with excellent outcome. Clinicians should consider vitamin B6 deficiency as a potential aetiology of seizures, even in patients who suffer from other underlying diseases which can cause seizures.

  1. Death caused by a signal rocket--not an isolated case*.

    Science.gov (United States)

    Alempijević, Djordje; Jecmenica, Dragan; Pavlekić, Snezana; Savić, Slobodan; Kovacević, Slobodan

    2008-09-01

    Fatalities related to sporting events are predominantly caused by blunt force injuries especially due to the emotional involvement of crowd, but occasionally other types of trauma are reported as well. A case of very rare trauma caused by shooting with a hand-held parachute signal rocket during a football match is presented. A 17-year-old football fan sustained fatal injuries, a combination of mechanical trauma caused by rocket penetration, as well as extensive thermal burning of the thoracic viscera. Analysis of the event was based on autopsy findings and evidence produced by medicolegal and ballistic experts. Improper use of a hand-held signal rocket, designed for marine distress signals, may cause serious injuries either mechanically, due to explosion, or as a result of thermal discharge. In the reported case, pattern of injuries is discussed, and medical finding corroborated to other available evidence. The presented case is a reminder that the forensic pathologist should be informed accordingly on the type and features of weapon suspected to produce injury, to be able to understand traumatic changes, and look for potential presence of foreign bodies at postmortem examination.

  2. The association between lifetime cigarette smoking and dysphonia in the Korean general population: findings from a national survey

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    Haewon Byeon

    2015-04-01

    Full Text Available This study aims to investigate the relationship between current smoking and lifetime amount smoked and the incidence of dysphonia using data from a national cross-sectional survey that represents the Korean population. Subjects were 3,600 non-institutionalised civilian adults over the age of 19 (1,501 males and 2,099 females who completed the laryngeal examination of the 2008 Korea National Health and Nutrition Examination Survey (KNHANES. For lifetime amount smoked, subjects were classified as light smokers (≤26.7 pack years, medium smokers (26.7–40.5 pack years, heavy smokers (40.5–55.5 pack years, and very heavy smokers (55.5–156 pack years based on pack years (packs smoked per day × years as a smoker. The odds ratio (OR for the statistical test was presented using hierarchical logistic regression. When adjusted for covariates (age, gender, level of education, income, occupation, alcohol consumption and pain/discomfort during the last two weeks, current smokers had a 1.8 times (OR = 1.77, 95% CI [1.17–2.68] higher risk for self-reported voice problems than non-smokers. Moreover, current smokers had a 1.6 times (OR = 1.56, 95% CI [1.02–2.38] higher risk of laryngeal disorder (p < 0.05. In terms of pack years, very heavy smokers were significantly more likely to have laryngeal disorder, while self-reported voice problems were significantly more likely for heavy smokers but not very heavy smokers. The results of this study imply that chronic smoking has a significant relationship with dysphonia. Longitudinal studies are required in future work to verify the causality between lifetime smoking amount and dysphonia.

  3. An unusual foreign body as cause of chronic sinusitis: a case report

    Directory of Open Access Journals (Sweden)

    Dinerman Harry

    2010-05-01

    Full Text Available Abstract Introduction The presence of a foreign body in the nose is a relatively uncommon occurrence. Many unusual foreign bodies in the nose have been reported in the literature, but no case of a nasal packing occurring as a foreign body in the nasal cavity for a prolonged time has been found. Case presentation We describe a unique case of the largest foreign body left in situ in the nasal cavity for over 10 years. Our patient was a 71-year-old Caucasian man with diabetes. Because of this, he was at high risk of developing complications from the foreign body and the chronic sinusitis. Amazingly, though, the foreign body had not caused any symptoms on our patient for many years, except for nasal discharge during the last few years. To the best of our knowledge, this is the first case in the literature of such a large intra-nasal foreign body described in an adult without mental illness and without trauma that remained in situ for such a long time. Conclusion Undoubtedly, even illnesses with no complications could prove difficult for clinicians to diagnose. Clinicians should recognize the underlying causes that are responsible for the symptoms of chronic sinusitis and a unilateral nasal discharge should be assumed to be caused by an intra-nasal foreign body until proven otherwise.

  4. Multiple thromboembolism with multiple causes in a 69-year-old woman: a case report

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    Pagnanelli Alessandro

    2011-05-01

    Full Text Available Abstract Introduction Aggressive, recurrent embolisms require accurate etiologic diagnosis. We describe the case of a 69-year-old Italian Caucasian woman with recurrent arterial embolisms in whom several sources and triggers of thrombosis were detected. Case presentation The patient, a 69-year-old Italian Caucasian woman, presented with a systemic embolism that was initially attributed to atrial fibrillation. The recurrence of embolisms despite anti-thrombotic therapy prompted a re-evaluation of the clinical presentation. New potential causes of thrombosis emerged in this patient, including thrombocytosis associated with the JAK2 V617F mutation and the very rare mural thrombosis of the descending aorta. A mural thrombus in the pulmonary artery was detected contiguous with the aortic mural thrombosis, raising the possibility of a clinically silent ductus Botalli as the initiating event. The patient was treated with warfarin, aspirin, hydroxyurea, and surgery. Conclusions The diagnosis was achieved via systematic use of imaging procedures and reconsideration of blood tests performed to explore the diagnosis of thrombosis. This allowed a deeper and more detailed analysis of the case beyond the conventional approach, which would have aimed to identify one cause for the condition at hand, in this case, atrial fibrillation. The broader approach that we used resulted in the diagnosis of multiple embolisms from multiple sites and multiple causes.

  5. Osteochondromas: An Unusual Cause of Vascular Disease in Young Patients: 2 Clinical Cases.

    Science.gov (United States)

    Parente, Basso; Fiorucci, Beatrice; Simonte, Gioele; Brambilla, Deborah Maria; Lenti, Massimo

    2016-04-01

    Osteochondroma is the most common benign tumor of bones in young patients. It is an unusual cause of nonatherosclerotic peripheral arteriopathy. It is mostly detected in youth and, thus, diagnosis can be delayed since symptoms such as claudication can be confused with muscular cramps. In case of clinical suspicion of peripheral artery disease in the young, the presence of an exostosis should be suspected. We reported our experience of 2 young patients with limb ischemia due to ab extrinseco compression of popliteal artery. In both cases, surgical exeresis of a lower limb exostosis was performed. In the first case, bypass surgery was not required since arterial wall was not damaged. In the second case, an autologous inverted saphenous vein femoro popliteal bypass was performed.

  6. Acute prostatitis caused by Raoultella planticola in a renal transplant recipient: a novel case.

    Science.gov (United States)

    Koukoulaki, M; Bakalis, A; Kalatzis, V; Belesiotou, E; Papastamopoulos, V; Skoutelis, A; Drakopoulos, S

    2014-06-01

    We present a unique case of acute bacterial prostatitis caused by a very rare human pathogen, Raoultella planticola, in a renal allograft recipient 3.5 months post transplantation. Only a few cases of human infection by this pathogen have been reported worldwide. The present study reports the case of a 67-year-old man who was admitted to our transplant unit 3.5 months post transplantation with fever, dysuria, suprapubic pain, symptoms and signs of acute prostatitis, and elevated markers of inflammation and prostate-specific antigen. R. planticola was isolated in the urine culture. The patient was treated with ciprofloxacin (based on the antibiogram) and had a full recovery, with satisfactory renal function. To the best of our knowledge, this is not only the first reported case of R. planticola prostatitis, but also the first report of such an infection in a solid organ transplant recipient or in a patient on immunosuppressive medication.

  7. [A case of repeated shunt malfunctions with eosinophilic meningitis caused by silicone allergy].

    Science.gov (United States)

    Kambara, Mizuki; Miyazaki, Takeshi; Yoshikane, Tsutomu; Sugimoto, Keiji; Akiyama, Yasuhiko

    2014-12-01

    The ventricular-peritoneal shunt for hydrocephalus is a well-known and established method but is sometimes complicated by shunt malfunction due to several causes. Eosinophilic meningitis is a rare disease, but has occasionally been reported as a cause of shunt malfunction. Here, we report the case of a 74-year-old woman with repeated shunt malfunction and eosinophilic meningitis due to a silicone allergy. Originally, the patient received a ventricular-peritoneal shunt for normal pressure hydrocephalus secondary to subarachnoid hemorrhage. However, shunt malfunction was identified 6 weeks later, and the first shunt revision was performed using a new shunt system from a different company. Further evaluation to identify the cause of the shunt malfunction revealed no abnormal findings, except for eosinophilia in the serum and cerebrospinal fluid. A second shunt malfunction was identified 16 weeks after the first shunt revision. We therefore concluded that eosinophilic meningitis caused by a silicone allergy might be the real culprit and a second shunt revision was performed using a silicone "extracted" tube. Since then, the patient's course has been free from shunt malfunction. In this case, the serum and cerebrospinal fluid eosinophilia were useful markers for identifying the cause of repeated shunt malfunctions. The silicone "extracted" tube may be helpful for diagnosis and therapy.

  8. A Dual Case of Peritonitis and Central Nervous System Infection Caused by Nutritionally Variant Streptococcal Species

    Science.gov (United States)

    Vivar, Sussi; Girotto, Jennifer E.

    2017-01-01

    Nutritional variant streptococci (NVS) are difficult to identify bacteria that can cause invasive infections such as endocarditis and meningitis. NVS as a cause of peritonitis has not been routinely described. This case of NVS as the etiology of peritonitis associated with previous neurosurgery and ventriculoperitoneal (VP) shunt revision demonstrates its potential role as a significant pathogen in patients with peritonitis and VP shunts. Therapy consists of vancomycin plus a second agent but since there are no standards for susceptibility testing, clinical response remains the standard for determining the efficacy of treatment. When there is central nervous system (CNS) involvement it is important to include drugs with appropriate CNS penetration. PMID:28239499

  9. [Anastomotic false-diverticulum causing an atypical dumping syndrome. A case report].

    Science.gov (United States)

    Covarelli, P; Esperti, L; Fratto, A; Cerroni, M; Marianeschi, P; Cristofani, R

    2003-02-01

    Aim of the study is to evaluate the causes of dumping syndromes following partial gastrectomies, and to report an unusual feature of dumping. A case of early dumping due to diverticular-like dilation of gastro-jejunal anastomosis is described with preoperative imaging and intraoperative picture. The surgical correction led to complete clinical remission; the common causes and physiopathological bases of dumping are reviewed and the role of en-Y gastro-jejunal reconstruction is underlined in order to reduce the risk of developing the syndrome.

  10. Staphylococcal abscess caused by trauma with a rosebush aculeus (Plantae, Rosaceae): apropos of a case.

    Science.gov (United States)

    Bernardes Filho, Fred; Alves, Andreia Oliveira; Martins, Gustavo; Sasso, Letícia Soares; Gama, Carolina Mendonça; Cenci, Gardênia Borges

    2013-01-01

    Cutaneous abscess is a localized collection of pus in the dermis and subcutaneous tissue usually caused by trauma. The authors report the case of a 30-year-old male patient, gardener, that presents an ulcerated plaque in the third right finger, caused by an aculeus plant wound. The examination of the lesion's exudate ruled out the existence of fungi and showed the presence of Staphylococcus aureus. The authors emphasize the sporotrichosis as an important differential diagnosis, especially in endemic areas, and the indication of the exudate culture is discussed.

  11. Adrenal Insufficiency as a Cause of Acute Liver Failure: A Case Report

    Directory of Open Access Journals (Sweden)

    Jamshid Vafaeimanesh

    2013-01-01

    Full Text Available Introduction. Many diseases and conditions can contribute to elevated liver enzymes. Common causes include viral and autoimmune hepatitis, fatty liver, and bile duct diseases, but, in uncommon cases like liver involvement in endocrine disorders, liver failure is also seen. Adrenal insufficiency is the rarest endocrine disorder complicating the liver. In the previously reported cases of adrenal insufficiency, mild liver enzymes elevation was seen but we report a case with severe elevated liver enzymes and liver failure due to adrenal insufficiency. Based on our knowledge, this is the first report in this field. Case Report. A 39-year-old woman was referred to emergency ward due to drowsiness and severe fatigue. Her laboratory tests revealed prothrombin time: 21 sec, alanine aminotransferase (ALT: 2339 IU/L, aspartate aminotransferase (AST: 2002 IU/L, and ALP: 90 IU/L. No common cause of liver involvement was discovered, and eventually, with diagnosis of adrenal insufficiency and corticosteroid therapy, liver enzymes and function became normal. Finally, the patient was discharged with good general condition. Conclusion. With this report, we emphasize adrenal insufficiency (primary or secondary as a reason of liver involvement in unexplainable cases and recommend that any increase in the liver enzymes, even liver failure, in these patients should be observed.

  12. Fistula Formation between Right Upper Bronchus and Bronchus Intermedius Caused by Endobronchial Tuberculosis: A Case Report.

    Science.gov (United States)

    Kim, Mikyoung; Kang, Eun Seok; Park, Jin Yong; Kang, Hwa Rim; Kim, Jee Hyun; Chang, YouJin; Choi, Kang Hyeon; Lee, Ki Man; Kim, Yook; An, Jin Young

    2015-07-01

    Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

  13. Familial aortic coarctation: a rare cause of refractory hypertension in the elderly: a case report.

    Science.gov (United States)

    Lara-Rojas, Carmen M; Bernal-Lopez, M Rosa; Lopez-Carmona, M Dolores; Gomez-Huelgas, Ricardo

    2015-01-01

    We report the first case of late presentation of familial aortic coarctation, a rare cause of hypertension. Diagnosis of familial aortic coarctation in the elderly is exceptional, given that in the absence of endovascular or surgical repair patients do not usually survive beyond 50 years of age. Our case concerns a 72-year-old woman with hypertension of long evolution, control of which improved markedly after endovascular repair of the coarctation. Her son had undergone surgery for repair of aortic coarctation at the age of 23 years.

  14. Ascariasis as a cause of hepatic abscess: A report of 3 cases

    Directory of Open Access Journals (Sweden)

    V Chauhan

    2015-01-01

    Full Text Available We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

  15. Brucellar discitis as a cause of lumbar disc herniation: a case report.

    Science.gov (United States)

    Yilmaz, Cem; Akar, Aykan; Civelek, Erdinç; Köksay, Berkay; Kabatas, Serdar; Cansever, Tufan; Caner, Hakan

    2010-01-01

    Brucellosis is an infectious disease spread by consumption of non-pasteurized milk products or through contact with infected animals. Spinal involvement is one of the most important complications and the lumbar area is the most frequently affected site. Among the neurological consequences, nerve root compression can be a result of epidural abscess, granuloma or discitis secondary to vertebral body involvement. In this case report we present a 50-year-old male patient with brucellar discitis without spondylitis which caused lumbar disc herniation. We want to emphasize that discitis should also be considered in differential diagnosis of nerve root compression in suspected cases.

  16. Infective endocarditis caused by Achromobacter xylosoxidans: a case report and review of the literature.

    Science.gov (United States)

    Tokuyasu, Hirokazu; Fukushima, Takehito; Nakazaki, Hirofumi; Shimizu, Eiji

    2012-01-01

    An 86-year-old woman who underwent placement of a prosthetic aortic valve for regurgitation 5 years previously was admitted because of spiking fever. The blood culture results were positive for gram-negative rods, which were identified as Achromobacter xylosoxidans. Approximately 4 months after being sent to the hospital, transthoracic echocardiography revealed vegetation at the prosthetic aortic valve. Ultimately, a diagnosis of A. xylosoxidans endocarditis of the prosthetic aortic valve was made. We report an extremely rare case of bacteremia associated by prosthetic valve endocarditis with A. xylosoxidans. In addition, we review 10 previously reported cases of endocarditis caused by A. xylosoxidans.

  17. A pediatric case of life-threatening airway obstruction caused by a cervicomediastinal thymic cyst

    Energy Technology Data Exchange (ETDEWEB)

    Komura, Makoto; Kanamori, Yutaka; Sugiyama, Masahiko; Iwanaka, Tadashi [University of Tokyo Hospital, Department of Pediatric Surgery, Tokyo (Japan); Fukushima, Noriyoshi [University of Tokyo Hospital, Department of Pathology, Tokyo (Japan)

    2010-09-15

    Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. Only 6-10% suffer dysphagia, dyspnoea, stridor, cervical pain or vocal paralysis. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants. We report a unique case of a 20-month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children. (orig.)

  18. Tinea corporis caused by Microsporum gallinae: first clinical case in Japan.

    Science.gov (United States)

    Miyasato, Hitona; Yamaguchi, Sayaka; Taira, Kiyohito; Hosokawa, Atsushi; Kayo, Susumu; Sano, Ayako; Uezato, Hiroshi; Takahashi, Kenzo

    2011-05-01

    We report herein a case of tinea corporis caused by Microsporum gallinae in a 96-year-old, otherwise healthy Japanese man. The patient had a long working history as a breeder of fighting cocks, and he suffered from two erythematous macules after being bitten by a cock. M. gallinae was identified as the infectious agent based on the morphology of isolates cultured on slides and analysis of DNA sequences of the internal transcribed spacers (ITS) from ribosomal DNA from cultured isolates. The patient was successfully treated with antifungal ointments. To our knowledge, this is the first case of M. gallinae infection in a human reported in Japan.

  19. A case of idiopathic colonic varices: A rare cause of hematochezia misconceived as tumor

    Institute of Scientific and Technical Information of China (English)

    Joung-Ho Han; Won-Joong Jeon; Hee-Bok Chae; Seon-Mee Park; Sei-Jin Youn; Seok-Hyung Kim; Il-Hun Bae; Sang-Jeon Lee

    2006-01-01

    Colonic varices are a very rare cause of lower gastrointestinal bleeding. Fewer than 100 cases of colonic varices, and 30 cases of idiopathic colonic varices (ICV) have been reported in the English literature.Among these 30 cases of ICV, 19 cases were diagnosed by angiography, and 7 operated cases were diagnosed later as ileocecal vein deficit, hemangioma, and idiopathic in 1, 1, 5 cases, respectively. We report the case of a 24-year-old man who suffered from multiple episodes of hematochezia of varying degree at the age of 11 years. He had severe anemia with hemoglobin of 21 g/L. On colonoscopy, tortuously dilated submucosal vein and friable ulceration covered with dark necrotic tissues especially at the rectosigmoid region were seen from the rectum up to the distal descending colon. It initially appeared to be carcinoma with varices. Mesenteric angiographic study suggested a colonic hemangioma.Low anterior resection was done due to medically intractable and recurrent hematochezia. Other bowel and mesenteric vascular structures appeared normal.Microscopic examination revealed normal colonic mucosa with dilated veins throughout the submucosa and serosa without representing new vessel growth. Taken all of these findings together, the patient was diagnosed as ICV. His postoperative course was uneventful.

  20. Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia.

    Science.gov (United States)

    Suppa, A; Marsili, L; Giovannelli, F; Di Stasio, F; Rocchi, L; Upadhyay, N; Ruoppolo, G; Cincotta, M; Berardelli, A

    2015-08-01

    In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during 'linguistic' tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated 'linguistic' task-related cortical excitability modulation in patients with adductor-type spasmodic dysphonia (ASD), a speech-related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non-dominant M1 excitability at baseline, during 'linguistic' (reading aloud/silent reading/producing simple phonation) and 'non-linguistic' tasks (looking at non-letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the 'linguistic' tasks with different voice intensities. We also examined MEPs in HS and ASD during hand-related 'action-verb' observation. Patients were studied under and not-under botulinum neurotoxin-type A (BoNT-A). In HS, TMS over the dominant M1 elicited larger MEPs during 'reading aloud' than during the other 'linguistic'/'non-linguistic' tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased-amplitude MEPs during 'reading aloud' and 'syllabic phonation' tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing 'linguistic'/'non-linguistic' tasks. In HS and ASD, 'linguistic' task-related excitability changes were present regardless of the different voice intensities. During hand-related 'action-verb' observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT-A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to 'linguistic' tasks; BoNT-A returns these excitability changes to normal.

  1. Combining Voice Therapy and Physical Therapy: A Novel Approach to Treating Muscle Tension Dysphonia

    Science.gov (United States)

    Craig, Jennifer; Tomlinson, Carey; Stevens, Kristin; Kotagal, Kiran; Fornadley, Judith; Jacobson, Barbara; Garrett, C. Gaelyn; Francis, David O.

    2015-01-01

    Objective This study investigated the role of a specialized physical therapy program for muscle tension dysphonia patients as an adjunct to standard of care voice therapy. Study Design Retrospective Cohort Study Methods Adult MTD patients seen between 2007 and 2012 were identified from the clinical database. They were prescribed voice therapy and, if concomitant neck pain, adjunctive physical therapy. In a pragmatic observational cohort design, patients underwent one of four potential treatment approaches: voice therapy alone (VT), voice therapy and physical therapy (VT+PT), physical therapy alone (PT), or incomplete/no treatment. Voice handicap outcomes were compared between treatment approaches. Results Of 153 patients meeting criteria (Median age 48 years, 68% female, and 30% had fibromyalgia, chronic pain, chronic fatigue, depression, and/or anxiety), there was a similar distribution of patients with moderate or severe pre-treatment VHI scores across treatment groups (VT 45.5%, VT+PT 43.8%, PT 50%, no treatment 59.1%; p=0.45). Patients treated with VT alone had significantly greater median improvement in VHI than those not treated: 10-point vs. 2-point (p=0.02). Interestingly, median VHI improvement in patients with baseline moderate-severe VHI scores was no different between VT (10), VT+PT (8) and PT alone (10; p=0.99). Conclusions Findings show voice therapy to be an effective approach to treating MTD. Importantly, other treatment modalities incorporating physical therapy had a similar, albeit not significant, improvement in VHI. This preliminary study suggests that physical therapy techniques may have a role in the treatment of a subset of MTD patients. Larger, comparative studies are needed to better characterize the role of physical therapy in this population. PMID:26012419

  2. A case of pneumonia caused by Legionella pneumophila serogroup 12 and treated successfully with imipenem.

    Science.gov (United States)

    Nishizuka, Midori; Suzuki, Hiroki; Ara, Tomoka; Watanabe, Mari; Morita, Mami; Sato, Chisa; Tsuchida, Fumihiro; Seto, Junji; Amemura-Maekawa, Junko; Kura, Fumiaki; Takeda, Hiroaki

    2014-06-01

    The patient was an 83-year-old man hospitalized for Haemophilus influenzae pneumonia, who developed recurrent pneumonia after improvement of the initial episode. Legionella pneumophila serogroup 12 was isolated from the sputum, accompanied by increased serum antibody titers to L. pneumophila serogroup 12. Therefore, the patient was diagnosed as having Legionella pneumonia caused by L. pneumophila serogroup 12. Case reports of pneumonia caused by L. pneumophila serogroup 12 are rare, and the case described herein is the first report of clinical isolation of this organism in Japan. When the genotype was determined by the protocol of The European Working Group for Legionella Infections (Sequence-Based Typing [SBT] for epidemiological typing of L. pneumophila, Version 3.1), the sequence type was ST68. Imipenem/cilastatin therapy was found to be effective for the treatment of Legionella pneumonia in this patient.

  3. Acute small bowel obstruction caused by endometriosis: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Antonella De Ceglie; Claudio Bilardi; Sabrina Blanchi; Massimo Picasso; Marcello Di Muzio; Alberto Trimarchi; Massimo Conio

    2008-01-01

    Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare (1%-7%).Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction,ranging from 7% to 23% of all cases with intestinal involvement.We report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery,in a woman whose symptoms were not related to menses.Histology of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular alteration. Endometrial lymph node involvement,with a cystic glandular pattern was also deted.

  4. Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: a case report.

    Science.gov (United States)

    Ito, Fumitake; Okubo, Tomoharu; Yasuo, Tadahiro; Mori, Taisuke; Iwasa, Koichi; Iwasaku, Kazuhiro; Kitawaki, Jo

    2013-01-01

    Congenital cutaneous candidiasis is a very rare disease with less than 100 cases published in the medical literature. Neonates having this disease present with systemic skin lesions caused by intrauterine Candida infections. We present a case of threatened premature delivery due to Candida chorioamnionitis, which caused both maternal postpartum endometritis and neonatal congenital cutaneous candidiasis. A 34-year-old woman who was admitted for fetal membrane bulging at 20 weeks of gestation underwent McDonald cervical cerclage. We diagnosed threatened premature delivery due to intrauterine infection; therefore, we terminated the gestation by cesarean section at 24 weeks of gestation. Fungi-like yeast was detected in infantile gastric juice. Histopathological findings of the placenta revealed that Candida albicans mycelium invaded the placenta, chorioamniotic membrane and umbilical cord.

  5. Biofilm in Osteomyelitis caused by a Rare Pathogen, Morganella morganii : A Case Report.

    Science.gov (United States)

    De, Asmita; Raj, Hirak Jyoti; Maiti, Prasanta Kumar

    2016-06-01

    Morganella morganii is a member of Enterobacteriaceae family, whose natural habitat is the human gastrointestinal tract. It rarely causes infection alone and is generally encountered in immunosuppressed patients. Osteoarticular pathologies are not commonly observed with Morganella morganii and infections by it have high mortality rate. Biofilm colonization is a causative factor behind the chronicity and/or refractoriness of certain infections. Biofilms colonize on inert medical devices, prosthesis, fibrosed tissues, sinus tracts as well as dead bones as in case of chronic osteomyelitis. Morganella morganii is not a common pathogen to produce biofilm. In this case report, we present a 56-year-old male patient with chronic osteomyelitis of right proximal tibia caused by biofilm producing strain of Morganella morganii, following trauma.

  6. Giant Fecaloma Causing Small Bowel Obstruction: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mosin Mushtaq

    2015-04-01

    Full Text Available Fecaloma is a mass of hardened feces being impacted mostly in rectum and sigmoid. The most common sites of the fecaloma is the sigmoid colon and the rectum. There are several causes of fecaloma and have been described in association with Hirschsprung’s disease, psychiatric patients, Chagas disease, both inflammatory and neoplastic, and in patients suffering with chronic constipation. Up to now several cases of giant fecaloma has been reported in the literature most of them presenting with megacolon or urinary retention. We herein report a case of giant fecaloma leading to bowel obstruction who was successfully treated by surgery. A 30-yrar-old man presented with sign and symptoms of acute bowel obstruction. He underwent exploratory laparotomy and enterotomy. He was found to have a giant fecaloma causing bowel obstruction in the jejunum. He was discharged after the operation with good condition. Jejunal fecaloma is extremely rare condition.

  7. Case report: cutaneous myiasis caused by Dermatobia hominis, the human botfly.

    Science.gov (United States)

    Garvin, Kanishka W; Singh, Virtaj

    2007-05-01

    Cutaneous myiasis caused by Dermatobia hominis, the human botfly, involves the infestation of human tissue with fly larvae, and is common in Central and South America. We report a case of a 57-year-old man with cutaneous myiasis imported into the US from Belize. The epidemiology, biological life cycle, clinical presentation, and various methods of larval extraction, including incision and drainage, are discussed.

  8. Emergency radiation treatment for paraplegia caused by extradural leukemic invasion; Report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Masao; Kuroda, Yasumasa; Sano, Akira (Tenri Hospital, Nara (Japan)) (and others)

    1993-02-01

    We present 2 cases of emergency radiation therapy for paraplegia caused by extradural leukemic invasion. Tumor regression was noted at 12 Gy, and complete disappearance at 20 Gy. MRI proved useful in early detection and in the follow-up. They were doing well for 14 months after irradiation. Irradiation should be the treatment of first choice for these tumors, and the detail such as radiation field, total dosage should be determined in consideration of other therapeutic measures. (author).

  9. Sinusitis caused by Scopulariopsis brevicaulis: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Laurent Sattler

    2014-07-01

    Full Text Available We report a case of non-invasive sinusitis caused by Scopulariopsis brevicaulis in a 70-year-old immunocompetent patient who had an antibiotic-resistant suppurative tooth infection evolving for seven months. The sinus endoscopy highlighted a foreign body at the bottom of the sinus, which led to the hypothesis of fungal ball sinusitis. Culture of excised tissue was positive for S. brevicaulis.

  10. Magnetic resonance imaging of endometriosis of the piriform muscle causing sciatica: case report

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, N.A.J.; Murphy, J.P.; Bloom, C.; Hamilton, P. [Sunnybrook and Women' s College Health Sciences Centre, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Endometriosis is the presence of functioning endometrial tissue in a location outside the uterus and is a rare cause of sciatica. The superior soft-tissue contrast and sensitivity of magnetic resonance imaging (MRI) in detecting blood products make it a valuable imaging modality in patients with pelvic endometriosis. In the case described below, it allowed a presumptive diagnosis to be made and the response to medical therapy to be monitored. (author)

  11. First case of cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis in Suriname.

    Science.gov (United States)

    Hu, Ricardo V P F; Kent, Alida D; Adams, Emily R; van der Veer, Charlotte; Sabajo, Leslie O A; Mans, Dennis R A; de Vries, Henry J C; Schallig, Henk D F H; Lai A Fat, Rudy F M

    2012-05-01

    The main causative agent of cutaneous leishmaniasis (CL) in Suriname is Leishmania (Viannia) guyanensis. This case report presents a patient infected with Leishmania (Viannia) braziliensis, a species never reported before in Suriname. This finding has clinical implications, because L. braziliensis has a distinct clinical phenotype characterized by mucocutaneous leishmaniasis, a more extensive and destructive form of CL that requires different treatment. Clinicians should be aware that chronic cutaneous ulcers in patients from the Guyana region could be caused by L. braziliensis.

  12. Fatal injuries caused by guns using shotshell: case reports and ballistic studies.

    Science.gov (United States)

    Rougé, D; Telmon, N; Alengrin, D; Marril, G; Bras, P M; Arbus, L

    1994-05-01

    The authors present six cases of homicide and suicide in which the weapon involved was a handgun using shotshell. The injuries caused are described and the ballistic characteristics of the weapons are studied. Such weapons, which are relatively easy to obtain, are not as innocuous as they may appear, since they may be modified either by changing the barrel or by removal of the device inside the barrel which is intended to prevent the firing of solid slugs.

  13. Colopleural fistula caused by aspergillus: an extremely rare complication after lung resection—case report

    OpenAIRE

    Hayashi, Akio; Susaki, Yoshiyuki; Ose, Naoko; Takeuchi, Yukiyasu; Maeda, Hajime

    2016-01-01

    A colopleural fistula is a rare condition reported to be caused by Crohn’s disease, a malignant tumor of the gastrointestinal tract, and other clinical conditions. Some studies have noted that a sub-diaphragmatic abscess, usually organized following abdominal surgery, may play some role in the formation of this type of fistula. Therefore, a colopleural fistula is a complication very rarely encountered by thoracic surgeons after lung resection. We experienced an extremely rare case of colopleu...

  14. Predictors of Cardiogenic and Non-Cardiogenic Causes in Cases with Bilateral Chest Infiltrates

    OpenAIRE

    Lee, Yeon Joo; Lee,Jinwoo; Park, Young Sik; Lee, Sang-min; Yim, Jae-Joon; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Lee, Chang-Hoon

    2013-01-01

    Background Differentiating cardiogenic pulmonary edema from other bilateral lung diseases such as pneumonia is frequently difficult. We conducted a retrospective study to identify predictors for cardiogenic pulmonary edema and non-cardiogenic causes of bilateral lung infiltrates in chest radiographs. Methods The study included patients who had newly developed bilateral lung infiltrates in chest radiographs and patients who underwent echocardiography. Cases were divided into two groups based o...

  15. Brown tumor of the patella caused by primary hyperparathyroidism: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Irie, Tomoko; Mawatari, Taro; Ikemura, Satoshi; Matsui, Gen; Iguchi, Takahiro; Mitsuyasu, Hiroaki [Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka (Japan)

    2015-06-15

    It has been reported that the common sites of brown tumors are the jaw, pelvis, ribs, femurs and clavicles. We report our experience in a case of brown tumor of the patella caused by primary hyperparathyroidism. An initial radiograph and CT showed an osteolytic lesion and MR images showed a mixed solid and multiloculated cystic tumor in the right patella. One month after the parathyroidectomy, rapid bone formation was observed on both radiographs and CT images.1.

  16. Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration

    OpenAIRE

    Eventov-Friedman, S; Rozin, I; Shinwell, E. S.

    2010-01-01

    The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.

  17. Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration.

    Science.gov (United States)

    Eventov-Friedman, S; Rozin, I; Shinwell, E S

    2010-02-01

    The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.

  18. Intractable hiccups caused by esophageal diverticular candidiasis in an immunocompetent adult: a case report

    Science.gov (United States)

    Yahata, Shinsuke; Kenzaka, Tsuneaki; Kushida, Saeko; Nishisaki, Hogara; Akita, Hozuka

    2017-01-01

    Introduction Various causes of intractable hiccups have been reported; however, to the best of our knowledge, there are no previous reports of either intractable hiccups due to esophageal candidiasis in an immunocompetent adult or improvement following antifungal therapy. Case presentation An 87-year-old man presented with intractable hiccups. Although the patient was immunocompetent, he used proton pump inhibitors. An esophagogastroduodenos-copy revealed several white deposits throughout the esophagus and extensive white deposits in the midesophageal diverticulum. A mucosal culture showed candidiasis, which was suspected to be the cause of the intractable hiccups. After oral fluconazole had been prescribed, the candidiasis resolved and the hiccups improved. Therefore, we concluded that esophageal diverticular candidiasis was the cause of his intractable hiccups. Conclusion Physicians should consider esophageal candidiasis as one of the differential diagnoses for intractable hiccups, even in immunocompetent adults. PMID:28243153

  19. Neglected Fournier’s Gangrene Caused by Acinetobacter baumannii: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Arif Emre

    2016-01-01

    Full Text Available Fournier’s gangrene, rare but life threatening disease, is characterized by an acute necrotic infection of the scrotum, penis, or perineum. Fournier’s gangrene is a mixed infection caused by both aerobic and anaerobic bacteria. Fournier’s gangrene caused by multidrug resistant Acinetobacter baumannii have been reported rarely. The mainstay of treatment is prompt recognition and a combination of antibiotics with radical debridement. We describe a case of a 56-year-old male patient presenting with neglected Fournier’s gangrene caused by Acinetobacter baumannii. Many treatment modalities including broad-spectrum antibiotics, aggressive debridement, negative pressure wound therapy, diversion colostomy, and partial-thickness skin grafts were applied to save the patient’s life.

  20. A fatal case of hypermagnesemia caused by ingesting magnesium chloride as a folk remedy.

    Science.gov (United States)

    Torikoshi-Hatano, Aiko; Namera, Akira; Shiraishi, Hiroaki; Maeno, Yoshitaka; Kato, Hideaki; Nagao, Masataka

    2013-11-01

    We report a fatal case of hypermagnesemia caused by oral ingestion of milk containing magnesium chloride as a folk remedy. The autopsy of the 75-year-old woman showed no injury or illness as the cause of death. Neither alcohol nor controlled drugs were found by the toxicological analysis. Her posthumous serum magnesium concentration was 10.2 mg/dL. The concentration of magnesium in serum was higher than that of the previous reports. Therefore, the cause of death was considered to be hypermagnesemia. Recently, the prescription drugs, over-the-counter drugs, and health foods containing magnesium are consumed as supplements in the world, and their potential toxicity should be recognized.

  1. [A case of acute intracranial epidural hematoma caused by chronic nasal sinusitis].

    Science.gov (United States)

    Kihara, Kazunori; Sato, Motoki; Kado, Ken; Fukuda, Kazumasa; Nakamura, Takao; Yamakami, Iwao

    2015-01-01

    Non-traumatic intracranial acute epidural hematoma(EDH)is rare. It is mostly caused by coagulation disorders, dural metastasis, or vascular malformations of the dura. We report a case of non-traumatic acute EDH caused by chronic nasal sinusitis and review the literature comprising 10 cases of acute EDH caused by chronic nasal sinusitis. A 16-year-old boy visited our outpatient clinic with a 2-day history of severe headache. He did not have fever or neurological abnormalities and showed no evidence of head trauma. Cranial computed tomography(CT)revealed sphenoid sinusitis and a small amount of epidural air in the middle fossa, but no other intracranial abnormalities. After eight days with no subsequent history of trauma, radiological exams showed a massive acute epidural hematoma in the left middle fossa and temporal convexity without any vascular lesion or skull fracture. The patient underwent a hematoma evacuation that revealed neither a skull fracture nor a vascular abnormality. In this adolescent, chronic nasal sinusitis caused fragility of the meningeal artery wall, an air collection in the epidural space, and the detachment of the dura mater from the inner surface of the skull, thereby resulting in a non-traumatic acute EDH.

  2. Myocardial bridging as a cause of acute myocardial infarction: a case report

    Directory of Open Access Journals (Sweden)

    Emiroglu Yunus

    2002-09-01

    Full Text Available Abstract Background Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. Myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. Case presentation A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI. Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. Blood transfusion was made because he had a deep anemia. A normal hemaglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. Conclusions Myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.

  3. Infectious crystalline keratopathy caused by Cladosporium sp. after penetrating keratoplasty: a case report

    Science.gov (United States)

    Stock, Ricardo Alexandre; Bonamigo, Elcio Luiz; Cadore, Emeline; Oechsler, Rafael Allan

    2016-01-01

    Background Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma. Case presentation A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract. The patient underwent penetrating keratoplasty and phacoemulsification. During postoperative follow-up, another therapeutic keratoplasty was required because unresponsive infectious keratitis was observed. The infiltrate’s characteristics were suggestive of infectious crystalline keratopathy; in particular, the infiltrate was insidious and progressive, and grayish-white branches appeared in the anterior corneal stroma. As different therapies were administered, inflammatory reactions ranging from mild to severe were observed. The infection was unresponsive to typical antifungal drugs. This lack of response most likely occurred due to steroid treatment and the diffuse corneal spread of an atypical microorganism, which was subsequently identified in culture as Cladosporium sp. After the second therapeutic keratoplasty, the patient’s eye integrity was successfully reestablished. Conclusion This study likely provides the first report describing a case of infectious crystalline keratopathy caused by Cladosporium sp. This case emphasizes the clinical characteristics and outcome of this type of keratitis. PMID:27621671

  4. Bartonella, a common cause of endocarditis: a report on 106 cases and review.

    Science.gov (United States)

    Edouard, Sophie; Nabet, Cecile; Lepidi, Hubert; Fournier, Pierre-Edouard; Raoult, Didier

    2015-03-01

    Bartonella spp. are fastidious bacteria that cause blood culture-negative endocarditis and have been increasingly reported. In this study, we included all patients retrospectively and prospectively diagnosed with Bartonella endocarditis in our French reference center between 2005 and 2013. Our diagnosis was based on the modified Duke criteria and microbiological findings, including serological and PCR results. To review the published literature, we searched all human Bartonella endocarditis cases published in the PubMed database between January 2005 and October 2013. We report here a large series of 106 cases, which include 59 cases that had not previously been reported or mentioned. Indirect immunofluorescence assays, Western blotting, and real-time PCR from total blood, serum, and valve tissue exhibited sensitivities of 58%, 100%, 33%, 36%, and 91%, respectively. The number of cases reported in the literature between 2005 and 2013 increased to reach a cumulative number of 196 cases. The number of cases reported in the literature by other centers is increasing more rapidly than that reported by our French reference center (P Bartonella endocarditis. We suggest that a positive PCR result from a cardiac valve or blood specimen, an IgG titer of ≥800 using an immunofluorescence assay, or a positive Western blot assay be considered major Duke criteria for Bartonella endocarditis. There is no real increase in the incidence of these infections but rather a better understanding and interest in the disease resulting from the improvement of diagnostic tools.

  5. Gastroduodenal Intussusception Caused by a Peutz- Jeghers Polyp in a Young Child: A Case Report

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    Roh, Jae Eun; Cho, Bum Sang; Lee, Seung Young; Jeon, Min Hee; Lee, Ji Hyuk; Lee, Ho Chang; Koo, Ji Hae [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2010-09-15

    Gastroduodenal intussusception is a rare condition caused by the prolapse of a gastric tumor with subsequent invagination of a portion of the gastric wall into the duodenum. Various gastric lesions including adenoma, lipoma, leiomyoma, hamartoma, adenocarcinoma, gastrointestinal stromal tumor (GIST), and as in our case a Peutz- Jeghers polyp, can serve as a lead point of intussusception. Only three cases of gastroduodenal intussusception secondary to a Peutz-Jeghers polyp have been reported. We experienced a case of gastroduodenal intussusception in a 36-month-old boy who presented with intermittent nonbilious vomiting, abdominal pain, and anemia. An abdominal ultrasound and contrast enhanced CT scan showed gastrointestinal intussusception and a mass-like lesion in the second portion of duodenum. A laparotomy revealed a 7x8 cm sized mass at the gastric body, which was pathologically confirmed as a Peutz-Jeghers polyp

  6. A Case of Delayed Myelopathy Caused by Atlantoaxial Subluxation without Fracture

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    Ryo Takamatsu

    2013-01-01

    Full Text Available We report a case of delayed myelopathy caused by atlantoaxial subluxation without fracture. The patient was a 38-year-old male who became aware of weakness in extremities. The patient had a history of hitting his head severely while diving into a swimming pool at the age of 14 years old. At that time, cervical spine plain X-ray images showed no fracture, and the cervical pain disappeared after use of a collar for several weeks. At his first visit to our department, X-ray images showed an unstable atlantoaxial joint. After surgery, weakness of the extremities gradually improved. At 6 months after surgery, bone union was completed and the symptoms disappeared. This case shows that atlantoaxial ligament injuries are difficult to diagnose and may easily be missed. A high level of suspicion is important in such cases, since neurological compromise or deterioration may occur many years after the injury.

  7. Peritonitis caused by Roseomonas in a patient undergoing automated peritoneal dialysis: case report and literature review.

    Science.gov (United States)

    Tsai, Shang-Feng; Chen, Chen-Hsu; Shu, Kuo-Hsiung; Wu, Ming-Ju

    2012-01-01

    A 48-year-old man was admitted with cloudy dialysate and diagnosed as peritoneal dialysis (PD)-related peritonitis caused by Roseomonas infection. This is the third case of PD-related peritonitis due to Roseomonas species and also the first case of peritonitis in automated peritoneal dialysis. Despite its low virulence and rare incidence in peritoneal dialysis, clinicians should be alert to the possibility of Roseomonas infection due to its high resistance to antibiotics. Literature on Roseomonas infection is also reviewed. The current guidelines for empirical peritonitis in PD patients do not adequately cover such infection. Refractory treatment in high risk cases should alert clinicians to upgrade antibiotics even for a vague manifestation.

  8. Contact dermatitis caused by airborne agents. A review and case reports

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    Dooms-Goossens, A.E.; Debusschere, K.M.; Gevers, D.M.; Dupre, K.M.; Degreef, H.J.; Loncke, J.P.; Snauwaert, J.E.

    1986-07-01

    A general review is given of airborne-induced contact dermatoses, particularly of the irritant and allergenic types. Because the reports in the literature often omit the term airborne, 12 volumes of Contact Dermatitis (January 1975-July 1985) were screened, and the cases cited were classified in function of the anamnesis, lesion locations, causative irritants and allergens, and other factors. The present article also discusses differential diagnoses, in particular with regard to contact dermatitis of the face, ears, and neck. Finally, seven case reports of occupational and nonoccupational contact dermatitis problems caused by airborne agents are presented. In some of the cases the allergens have not been mentioned in published literature previously. 84 references.

  9. Cracked mercury dental amalgam as a possible cause of fever of unknown origin: a case report

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    Bamonti Fabrizia

    2008-03-01

    Full Text Available Abstract Introduction Sudden fever of unknown origin is quite a common emergency and may lead to hospitalization. A rise in body temperature can be caused by infectious diseases and by other types of medical condition. This case report is of a woman who had fever at night for several days and other clinical signs which were likely related to cracked dental mercury amalgam. Case presentation A healthy women developed fever many days after had cracked a mercury dental amalgam filling. Blood tests evidenced increased erythrocyte sedimentation rate, anemia and elevated white cell count; symptoms were headache and palpitations. Blood tests and symptoms normalized within three weeks of removal of the dental amalgam. Conclusion This case highlights the possible link between mercury vapor exposure from cracked dental amalgam and early activation of the immune system leading to fever of unknown origin.

  10. Secondary infertility caused by the retention of fetal bones after an abortion: a case report

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    Kramer Hannah MC

    2008-06-01

    Full Text Available Abstract Introduction Unwanted contraception through prolonged retention of fetal bone is a rare cause of secondary infertility. It is usually associated with a history of abortion, either spontaneous or induced. Case presentation We describe a case of intrauterine retention of fetal bone diagnosed 8 years after the termination of a pregnancy. The patient had no complaints of pain, irregular vaginal bleeding or discharge. A hysteroscopy was performed and irregular structures were removed. These fragments were fetal bones, which probably functioned as an intrauterine contraceptive device. After removal of the fetal bone fragments the patient conceived spontaneously within 6 months. Conclusion This case report stresses the importance of taking a thorough history and evaluation of the endometrium by transvaginal ultrasound or hysteroscopy in women with secondary infertility.

  11. Static winging of the scapula caused by osteochondroma in adults: a case series

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    Orth Patrick

    2012-10-01

    Full Text Available Abstract Introduction Although palsy of the long thoracic nerve is the classical pathogenesis of winging scapula, it may also be caused by osteochondroma. This rare etiopathology has previously been described in pediatric patients, but it is seldom observed in adults. Case presentation We describe three cases of static scapular winging with pain on movement. Case 1 is a Caucasian woman aged 35 years with a wing-like prominence of the medial margin of her right scapula due to an osteochondroma originating from the ventral omoplate. Histopathological evaluation after surgical resection confirmed the diagnosis. The postoperative course was unremarkable without signs of recurrence on examination at 2 years. Case 2 is a Caucasian woman aged 39 years with painful scapula alata and neuralgic pain projected along the left ribcage caused by an osteochondroma of the left scapula with contact to the 2nd and 3rd rib. Following surgical resection, the neuropathic pain continued, demanding neurolysis of the 3rd and 4th intercostal nerve after 8 months. The patient was free of symptoms 2 years after neurolysis. Case 3 is a Caucasian woman aged 48 years with scapular winging due to a large exostosis of the left ventral scapular surface with a broad cartilaginous cap and a large pseudobursa. Following exclusion of malignancy by an incisional biopsy, exostosis and pseudobursa were resected. The patient had an unremarkable postoperative course without signs of recurrence 1 year postoperatively. Based on these cases, we developed an algorithm for the diagnostic evaluation and therapeutic management of scapula alata due to osteochondroma. Conclusions Orthopedic surgeons should be aware of this uncommon condition in the differential diagnosis of winged scapula not only in children, but also in adult patients.

  12. Ortner’s syndrome: a case report and literature review

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    Bruno Landim Dutra

    2015-08-01

    Full Text Available AbstractThe authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner’s syndrome.

  13. The association between lifetime cigarette smoking and dysphonia in the Korean general population: findings from a national survey.

    Science.gov (United States)

    Byeon, Haewon

    2015-01-01

    This study aims to investigate the relationship between current smoking and lifetime amount smoked and the incidence of dysphonia using data from a national cross-sectional survey that represents the Korean population. Subjects were 3,600 non-institutionalised civilian adults over the age of 19 (1,501 males and 2,099 females) who completed the laryngeal examination of the 2008 Korea National Health and Nutrition Examination Survey (KNHANES). For lifetime amount smoked, subjects were classified as light smokers (≤26.7 pack years), medium smokers (26.7-40.5 pack years), heavy smokers (40.5-55.5 pack years), and very heavy smokers (55.5-156 pack years) based on pack years (packs smoked per day × years as a smoker). The odds ratio (OR) for the statistical test was presented using hierarchical logistic regression. When adjusted for covariates (age, gender, level of education, income, occupation, alcohol consumption and pain/discomfort during the last two weeks), current smokers had a 1.8 times (OR = 1.77, 95% CI [1.17-2.68]) higher risk for self-reported voice problems than non-smokers. Moreover, current smokers had a 1.6 times (OR = 1.56, 95% CI [1.02-2.38]) higher risk of laryngeal disorder (p lifetime smoking amount and dysphonia.

  14. Multidimensional assessment of strongly irregular voices such as in substitution voicing and spasmodic dysphonia: a compilation of own research.

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    Moerman, Mieke; Martens, Jean-Pierre; Dejonckere, Philippe

    2015-04-01

    This article is a compilation of own research performed during the European COoperation in Science and Technology (COST) action 2103: 'Advance Voice Function Assessment', an initiative of voice and speech processing teams consisting of physicists, engineers, and clinicians. This manuscript concerns analyzing largely irregular voicing types, namely substitution voicing (SV) and adductor spasmodic dysphonia (AdSD). A specific perceptual rating scale (IINFVo) was developed, and the Auditory Model Based Pitch Extractor (AMPEX), a piece of software that automatically analyses running speech and generates pitch values in background noise, was applied. The IINFVo perceptual rating scale has been shown to be useful in evaluating SV. The analysis of strongly irregular voices stimulated a modification of the European Laryngological Society's assessment protocol which was originally designed for the common types of (less severe) dysphonia. Acoustic analysis with AMPEX demonstrates that the most informative features are, for SV, the voicing-related acoustic features and, for AdSD, the perturbation measures. Poor correlations between self-assessment and acoustic and perceptual dimensions in the assessment of highly irregular voices argue for a multidimensional approach.

  15. Laryngeal manual therapy palpatory evaluation scale: A preliminary study to examine its usefulness in diagnosis of occupational dysphonia

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    Ewelina Woźnicka

    2017-04-01

    Full Text Available Background: The aim of this study has been to assess the larynx and soft tissue around the vocal tract in a group of people with healthy voice, and in a group of patients with occupational dysphonia using the new laryngeal manual therapy palpatory evaluation scale (LMTPE. Material and Methods: The examinations were performed in a study (dysphonic group of professional voice users who had developed voice disorders (N = 51 and in the control group of normophonic subjects (N = 50. All the participants underwent perceptual voice assessment and examination by means of the LMTPE scale. Additionally, phoniatric examination including VHI (Voice Handicap Index questionnaire, GRBAS (the Grade of hoarseness, Roughness, Breathiness, Asthenic, Strained perceptual evaluation, maximum phonation time (MPT measurement and videostroboscopy was performed in the study group. Results: The comparison of the LMTPE total score showed that the results of the study group were significantly poorer than those of controls (p < 0.001. In the study group, correlations were found between the LMTPE results and the VHI scores (p < 0.05, perceptual evaluation by the GRBAS (p < 0.05 and the objective parameter MPT (p < 0.05. Conclusions: The study has proven that the LMTPE scale is characterized by the high score of Cronbach’s α ratio estimating the reliability of the test. The results have confirmed that the LMTPE scale seems to be a valuable tool, useful in diagnostics of occupational dysphonia, particularly of hyperfunction origin. Med Pr 2017;68(2:179–188

  16. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

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    Jae Wook Kim

    2014-01-01

    Full Text Available Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group. Methods. Thirty patients with adductor spasmodic dysphonia (ADSD, who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05. There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

  17. [What are the causes of death of patients with tuberculosis: multiple causes of death in a cohort of cases and a research proposal of presumed causes].

    Science.gov (United States)

    Rocha, Marli Souza; Oliveira, Gisele Pinto de; Aguiar, Fernanda Pinheiro; Saraceni, Valéria; Pinheiro, Rejane Sobrino

    2015-04-01

    The objective of this study was to analyze the multiple causes of death in a cohort of patients with tuberculosis (TB) and to introduce an investigation proposal death for TB from a list of presumable causes. We performed a probabilistic record linkage with the databases of the Information System for Notifiable Diseases (SINAN) 2006 and the Mortality Information System (SIM) 2006-2008. There were 825 deaths, of which 23% for death for TB, deaths due to TB with 16% and 61% without mention of TB. Two hundred and fifteen (42.7%) deaths occurred within the period of treatment, whose profile differed from the pattern of causes when TB was an associated cause, with high frequency of respiratory diseases, AIDS and ill-defined causes. We elaborated a proposal for correction of associated causes of death and an investigation proposal death for TB from a list of presumable causes. According to the proposal, 26 deaths could have modified the underlying cause. This study highlights the importance of record linkage to TB surveillance and improvement of information the SIM and SINAN.

  18. Alterations in CNS Activity Induced by Botulinum Toxin Treatment in Spasmodic Dysphonia: An H[subscript 2][superscript 15]O PET Study

    Science.gov (United States)

    Ali, S. Omar; Thomassen, Michael; Schulz, Geralyn M.; Hosey, Lara A.; Varga, Mary; Ludlow, Christy L.; Braun, Allen R.

    2006-01-01

    Speech-related changes in regional cerebral blood flow (rCBF) were measured using H[subscript 2][superscript 15]O positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest…

  19. Ileocecal-colonic intussusception caused by cecal adenocarcinoma A case report.

    Science.gov (United States)

    Verre, Luigi; Rossi, Rachele; Gaggelli, Ilaria; Piccolomini, Alessandro; Podzemny, Vlasta; Tirone, Andrea

    2012-01-01

    INTRODUCTION: Intussusception in adults is an infrequent cause of intestinal occlusion that is usually due to neoplasm lesions. The unspecific nature of the clinical presentation often delays diagnosis. It is most commonly emergency explorative laparotomy which clarifies the etiology of the occlusion. The authors report a case of intestinal occlusion caused by ileocecal-colonic invagination with a small cecal adenocarcinoma as lead point, in a 74-year-old woman. CASE REPORT: A 74-year-old woman came to the Emergency Department, complaining of crampy pain in the mid- and lower abdomen. An abdominal ultrasound revealed a "pseudokidney sign" apparently involving the cecum. Because there were no clear signs of occlusion, the patient was dicharged on the same day. Three days later, upon admission, the patient complained of episodes of abdominal pain with intervals of moderate well-being, associated with nausea, vomiting and an inability to pass stool (but not gas) for 36 hours. On clinical examination her abdomen was distended and tender on palpation in all quadrants, especially in the right iliac fossa where a large mass could be felt. Standard abdominal x-Ray documented gaseous distension of some loops of the jejunum-ileum with some air-fluid level. The patient underwent an abdominal CT scan which showed advanced intussusception that appeared to be ileocolic and multiple enlarged lymphnodes were found in the invaginated mesentery at the base of which there appears to be a thickening of the intestinal wall that is probably neoplastic in nature. The patient underwent explorative laparotomy. Ileocecal-colonic intussusception caused by a cecal growth 5 cm in diameter was found on examination of the surgical specimen. Histology showed that the cause of the large swelling of the ascending colon was a vegetating ulcerated adenocarcinoma (medium grade differentiation: G2), measuring 6.5x 4.0 cm, arising from a tubulovillous adenoma infiltrating the submucosa. CONCLUSIONS

  20. Uterine vascular lesions: a rare cause of abnormal uterine bleeding, reporting of two cases

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    Sunita Arora

    2014-06-01

    Full Text Available Uterine vascular lesions in the form of arteriovenous malformation or pseudo aneurysm are rare but potential life-threatening source of bleeding. A high index of suspicion and accurate diagnosis of the condition in a timely manner are essential because instrumentation that is often used for other causes of uterine bleeding can lead to massive hemorrhage. We describe two cases of uterine vascular malformation, one presenting as postabortal hemorrhage and other as postpartum hemorrhage. Case one presented as postabortal hemorrhage after induced abortion following dilatation and curettage. Case two presented as delayed postpartum hemorrhage after six weeks following cesarean section. In both cases diagnosis of uterine arteriovenous malformation was made on Doppler ultrasonography which was subsequently confirmed on pelvic angiography. The embolization of affected uterine arteries was performed successfully in both cases. Uterine vascular lesion should be suspected in patient with abnormal vaginal bleeding, especially who has recent medical history of induced abortion or dilatation and curettage or cesarean section and so on. Although angiography remains the gold standard for making diagnosis, Doppler ultrasonography is also a good noninvasive technique for the same. Uterine artery embolization offers a safe and effective treatment. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 749-753

  1. A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report

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    Senadhi Viplove

    2010-11-01

    Full Text Available Abstract Introduction Chronic mesenteric ischemia is a condition that is classically associated with significant atherosclerosis of the abdominal arteries, causing postprandial abdominal pain out of proportion to physical examination. The abdominal pain is exacerbated after meals due to the shunting of blood away from the intestines to the stomach, causing relative ischemia. More than 95% of chronic mesenteric ischemia cases are due to atherosclerosis. We report the first known case of chronic mesenteric ischemia from fibromuscular dysplasia. To the best of our knowledge, this is also the first known case in the literature where postprandial abdominal pain was the presenting symptom of fibromuscular dysplasia. Case presentation A 44-year-old Caucasian woman with a history of hypertension and preeclampsia, who had taken oral contraceptive pills for 15 years, presented with an intractable, colicky abdominal pain of two weeks duration. This abdominal pain worsened with oral intake. It was also associated with diarrhea and vomiting. Physical examination revealed stage III hypertension out of proportion to her risk factors and diffuse abdominal pain without peritoneal signs. An abdominal computed tomography scan, completed in the emergency room, revealed nonspecific colitis. Laboratory work revealed leukocytosis with a left shift, an erythrocyte sedimentation rate of 79 and a C-reactive protein level of 100. She was started on intravenous flagyl and intravenous ciprofloxacin. However, all microbial cultures were negative including three cultures for clostridium difficile. Urine analysis revealed nephritic range proteinuria. The laboratory profile was within normal limits for perinuclear-anti-neutrophil cytoplasmic antibody, cytoplasmic-anti-neutrophil cytoplasmic antibody, anti-saccharomyces cerevisiae antibody, antinuclear antibody test, celiac profile, lactate, carbohydrate antigen-125 and thyroid stimulating hormone. A colonoscopy was completed

  2. Synthetic fiber from a teddy bear causing keratitis and conjunctival granuloma: case report

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    Prause Jan U

    2011-06-01

    Full Text Available Abstract Background To report a case of keratitis and a case of conjunctivitis caused by synthetic fibers from toy teddy bears. Case presentation Case stories with histopathological analysis. 1 A two-year-old girl developed a severe case of keratitis and corneal ulceration. The initial treatment with various antibiotics gave no improvement and eventually the patient developed spontaneous perforation of the cornea. The corneal swabs contained no bacteria or fungi. Corneal grafting was performed and the corneal button was sent for histopathological examination. 2 A five-year-old girl presented with ocular irritation in her left eye. Examination revealed a conjunctival granuloma in the inferior fornix. The lesion was excised and histopathologically examined. Results Microscopy revealed synthetic fibers embedded in the cornea and in the conjunctival granuloma. The diagnosis was confirmed by demonstration of marked birefringence of the synthetic fibers. Microscopical examination of synthetic fibers from two different types of fur (whiskers and face hairs from the two-year-old girl's teddy bear was performed. Hairs from the face of the teddy bear were morphologically and microscopically identical with the fibers causing the severe corneal ulceration in the two-year-old girl. Conclusions Doctors should especially in small children be aware of the risk of ocular consequences of close exposure of synthetic fibers from stuffed toy animals. Corneal ulceration, clinically presenting as corneal infection with negative culturing and staining, should lead to a different clinical strategy and treatment. The treatment of conjunctival synthetic fiber granuloma is excision and antibiotic eye drops.

  3. Case Reports of Aripiprazole Causing False-Positive Urine Amphetamine Drug Screens in Children.

    Science.gov (United States)

    Kaplan, Justin; Shah, Pooja; Faley, Brian; Siegel, Mark E

    2015-12-01

    Urine drug screens (UDSs) are used to identify the presence of certain medications. One limitation of UDSs is the potential for false-positive results caused by cross-reactivity with other substances. Amphetamines have an extensive list of cross-reacting medications. The literature contains reports of false-positive amphetamine UDSs with multiple antidepressants and antipsychotics. We present 2 cases of presumed false-positive UDSs for amphetamines after ingestion of aripiprazole. Case 1 was a 16-month-old girl who accidently ingested 15 to 45 mg of aripiprazole. She was lethargic and ataxic at home with 1 episode of vomiting containing no identifiable tablets. She remained sluggish with periods of irritability and was admitted for observation. UDS on 2 consecutive days came back positive for amphetamines. Case 2 was of a 20-month-old girl who was brought into the hospital after accidental ingestion of an unknown quantity of her father's medications which included aripiprazole. UDS on the first day of admission came back positive only for amphetamines. Confirmatory testing with gas chromatography-mass spectrometry (GC-MS) on the blood and urine samples were also performed for both patients on presentation to detect amphetamines and were subsequently negative. Both patients returned to baseline and were discharged from the hospital. To our knowledge, these cases represent the first reports of false-positive amphetamine urine drug tests with aripiprazole. In both cases, aripiprazole was the drug with the highest likelihood of causing the positive amphetamine screen. The implications of these false-positives include the possibility of unnecessary treatment and monitoring of patients.

  4. Subvalvular aortic stenosis as a cause of sudden death: two case reports.

    Science.gov (United States)

    Turan, Arzu Akcay; Guven, Taner; Karayel, Ferah; Pakis, Isil; Gurpinar, Kagan; Ozaslan, Abdi

    2006-03-01

    Sudden death is defined as a death that occurs suddenly, develops during an unpredictable course, and is due to natural or unnatural causes. Although there is no universally standardized definition on how "sudden" a sudden death is, WHO defines sudden death as a death that occurs within 24 hours after the onset of symptoms. The aim of this study is to present 2 rarely reported autopsy cases and to emphasize the importance of systemic autopsy at sudden death. On macroscopic examination, crescent-shaped, thick, fibrous membranes, located 5 mm and 3 mm away from the aortic valves, were detected. Fibrous membranes extended from the ventricular septum to the left ventricular outflow tract, thus apparently narrowing this region. Left ventricular wall and septum were slightly thickened, and there were scattered grayish-white areas of a small diameter. These became more intense in the septum and myocardium of the left ventricle on the anterior plane of the myocardial sections. In both cases, the aortic valves of were thickened and also markedly narrowed on one of them. In this case, the fibrous membrane adhered to the aortic valve and extended to the anterior leaflet of the mitral valve at one side. Both aortic valves comprised 3 leaflets. Other valves and coronary arteries showed no macroscopic pathologic findings. Microscopic examination of both cases demonstrated that the fibrous membrane comprising abundant collagen fibers was situated on the ventricular septum. Hypertrophy, moderate to severe interstitial fibrosis, and focal areas of scarring were observed in the specimens taken from the septal and ventricular myocardium. No abnormality was found on the conduction system examinations. Toxicologic analysis results in blood were negative. Based on the findings, membranous-type (discrete type) subvalvular aortic stenosis, diagnosed during the autopsy, was considered as the cause of sudden death in both cases.

  5. A case of generalized peritonitis due to a rupture of the bladder caused by radiation cystitis

    Energy Technology Data Exchange (ETDEWEB)

    Fujitake, Shin-ichi; Nozaki, Hideki; Shimizu, Minoru; Maeda, Yoshiyuki; Kataoka, Susumu [Meitetsu Hospital, Nagoya (Japan)

    1999-03-01

    An 83-year-old woman was admitted to the department of gastroenterology in our hospital with a diagnosis of adhesive ileus following operation for a uterine cancer on July 22, 1997. Conservative therapy was started, but three days later, peritoneal signs appeared and white blood cell count and CRP level increased. An emergency operation was performed. Upon laparotomy, there were a large volume of ascites and a rupture of the bladder of which wall had become fragile. It was thought that the cause of rupture might result from radiation cystitis because she received irradiation after operation for the uterine cancer. Ruptured site of the bladder was sutured. Possible causes of the ileus were thought to be intestinal paralysis due to generalized peritonitis and a narrowing of the ileum where inflammatory change was remarkable. For this, an excision of the ileum with ileostomy was performed. Thereafter a closure of the ileostomy and ileocolostomy were carried out. The patient had difficulty in management of evacuation for a while, but she was discharged on March 2, 1998. Spontaneous rupture of the bladder is rare. This paper presents such a rare case caused by radiation cystitis, together with 14 cases reported in Japan. It is thought that surgeons who manage acute abdomen may encounter the disease. (author)

  6. A case report of a crisis caused by external radiation in the malignant pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Akiyo; Tena, Shinichi; Nomura, Kaoru; Demura, Hiroshi [Tokyo Women`s Medical Coll. (Japan)

    1996-08-01

    A case of a severe complication not described hitherto was reported, which was caused by external radiation to bone metastasis of malignant pheochromocytoma to resolve pain. The patient, a female of 59 y, with multiple bone metastasis gave MRI findings of tumor lesion and osteolysis at thoracic vertebra. Internal radiation was thought to be ineffective since the uptake of {sup 131}I-MIBG was insufficient in the tumor. Alpha-methyl tyrosine, phentolamine and propranolol were treated. After external irradiation of total dose of 20 Gy/week to thoracic vertebra was done at a single dose of 4 Gy to resolve pain, a crisis of hypertension (200/110 mmHg) was caused accompanying with tachycardia (160/min), perspiration, cold feeling of limb, dehydration and increase of serum LDH, ALP and K. The symptom was improved by the dose increase of alpha-methyltyrosine and other above drugs. This case indicates that even a small dose of external radiation can cause a crisis described above in pheochromocytoma and alpha- and beta-blockers together with inhibitor of catecholamine synthesis should be given before radiation. (K.H.)

  7. Severe Facet Joint Arthrosis Caused C7/T1 Myelopathy: A Case Report

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    Toshimi Aizawa

    2009-01-01

    Full Text Available Cervical myelopathy is caused by degenerative processes of the spine including intervertebral disc herniation and posterior spur usually developing at C3/4 to C5/6. C7/T1 single level myelopathy is very rare because of the anatomical characteristics. Facet joint arthrosis can be a cause of cervical myelopathy but only a few cases have been reported. The authors report an extremely rare case of C7/T1 myelopathy caused by facet joint arthrosis. A 58-year-old male presented with hand and gait clumsiness. The radiological examinations revealed severe C7/T1 facet joint arthrosis with bony spur extending into the spinal canal, which compressed the spinal cord laterally. The T1 spinous process indicated nonunion of a “clay-shoveler's” fracture, which suggested that his cervico-thoracic spine had been frequently moved, and thus severe arthrosis had occurred in the facet joints. A right hemilaminectomy of C7 and C7/T1 facetectomy with single level spinal fusion led to complete neurological improvement.

  8. Increased spasticity from a fracture in the baclofen catheter caused by Charcot spine: case report.

    Science.gov (United States)

    Ravindra, Vijay M; Ray, Wilson Z; Sayama, Christina M; Dailey, Andrew T

    2015-04-01

    In patients with Charcot spine, a loss of normal feedback response from the insensate spine results in spinal neuropathy. Increasing deformity, which can manifest as sitting imbalance, crepitus, or increased back pain, can result. We present the case of a patient with a high-thoracic spinal cord injury (SCI) who subsequently developed a Charcot joint at the T10-11 level that resulted in a dramatic increase in previously controlled spasticity after fracture of an existing baclofen catheter. The 68-year-old man with T4 paraplegia presented with increasing baclofen requirements and radiographic evidence of fracture of the intrathecal baclofen catheter with an associated Charcot joint with extensive bony destruction. The neuropathic spinal arthropathy caused mechanical baclofen catheter malfunction and resulting increased spasticity. The patient was found to have transected both his spinal cord and the baclofen catheter. Treatment consisted of removal of the catheter and stabilization with long-segment instrumentation and fusion from T6 to L2. Follow-up radiographs obtained a year and a half after surgery showed no evidence of hardware failure or significant malalignment. The patient has experienced resolution of symptoms and does not require oral or intrathecal baclofen. This is the only reported case of a Charcot spine causing intrathecal catheter fracture, leading to increased spasticity. This noteworthy case suggests that late spinal instability should be considered in the setting of SCI and increased spasticity.

  9. Low back pain during pregnancy caused by a sacral stress fracture: a case report

    Directory of Open Access Journals (Sweden)

    Pishnamaz Miguel

    2012-04-01

    Full Text Available Abstract Introduction Sacral stress fractures are a rare but well known cause of low back pain. This type of fracture has also been observed as a postpartum complication. To date, no cases of intrapartum sacral stress fractures have been described in the literature. Case presentation We report the case of a 26-year-old Caucasian European primigravid patient (30 weeks and two days of gestation who presented to our outpatient clinic with severe low back pain that had started after a downhill walk 14 days previously. She had no history of trauma. A magnetic resonance imaging scan revealed a non-displaced stress fracture of the right lateral mass of her sacrum. Following her decision to opt for non-operative treatment, our patient received an epidural catheter for pain control. The remaining course of her pregnancy was uneventful and our patient gave birth to a healthy child by normal vaginal delivery. Conclusions We conclude that a sacral stress fracture must be considered as a possible cause of low back pain during pregnancy.

  10. Concomitant Lipoma and Ganglion Causing Ulnar Nerve Compression at the Wrist: A Case Report and Review of Literature.

    Science.gov (United States)

    Gan, Lee Ping; Tan, Jacqueline Siau Woon

    2016-04-01

    We present a rare case of ulnar nerve compression caused by concurrent lumps-a lipoma and a ganglion at the wrist, with no prior report cited in the English literature. This case illustrates the possibility of dual concurrent pathologies causing ulnar neuropathy and the importance of not missing one.

  11. Quantifying the impact of selection bias caused by nonparticipation in a case-control study of mobile phone use

    DEFF Research Database (Denmark)

    Vrijheid, Martine; Richardson, Lesley; Armstrong, Bruce K;

    2009-01-01

    To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor.......To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor....

  12. Eosinophilic cholecystitis along with pericarditis caused by Ascaris lumbricoides: A case report

    Institute of Scientific and Technical Information of China (English)

    Kosuke Kaji; Mitsuteru Kitade; Hideto Kawaratani; Masahito Uemura; Junichi Yamao; Masao Fujimoto; Akira Mitoro; Masahisa Toyohara; Motoyuki Yoshida; Hiroshi Fukui; Hitoshi Yoshiji; Masahide Yoshikawa; Masaharu Yamazaki; Yasuhide Ikenaka; Ryuichi Noguchi; Masayoshi Sawai; Masatoshi Ishikawa; Tsuyoshi Mashitani

    2007-01-01

    Although the etiology of eosinophilic cholecystitis is still obscure, the postulated causes include allergies,parasites, hypereosinophilic syndrome, and eosinophilic gastroenteritis. It is sometimes accompanied by several complications, but a simultaneous onset with pericarditis is very rares. A 28-year-old woman complained of acute right hypocondrial pain and dyspnea associated with systemic eruption. Several imaging modalities revealed acute cholecystitis and pericarditis with massive pericardial effusion. A marked peripheral blood eosinophilia was observed, and the eruption was diagnosed as urticaria. Her serum had a high titer of antibody against Ascaris lumbricoides. Treatment with albendazole drastically improved all clinical manifestations along with normalization of the imaging features and eosinophilia. We report herein a rare case of simultaneous onset of acute cholecystitis and pericarditis associated with a marked eosinophilia caused by parasitic infection.

  13. Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Dewan Udita

    2010-01-01

    Full Text Available Extramedullary hemopoiesis (EMH is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

  14. Strangulation Caused by a Small Bowel Epiploic Appendage: Report of a Case

    Directory of Open Access Journals (Sweden)

    Hiroshi Nemoto

    2008-07-01

    Full Text Available While many recent cases of colonic epiploic appendage causing acute abdomen have been reported, such appendages of the small bowel are extremely rare. We present a 59-year-old woman in whom a small bowel epiploic appendage caused volvulus. She presented with abdominal pain and vomiting in the absence of previous abdominal operations. A diagnosis of small bowel obstruction from strangulation was made. Laparotomy disclosed bloody peritoneal fluid and a closed loop of strangulated small intestine. An adherent band composed of an epiploic appendage and intestine had completely encircled a loop of jejunum, leading to obstruction. This band was released, and approximately 80 cm of gangrenous bowel was resected. Four epiploic appendages 5–6 cm in length were attached to the ileum at the mesenteric border, beginning at a point 70 cm proximal to the terminal ileum.

  15. Upper extremity myonecrosis caused by Edwardsiella tarda resulting in transhumeral amputation: case report.

    Science.gov (United States)

    Crosby, Samuel N; Snoddy, Mark C; Atkinson, Cameron T; Lee, Donald H; Weikert, Douglas R

    2013-01-01

    Necrotizing soft tissue infections are rapidly progressive infections with a high rate of mortality. One type of necrotizing soft tissue infection is caused by marine gram-negative bacteria and commonly occurs in immunocompromised hosts. These types of infections are more common in patients with chronic liver disease, possibly because of impaired iron metabolism. We present the case of a rapidly progressive necrotizing soft tissue infection caused by Edwardsiella tarda, a marine gram-negative pathogen common in catfish. Few extraintestinal infections of E tarda have been described previously. Our patient had hepatitis C and was exposed to the bacteria by a puncture injury from a wild catfish. His infection required multiple debridements and ultimately required a transhumeral amputation for local control of the infection.

  16. Nonpreserved amniotic membrane transplantation for bilateral toxic keratopathy caused by topical anesthetic abuse: a case report

    Directory of Open Access Journals (Sweden)

    Altinok Ayse

    2010-08-01

    Full Text Available Abstract Introduction Corneal damage associated with abuse of topical anesthetics is a rare clinic entity. Topical anesthetic abuse is one of the causes of ring keratitis. Ring keratitis is easily overlooked because it can mimic acanthamoeba keratitis or other infectious keratitis. The outcome is often poor, leading to persistent epithelial defects, corneal scarring, and perforations. Case presentation We report the clinical presentation, diagnosis, and treatment of a 65-year-old Caucasian man, who worked as a health care worker, with bilateral toxic keratopathy caused by topical anesthetic abuse. Nonpreserved amniotic membrane transplantation was performed for both eyes of the patient. Conclusion It is important to identify and treat patients who abuse topical anesthetics before permanent vision loss ensues. Nonpreserved amniotic membrane transplantation may be useful in relieving pain and improving corneal surface in anesthetic agent abusers.

  17. A case of odontogenic orbital cellulitis causing blindness by severe tension orbit.

    Science.gov (United States)

    Park, Chang Hyun; Jee, Dong Hyun; La, Tae Yoon

    2013-02-01

    We report a very rare case of odontogenic orbital cellulitis causing blindness by severe tension orbit. A 41-yr old male patient had visited the hospital due to severe periorbital swelling and nasal stuffiness while he was treated for a periodontal abscess. He was diagnosed with odontogenic sinusitis and orbital cellulitis, and treated with antibiotics. The symptoms were aggravated and emergency sinus drainage was performed. On the next day, a sudden decrease in vision occurred with findings of ischemic optic neuropathy and central retinal artery occlusion. Deformation of the eyeball posterior pole into a cone shape was found from the orbital CT. A high-dose steroid was administered immediately resulting in improvements of periorbital swelling, but the patient's vision had not recovered. Odontogenic orbital cellulitis is relatively rare, but can cause blindness via rapidly progressing tension orbit. Therefore even the simplest of dental problems requires careful attention.

  18. A case of perforating injury of eyeball and traumatic cataract caused by acupuncture

    Directory of Open Access Journals (Sweden)

    Han Shuang

    2016-01-01

    Full Text Available Perforating globe injury is the leading cause of monocular blindness and vision loss. A 58-year-old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. To the best of our knowledge, this is the first case report of perforating injury of the eyeball and traumatic cataract caused by acupuncture. The patient was hospitalized due to diagnosis of perforating ocular injury, traumatic cataract, and corneal and iris perforating injury. Moreover, he had to accept treatments of phacoemulsification, anterior vitrectomy along with intraocular lens implantation in the sulcus to improve his visual acuity. As acupuncture therapy has been widely performed for various diseases and achieved highly approval, the aim of this report is to remind acupuncturists operating accurately to avoid unnecessary injury during the treatment process, or the cure can also become the weapon.

  19. The first cases of human bacteremia caused by Acinetobacter seifertii in Japan.

    Science.gov (United States)

    Kishii, Kozue; Kikuchi, Ken; Tomida, Junko; Kawamura, Yoshiaki; Yoshida, Atsushi; Okuzumi, Katsuko; Moriya, Kyoji

    2016-05-01

    Acinetobacter seifertii, a novel species of Acinetobacter, was first reported in 2015. A. seifertii strains were isolated from human clinical specimens (blood, respiratory tract, and ulcer) and hospital environments. Here, we report the first cases of bacteremia caused by A. seifertii in patients with catheter-related bloodstream infection in Japan. The patients favorably recovered, without any complications, after removal of the peripheral intravenous catheters and administration of antibiotics. The pathogens were initially identified as Acinetobacter baumannii, using phenotypic methods and the MicroScan Walkaway System; however, rpoB gene sequence analysis indicated 99.54% similarity to A. seifertii. Moreover, antimicrobial susceptibility testing revealed that one of the strains was not susceptible to gentamicin and ceftazidime. Our report shows that Acinetobacter species other than A. baumannii can also cause nosocomial infections and that accurate methods for the identification of causative agents should be developed.

  20. Brunner's Gland Adenoma – A Rare Cause of Gastrointestinal Bleeding: Case Report and Systematic Review

    Science.gov (United States)

    Sorleto, Michele; Timmer-Stranghöner, Annette; Wuttig, Helge; Engelhard, Oliver; Gartung, Carsten

    2017-01-01

    Brunner's gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner's gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding. A rest endoscopic polypectomy with the submucosal dissection technique was planned. However, on request of the patient, an elective surgical duodenotomy with submucosal resection of the remaining small duodenal tumor was performed. To better define the patient's characteristics and treatment options of such lesions, we performed a systematic review of the available literature in PubMed. Recently, an endoscopic removal is being increasingly practiced and is considered as a safe treatment modality of such lesions. PMID:28203131

  1. A case of obstructive colitis caused by rectal stenosis and adhesion due to irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Tochika, Naoshige; Sugimoto, Takeki; Takano, Atsushi; Kobayashi, Michiya; Matsuura, Kimio; Araki, Keijiro [Kochi Medical School, Nankoku (Japan)

    2000-03-01

    We report a case of obstructive colitis associated with rectal stenosis and adhesion due to irradiation. A 68-year-old woman who had been suffering from constipation after an episode of irradiation for cervical cancer of the uterus two years previously was admitted to our hospital complaining of the lower abdominal pain. After two days, an operation was performed under a diagnosis or panperitonitis. Stenosis and adhesion of the rectum and necrosis at the oral side of the adhesion was recognized. Histologically, necrosis of the rectum from mucosa to serosa was recognized, and no neoplastic change was seen at the stenotic portion. The most common cause of local stenosis of the colon leading to obstructive colitis is colon cancer. Obstructive colitis caused by a benign stenosis as reported here is rare. (author)

  2. Angioedema - a rare cause of acute episodic dysuria: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Panicker Radhakrishna

    2007-01-01

    Full Text Available The presentations of acute angioedema vary and depend upon the organs involved. Acute episodes of angioedema can be life-threatening if it involves the larynx leading to the obstruction of upper airways and it is a major cause of death. Angioedema involving the lips, cheek and tongue are common with bizarre presentations. Angioedema of the gastro intestinal tract frequently mimic an acute abdomen resulting in unnecessary surgical intervention and increased morbidity. Here we present an unusual case of angioedema involving the external urethra resulting in severe discomfort and burning sensation during micturition. He was later investigated and diagnosed as idiopathic urticaria with angioedema and promptly responded to antihistamines.

  3. A rare case of life-threatening penetrating oropharyngeal trauma caused by toothbrush in a child

    Directory of Open Access Journals (Sweden)

    Sagar S

    2010-06-01

    Full Text Available We present a case of 10year-old boy with oropharyngeal injury caused by a toothbrush which penetrated the parapharyngeal space. Initial examination revealed broken end of the toothbrush in oral cavity with the head of the toothbrush having bristles, beyond the soft palate. Tongue and palate were lacerated and there were blood and oral secretions in the oral cavity. Patient was having bradycardia. Computed tomography (CT scan showed the toothbrush head near the carotid artery, the carotid being laterally displaced. The foreign body was surgically removed without any intraoperative or postoperative complications.

  4. [An uncommon cause for unilateral vocal fold paralisis: aortic aneurysms. Case report and literature review].

    Science.gov (United States)

    Coscarón Blanco, E; Blanco García, J L; Gómez González, J L

    2006-01-01

    Unilateral vocal fold paralysis is frequently encountered during ENT practise. It may result from many different conditions and it always should be regarded as a sign revealingan underlaying disease that can be located anywhere along the traject of the tenth cranial nerve or at the cricoarytenoidjoint being malignancies and trauma the leading causes. Etiology, glottal characteristics and compensative maneuvers, and individual factors such as comorbility or age must be considered when treatment options are proposed to the patient. A case of an uncommon etiology for unilateral vocal fold paralysis, an aortic aneurysm, is presented and considerations about the management of this condition are provided.

  5. Two cases of infectious purpura fulminans and septic shock caused by Capnocytophaga canimorsus transmitted from dogs

    DEFF Research Database (Denmark)

    Christiansen, Claus Behrend; Berg, Ronan Martin Griffen; Plovsing, Ronni R.

    2012-01-01

    , haemolytic anaemia, metabolic acidosis, and renal failure, which may be common in C. canimorsus-associated purpura fulminans. The patients survived after treatment with broad-spectrum antibiotics and supportive intensive care. C. canimorsus should be considered as a possible cause of infectious purpura......We report 2 cases of Capnocytophaga canimorsus-induced septicaemia complicated by purpura fulminans in previously healthy individuals, both of whom had been exposed to dog saliva prior to disease. They both presented with purpuric skin lesions, as well as the tetrad of abdominal symptoms...... fulminans in the unresolved critically ill patient with a history of dog exposure....

  6. Gangrene intestine caused by Ascaris lumbricoides; report of 5 cases in children.

    Science.gov (United States)

    Kawatra, Vibha; Arora, Prerna; Lakshmikantha, Akhila; Varma, Deepali; Khurana, Nita

    2010-05-15

    Ascaris infestation in the gastrointestinal tract is well known in Asian countries. It can be asymptomatic or can present with symptoms of acute abdomen. Perforation and torsion with gangrene are its very rare fatal complications but an important cause of mortality in children. Although ascariasis is very rare in developed countries, clinicians should consider this potentially dangerous, yet treatable, infection in the differential diagnosis of acute abdomen. We herein report a series of five cases of intestinal gangrene secondary to extensive infestation by Ascaris lumbricoides in children aged 1-4 years.

  7. Fixed Food Eruption Caused by Actinidia arguta (Hardy Kiwi): A Case Report and Literature Review.

    Science.gov (United States)

    Sohn, Kyoung Hee; Kim, Byung Keun; Kim, Ju Young; Song, Woo Jung; Kang, Hye Ryun; Park, Heung Woo; Cho, Sang Heon; Min, Kyung Up

    2017-03-01

    Fixed drug eruption (FDE) is a common hypersensitivity reaction characterized by recurrent, well-circumscribed, erythematous patches that arise at the same site as a result of systemic drug exposure. However, fixed food eruption (FFE), a lesion triggered by food ingestion, is a rare allergy that was first defined in 1996. Based on their anti-inflammatory and anti-oxidant properties, the fruit and leaves of Actinidia arguta, the hardy kiwi, are widely consumed across Korea, Japan, and China. This report describes the first case of FFE caused by hardy kiwi leaves, known as Daraesun in Korean, confirmed by oral provocation tests and skin biopsy.

  8. Intracranial hydatid cyst is a rare cause of midbrain herniation: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Yusuf Kurtulus Duransoy

    2013-01-01

    Full Text Available Hydatid disease is a parasitic infection affecting the brain in about 2% of the cases. Brain involvement is most commonly observed in children. Here, we report a 13-year-old male patient who presented with headache, nausea, and vomiting. Before cranial computed tomography (CT was performed, the patient had generalized epileptic seizures. He was disoriented, and had anisocoria with dilatation of the right pupilla. CT showed a cystic lesion of 10-cm diameter in the right temporoparietal region that had caused a shift of the midline structures to the contralateral side; an urgent operation was performed as there were signs of midbrain herniation.

  9. Recurrent abdominal complaints caused by a cecal neurofibroma: A case report

    Institute of Scientific and Technical Information of China (English)

    Willem Donk; Paul Poyck; Pieter Westenend; Wilco Lesterhuis; Fried Hesp

    2011-01-01

    Gastrointestinal involvement of neurofibromatosis type 1 (NF1, Von Recklinghausen's disease) is generally associated with the upper gastrointestinal tract. Abdominal manifestation of NF1 includes several tumors such as malignant peripheral nerve sheath tumors, gastrointestinal stromal tumors and ampulla of vater tumors. However, colonic involvement in NF1 patients is rare. We report a case of a patient presenting with dysphagia, weight loss, intermittent abdominal pain and constipation caused by a single cecal neurofibroma obstructing the ileocecal valve. Also gastrointestinal involvement of the lower tract should be considered in patients with NF1 presenting with abdominal complaints.

  10. Periostitis of the metatarsal caused by a date palm thorn in a child: a case report.

    Science.gov (United States)

    Suresh, S S

    2011-01-01

    Date palm thorn injuries are common in Middle Eastern countries, where there are many date palm plantations. If detected, these injuries can be treated without subsequent complications. In children, however, the diagnosis can very easily be missed. An untreated embedded thorn may cause late complications, including periostitis or osteomyelitis. In this article, the author presents a case of date palm thorn-induced periostitis of the fourth metatarsal. The lesion was successfully treated in this 10-year-old male by curettage of the lesion and removal of the thorn embedded in the periosteum of the metatarsal. The presence of the date palm thorn was confirmed with ultrasound scan and computerized tomography.

  11. [A case of sustained cholestasis caused by acute A viral hepatitis in Dubin-Johnson syndrome].

    Science.gov (United States)

    Ra, Sang Ho; Sung, Se Yong; Jung, Ho Yeon; Cha, Jae Hwang; Baik, Soon Koo; Cho, Mee Yon; Kim, Moon Young

    2012-04-01

    Dubin-Johnson syndrome is a rare clinical entity. It shows intermittent symptoms such as chronic or intermittent jaundice, abdominal pain, weakness, nausea, vomiting, anorexia and diarrhea. Symptoms are precipitated or aggravated by pregnancy, alcoholism, surgical procedures and intercurrent disease. Chronic idiopathic jaundice is typical of Dubin-Johnson syndrome and its prognosis is good. We describe a case of prolonged cholestasis for more than 10 months caused by acute A viral hepatitis in a patient with Dubin-Johnson syndrome. It is a first report of cholestasis complicated by acute A viral hepatitis in a patient with Dubin-Johnson syndrome.

  12. Primary Epidural Varicosis as a Rare Cause of Sciatica: A Case Report

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2015-11-01

    Full Text Available Non-discogenic sciatica can be caused by any lesion along the course of the lumbosacral nerve roots and sciatic nerve. We aim to present a rare case of refractory sciatica in an otherwise healthy 25-year-old man. He complained of left leg pain without significant back pain. Extensor hallucis longus muscle was weak on the left side with limited straight leg rising. On magnetic resonance imaging, a space-occupying lesion resembling a sequestrated disc was noted that after surgical decompression, epidural varicosis was demonstrated.

  13. [Three cases of stomatitis caused by chemotherapy for gastrointestinal cancer that responded well to lafutidine].

    Science.gov (United States)

    Uchida, Kazumi; Hayashi, Kazuhiko; Kuramochi, Hidekazu; Nakajima, Go; Yamamoto, Masakazu

    2008-08-01

    We described 3 cases of stomatitis caused by chemotherapy with the fluoropyrimidine preparation S-1, alone or combined with other anticancer drugs. The stomatitis did not respond to conventional oral mucosal treatment such as triamcinolone acetonide(Kenalog)or allopurinol, but improved after treatment with the histamine H2-receptor antagonist lafutidine. The concurrent use of lafutidine allowed these 3 patients to continue chemotherapy with no recurrence of stomatitis. We concluded that lafutidine may be a viable treatment option for chemotherapy-induced stomatitis, allowing treatment to be continued.

  14. A Case of Occupational Rhinitis Caused by Rice Powder in the Grain Industry

    OpenAIRE

    Kim, Joo-Hee; Kim, Jeong Eun; Choi, Gil-Soon; Hwang, Eui-Kyung; An, Soyeon; Ye, Young-Min; Park, Hae-Sim

    2010-01-01

    Rice is the major staple food in a large part of the world, especially in Asia. Hypersensitivity reactions to rice are rare. Moreover, cases of occupational allergies induced by inhalation of rice powder are uncommon. We report a 31-year-old male with work-related rhinitis and conjunctivitis symptoms caused by occupational exposure to rice powder in the grain industry. He showed positive responses to rice extracts on a skin prick test, and a high level of serum specific IgE to rice was detect...

  15. Nasolabial bilateral cyst as cause of the nasal obstruction: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Enoki, Alexandre Minoru

    2012-01-01

    Full Text Available Introduction: The nasolabial cyst is a rare disease, usually unilateral, benign, of embryonic origin, located in soft parts from the nasolabial folds and nasal wings. The diagnosis is essentially clinic, take into consideration the cyst topography, that is usually asymptomatic. Objective: This article has as main goal the description of a unusual case of nasolabial bilateral cyst with nasal obstruction, its treatment, anatomic pathological and accompaniment, besides the literature review. Case Report: Female patient, brown, 24 years old, showing bulging in nasolabial region and nasal obstruction. Physical and complementary exams with nasolabial cyst. Indicate surgical treatment of excision of the lesion. Final Considerations: The nasolabial bilateral cyst, although is rare, is a possible cause for the nasal obstruction, with good response to surgical therapy.

  16. Recovery from azoospermia caused by a testicular injury: a case report.

    Science.gov (United States)

    Hagiuda, J; Ishikawa, H; Hanawa, Y; Marumo, K

    2014-05-01

    Some cases of testicular trauma cause infertility especially when the injured testes are not removed. However, only a few long-term follow-up studies investigating endocrinological and semen parameters in patients who had testicular trauma have been conducted. Herein, we report an interesting case of a patient who spontaneously recovered from azoospermia due to a traffic injury and present in detail the results of the hormonal examination and semen analysis. The patient was a 22-year-old man with a history of left testicular injury and bilateral orchidopexy. Four months after the injury, the semen parameters improved but azoospermia occurred 1 year later. However, spermatogenesis spontaneously recovered without any treatment or without undergoing orchiectomy 6 months after the testicular injury.

  17. An Unusual Cause for Sister Mary Joseph’s Nodule: A Case Report

    Directory of Open Access Journals (Sweden)

    Yasser Aljehani

    2014-11-01

    Full Text Available Sister Mary Joseph’s nodule refers to palpable nodules bulging into the umbilicus as a result of metastasis from malignancy in the abdomen or pelvis. The most common primaries are in the gastrointestinal or genital tract, while other origins are considered rare. We recently treated a 71-year-old man who presented with painless umbilical swelling. Further investigation, including laboratory, radiological and histopathological exam, confirmed the diagnosis of a metastatic neuroendocrine tumor. The peculiarity of this case is that the umbilical swelling was the initial presentation of a neuroendocrine tumor and, to our knowledge, this is the first to be reported. This case demonstrates that neuroendocrine tumor is a rare cause of Sister Mary Joseph’s nodule.

  18. A Morgagni hernia with an absent ductus venosus: An unusual case causing unusual consequences

    Directory of Open Access Journals (Sweden)

    Maria Phillis

    2016-09-01

    Full Text Available A Morgagni hernia is a rare form of congenital diaphragmatic hernia (CDH, comprising only 3–5% of all CDH cases. Agenesis of the ductus venosus with direct umbilical vein blood flow to the heart is a relatively uncommon finding that is often fatal in utero. We present a case of a 2-month-old infant with Morgagni hernia and absence of the ductus venosus. These combined defects led to neovascularization of the liver, severe pulmonary hypertension and right heart failure. In this report, we describe a Morgagni hernia that's presentation resembled that of a Bochdalek hernia likely because of concomitant absence of the ductus venosus causing severe pulmonary hypertension.

  19. Cellular Phone Overuse as A Cause for Trapeziometacarpal Osteoarthritis: A Two Case Report

    Science.gov (United States)

    Canillas, Fernando; Colino, Alvaro; Menéndez, Pablo

    2014-01-01

    Introduction: New technologies have been related to upper limb diseases Trapeziometacarpal osteoarthritis in young patients has not been described yet as one of these “overuse pathologies”. Case Report: We present two cases. A 33 and a 32 year-old women, right handed, suffering from trapeziometacarpal pain. Neither previous trauma nor rheumatic disease was reported. Excessive use of last generation cellular phone was the only background reported. Pain and joint crepitation were found on physical examination and osteoarthritis signs were seen on MRI scans. One of the patients improved after using a cast, physical activity restrictions and a specific rehabilitation program; whilst the other required a corticosteroid joint injection. Conclusion: We warn about the potential growth of these pathologies caused by an indiscriminate use (or abuse) of touch-screen cellular phones. PMID:27298990

  20. Cases of human envenoming caused by Philodryas olfersii and Philodryas patagoniensis (serpentes: Colubridae

    Directory of Open Access Journals (Sweden)

    Maria Elisabeth de Araújo

    1997-12-01

    Full Text Available The present paper reports two cases of human envenoming by colubrid snakes of Philodryas, considered as not poisonous, showing evidence of the clinical aspects and the evolution of the symptoms of envenoming. The similarity of these cases with those caused by Bothrops suggests a more careful evaluation on the victims considering the medical treatment to be adopted.O presente trabalho é um relato de dois casos de acidentes com colubrídeos (Philodryas olfersii e P. patagoniensis considerados não peçonhentos, que destaca as manifestações clínicas e as suas evoluções. A semelhança de tais acidentes com aqueles causados por serpentes Bothrops indica a necessidade de uma melhor avaliação dos pacientes quanto à terapêutica a ser adotada.

  1. A derangement of the brain wound healing process may cause some cases of Alzheimer's disease.

    Science.gov (United States)

    Lehrer, Steven; Rheinstein, Peter H

    2016-08-01

    A derangement of brain wound healing may cause some cases of Alzheimer's disease. Wound healing, a highly complex process, has four stages: hemostasis, inflammation, repair, and remodeling. Hemostasis and the initial phases of inflammation in brain tissue are typical of all vascularized tissue, such as skin. However, distinct differences arise in brain tissue during the later stages of inflammation, repair, and remodeling, and closely parallel the changes of Alzheimer's disease. Our hypothesis -- Alzheimer's disease is brain wound healing gone awry at least in some cases -- could be tested by measuring progression with biomarkers for the four stages of wound healing in humans or appropriate animal models. Autopsy studies might be done. Chronic traumatic encephalopathy might also result from the brain wound healing process.

  2. A Case of False-Positive Mycobacterium tuberculosis Caused by Mycobacterium celatum

    Directory of Open Access Journals (Sweden)

    Edward Gildeh

    2016-01-01

    Full Text Available Mycobacterium celatum is a nontuberculous mycobacterium shown to cause symptoms similar to pulmonary M. tuberculosis. Certain strains have been shown to cross-react with the probes used to detect M. tuberculosis, making this a diagnostic challenge. We present a 56-year-old gentleman who developed signs and symptoms of lung infection with computed tomography scan of the chest showing right lung apex cavitation. Serial sputum samples were positive for acid-fast bacilli and nucleic acid amplification testing identified M. tuberculosis ribosomal RNA, resulting in treatment initiation. Further testing with high performance liquid chromatography showed a pattern consistent with M. celatum. This case illustrates the potential for M. celatum to mimic M. tuberculosis in both its clinical history and laboratory testing due to the identical oligonucleotide sequence contained in both. An increasing number of case reports suggest that early reliable differentiation could reduce unnecessary treatment and public health intervention associated with misdiagnosed tuberculosis.

  3. Inspections of causes in vocal cord paralysis with diagnostic imaging. Cases with malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Furukawa, Masaki; Yuyama, Seiichirou; Kaneko, Madoka; Furukawa, Shigeru; Kubota, Akira; Hiiragi, Koichi; Ooishi, Kiminao; Sawaki, Shuji; Igari, Hidenori.

    1988-02-01

    The vocal cord paralysis may be caused by the occult type malignancies. The tumor occupies along the route of the vagus nerve or recurrent laryngeal nerve. To detect such a malignant tumor, it is advocated that the diagnosis should be performed with various kind of figures, such as X-ray picture, CT and ultrasonography. Consequently 13 cases were diagnosed to the malignant tumors among 31 vocal cord paralysis cases. They were thyroid cancer, lung cancer, esophageal cancer and others. CT and ultrasonography were very useful for the evaluation of the mass lesions in the head and neck area. Additionally, the fine needle aspiration biopsy under the ultrasonographic imaging was available to diagnose whether the mass lesions were benign or malignant.

  4. Paget's disease of the skull causing hyperprolactinemia and erectile dysfunction: a case report

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    Hepherd Rachel

    2008-07-01

    Full Text Available Abstract Introduction Hyperprolactinemia is an uncommon cause of erectile dysfunction in men. Paget's disease of the skull is a relatively common disease. This case proposes a rare example of a causative link between the two and how treatment of the Paget's disease with bisphosphonates helped the patient regain erectile function. Case presentation A 67-year-old man with Paget's disease of the skull presented with prostatitis, erectile dysfunction, and hyperprolactinemia. Radio-isotope scanning showed increased vascularity around the sphenoid bone. Treatment with intravenous bisphosphonates improved the active Paget's disease as indicated by declining alkaline phosphatase levels and the patient's erectile function while serum prolactin levels became normal and serum testosterone levels remained unchanged. Conclusion It is possible that hyperprolactinemia is unrecognised in other patients with Paget's disease of the skull. Normalizing elevated prolactin levels by using bisphosphonates in treating Paget's disease appears to be more appropriate than traditional treatment for hyperprolactinemia.

  5. Candidiasis, A Rare Cause of Gastric Perforation: A Case Report and Review of Literature.

    Science.gov (United States)

    Ukekwe, F I; Nwajiobi, C; Agbo, M O; Ebede, S O; Eni, A O

    2015-01-01

    Fungi are unusually rare causes of gastric perforation, with most cases of gastric perforation occurring as complications of peptic ulcer disease (PUD), nonsteroidal anti-inflammatory drugs (NSAIDs) and gastric neoplasms. Here, we report the case of a 70-year-old Nigerian male who presented with severe epigastric pain, with no associated history of PUD, NSAIDs use or gastric neoplasm. An emergency exploratory laparotomy was performed and a gastric perforation was discovered and repaired. Histopathological examination of the gastric perforation edge biopsy revealed an intense Candida growth consisting of numerous fungal spores and hyphae invading and destroying the gastric wall. He was subsequently treated with fluconazole antifungal and discharged home after an uneventful postoperative period.

  6. [Vertebral osteomyelitis caused by Streptococcus agalactiae in healthy adults. Description of 2 new cases].

    Science.gov (United States)

    Rivero Marcotegui, M; Hidalgo Ovejero, A; Lecumberri, M Cía; Otermin Maya, I; Pereda García, A

    2009-10-01

    The importance of Streptococcus agalactiae as a pathogen in nonpregnant adults has been widely recognized in recent years, especially in the elderly or immunocompromised patients. Two cases of vertebral osteomyelitis caused by S. agalactiae in young patients with no known underlying diseases or predisposing factor to infection are reported. A systematic review of the literature (MEDLINE, 1976-May 2008) was performed, 10 cases previously reported in the literature of vertebral osteomyelitis due to S. agalactiae being found in adults under 65 years of age with no predisposing risk factors for infection, most of which have been reported over the last 10 years. We believe that this microbial etiology should be considered in patients of any age and immunological status. Other factors, other than increasing the number of patients with chronic diseases, explaining the increased rate of S. agalactiae infections in adults need to be studied.

  7. A CASE OF MULTIPLE PROXIMAL JEJUNAL DIVERTICULAE CAUSING INTESTINAL OBSTRUCTION : A VERY RARE PRESENTATION

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    Challapalli Srikanth

    2015-01-01

    Full Text Available Diverticulosis of small intestine is an uncommon disease, with variable clinical presentation. Among the small bowel diverticulae, distal jejunal diverticulae form the most common subset. D iverticulosis of proximal jejunum represents an uncommon pathology of the small bowel. The condition is usually asymptomatic and should be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain or discomfort. Complications such as diverticulitis, perforation, bleeding or intestinal obstruction appear in 10 - 30% of the patients increasing morbidity and mortality rates. We herein report a case of a 45 year - old man, who presented at the emergency department with acute abdominal pain, vomiting and abdominal distension. Preoperative radiol ogical examination followed by laparotomy revealed multiple proximal jejunal diverticulae, filled with food, adherent to and compressing upon the terminal ileum, causing intestinal obstruction.

  8. Vascular Rupture Caused by a Molding Balloon during Endovascular Aneurysm Repair: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hee Young; Do, Young Soo; Park, Hong Suk; Park, Kwang Bo [Dept. of Radiology, Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Young Wook; Kim, Dong Ik [Dept. of Surgery, Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    Endovascular aneurysm repair (EVAR) has been accepted as an alternative to traditional open surgery in selected patients. Despite the minimally invasiveness of this treatment, several complications may occur during or after EVAR. Complications include endoleak, aortic dissection, distal embolism, or iatrogenic injury to the access artery. However, there are few reports on the vascular rupture caused by a molding balloon during EVAR. We report two cases of infrarenal abdominal aortic aneurysms complicated by procedure-related aortic or iliac artery rupture by the molding balloon during EVAR. In our cases, we observed suddenly abrupt increase of the diameter of the endograft during balloon inflation, because we inflated the balloon rapidly. In conclusion, careful attention must be paid during inflation of the molding balloon to prevent vascular rupture.

  9. Infectious crystalline keratopathy caused by Cladosporium sp. after penetrating keratoplasty: a case report

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    Stock RA

    2016-08-01

    Full Text Available Ricardo Alexandre Stock,1 Elcio Luiz Bonamigo,2 Emeline Cadore,3 Rafael Allan Oechsler4 1Corneal Transplant Section, Santa Terezinha University Hospital, 2Department of Ophthalmology and Bioethics, 3University of Western Santa Catarina, Joaçaba, 4Cornea Department, Oftalmo Center Blumenau, Blumenau, Santa Catarina, Brazil Background: Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma.Case presentation: A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract. The patient underwent penetrating keratoplasty and phacoemulsification. During postoperative follow-up, another therapeutic keratoplasty was required because unresponsive infectious keratitis was observed. The infiltrate’s characteristics were suggestive of infectious crystalline keratopathy; in particular, the infiltrate was insidious and progressive, and grayish-white branches appeared in the anterior corneal stroma. As different therapies were administered, inflammatory reactions ranging from mild to severe were observed. The infection was unresponsive to typical antifungal drugs. This lack of response most likely occurred due to steroid treatment and the diffuse corneal spread of an atypical microorganism, which was subsequently identified in culture as Cladosporium sp. After the second therapeutic keratoplasty, the patient’s eye integrity was successfully reestablished.Conclusion: This study likely provides the first report describing a case of infectious crystalline keratopathy caused by Cladosporium sp. This case

  10. Fusarium species causing eumycetoma: Report of two cases and comprehensive review of the literature.

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    Al-Hatmi, Abdullah M S; Bonifaz, Alexandro; Tirado-Sánchez, Andrés; Meis, Jacques F; de Hoog, G Sybren; Ahmed, Sarah A

    2017-03-01

    Recently, mycetoma was added to the World Health Organization's list of neglected tropical disease priorities. Fusarium as a genus has been reported to cause eumycetoma, but little is known about the species involved in this infection and their identification. In this study, molecular tools were applied to identify Fusarium agents from human eumycetoma cases. The partial translation elongation factor 1-alpha (TEF-1α) gene was used as diagnostic parameter. Two additional cases of eumycetoma, due to F. keratoplasticum and F. pseudensiforme, respectively, are presented. A systematic literature review was performed to assess general features, identification, treatment and outcome of eumycetoma infections due to Fusarium species. Of the 20 reviewed patients, the majority (75%) were male. Most agents belonged to the F. solani species complex, ie F. keratoplasticum, F. pseudensiforme, and an undescribed lineage of F. solani. In addition, F. thapsinum, a member of Fusarium fujikuroi species complex was encountered. The main antifungal drugs used were itraconazole, ketoconazole and amphotericin B, but cure rates were low (15%). Partial response or relapse was observed in some cases, and a case ended in amputation. Clinical management of eumycetoma due to Fusarium is complex and combination therapy might be required to increase cure rates.

  11. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

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    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  12. A rare case of gestational thyrotoxicosis as a cause of acute myocardial infarction

    Science.gov (United States)

    Lvovsky, Dmitry

    2016-01-01

    Summary Angina pectoris in pregnancy is unusual and Prinzmetal’s angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves’ disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70–80 000 IU/L. Gestational transient thyrotoxicosis is transient and generally resolves spontaneously in the latter half of pregnancy, and specific antithyroid treatment is not required. Treatment with calcium channel blockers or nitrates reduces spasm in most of these patients. Overall, the prognosis for hyperthyroidism-associated coronary vasospasm is good. We describe a very rare case of an acute myocardial infarction in a 27-year-old female, at 9 weeks of gestation due to right coronary artery spasm secondary to gestational hyperthyroidism with free thyroxine of 7.7 ng/dL and TSH therapy is extremely rare. Gestational hyperthyroidism should be considered in pregnant patients presenting with ACS-like symptoms especially in the setting of hyperemesis gravidarum. Our case highlights the need for increased awareness of general medical community that GTT can lead to significant cardiac events. Novel methods of controlling GTT as well as medical interventions like ICD need further study. PMID:27933173

  13. Septic arthritis caused by Mycobacterium fortuitum and Mycobacterium abscessus in a prosthetic knee joint: case report and review of literature.

    Science.gov (United States)

    Wang, Shu-Xiang; Yang, Chang-Jen; Chen, Yu-Chuan; Lay, Chorng-Jang; Tsai, Chen-Chi

    2011-01-01

    Nontuberculous mycobacterium (NTM) is an infrequent cause of prosthetic knee joint infections. Simultaneous infection with different NTM species in a prosthetic knee joint has not been previously reported. A case of prosthetic knee joint infection caused by Mycobacterium abscessus and M. fortuitum is described in this report. The patient was successfully treated with adequate antibiotics and surgery. The clinical features of sixteen previously reported cases of prosthetic knee joint infection caused by NTM are reviewed.

  14. Disfonias: relação S/Z e tipos de voz Dysphonias: S/Z ratio and types of voice

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    Carla Aparecida Cielo

    2008-12-01

    Full Text Available OBJETIVO: verificar o resultado da relação s/z e do tipo de voz em pacientes com diagnóstico de disfonias orgânico-funcionais (DOF e disfonias funcionais por uso incorreto da voz (DFUIV, bem como a ocorrência das diferentes patologias dentro das DOF. MÉTODOS: 70 indivíduos, de ambos os sexos, entre cinco e 65 anos de idade, atendidos numa clínica-escola, cadastrados em Banco de Dados, entre 1998 e 2006, com DOF e DFUIV, ambos classificados em três subgrupos: casos em que a relação s/z indicava hipercontração, normalidade, e falta de coaptação das pregas vocais durante a fonação. Os tipos de voz foram classificados conforme a ocorrência em: sem alteração; ruidosa; ruidosa, comprimida e/ou apresentando alteração de f0h; ruidosa e/ou apresentando alteração de f0h; e comprimida. RESULTADOS: ocorrência significativa de DOF e de DOF com nódulos vocais; nas DOF e DFUIV, ocorrência significante de relação s/z normal com tempos isolados de /s/ e /z/ abaixo do normal e voz ruidosa. CONCLUSÕES: O resultado da relação s/z foi estatisticamente significativo a favor da faixa de normalidade estabelecida, tanto nos pacientes com diagnóstico de DOF, quanto naqueles com DFUIV, sendo que, em ambos os grupos de pacientes, a voz ruidosa foi a mais freqüente. Dentro das DOF, os nódulos vocais foram significativamente mais freqüentes do que as demais patologias.PURPOSE: to check the result of s/z ratio and types of voice in patients with diagnosis of organic-functional dysphonias (DOF and functional dysphonias by incorrect use of voice (DFUIV, as well as the occurrence of the various pathologies within the DOF. METHODS: 70 subjects of both genders, between 5 and 65 years old, seen in a clinic-school, registered in a data bank from 1998 to 2006, with DOF and DFUIV, both classified in three sub-groups: cases in which the s/z ratio indicated hypercontraction, normality and lack of coaptation of the vocal folds during phonation

  15. Trousseau's Syndrome Caused by Intrahepatic Cholangiocarcinoma: An Autopsy Case Report and Literature Review

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    Takashi Yuri

    2014-05-01

    Full Text Available An autopsy case report of Trousseau's syndrome caused by intrahepatic cholangiocarcinoma is presented, and seven previously reported cases are reviewed. A 73-year-old woman experiencing light-headedness and dementia of unknown cause for 6 months developed severe hypotonia. A hypointense lesion compatible with acute cerebral infarction was detected by magnetic resonance imaging. Abdominal computed tomography revealed an ill-defined large liver mass in the right lobe. The mass was not further investigated because of the patient's poor condition. She died of multiple organ failure, and an autopsy was conducted. Postmortem examination revealed intrahepatic cholangiocarcinoma, fibrous vegetations on the mitral valves and multiple thromboemboli in the cerebrum, spleen and rectum. Trousseau's syndrome is defined as an idiopathic thromboembolism in patients with undiagnosed or concomitantly diagnosed malignancy. This syndrome is encountered frequently in patients with mucin-producing carcinomas, while the incidence in patients with intrahepatic cholangiocarcinoma is uncommon. We found that tissue factor and mucin tumor marker (CA19-9, CA15-3 and CA-125 expression in cancer cells may be involved in the pathogenesis of thromboembolism. A patient with unexplained thromboembolism may have occult visceral malignancy; thus, mucin tumor markers may indicate the origin of a mucin-producing carcinoma, and postmortem examination may play an important role in revealing the hidden malignancy.

  16. A Case of Fatal Bacterial Meningitis Caused by Enterococcus Faecalis: Postmortem Diagnosis

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    Gülhan Yağmur

    2015-10-01

    Full Text Available Enterococcus species rarely cause bacterial meningitis without predisposing factors such as trauma, brain surgery, etc. In this study, we present a bacterial meningitis case caused by Enterococcus faecalis (E. faecalis in a 13-year-old male who was found dead at home. One hundred and forty two cm tall, 37 kg weight male had admitted to hospital two days after the beginning of complaints such as weakness, headache, swelling of left eye, nausea and vomiting. Body temperature was 37.3 oC, leucocyte count 22100/ mm3, and CRP 71 g/dl at the hospital admission. Antibiotic treatment with amoxicillin/clavulanic acid (625 mg was given to the patient but he was found dead in his house the day after. In autopsy; yellow-green purulant liquid in left frontoparietal zone, fullness of meningeal vessels and oedema was seen in brain. Isolated bacteria in cerebrospinal fluid (CSF was identificated as E. faecalis by mini API 32 Strep®. Postmortem microbiological sampling in autopsy and defining etiologic agents is important for rare meningitis cases in which antemortem identification could not be done before death.

  17. IDIOPATHIC SCLEROSING ENCAPSULATING PERITONITIS CAUSING ACUTE INTESTINAL OBSTRUCTION AND GANGRENE: A CASE REPORT

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    Nava

    2016-04-01

    Full Text Available INTRODUCTION Sclerosing encapsulating peritonitis (SEP is a relatively rare cause of intestinal obstruction resulting from encasement of variable lengths of bowel by dense fibro-collagenous membrane. It is more common in young females, and shows tropical and sub-tropical distribution. The idiopathic cases of SEP, which lack any identifiable cause from clinical, radiological and histopathological findings, are also reported under the descriptive term “abdominal cocoon syndrome”. SEP presents with acute or sub-acute intestinal obstruction with or without a mass. In the era of laparoscopic surgery, inadvertent damage to the small bowel at insertion of the trocar and cannula can occur by being unaware of this condition resulting in unnecessary bowel resection. Persistent untreated SEP may advance to bowel gangrene or intestinal perforation, representing life threatening conditions. We report the clinical presentation of a 75-year-old female presenting with signs of intestinal obstruction whose imaging findings revealed abdominal cocoon with bowel gangrene leading to perforation and the same confirmed at surgery. Surgical excision of the fibrotic sac encasing the bowel, resection of gangrenous bowel segment and end ileostomy was performed. Histopathology of the excised membrane confirmed sclerosing encapsulating peritonitis. To our knowledge, only a few cases of abdominal cocoon with perforation have been reported in literature so far. Radiologists should be aware of this relatively rare cause of intestinal obstruction, its imaging findings and complications, as preoperative diagnosis will prevent delay and aid in treatment planning to the surgeon. Identification of soft tissue density membrane encasing congregated small bowel loops into a single area on computed-tomography gives diagnostic clue. Surgical excision of sac, release of bowel loops and adhesions with partial intestinal resection when necessary is the treatment.

  18. Case report of death from falling: Did heart tumor cause syncope?

    Science.gov (United States)

    Yamamoto, Takuma; Takasu, Kosho; Emoto, Yuko; Shikata, Nobuaki; Matoba, Ryoji

    2012-07-01

    A healthy man in his 30s was working on the balustrade of stairs on the second floor. He suddenly fell downstairs without saying anything. On emergency hospitalization, chest echogram showed left hemothorax. Cardiac echogram showed a floating mass from the mitral valve in the left ventricle and severe mitral regurgitation. Surgery for hemothorax and pulmonary contusion was immediately undertaken. However, bleeding from pulmonary contusion could not be controlled and he underwent cardiopulmonary arrest. Autopsy showed a white, elastic, pendulous mass in the left atrium and a white mass in the lower lobe of the left lung. Tumor histology showed a reticular pattern, Schiller-Duval bodies, eosinophilic hyaline globules, and positive staining for α-fetoprotein. We diagnosed primary lung yolk sac tumor with metastatic intracardiac yolk sac tumor, a rare and highly malignant germ cell tumor. It usually arises in the ovaries and testes, and intracardiac yolk sac tumor is rare. Intracavitary tumors induce obstruction of inflow into and outflow from the ventricular cavity. The most common clinical presentation is dyspnea and syncope. In the present case, metastatic cardiac yolk sac tumor might have disturbed cardiac outflow and affected hemodynamics, probably causing syncope. Unfortunately, he was in a high place at that time and fell to receive pulmonary contusion that led to death. Autopsy may sometimes reveal latent diseases which might be related to the cause of death. We should perform autopsy thoroughly to diagnose not only the cause of death but also the factors leading to death.

  19. Serratus muscle stimulation effectively treats notalgia paresthetica caused by long thoracic nerve dysfunction: a case series

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    Barad Meredith

    2009-09-01

    Full Text Available Abstract Currently, notalgia paresthetica (NP is a poorly-understood condition diagnosed on the basis of pruritus, pain, or both, in the area medial to the scapula and lateral to the thoracic spine. It has been proposed that NP is caused by degenerative changes to the T2-T6 vertebrae, genetic disposition, or nerve entrapment of the posterior rami of spinal nerves arising at T2-T6. Despite considerable research, the etiology of NP remains unclear, and a multitude of different treatment modalities have correspondingly met with varying degrees of success. Here we demonstrate that NP can be caused by long thoracic nerve injury leading to serratus anterior dysfunction, and that electrical muscle stimulation (EMS of the serratus anterior can successfully and conservatively treat NP. In four cases of NP with known injury to the long thoracic nerve we performed transcutaneous EMS to the serratus anterior in an area far lateral to the site of pain and pruritus, resulting in significant and rapid pain relief. These findings are the first to identify long thoracic nerve injury as a cause for notalgia paresthetica and electrical muscle stimulation of the serratus anterior as a possible treatment, and we discuss the implications of these findings on better diagnosing and treating notalgia paresthetica.

  20. Interstitial nephritis caused by HIV infection by itself: a case report

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    Doi A

    2016-09-01

    Full Text Available Asako Doi,1,2 Kentaro Iwata,3 Shigeo Hara,4 Yukihiro Imai,5 Toshikazu Hasuike,1,2 Hiroaki Nishioka,1,2 1Department of Infectious Diseases, 2Department of General Internal Medicine, Kobe City Medical Center General Hospital, 3Division of Infectious Diseases, 4Department of Diagnostic Pathology, Kobe University Hospital, 5Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan Abstract: Interstitial nephritis is a common cause of renal dysfunction. It is primarily caused by drugs, infections, or autoimmune disorders. Patients with human immunodeficiency virus (HIV infection can develop interstitial nephritis, although it typically occurs because of the aforementioned etiologies and not as a direct consequence of HIV infection. Interstitial lesions may occur in patients with HIV-associated nephropathy (HIVAN. However, interstitial nephritis without the glomerular injuries characteristic of HIVAN, and without the risk factors described earlier, is very rare. Here, we describe a rare case of interstitial nephritis that was likely caused directly by HIV infection and not by other etiologies. Keywords: human immunodeficiency virus, interstitial nephritis, HIV-associated nephropathy

  1. [A case of urogenital myiasis caused by Psychoda albipennis (Diptera: Nematocera)].

    Science.gov (United States)

    Yenice, Mustafa Gürkan; Demir, Tülin; Babür, Cahit; Nalbantoğlu, Serpil; Kılıç, Selçuk

    2011-07-01

    Myiasis which is a parasitic disease of humans and vertebrates, is caused by dipterous fly larvae feeding on the host's necrotic or living tissue. Although infestation by fly larvae is much more prevalent in animals, it occurs relatively frequently in humans in rural, tropical and subtropical regions of Africa and America. Myiasis is usually associated with poor general health and hygiene, restricted mobility and ulcerating lesions. The pathophysiology of the human infection differs depending on the fly species and where the larvae are located. It could be external or internal, and the invasion by the maggot could be obligatory, facultative and sometimes acci-dental. Myiasis is a self-limiting infestation with minimal morbidity in the vast majority of cases. Urogenital myiasis, associated with urinary obstruction, poor hygiene of the local site and ulcerating lesions has been infrequently reported. In this report, a case of 29 year-old male patient who presented with genitourinary myiasis caused by Psychoda albipennis (Diptera: Nematocera), was presented. The patient was admitted to the hospital with the complaints of urinary incontinence of one week duration and presence of small, thin, motile, grayishwhite objects in his urine. Physical examination, blood and urine examination and stool microscopy revealed no pathology. No growth was detected in his urine culture. The examination of discharged larva in urine sample at Refik Saydam National Public Health Agency, Parasitology Laboratory led to the diagnosis of urogenital myiasis. No risk factor was identified in the patient who had proper hygienic conditions, was living in urban area and was of high socioeconomic status. This case was presented to withdraw attention to myiasis which is frequent in Turkey, however, is usually overlooked.

  2. Ethylene Glycol Poisoning; an Unusual Cause of Hyperglycemia: A Case Report

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    Abdul Raoof Kunnummal Madathodi

    2015-03-01

    Full Text Available Background:Poisoning with ethylene glycol (EG can be fatal even if appropriate treatments are delivered. EG poisoning usually causes central nervous system depression, cardiovascular dysfunction, metabolic acidosis and acute renal failure (ARF. Case Report:A 33-year-old man was referred to the emergency department with reduced consciousness and dyspnea of four-hour duration due to unknown reason. The patient had no history of diabetes, hypertension, cardiac disease or asthma. He was tachycardic, tachypneic and hypertensive. Laboratory investigations revealed hyperglycemia, high serum creatinine, hyponatremia, hyperkalemia, leukocytosis and high anion gap metabolic acidosis (HAGMA. He was initially managed as diabetic ketoacidosis (DKA. Alternative diagnoses of toxic alcohols poisoning was considered as there was no improvement. EG ingestion was confirmed when the relatives found an empty bottle of automotive brake oil, a poly glycol-based product, in the patient’s room. Although he was treated with ethanol and hemodialysis, renal failure worsened and finally he succumbed to death due to severe sepsis on the seventh day of EG ingestion. Discussion: This case illustrates the difficulties posed by high toxicity as well as unraveled and delayed diagnosis of EG poisoning. High anion gap and high osmolal gap are characteristics of EG poisoning. Transient pancreatitis caused by EG and insulin resistance due to ARF are the possible explanations for hyperglycemia secondary to EG poisoning. Conclusion:EG poisoning may manifest with hyperglycemia and HAGMA resembling DKA. It is important for the clinician to have high degree of suspicion for EG poisoning in case of HAGMA and ARF refractory to common treatments.

  3. Hyperparathyroidism as a cause of recurrent acute pancreatitis: A case report

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    Tešić-Rajković Snežana

    2016-01-01

    Full Text Available Introduction. One of the more uncommon etiological factors responsible for the development of acute pancreatitis (AP is hypercalcemia. Hyperparathyroidism (HPT, as a cause of hypercalcemia, is responsible for 1.5–13% of AP according to a number of studies. A mechanism of the development of AP in hyperparathyroidism is still unclear. Case report. We presented a 47-year-old female patient, who had five episodes of AP in total before the etiological factors were finally determined. The patient had certain comorbidities which were considered to be potential causes of AP. She had chronic renal insufficiency (she was on a regular hemodialysis program, systemic lupus erythematosus and mioma uteri. She used to regularly take an antiepileptic drug (combination of sodium valproate and valproic acid. During the fifth episode of AP, the serum calcium level was for the first time elevated to twice the normal value. Level of parathyroid hormone was several times higher. A static scintigraphy found hyperplasia or hyperfunctional adenoma of the right inferior and superior parathyroid glands. Abdominal multislice computed tomography (MSCT scan verified the enlargement of the entire pancreas, as well as the presence of heterogeneous structures with diffuse amorphous calcifications. The lytic lesions in the pelvic bones could be seen in both sides. Parathyroidectomy was being postponed by an endocrine surgeon because of the poor overall condition of the patient. In the next period the patient had five more episodes of AP. The condition was significantly contributed by increasingly more frequent and longer episodes of metrorrhagia. Despite all therapeutic measures that were taken, systemic inflammatory response syndrome (SIRS developed, and fatal outcome occurred. Conclusion. In case of recurrent pancreatitis, hyperparathyroidism is to be considered even if a significant elevation of serum calcium is not present. This is especially the case for patients with

  4. Ileo-ileal Intussusception in an Adult Caused by Vanek’s Tumour: A Rare Case Report

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    Teli, Bhavuray; CP, Madhu; S, Sudhir; MV, Shreeharsha

    2013-01-01

    Adult intussusception is relatively rare in patients with bowel obstructions. Adult invagination is mostly caused by benign tumours. Intussusceptions caused by inflammatory fibroid polyps (IFPs) are uncommon. IFPs are rare, localized, non-neoplastic lesions originating in the submucosa of the gastrointestinal tract. We are reporting a rare case of intestinal obstruction caused by an ileo-ileal intussusception, caused by an IFP, a rare but peculiar and always benign tumour. PMID:24551704

  5. A local outbreak of dengue caused by an imported case in Dongguan China

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    Peng Hong-Juan

    2012-01-01

    Full Text Available Abstract Background Dengue, a mosquito-borne febrile viral disease, is found in tropical and sub-tropical regions around the world. Since the first occurrence of dengue was confirmed in Guangdong, China in 1978, dengue outbreaks have been reported sequentially in different provinces in South China transmitted by.peridomestic Ae. albopictus mosquitoes, diplaying Ae. aegypti, a fully domestic vector that transmits dengue worldwide. Rapid and uncontrolled urbanization is a characteristic change in developing countries, which impacts greatly on vector habitat, human lifestyle and transmission dynamics on dengue epidemics. In September 2010, an outbreak of dengue was detected in Dongguan, a city in Guangdong province characterized by its fast urbanization. An investigation was initiated to identify the cause, to describe the epidemical characteristics of the outbreak, and to implement control measures to stop the outbreak. This is the first report of dengue outbreak in Dongguan, even though dengue cases were documented before in this city. Methods Epidemiological data were obtained from local Center of Disease Control and prevention (CDC. Laboratory tests such as real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR, the virus cDNA sequencing, and Enzyme-Linked immunosorbent assay (ELISA were employed to identify the virus infection and molecular phylogenetic analysis was performed with MEGA5. The febrile cases were reported every day by the fever surveillance system. Vector control measures including insecticidal fogging and elimination of habitats of Ae. albopictus were used to control the dengue outbreak. Results The epidemiological studies results showed that this dengue outbreak was initiated by an imported case from Southeast Asia. The outbreak was characterized by 31 cases reported with an attack rate of 50.63 out of a population of 100,000. Ae. albopictus was the only vector species responsible for the outbreak. The virus c

  6. Queixas vocais e grau de disfonia em professoras do ensino fundamental Vocal complaints and degree of dysphonia in elementary school teachers

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    Luciana Lemos de Azevedo

    2009-01-01

    Full Text Available OBJETIVO: Realizar o levantamento das queixas vocais e grau de disfonia encontradas em professoras de uma Escola Municipal da Cidade de Betim. MÉTODOS: Foi realizada coleta de dados de 13 professoras do ensino fundamental, com idade entre 20 a 50 anos (média de 36 anos e carga horária mínima de 20 horas semanais, por meio de questionário aplicado e gravação de voz, no programa de análise acústica GRAM 5.7. Os dados foram analisados e as vozes classificadas por três fonoaudiólogas com experiência clínica na área, mínima de cinco anos. RESULTADOS: Das professoras incluídas no estudo, 30,77% apresentaram qualidade vocal sem alteração, 23,08% apresentaram disfonia discreta, 46,15% disfonia moderada e nenhuma apresentou disfonia severa. Intervalos de confiança de 95% estimaram proporções mínimas de 6,6% de professoras com disfonia discreta e 22,39% com disfonia moderada na população de referência. Independentemente do tipo de queixa vocal, o número total de queixas entre as professoras com disfonia moderada foi significantemente maior do que entre professoras sem alterações de voz. Não houve, no entanto, diferenças entre os grupos na distribuição das queixas específicas, quando estas foram analisadas isoladamente. CONCLUSÃO: A maioria dos professores da amostra apresentou qualidade vocal alterada, sendo o grau moderado o mais frequente. Queixas específicas parecem se distribuir igualmente entre professoras com e sem alteração de voz. Os resultados apontam a importância de projetos de saúde vocal para esta população.PURPOSE: The aim of this study was to survey vocal complaints and degree of dysphonia among teachers from a public elementary school at Betim, MG (Brazil. METHODS: Thirteen elementary school teachers with ages between 20 and 50 years (mean of 36 years old, who taught at least 20 hours a week, participated in the study. Data were obtained using a questionnaire and voice recording, analyzed on the

  7. Megadolicho basilar artery as a cause of asymmetrical sensorineural hearing loss - case report

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    Melo, Antonio Antunes

    2011-07-01

    Full Text Available Introduction: At the differentiated diagnosis of asymmetrical sensorineural hearing losses, vascular disorders are present, one of which is megadolicho basilar artery. This disease is generally asymptomatic, and when symptoms are found, they can be caused by a compression or ischemia. Clinically, sensorineural hearing loss, tinnitus, headache, facial hypoesthesia, trigeminal neuralgia, vertigo, diplopia and facial palsy, among others, are likely to occur. The image examination of choice for its diagnosis is nuclear magnetic resonance. The megadolicho basilar artery therapy can be surgical or conservative, according to the associated findings. A multidisciplinary approach, including a neurologist, neurosurgeon and an otorhinolaryngologist is recommended for a proper administration of the case. Objective: Report the case of a patient with asymmetrical sensorineural hearing loss, diagnosed of megadolicho basilar artery. Case report: JBS, 57-year-old white male with a history of asymmetrical sensorineural hearing loss and bilateral whistle-like tinnitus for several years. The otorhinolaryngologic evaluation, including otoscopy, anterior rhinoscopy and oral pharynx, was normal. Final Comments: The treatment consisted in following up with the patient, controlling the tinnitus by drugs and using an individual sound amplification apparatus on the left ear.

  8. A Case of Large Phyllodes Tumor Causing “Rupture” of the Breast: A Unique Presentation

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    Junaid Nabi

    2013-01-01

    Full Text Available Introduction. Phyllodes tumors are rare fibroepithelial tumors which constitute less than 1% of all known breast neoplasms. The importance of recognizing these tumors lies in the need to differentiate them from fibroadenomas and other benign breast lesions to avoid inappropriate surgical management. We report a case of large phyllodes tumor which caused rupture of the breast and presented as an external fungating breast mass, a presentation which is exceedingly rare. Case Presentation. A 32-year-old female presented with a 1-year history of a mass in her right breast and eruption of the mass through the skin for the last 3 months. On physical examination, an ulcerated, irregular, and nodular mass measuring  cms was found hanging in the lower and outer quadrant of the right breast. Ultrasonography revealed an exophytic mass with heterogeneous echotexture and vascularity. Under general anesthesia, the tumor was excised. The resected specimen was  cm in size and the tumor was not invasive to the surrounding tissues. Histological examination confirmed a benign case of Phyllodes tumor. Conclusion. Clinicians should be aware of the myriad ways in which Phyllodes can present. A rapidly growing breast mass in a female should raise strong suspicion for Phyllodes. It is necessary to differentiate it from fibroadenomas to avoid inappropriate surgical management which may lead to local recurrence.

  9. Two Cases of Occupational Contact Urticaria Caused by Percutaneous Sensitization to Parvalbumin

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    Akiyo Sano

    2015-08-01

    Full Text Available Background: In recent years, it has been proposed that the primary mechanism for the development of food allergies is percutaneous sensitization. Since 2010, in Japan, the number of immediate-type wheat allergy due to hydrolyzed wheat protein has dramatically increased among those who have been using soap containing hydrolyzed wheat. This incidence supports the hypothesis that food allergens arise through percutaneous sensitization. Clinical Summary: A 25-year-old man (case 1 and an 18-year-old girl (case 2 with atopic dermatitis visited our Department because of food allergy and hand eczema. After starting their work with fish, severe itchy eczema appeared on their hands. They subsequently started to experience oral allergic symptoms, intraoral itchiness and dyspnea after eating fish. Specific IgE antibodies were detected for many fishes, and skin prick tests showed positive reactions for a variety of fishes in both cases. Furthermore, the fluorescence intensities of specific IgE antibodies against parvalbumin from various types of fish in microarray immunoassay analysis showed positive reactions. We diagnosed them as contact urticaria caused by percutaneous sensitization to parvalbumin through job-related physical contact with fish. Conclusion: The patients' histories and findings indicate the possibility of percutaneous sensitization through occupational exposure to parvalbumin, leading to food allergy.

  10. Hirayama disease, a rare cause of posture related cord compression: a case report from radiological perspective.

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    Arooj, Shumaila; Mubarak, Fatima; Azeemuddin, Muhammad; Sajjad, Zafar; Jilani, Wasey

    2013-11-01

    Hirayama Disease is a disease of young adults lying in the age group between twenty to thirty years. It is an extremely uncommon disorder. Its other synonyms are juvenile muscular atrophy of the distal upper extremity (JMADUE) or monomelic amyotrophy (MMA). A previously healthy 25-year-old man presented with gradually increasing weakness in both hands for the past few years. There was neither history of trauma nor family history of neuromuscular disease. MRI was advised. Routine cervical sagittal MR images (Non-flexion or extension) revealed cord flattening and atrophy at C5 to C7 levels.There was evidence of syrinx. Flexion MRI was performed later on. Midline sagittal T1- and T2-weighted images of the cervical spine showed anterior displacement of the cervical cord with marked flattening of cord. The patient was advised to modify his posture, avoid flexion and to apply cervical collar. Physiotherapy was started to improve the tone of muscles. In case of deterioration of symptoms he was advised to consult for surgery. The purpose of this case report is to show the importance of dynamic scan in symptomatic patients especially in their second or third decade with progressive upper limb weakness. Mostly the scanning in neutral posture does not reveal any significant cord compression. Similarly a normal looking thecal sac with preserved anterior and posterior thecal sleeves without disc disease dramatically changes on change of posture. This case shows the importance of dynamic scanning in symptomatic patients with progressive upper limb weakness and with no obvious cause of the cord changes on routine MR images. Cervical collar, physiotherapy and in resistant cases surgery is recommended for management.

  11. Detection of diabetic metabolism disorders post-mortem--forensic case reports on cause of death hyperglycaemia.

    Science.gov (United States)

    Hess, C; Wöllner, K; Musshoff, F; Madea, B

    2013-01-01

    Diabetic coma is the most severe form of hyperglycaemic metabolic disorders. The post-mortem diagnosis of this disorder of glucose metabolism can be difficult and vague due to a lack of characteristic morphological findings. Six death cases caused by diabetic coma are described with special focus on biochemical (and histological) findings. The possible glycaemia markers glucose, lactate, HbA1c, fructosamine, anhydroglucitol, and ketone bodies were measured and the usefulness of these parameters is evaluated and discussed. Estimations of glucose concentrations in vitreous humour or cerebrospinal fluid and of ketone bodies in blood or other matrices are obligatory while measurements of HbA1c, fructosamine, or anhydroglucitol can only provide additional information on the long-term adjustment of diabetes in the deceased. Lactate concentrations (addition of glucose and lactate levels to form the sum formula of Traub) do not give more information than the glucose concentration itself and can be therefore omitted.

  12. [A case of black dot ringworm on the right forearm caused by Trichophyton tonsurans].

    Science.gov (United States)

    Fujita, Shigeru; Mochizuki, Takashi

    2007-01-01

    We report a case of black dot ringworm on the right forearm caused by Trichophyton (T.) tonsurans. A 16-year-old male high school Judo-wrestler visited our clinic on September 30, 2005, complaining of a round erythematosquamous eruption with a distinct margin on the right forearm. Black dots were observed in the lesion. KOH-Parker ink prepared direct microscopy revealed abundant large endotrix arthroconidia in the hair shaft. Culture yielded yellowish-brown colonies. The isolate produced numerous round, short club-shaped microconidia along the hyphae unstained with lactophenol cotton blue (resembling matchsticks) and chlamydospores. PCR-RFLP analysis of internal transcribed spacer regions of ribosomal DNA revealed a banding pattern compatible with T. tonsurans. The lesion was cured by daily administration of 125 mg of terbinafine for 13 weeks.

  13. A CASE OF SUBCUTANEOUS PHAEOHYPHOMYCOSIS CAUSED BY EXSEROHILUM SPECIES IN AN IMMUNOCOMPROMISED PATIENT

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    Koppada Rajasekhar

    2013-10-01

    Full Text Available Phaeohyphomycoses are rare fungal infections, caused by dematiaceous fungi, manifested as cutaneous and subcutaneous infections, meningitis, sinusitis, keratitis, osteomyelitis and disseminated infection. This is a case report of a 45year old immuno compromised female on ART (Anti Retroviral therapy presented with fever and generalized nodular lesions draining pus on face, hands, axilla, groin and labia majora since one month. Biopsy of the subcutaneous nodule on the lateral aspect of the thigh revealed septate fungal hyphae on 10% KOH (10% Potassium Hydroxide mount. Fungal culture of the biopsy material on SDA (Sabouraud’s Dextrose Agar at 250C showed cotton wooly, dark gray to olivaceous black growth with black reverse and identified as dematiaceous fungi belonging to Exserohilum species by microscopy. The patient was put on Itraconazole 200mg BD in combination with Terbinafine 250mg BD for which she responded with healing of pustular lesions in two weeks and complete remission in two months..

  14. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

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    Sultan Şevik Eliçora

    2015-01-01

    Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

  15. A Rare Case of Soft-Tissue Infection Caused by Raoultella planticola.

    Science.gov (United States)

    O' Connell, Karina; Kelly, Jack; Niriain, Una

    2010-01-01

    Raoultella species are Gram-negative, non-motile bacilli primarily considered to be environmental bacteria. Raoultella planticola is a rare cause of human infections. We report a case of serious soft-tissue infection in a young male tiler who presented with cellulitis of his left thumb. He had sustained a crush injury to his left thumb 10 days earlier in a soiled environment. He noted a minor break in the skin and he washed the wound out with running water. One week later, he experienced pain, erythema, and swelling of his thumb and attended his general practitioner who prescribed oral flucloxacillin and penicillin V. Despite this treatment, he noticed progressive erythema and swelling of his thumb requiring hospital admission 3 days later. He underwent washout and debridement of his thumb. Tissue obtained intraoperatively cultured Raoultella planticola. He was treated with broad-spectrum antibiotics including ciprofloxacin and made a full and rapid recovery.

  16. Adult intussusception caused by cystic lymphangioma of the colon: A rare case report

    Institute of Scientific and Technical Information of China (English)

    Tae Oh Kim; Jung Hyun Lee; Gwang Ha Kim; Jeong Heo; Dae Hwan Kang; Geun Am Song; Mong Cho

    2006-01-01

    We experienced a case of intussusception caused by cystic lymphangioma of the colon in a 32 years old female who was admitted to our hospital for the chief complaint of bloody stool. In the colonoscopic examination,cystic mass with stalk which had smooth mucosal surface was noted at the descending colon. Abdominal ultrasonography and computed tomography revealed left colon intussusception with a multilocular cystic tumor as a leading point. Emergent operation was performed. On the histopathologic examination, the cystically dilated spaces lined by endothelium and septated by fibrous septa were present. The pathological diagnosis was cystic lymphangioma of the colon. Although intussusception due to lymphangioma in an adult are rare, it should be taken into consideration that it is possible diagnosis.

  17. Acute intoxication caused by synthetic cannabinoids 5F-ADB and MMB-2201: A case series.

    Science.gov (United States)

    Barceló, Bernardino; Pichini, Simona; López-Corominas, Victoria; Gomila, Isabel; Yates, Christopher; Busardò, Francesco Paolo; Pellegrini, Manuela

    2017-02-02

    Synthetic cannabinoids are relatively new substances of abuse. Recently, abuse of synthetic cannabinoids has been increasingly reported in the lay press and medical literature. When new compounds are introduced, their use is initially not restricted by prohibition therefore their consumption cannot be verified by standard drug tests. The use of these compounds among adolescents and young adults is constantly growing, making it important for emergency services to be familiar with the signs and symptoms of intoxication present. Overdose and chronic use of these substances can cause adverse effects including altered mental status, tachycardia, and loss of consciousness. Here, we report five cases of acute intoxication by synthetic cannabinoids 5F-ADB and MMB-2201 with analytical confirmation.

  18. Erythema nodosum caused by ascariasis and Chlamydophila pneumoniae pulmonary infection--a case report.

    Science.gov (United States)

    Bergler-Czop, Beata; Lis-Swiety, Anna; Kamińska-Winciorek, Grazyna; Brzezińska-Wcisło, Ligia

    2009-12-01

    Erythema nodosum belongs to a group of relatively common hypodermal inflammations. It occurs mainly among women, particularly young women. The etiology of the disease is not clear. Most frequently, changes appear on the surface of the frontal part of the shins. Initially, red nodules change in color to dark brown and then to yellow and green. There is neither dissolution nor cicatrization of the exanthema. Regression is frequent. We present a case of erythema nodosum caused by Ascaris lumbricoides infection as well as by an early Chlamydophila pneumoniae infection, whose etiology has rarely been described in the literature. We were not able to confirm which factor was responsible for the occurrence of the skin changes as treatment of both infections was effective and all skin changes later disappeared completely. Particular attention should be paid to the fact that precise diagnosis of a patient and the search for etiologic factors, even rare ones, are crucial to obtain good results with treatment of erythema nodosum.

  19. [A Case of Hyperammonemia Caused by Urinary Tract Infection Due to Urease-Producing Bacteria].

    Science.gov (United States)

    Emura, Masahiro; Tsuchihashi, Kazunari; Shimizu, Yosuke; Kanamaru, Sojun; Matoba, Shun; Ito, Noriyuki

    2016-08-01

    We present here a rare case of hyperammonemia without liver dysfunction or portal-systemic shunting. The patient was an 80-year-old woman with a history of neurogenic bladder. She was admitted to a nearby hospital for vomiting, diarrhea and consciousness disturbance. Two days after admission, she was transferred to our hospital because of persistant consciousness disturbance. Laboratory data revealed hyperammonemia, but there was no indication of liver dysfunction. Moreover abdominal computed tomography did not reveal any clear finding of liver disease or portal-systemic shunting, but we noted multiple large bladder diverticula. Antibiotic therapy, tracheal intubation, ventilator management and bladder catheterization were performed. The patient's level of consciousness improved rapidly. Urinary culture revealed Bacteroides ureolyticus (urease-producing bacteria). The patient was diagnosed with hyperammonemia and a urinary tract infection due to urease-producing bacteria. Thus, physicians should be aware that obstructive urinary tract infections due to urease-producing bacteria can also be the cause of hyperammonemia.

  20. A Rare Case of Soft-Tissue Infection Caused by Raoultella planticola

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    Karina O' Connell

    2010-01-01

    Full Text Available Raoultella species are Gram-negative, non-motile bacilli primarily considered to be environmental bacteria. Raoultella planticola is a rare cause of human infections. We report a case of serious soft-tissue infection in a young male tiler who presented with cellulitis of his left thumb. He had sustained a crush injury to his left thumb 10 days earlier in a soiled environment. He noted a minor break in the skin and he washed the wound out with running water. One week later, he experienced pain, erythema, and swelling of his thumb and attended his general practitioner who prescribed oral flucloxacillin and penicillin V. Despite this treatment, he noticed progressive erythema and swelling of his thumb requiring hospital admission 3 days later. He underwent washout and debridement of his thumb. Tissue obtained intraoperatively cultured Raoultella planticola. He was treated with broad-spectrum antibiotics including ciprofloxacin and made a full and rapid recovery.

  1. [Hyperkalemia caused by intravenous administration of mannitol in a patient with arteriovenous malformation: case report].

    Science.gov (United States)

    Kimura, Shigeyoshi; Ogawa, Haruhiko; Katayama, Yoichi

    2006-01-01

    We experienced a case in which hyperkalemia was induced by mannitol administration. The medication with mannitol was given to a 15-year-old male patient who underwent a removal operation for arteriovenous malformation under general anesthesia. Following the mannitol infusion, his arterial blood gas and electrolyte analysis revealed severe metabolic acidosis and an increase in serum potassium. Furthermore, a change in his electrocardiogram was observed. The hyperkalemia was quickly normalized by medication with calcium gluconate and sodium bicarbonate. We stopped the removal operation with the aim of giving priority to the patient's safety. It is speculated that the hyperkalemia was caused by the administration of mannitol. Checks of electrolyte levels, arterial blood gas analysis and electrocardiogram monitoring should therefore be carried out when using mannitol, especially in an emergency situation such as intracranial hemorrhage.

  2. Pterygoid hamulus bursitis as a cause of craniofacial pain: a case report.

    Science.gov (United States)

    Cho, Jin-Yong; Cheon, Kang-Yong; Shin, Dong-Whan; Chun, Won-Bae; Lee, Ho

    2013-06-01

    Pain on the soft palate and pharynx can originate in several associated structures. Therefore, diagnosis of patients who complain of discomfort in these areas may be difficult and complicated. Pterygoid hamulus bursitis is a rare disease showing various symptoms in the palatal and pharyngeal regions. As such, it can be one of the reported causes of pain in these areas. Treatment of hamular bursitis is either conservative or surgical. If the etiologic factor of bursitis is osteophytic formation on the hamulus or hypertrophy of the bursa, resection of the hamulus is usually the preferred surgical treatment. We report on a case of bursitis that was managed successfully by surgical treatment and a review of the literature.

  3. Severe fungal sclerokeratitis caused by Metarhizium anisopliae: a case report and literature review.

    Science.gov (United States)

    Eguchi, Hiroshi; Toibana, Toshi; Hotta, Fumika; Miyamoto, Tatsuro; Mitamura, Yoshinori; Yaguchi, Takashi

    2015-02-01

    To date, there has been only one published report on the infectious sclerokeratitis caused by Metarhizium anisopliae, which is an entomopathogenic fungus. Regarding corneal infection, three reports have been published to date. Although the prognoses of the corneal infections are favourable, prognosis when scleral infection is involved is very poor. A 76-year-old patient presented with foreign body sensation in the left eye. Microscopic examination with Fungi Flora Y staining of the corneal scraping revealed fungal infection. The conjunctiva was melted by the infection over a wide area. Although intensive medications were administered, an emergency surgery was necessary because scleral thinning, corneal perforation and lens prolapse occurred. The fungal isolate was identified as M. anisopliae by sequencing the internal transcribed spacer region. Herein, we report the second known case worldwide of M. anisopliae sclerokeratitis, and we review the literature related to the ocular infections.

  4. An atypical case of fragile X syndrome caused by a deletion that includes FMRI gene

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    Quan, F.; Zonana, J.; Gunter, K.; Peterson, K.L.; Magenis, R.E., Popovich, B.W. [Shriners Hospital for Crippled Children, Portland, OR (United States)

    1995-05-01

    Fragile X syndrome is the most common form of inherited mental retardation and results from the transcriptional inactivation of the FMR1 gene. In the vast majority of cases, this is caused by the expansion of an unstable CGG repeat in the first exon of the FMR1 gene. We describe here a phenotypically atypical case of fragile X syndrome, caused by a deletion that includes the entire FMR1 gene and {ge}9.0 Mb of flanking DNA. The proband, RK, was a 6-year-old mentally retarded male with obesity and anal atresia. A diagnosis of fragile X syndrome was established by the failure of RK`s DNA to hybridize to a 558-bp PstI-XhoI fragment (pfxa3) specific for the 5{prime}-end of the FMR1 gene. The analysis of flanking markers in the interval from Xq26.3-q28 indicated a deletion extending from between 160-500 kb distal and 9.0 Mb proximal to the FMR1 gene. High-resolution chromosome banding confirmed a deletion with breakpoints in Xq26.3 and Xq27.3. This deletion was maternally transmitted and arose as a new mutation on the grandpaternal X chromosome. The maternal transmission of the deletion was confirmed by FISH using a 34-kb cosmid (c31.4) containing most of the FMR1 gene. These results indicated that RK carried a deletion of the FMR1 region with the most proximal breakpoint described to date. This patient`s unusual clinical presentation may indicate the presence of genes located in the deleted interval proximal to the FMR1 locus that are able to modify the fragile X syndrome phenotype. 36 refs., 7 figs.

  5. Causes of Acquired Vocal Cord Palsy in Indian Scenario.

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    Swapna Sebastian

    2012-10-01

    Full Text Available Vocal cord paresis or paralysis occurs due to lesion in the vagus nerve. Vocal cord paralysis can lead to dysphonia as well as dysphagia which lead the patient to frustration and emotional problems. The literature available on the etiology and the problems faced by them in Indian population is very scanty. Hence a prospective study was done on 41 Patients with vocal cord palsy who were referred to the Department of ENT for voice assessment and management from March 1st 2012 till 1st August 2012. The medical and surgical reports were examined. They were evaluated by an otorhinolaryngologist, and a Speech Language Pathologist. Diagnosis was made based on video stroboscopic findings. We also examined voice-related quality of life (V-RQOL outcomes in these patients. In this study, endo-tracheal intubation (15/41; 36.5% was the major cause of vocal cord palsy. The second major cause for vocal cord palsy in our study was surgical trauma (iatrogenic which constituted 26.8% (11/41, out of which thyroidectomy contributed to 81.81% (9/11 and cardiac surgery (Coronary Artery Bypass Grafting (CABG contributed to 18.18% (2/11. Neurological problems caused 14.63% (6/41 of the total cases. Non-surgical trauma constituted 9.75% (4/41 of the total patients. Left recurrent laryngeal nerve paralysis was found as a complication of heart disease in 7.3%(3/41. Tuberculosis of lungs and cancer of lungs accounted to be the rarest causes. Hoarseness of voice was the most common symptom with associated dysphagia in a few. The voice related quality of life of these patients was found to be poor. They were found to have problems in the social-emotional domain and physical functioning domain.

  6. Neuropathy caused by B12 deficiency in a patient with ileal tuberculosis: A case report

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    Toosi Taraneh

    2008-03-01

    Full Text Available Abstract Introduction Vitamin B12 deficiency can result in macrocytic anemia. Neurologic abnormalities of B12 deficiency include sensory deficits, loss of deep tendon reflexes, movement disorders, neuropsychiatric changes and seizures. Segmental involvement of the distal ileum, such as in tuberculosis, can cause vitamin B12 deficiency. To our knowledge, macrocytic anemia with unusual manifestations such as brain atrophy and seizures due to intestinal tuberculosis has not been reported in the literature. Case presentation A 14-year-old girl presented with complaints of paraplegia, ataxia, fever and fatigue that had started a few months earlier and which had been getting worse in the last three weeks. Her laboratory results were indicative of macrocytic anemia with a serum B12 level Conclusion Vitamin B12 deficiency should be considered in patients with neurologic features such as paresthesia, sensory deficits, urinary incontinence, dysarthria, and ataxia. The underlying cause of B12 deficiency should be determined and treated to obviate the patients' need for long term vitamin B12 therapy.

  7. Endoscopically observable white nodule caused by distal intramural lymphatic spread of rectal cancer: a case report

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    Tsumura Ayako

    2012-10-01

    Full Text Available Abstract This report describes a case of rectal cancer with endoscopically observable white nodules caused by distal intramural lymphatic spread. A 57-year-old female presented to our hospital with frequent diarrhea and hemorrhoids. Computed tomography showed bilateral ovarian masses and three hepatic tumors diagnosed as rectal cancer metastases, and also showed multiple lymph node involvement. The patient was preoperatively diagnosed with stage IV rectal cancer. Colonoscopy demonstrated that primary rectal cancer existed 15 cm from the anal verge and that there were multiple white small nodules on the anal side of the primary tumor extending to the dentate line. Biopsies of the white spots were performed, and they were identified as adenocarcinoma. The patient underwent Hartmann’s procedure because of the locally advanced primary tumor. The white nodules were ultimately diagnosed as being caused by intramural lymphatic spreading because lymphatic permeation was strongly positive at the surrounding area. Small white nodules near a primary rectal cancer should be suspected of being intramural spreading. Endoscopic detection of white nodules may be useful for the diagnosis of distal intramural spread.

  8. Chronic hypertrophic nonunion of the Type II odontoid fracture causing cervical myelopathy: Case report and review of literature

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    Mohammed F Shamji

    2016-01-01

    Conclusion: Rarely, nonunion of Type II odontoid fractures may be hypertrophic where both instability and compression cause neurological morbidity. Such cases require anterior transoral decompression, posterior cervical decompression, and instrumented fusions.

  9. Transarterial embolization of massive gastric ulcer bleeding in gastrostomy patients caused by a balloon replacement tube: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Youn, Byong Jong; Hur, Jin; Lee, Kwang Hun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2007-02-15

    We present the case of a 77-year-old woman with massive gastric ulcer bleeding caused by a balloon replacement tube that required emergent transcatheter left gastric arterial embolization in stop the ulcer bleeding.

  10. A case of cellulitis of the hands caused by a predatory bird attack

    Institute of Scientific and Technical Information of China (English)

    M Adil Abbas Khan; Mohammed Farid; Zain A Sobani; Syed Nadir Ali; Huzaifa Malick; Maryam Baqir; Hasanat Sharif; M Asim Beg

    2011-01-01

    Many species have been drastically affected by rapid urbanization. Harris's hawks from their natural habitat of open spaces and a supply of rodents, lizards and other small prey have been forced to change their natural environment adapting to living in open spaces in sub- and peri-urban areas. Specific areas include playgrounds, parks and school courtyards. The migration of this predatory species into these areas poses a risk to individuals, and especially the children are often attacked by claws, talons and beaks intentionally or as collateral damage while attacking rodent prey. In addition, the diverse micro-organisms harbored in the beaks and talons can result in wound infections, presenting a challenge to clinical management. Here we would like to present a case of an80-year-old man with cellulitis of both hands after sustaining minor injuries from the talons of a Harris's hawk and review the management options. We would also like to draw attention to the matter that, even though previously a rarity, more cases of injuries caused by birds of prey may be seen in hospital settings.

  11. Extreme gastric dilation caused by chronic lead poisoning: A case report

    Institute of Scientific and Technical Information of China (English)

    Vesna Begovic; Darko Nozic; Srdjan Kupresanin; Dino Tarabar

    2008-01-01

    Lead is a toxic metal that affects many organ systems and functions in humans.In the majority of adults,chronic lead poisoning comes from exposures to work places and can occur in numerous work settings, such as manufacturing, lead smelting and refinement, or due to use of batteries, pigments, solder, ammunitions,paint, car radiators, cable and wires, certain cosmetics.In some countries, lead is added to petrol.We present a rare case of gastric dilation caused by long-term petrol ingestion.A 16-year-old young man was admitted to our hospital due to a 6-mo history of exhaustion, dizziness,nausea, abdominal cramps and constipation.X-ray examination revealed dilated stomach descending into the pelvis and small bowel distension.After a long clinical observation, we found that the reason for the chronic lead poisoning of the patient was due to a 3-year history of petrol ingestion.The patient spontaneously recovered and stomach returned to its normal position and size.Lead poisoning should be taken into consideration in all unexplained cases of gastric dilation.

  12. A case of cellulitis of the hands caused by a predatory bird attack

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    M Adil Abbas Khan

    2011-04-01

    Full Text Available Many species have been drastically affected by rapid urbanization. Harris's hawks from their natural habitat of open spaces and a supply of rodents, lizards and other small prey have been forced to change their natural environment adapting to living in open spaces in sub- and peri-urban areas. Specific areas include playgrounds, parks and school courtyards. The migration of this predatory species into these areas poses a risk to individuals, and especially the children are often attacked by claws, talons and beaks intentionally or as collateral damage while attacking rodent prey. In addition, the diverse micro-organisms harbored in the beaks and talons can result in wound infections, presenting a challenge to clinical management. Here we would like to present a case of an 80-year-old man with cellulitis of both hands after sustaining minor injuries from the talons of a Harris's hawk and review the management options. We would also like to draw attention to the matter that, even though previously a rarity, more cases of injuries caused by birds of prey may be seen in hospital settings.

  13. An oblique muscle hematoma as a rare cause of severe abdominal pain: a case report

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    Shimodaira Masanori

    2013-01-01

    Full Text Available Abstract Background Abdominal wall hematomas are an uncommon cause of acute abdominal pain and are often misdiagnosed. They are more common in elderly individuals, particularly in those under anticoagulant therapy. Most abdominal wall hematomas occur in the rectus sheath, and hematomas within the oblique muscle are very rare and are poorly described in the literature. Here we report the case of an oblique muscle hematoma in a middle-aged patient who was not under anticoagulant therapy. Case presentation A 42-year-old Japanese man presented with a painful, enlarging, lateral abdominal wall mass, which appeared after playing baseball. Abdominal computed tomography and ultrasonography showed a large soft tissue mass located in the patient’s left internal oblique muscle. A diagnosis of a lateral oblique muscle hematoma was made and the patient was treated conservatively. Conclusion Physicians should consider an oblique muscle hematoma during the initial differential diagnosis of pain in the lateral abdominal wall even in the absence of anticoagulant therapy or trauma.

  14. First three reported cases of nosocomial fungemia caused by Candida auris.

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    Lee, Wee Gyo; Shin, Jong Hee; Uh, Young; Kang, Min Gu; Kim, Soo Hyun; Park, Kyung Hwa; Jang, Hee-Chang

    2011-09-01

    Candida auris is a newly described species whose clinical significance is not clear. Here, we describe the first three cases of nosocomial fungemia caused by C. auris, which confirms that it is a causative agent of bloodstream infections. All three patients presented persistent fungemia for 10 to 31 days. The isolates obtained from the three patients were misidentified as Candida haemulonii and Rhodotorula glutinis by the Vitek 2 and the API 20C systems, respectively. C. auris was confirmed by sequence analysis of the internal transcribed spacer region and D1/D2 regions of the 26S ribosomal DNA of the rRNA gene. The MIC ranges of amphotericin B (AMB), fluconazole (FLU), itraconazole, and voriconazole were 0.5 to 1, 2 to 128, 0.125 to 2, and 0.06 to 1 μg/ml, respectively. All isolates were susceptible to caspofungin (MIC = 0.06 μg/ml) and micafungin (MIC = 0.03 μg/ml). One patient developed breakthrough fungemia while receiving FLU therapy, and two patients who received FLU therapy followed by AMB showed therapeutic failure and fatal outcomes. Our cases show that C. auris fungemia can be persistent, despite FLU or AMB therapy, which emphasizes the importance of accurately identifying this species.

  15. Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

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    Sood Suneet

    2010-06-01

    Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

  16. Superior Mesenteric Vein Occlusion Causing Severe Gastrointestinal Haemorrhage in Two Paediatric Cases

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    Anna L. Fox

    2012-01-01

    Full Text Available Reports about superior mesenteric vein thrombosis in childhood are very rare and have not been associated with gastrointestinal bleeding. We describe two cases of severe bleeding from the upper and lower gastrointestinal tract in children who had undergone complex abdominal surgery at considerable time before. The first child had a tracheoesophageal fistula, corrected by division, gastrostomy insertion, and repair of duodenal rupture. The child presented with severe bleeding from the gastrostomy site and was diagnosed with a thrombosis of the proximal superior mesenteric vein. The second child had a gastroschisis and duodenal atresia, and required duodenoplasty, gastrostomy insertion, hemicolectomy, and adhesiolysis. The child presented with intermittent severe lower gastrointestinal bleeding, resulting from collateral vessels at location of the surgical connections. He was diagnosed with a thrombosis of the superior mesenteric vein. In both children, the extensive previous surgery and anastomosis were considered the cause of the mesenteric thrombosis. CT angiography confirmed the diagnosis in both cases, in addition to characteristic findings on endoscopy. Paediatricians should suspect this condition in children with severe gastrointestinal bleeding, particularly in children with previous, complex abdominal surgery.

  17. Application of a hormonal intrauterine device causing uterine perforation: A case report

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    Žižić Vojislav

    2011-01-01

    Full Text Available Introduction. The last decade of the usage of intrauterine contraception has been marked by the application of levonorgestrel-releasing hormonal devices. A hormonal intrauterine device (IUD releases a certain amount of progestogen, whose effect on endometrium is such that, apart from preventing unwanted pregnancy, also regulates the menstrual bleeding by reducing the quantity and the duration of haemorrhage. This effect of hormonal IUDs has led to their additional indications and use, so that nowadays these IUDs are used not only as contraceptives but for therapeutic purposes as well. Case Outline. After examination and treatment in an out-patient department, a 38-year-old woman was referred to our hospital due to suspected spontaneous uterine perforation caused by hormonal IUD (Mirena® one month after its application. Clinical and sonographic examinations were unable to determine the uterine perforation or the exact IUD location. Radiographic examination confirmed the presence of the IUD in the abdomen, so it was decided to operate on the patient. Perforation in the isthmus of the uterus and to the right was identified intraoperatively. By exploration of the genital organs and the abdominal cavity, the IUD was finally located in the omentum. Conclusion. Even in cases of adequate indications for hormonal IUD application, the doctor’s experience and complying with all the principles of appropriate insertion, we should always consider the possibility of the occurrence of serious complications, which sometimes may even require surgery. The extragenital position of IUD, as in this case, may create serious difficulties in the detection of location. A possible development of asymptomatic complications additionally emphasizes the necessity of regular check-ups of all IUD users.

  18. A rare case report of subcutaneous phaeohyphomycotic cyst caused by Exophiala oligosperma in an immunocompetent host with literature review.

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    Venkateshwar, Sithara; Ambroise, M Moses; Asir, G Johny; Mudhigeti, Nagaraja; Ramdas, Anita; Authy, K; Shivaprakash, M R; Kanungo, Reba

    2014-08-01

    We report a rare case of phaeohyphomycotic cyst in an immunocompetent patient caused by Exophiala oligosperma. This fungus is earlier known to cause infections in the immunocompromised. Identification of black fungi at species level is more challenging by conventional methods, and hence final identification of the fungi was based on sequencing of rDNA. The patient was managed with surgical excision. To the best of our knowledge, this is the first case report of E. oligosperma human infection from India.

  19. Ortner's syndrome: a case report and literature review

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    Dutra, Bruno Landim; Campos, Lenilton da Costa; Marques, Helder de Castro; Vilela, Vagner Moyses, E-mail: brunolandim@yahoo.com.br [Universidade Federal de Juiz de Fora (HU/UFJF), MG (Brazil). Hospital Universitario. Unidade de Radiologia e Diagnostico por Imagem; Carvalho, Rodolfo Elias Diniz da Silva [Centro de Diagnostico Medico (CRM), Sao Mateus, ES (Brazil); Duque, Andre Geraldo da Silva [Axial Medicina Diagnostica, Belo Horizonte, MG (Brazil)

    2015-07-15

    The authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner's syndrome. (author)

  20. Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

    Science.gov (United States)

    Fredouille, Corinne; Pouchoulin, Gilles; Ghio, Alain; Revis, Joana; Bonastre, Jean-François; Giovanni, Antoine

    2009-12-01

    This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists). The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices), rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0-3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

  1. [Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Białystok].

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    Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jan; Pepiński, Witold

    2004-01-01

    Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Białystok through the period of 1999-2001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character.

  2. Neurogenic stuttering as a manifestation of stroke and a mask of dysphonia.

    Science.gov (United States)

    Rao, P R

    1991-01-01

    R. L. was a 52-year-old man who was referred for an SLP consultation to determine the nature of his fluency disorder, whether or not treatment would be beneficial, and finally whether resumption of pre-trauma vocational status was feasible. The patient was involved in a motor vehicle accident with no resulting detectable trauma. However, shortly after the accident, R. L. developed a severe dysfluency that was later described as cortical stuttering. We reviewed the medical and rehabilitation work-up that attempted to determine whether the communication disorder was functional or organic in origin. Once the fluency disorder was determined to be caused by a suspected small, focal, hemispheric lesion, a five-month treatment program was undertaken that used a noval prosthetic approach to restore fluency. Once fluency was restored with the use of an artificial larynx, a residual anomia was detected and treated. The case of R. L. illustrates a stuttering that appeared to be caused by a combined neurogenic dyspraxic (vocal control), dysarthric (motor control), and dysnomic (word-finding) dysfluency. The literature on this issue was reviewed and the underlying mechanism of recovery was discussed.

  3. Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus: a toxic shock-prevented case.

    Science.gov (United States)

    Goto, Masafumi; Gotoh, Masafumi; Mitsui, Yasuhiro; Shibata, Hideaki; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

    2014-01-01

    Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus (GAS) is rare. GAS sometimes causes group A β-hemolytic streptococcal toxic shock syndrome. We encountered a case of pyogenic knee arthritis caused by GAS that resolved after appropriate treatment (emergency arthroscopic synovectomy and medication) administered within 48 h of onset. In cases of a history of another infection with acute knee joint pain, the possibility of GAS-induced pyogenic knee arthritis should be considered, and proper treatment should be administered immediately.

  4. Tomophobia, the phobic fear caused by an invasive medical procedure - an emerging anxiety disorder: a case report

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    Schmid Markus

    2009-11-01

    Full Text Available Abstract Introduction Tomophobia refers to fear or anxiety caused by forthcoming surgical procedures and/or medical interventions. Case presentation We present the case of a 69-year-old Caucasian man who refused urgently indicated medical intervention because of severe tomophobia. Conclusion Due to the rising number of surgical interventions in modern medicine, as well as the high number of unrecognised cases of tomophobia, this common but underdiagnosed anxiety disorder should be highlighted.

  5. [A sepsis case caused by a rare opportunistic pathogen: Bacillus pumilus].

    Science.gov (United States)

    Borsa, Barış Ata; Aldağ, Mehmet Ersoy; Tunalı, Birsen; Dinç, Uğur; Güngördü Dalar, Zeynep; Özalp, Veli Cengiz

    2016-07-01

    The high prevalence of Bacillus species in nature and the detection of these bacteria as contaminant in cultures may lead diagnostic dilemma, however they should still be considered as a pathogen particularly in case of repeated positive cultures from patients with risk factors. Bacillus pumilus is a bacteria, though rarely, been reported as the causative agent of various infections such as sepsis, endocarditis, skin infections and food poisoning in human. In this report, a sepsis case in an immunocompetent patient caused by B.pumilus was presented. A 38-year-old female patient was admitted to emergency service of our hospital with the complaints of headache, dizziness and diarrhea. She had not any risk factors except a history of heart valve replacement operation two years ago. In physical examination, she had abdominal retention, high fever and hypotension, together with the high levels of sedimentation rate (ESR) and C-reactive protein (CRP). The patient was hospitalized with the preliminary diagnosis of sepsis. Three sets of blood samples at two different periods were taken for the culture. All blood culture vials had a positive signal at the second day of incubation in BD BACTEC™ 9050 system, therefore subcultures were performed in sheep blood agar, chocolate agar and MacConkey agar, and incubated in aerobic and anaerobic conditions. Beta-haemolytic, gray-colored large colonies were isolated from anaerobic culture at the end of 18-24 hours incubation, and Gram staining from colonies showed gram-positive rods. The isolate was identified as B.pumilus with 99% accuracy rate by using BD Phoenix™ 100 identification system. This result was also confirmed by MALDI-TOF based VITEK® MS system and 16S rRNA sequencing by Illumina MiSeq® platform. Antibiotic susceptibility test performed by BD Phoenix™ 100 system and the isolate was found to be resistant against penicillin, while it was susceptible to vancomycin, erythromycin, clindamycin, levofloxacin, and

  6. Isolated varices over hepatic flexure colon indicating superior mesenteric venous thrombosis caused by uncinate pancreatic head cancer- a case report

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    Yu-Pin Ho; Chun-Jung Lin; Ming-Yao Su; Jeng-Hwei Tseng; Cheng-Tang Chiu; Pang-Chi Chen

    2005-01-01

    Very rare cases of varices involving right side colon were reported. Most of them were due to cirrhotic portal hypertension or other primary causes. No report case contributed to pancreatic cancer. Here, we reported a case of uncinate pancreatic cancer with the initial finding of isolated hepatic flexure colon varices. Following studies confirmed isolated varices involving hepatic flexure colon due to pancreatic cancer with occlusion of superior mesenteric vein. From this report, superior mesenteric vein occlusion caused by uncinate pancreatic head cancer should be considered as a differential diagnosis of colon varices.

  7. Causes of Borehole Failure in Complex Basement Terrains: ABUAD Case Study, Southwestern Nigeria

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    1 Ogundana, A.K , 2 Aladesanmi A. O., 3 Okunade A., 4Olutomilola O.O

    2015-10-01

    Full Text Available A preliminary assessment of primary causes of borehole failure has being conducted using Afe Babalola University as a case study. A total of fourteen boreholes (namely borehole 1-14 were studied, vertical electrical soundings, depth sounding, flushing and pump testing were conducted on each of the boreholes to establish their status at the time of the study and possible evaluation of the groundwater potential of the wells. Four out of the fourteen boreholes (borehole 1-4 are productive and in-use, while the remaining ten (borehole 5-14 are out-of-use and abandoned for various. The productive holes were able to support continuous flow of water for over 3 hours without drop in volume of water flow. Seven of the holes (boreholes 5, 6, 8, 9, 11, 12 & 14 failed and were abandoned because of low yield (could not flow beyond 5 minutes, while the remaining three (boreholes 7, 10 & 13 failed and were abandoned due to wrong location and improper completion, caving/formation problems, and wrong installation/completion respectively. Proper well completion is essential in areas prone to caving and other formation related problems. Air drilling should be avoided in areas with thick and loose overburden. Right mixture of drilling mud should be applied to secure the hole wall while flushing should be continuous throughout drilling in such formation. Casing should be done immediately and such holes should be lined and grouted. Timers should be installed on low yield wells and regulated/programmed for 5 or 10 minutes flow depending on the recharge rate. Pump rating for installation should be strictly based on well recharge rate. Productive wells should be properly maintained and monitored for optimal performance.

  8. Suspected anemia caused by maternal anti-Jra antibodies: a case report.

    Science.gov (United States)

    Endo, Yasufumi; Ito, Shoichi; Ogiyama, Yoshiko

    2015-01-01

    Most cases of hemolytic disease of the newborn associated with anti-Jra are mild. However, rare cases of hydrops fetalis and severe anemia have been reported. We treated a neonate with anemia who was born with maternal anti-Jra, which were detected in the umbilical cord plasma. The Jra antigens in the neonate core blood red blood cells (RBCs) exhibited extremely weak reactivity to PEG-IAT, an anti-Jra reagent. However, upon re-examination of Jra antigen using PEG-IAT at 3 months postpartum, positivity was observed. Thereafter, upon performing PCR-SSP analysis of blood relatives targeting ABCG2 at positions 376 and 421, we found that the mother was Jr(a-) with 376 T homozygosity, whereas the father was Jr(a+) with 376 C homozygosity and a carrier of a 421 C > A mutation. The first sibling, like the propositus, was Jr(a+), exhibiting 376 CT heterozygosity. However, the first sibling carried a 421 C > A mutation, whereas the propositus had no mutation at position 421. Setting the normal Jra (a+) type (376 C, 421 C) to 100 %, we identified the amount of Jra in RBC using FCM to be 82 % in the father, 31 % in the first sibling, and 69 % in the propositus. Furthermore, upon comparing peripheral blood and myelograms of the neonate at the time of birth, we found a low myeloid cells/erythroid cells ratio, undifferentiated erythroblasts, and reduced megakaryocytes. On the basis of these findings, we suggest that cell surface antigen is involved in the HDN caused by anti-Jra, and that a cytodifferentiation abnormality is present in the hematopoietic system.

  9. Liver and brain abscess caused by Aggregatibacter paraphrophilus in association with a large patent foramen ovale: a case report

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    Carmichael Andrew

    2010-02-01

    Full Text Available Abstract Introduction Aggregatibacter paraphrophilus (former name Haemophilus paraphrophilus is a normal commensal of the oral flora. It is a rare cause of hepatobiliary or intracerebral abscesses. Case presentation We report a case of a 53-year-old Caucasian man with a liver abscess and subsequent brain abscesses caused by Aggregatibacter paraphrophilus. The probable source of the infection was the oral flora of our patient following ingestion of a dental filling. The presence of a large patent foramen ovale was a predisposing factor for multifocal abscesses. Conclusion In this case report, we describe an unusual case of a patient with both liver and brain abscesses caused by an oral commensal Aggregatibacter paraphrophilus that can occasionally show significant pathogenic potential.

  10. Two Cases of Endogenous Endophthalmitis Caused by Gram-Positive Bacteria with Good Visual Outcome

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    Machiko Itoh

    2010-09-01

    Full Text Available Background: Endogenous endophthalmitis is a rare disease and its visual prognosis is poor. Case Reports: We present two patients, a 60-year-old man and a 53-year-old man, who developed endogenous endophthalmitis caused byGram-positive organismsbut recovered good vision after antibiotics and vitrectomy. Results: The first patient complained of ocular pain and visual decrease in his right eye. Ophthalmoscopy showed inflammation in the anterior chamber and vitreous opacities. Antibiotic was administrated systemically, and blood culture detected Streptococcus anginosus. He underwent successful heart surgery for endocarditis and total dental extraction for severe gingivitis. Vitrectomy was performed 36 days after the onset and vision improved from 0.02 to 0.7. The second patient was referred for acute visual decrease in his left eye. Severe iritis and vitreous opacities were observed, and systemic examination showed acute pyelitis and prostatic abscesses. Blood cultures detected Staphylococcus sp., and systemic antibiotics were given. Vitrectomy was performed 12 days after the onset, and vision improved from 0.06 to 1.2. Conclusions: We conclude that the rapid treatment with systemic antibiotics for the organisms at the primary site, and the vitrectomy, even though delayed, can lead to a good recovery of vision.

  11. Rare cause of upper gastrointestinal bleeding owing to hepatic cancer invasion: a case report.

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    Wu, Wei-Ding; Wu, Jia; Yang, Hong-Guo; Chen, Yuan; Zhang, Cheng-Wu; Zhao, Da-Jian; Hu, Zhi-Ming

    2014-09-21

    Upper gastrointestinal bleeding refers to bleeding that arises from the gastrointestinal tract proximal to the ligament of Treitz. The primary reason for gastrointestinal bleeding associated with hepatocellular carcinoma is rupture of a varicose vein owing to pericardial hypotension. We report a rare case of gastrointestinal bleeding with hepatocellular carcinoma in a patient who presented with recurrent gastrointestinal bleeding. The initial diagnosis was gastric cancer with metastasis to the multiple lymph nodes of the lesser curvature. The patient underwent exploratory laparotomy, which identified two lesions in the gastric wall. Total gastrectomy and hepatic local excision was then performed. Pathological results indicated that the hepatocellular carcinoma had invaded the stomach directly, which was confirmed immunohistochemically. The patient is alive with a disease-free survival of 1 year since the surgery. Hepatocellular carcinoma with gastric invasion should be considered as a rare cause of upper gastrointestinal bleeding in hepatocellular carcinoma patients, especially with lesions located in the left lateral hepatic lobe. Surgery is the best solution.

  12. Clinical heterogeneity of neonatal intrahepatic cholestasis caused by citrin deficiency: case reports from 16 patients.

    Science.gov (United States)

    Tazawa, Yusaku; Kobayashi, Keiko; Abukawa, Daiki; Nagata, Ikuo; Maisawa, Shunichi; Sumazaki, Ryo; Iizuka, Toshiyuki; Hosoda, Yoshito; Okamoto, Manabu; Murakami, Jun; Kaji, Shunsaku; Tabata, Ayako; Lu, Yao Bang; Sakamoto, Osamu; Matsui, Akira; Kanzaki, Susumu; Takada, Goro; Saheki, Takeyori; Iinuma, Kazuie; Ohura, Toshihiro

    2004-11-01

    A deficiency of citrin, which is encoded by the SLC25A13 gene, causes both adult-onset type II citrullinemia (CTLN2) and neonatal intrahepatic cholestasis (NICCD). We analyzed 16 patients with NICCD to clarify the clinical features of the disease. Severe intrahepatic cholestasis with fatty liver was the most common symptom, but the accompanying clinical features were variable, namely; suspected cases of neonatal hepatitis or biliary atresia, positive results from newborn screening, tyrosinemia, failure to thrive, hemolytic anemia, bleeding tendencies and ketotic hypoglycemia. Laboratory data showed elevated serum bile acid levels, hypoproteinemia, low levels of vitamin K-dependent coagulation factors, and hypergalactosemia. Hypercitrullinemia was detected in 11 out of 15 patients examined. Most of the patients were given a lactose-free and/or medium chain triglycerides-enriched formula and lipid-soluble vitamins. The prognosis of the 16 patients is going fairy well at present, but we should observe these patients carefully to see if they manifest any symptom of CTLN2 in the future.

  13. Anterior Uveitis Caused by Ocular Side Effects of Afatinib: A Case Report.

    Science.gov (United States)

    Todokoro, Daisuke; Itakura, Hirotaka; Ibe, Takashi; Kishi, Shoji

    2016-01-01

    Afatinib is a second-generation epidermal growth factor receptor (EGFR) inhibitor that has been shown to be effective against EGFR-mutated non-small cell lung cancer (NSCLC) resistant to conventional EGFR inhibitors such as gefitinib and erlotinib. Although ocular side effects of gefitinib and erlotinib have been reported, those for afatinib have yet to be definitively established. This report presents details on the first case of unilateral iridocyclitis associated with the side effects of afatinib therapy. A 75-year-old Japanese male ex-smoker with EGFR-mutated NSCLC underwent afatinib therapy for multiple metastases. At 2 weeks, bilateral conjunctivitis developed. Topical medication and a 1-week afatinib washout period resulted in the improvement of the conjunctivitis. However, 3 days after the resumption of afatinib, the patient developed unilateral granulomatous anterior uveitis in his right eye. Best-corrected visual acuity (BCVA) measurement indicated a decimal visual acuity of 0.2, while the slit-lamp findings were characterized by granulomatous inflammation, keratic precipitates, Koeppe nodules and posterior synechiae. There was no evidence suggesting other intraocular inflammatory disease or metastatic tumor. The left eye was intact. The use of topical medication including steroids and a washout of afatinib resulted in a gradual subsiding of the anterior uveitis. After resolution of the anterior uveitis, oral afatinib was resumed. BCVA of the right eye finally recovered to a decimal acuity of 1.0. Ophthalmologists should be aware of the possibility that side effects associated with afatinib could cause granulomatous anterior uveitis.

  14. Corynebacterium glucuronolyticum causing genitourinary tract infection: Case report and review of the literature

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    G. Gherardi

    2015-01-01

    In this report, we describe a urethritis case caused by C. glucuronolyticum in a 37-year-old, apparently healthy male, who complained mild pain in the lower abdomen, with several urinary symptoms. While urethral and semen specimens did not yield positive results for microbiological evaluation, cultures of urine samples revealed the monomicrobial growth on blood-containing media of tiny colonies after 24 h of incubation, clearly evident only after 48 h of incubation under CO2-enriched atmosphere. Colonies were identified as C. glucuronolyticum both by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF and 16S rRNA gene sequencing. Oral ciprofloxacin gradually led to clinical improvement and, finally, to a complete recovery, in accordance with microbiological findings. In spite of its infrequent detection, C. glucuronolyticum might be a potential urogenital pathogen in males more commonly that what believed, perhaps due to slow growth leading to underrecognition; we suggest therefore to consider the organism in the differential diagnostics of bacterial diseases of the urinary tract.

  15. Case Report: Trigeminal Neuralgia Caused by a Minute Meningioma with Hyperostosed Suprameatal Tubercle

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    Yukitomo Ishi

    2015-08-01

    Full Text Available Cerebellopontine angle tumors might occasionally provoke trigeminal neuralgia but are usually large enough to be diagnosed radiographically. We present a case of trigeminal neuralgia caused by a very small meningioma covering the suprameatal tubercle that displayed hyperostosis at the entrance of Meckel's cave and was not obvious on routine magnetic resonance (MR images. A 72-year-old woman with intractable trigeminal neuralgia in the left V3 territory was referred to our institution. Preoperative imaging studies revealed that the left trigeminal nerve was medially distorted at the entrance of Meckel's cave by a laterally seated bone bulge covered by a minute enhanced lesion. Trigeminal nerve decompression surgery was performed via a retrosigmoid intradural suprameatal approach. We found a small meningioma that had compressed and flattened the trigeminal nerve root at the entrance of Meckel's cave, which was grossly and totally removed by suprameatal tubercle resection. There was no vascular compression of the trigeminal nerve root. The trigeminal neuralgia ceased completely after the operation. Accurate preoperative determination of the causative pathologies is essential to achieve adequate surgical results after microvascular decompression for neurovascular compression syndrome. Because conventional MR sequences are inadequate for the precise interpretation of complex neurovascular anatomy in the cerebellopontine angle and such small tumors can be overlooked on routine MR studies, high-resolution thin-slice MR examinations and careful radiological interpretations are required for correct diagnosis and treatment.

  16. Case Report: Trigeminal Neuralgia Caused by a Minute Meningioma with Hyperostosed Suprameatal Tubercle.

    Science.gov (United States)

    Ishi, Yukitomo; Asaoka, Katsuyuki; Sugiyama, Taku; Yokoyama, Yuka; Yamazaki, Kazuyoshi; Echizenya, Sumire; Itamoto, Koji; Echizenya, Kohei

    2015-01-01

    Cerebellopontine angle tumors might occasionally provoke trigeminal neuralgia but are usually large enough to be diagnosed radiographically. We present a case of trigeminal neuralgia caused by a very small meningioma covering the suprameatal tubercle that displayed hyperostosis at the entrance of Meckel's cave and was not obvious on routine magnetic resonance (MR) images. A 72-year-old woman with intractable trigeminal neuralgia in the left V3 territory was referred to our institution. Preoperative imaging studies revealed that the left trigeminal nerve was medially distorted at the entrance of Meckel's cave by a laterally seated bone bulge covered by a minute enhanced lesion. Trigeminal nerve decompression surgery was performed via a retrosigmoid intradural suprameatal approach. We found a small meningioma that had compressed and flattened the trigeminal nerve root at the entrance of Meckel's cave, which was grossly and totally removed by suprameatal tubercle resection. There was no vascular compression of the trigeminal nerve root. The trigeminal neuralgia ceased completely after the operation. Accurate preoperative determination of the causative pathologies is essential to achieve adequate surgical results after microvascular decompression for neurovascular compression syndrome. Because conventional MR sequences are inadequate for the precise interpretation of complex neurovascular anatomy in the cerebellopontine angle and such small tumors can be overlooked on routine MR studies, high-resolution thin-slice MR examinations and careful radiological interpretations are required for correct diagnosis and treatment.

  17. Nursing student medication errors: a case study using root cause analysis.

    Science.gov (United States)

    Dolansky, Mary A; Druschel, Kalina; Helba, Maura; Courtney, Kathleen

    2013-01-01

    Root cause analysis (RCA) has been used widely as a means to understand factors contributing to medication errors and to move beyond blame of an individual to identify system factors that contribute to these errors. Nursing schools respond to student medication errors seriously, and many choose to discipline the student without taking into consideration both personal and system factors. The purpose of this article is to present a case study that highlights an undergraduate nursing student medication error and the application of an RCA. The use of this method was a direct result of our nursing program implementation of the Quality and Safety Education for Nurses competencies. The RCA included a critical evaluation of the incident and a review of the literature. Factors identified were environmental, personal, unit communication and culture, and education. The process of using the RCA provided an opportunity to identify improvement strategies to prevent future errors. The use of the RCA promotes a fair and just culture in nursing education and helps nursing students and faculty identify problems and solutions both in their performance and the systems in which they work.

  18. Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

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    Shih Hao Wang

    2017-01-01

    Full Text Available A case of choroidal rupture caused by airbag-associated blunt eye trauma and complicated with massive subretinal hemorrhage and vitreous hemorrhage that was successfully treated with intravitreal injection of expansile gas and bevacizumab is presented. A 53-year-old man suffered from loss of vision in his right eye due to blunt eye trauma by a safety airbag after a traffic accident. On initial examination, the patient had no light perception in his right eye. Dilated ophthalmoscopy revealed massive subretinal hemorrhage with macular invasion and faint vitreous hemorrhage. We performed intravitreal injection of pure sulfur hexafluoride twice for displacement, after which visual acuity improved to 0.03. For persistent subretinal hemorrhage and suspicion of choroidal neovascularization (CNV, intravitreal bevacizumab (1.25 mg/0.05 mL injection was administered. After 3 weeks, the visual acuity of his right eye recovered to 0.4. For early-stage choroidal rupture-induced subretinal hemorrhage and complications of suspected CNV, intravitreal injection of expandable gas and intraocular injection of antiangiogenesis drugs seem to be an effective treatment.

  19. Two cases of uveitis masquerade syndrome caused by bilateral intraocular large B-cell lymphoma

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    Jovanović Svetlana

    2013-01-01

    Full Text Available Introduction. Sometimes it is not easy to clinically recognize subtle differences between intraocular lymphoma and noninfectious uveitis. The most common lymphoma subtype involving the eye is B-cell lymphoma. Case report. We presented two patients aged 59 and 58 years with infiltration of the subretinal space with a large B-cell non-Hodgkin intraocular lymphoma. The patients originally had clinically masked syndrome in the form of intermediate uveitis. As it was a corticosteroid-resistant uveitis, we focused on the possible diagnosis of neoplastic causes of this syndrome. During hospitalization, the neurological symptoms emerged and multiple subretinal changes accompanied by yellowish white patches of retinal pigment epithelium with signs of vitritis, which made us suspect the intraocular lymphoma. Endocranial magnetic resonance imaging established tumorous infiltration in the region of the left hemisphere of the cerebellum. The histopathological finding confirmed the diagnosis of large B-cell non-Hodgkin lymphoma of risk moderate degree, immunoblast - centroblast cytological type. The other patient had clinical chronic uveitis accompanied by yellowish shaped white echographic changes of the retina and localized changes in the level of the subretina. The diagnosis of lymphoma was made by brain biopsy. Conclusion. Uveitis masquerade syndrome should be considered in all patients over 40 years with idiopathic steroid-resistant uveitis. Treatment begun on time can affect the course and improve the prognosis of uveitis masquerade syndrome (UMS and systemic disease.

  20. Rectovesicovaginal fistula following rectovaginal fistula caused by radiation therapy for uterine cancer. A case report

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    Hara, Tsuneo; Shiba, Masahiro; Matsuoka, Yasuhiro; Kakimoto, Ken-ichi; Oda, Masayoshi; Koide, Takuo [Osaka Koseinenkin Hospital (Japan)

    1997-07-01

    A case of rectovesicovaginal fistula caused by pelvic radiation for uterine cancer is presented. A 62-year-old woman visited our department complaining of macroscopic hematuria, mictional pain and pollakisuria. She had a history of total hysterectomy and radiation therapy for cervical cancer 26 years earlier. Melena was noted in March 1994 and an escape of stool from the vagina followed nine months later. She consulted a surgeon about it, however no active treatment was performed before coming under our care. Computed tomography demonstrated that the posterior bladder wall was extremely thin and the possibility of the formation of vesical perforation was strongly suggested. We constructed transverse-colostomy, however, a rectovesicovaginal fistula developed seven months later. Therefore, in order to regain a dry life, an ileal conduit was constructed and her quality of life began to improve. It is probable that the rectovesicovaginal fistula could have been prevented if colostomy had been carried out soon after the appearance of melena or soon after the formation of the rectovaginal fistula. (author)

  1. Hemolysis and hyperhomocysteinemia caused by cobalamin deficiency: three case reports and review of the literature

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    Hsueh Chung-Tsen

    2008-12-01

    Full Text Available Abstract Concurrent hemolysis in patients with vitamin B12 deficiency is a well-recognized phenomenon and has been attributed to intramedullary destruction of erythrocytes (ineffective erythropoiesis. Recent studies revealed that homocysteine increased the risk of hemolysis in vitamin B12 deficiency in vitro and there is a high frequency (30% of vitamin B12 deficiency in asymptomatic patients with homozygous methylene tetrahydrofolate reductase (MTHFR C677T mutation, a known cause of hyperhomocysteinemia. Here we report three patients with MTHFR mutations and vitamin B12 deficiency presenting with hemolytic anemia and severely elevated homocysteine levels. Patients demonstrated complete resolution of hemolysis with simultaneous normalization of serum homocysteine levels after vitamin B12 treatments. We reviewed pertinent literature, and hypothesized that hemolytic anemia may be more prevalent in patients who have a coexisting MTHFR gene mutation and vitamin B12 deficiency possibly related to severely elevated homocysteine levels. The hemolysis in these cases occurred predominantly in peripheral blood likely due to the combined effects of structurally defective erythrocytes and homocysteine-induced endothelial damage with microangiopathy.

  2. Human case of bacteremia caused by Streptococcus canis sequence type 9 harboring the scm gene.

    Science.gov (United States)

    Taniyama, Daisuke; Abe, Yoshihiko; Sakai, Tetsuya; Kikuchi, Takahide; Takahashi, Takashi

    2017-01-01

    Streptococcus canis (Sc) is a zoonotic pathogen that is transferred mainly from companion animals to humans. One of the major virulence factors in Sc is the M-like protein encoded by the scm gene, which is involved in anti-phagocytic activities, as well as the recruitment of plasminogen to the bacterial surface in cooperation with enolase, and the consequent enhancement of bacterial transmigration and survival. This is the first reported human case of uncomplicated bacteremia following a dog bite, caused by Streptococcus canis harboring the scm gene. The similarity of the 16S rRNA from the infecting species to that of the Sc type strain, as well as the amplification of the species-specific cfg gene, encoding a co-hemolysin, was used to confirm the species identity. Furthermore, the isolate was confirmed as sequence type 9. The partial scm gene sequence harbored by the isolate was closely related to those of other two Sc strains. While this isolate did not possess the erm(A), erm(B), or mef(A), macrolide/lincosamide resistance genes, it was not susceptible to azithromycin: its susceptibility was intermediate. Even though human Sc bacteremia is rare, clinicians should be aware of this microorganism, as well as Pasteurella sp., Prevotella sp., and Capnocytophaga sp., when examining and treating patients with fever who maintain close contact with companion animals.

  3. An unusual cause of intestinal obstruction in an adolescent: a case report

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    Victor Hip Wo Yeung

    2009-11-01

    Full Text Available A 15-year-old boy presented with intestinal obstruction two weeks following a blunt abdominal trauma. He had progressive bilious vomiting without abdominal distension or peritonitis. The contrast computed tomography (CT scan of the abdomen provided the definitive diagnosis: there was an obstructing duodenal hematoma, which might have been slowly progressing or have arisen from secondary hemorrhage after the initial injury. The boy remained stable over a ten-day period of conservative treatment, and his obstructive symptoms and signs were resolved completely. A follow-up CT scan of the abdomen (16 days after admission showed an almost complete resolution of the hematoma. Delayed duodenal hematoma causing intestinal obstruction has been reported rarely in previous literature. Occasionally a significant secondary hemorrhage resulting in intestinal obstruction can become life threatening. Clinical follow-up is paramount after initial recovery. Although conservative treatment suffices in most cases, the surgeon should be wary of the need for definitive surgical intervention if there is evidence of ongoing acute hemorrhage or of the obstructing hematoma failing to resolve. Laparoscopic drainage of the hematoma provides optimistic results for patients failing conservative management.

  4. Exophiala spinifera as a cause of cutaneous phaeohyphomycosis: case study and review of the literature.

    Science.gov (United States)

    Harris, John E; Sutton, Deanna A; Rubin, Adam; Wickes, Brian; De Hoog, G S; Kovarik, Carrie

    2009-02-01

    Exophiala spinifera has been reported as an agent of cutaneous disease 18 times in the literature. Clinical presentations of cutaneous lesions vary widely, including erythematous papules, verrucous plaques, and deep subcutaneous abscesses. The clinical distribution and course of disease are also variable, depending on the age and immune competency of the patient. Histologic appearance occurs in one of two patterns--phaeohyphomycosis or chromoblastomycosis. While E. spinifera appears to be susceptible to multiple antimicrobial agents in vitro, clinical experience with treatment modalities has been variable. Prior to the availability of sequencing methods, species identification was based on the histopathologic presentation in tissue and morphologic features of the fungus in culture. It is likely that E. spinifera cutaneous infections have been underreported due to its incorrect identification based on earlier methods. We report an additional case of E. spinifera phaeohyphomycosis, the first to be definitively identified by sequencing. In addition, we summarize the variable clinical, histopathologic, and morphologic features, as well as treatment responses described in previously reported cutaneous infections caused by E. spinifera.

  5. Fatal liver failure caused by reactivation of lamivudine-resistant hepatitis B virus: A case report

    Institute of Scientific and Technical Information of China (English)

    Yuka Suzuki; Fumio Itoh; Hiroshi Yotsuyanagi; Chiaki Okuse; Yoshihiko Nagase; Hideaki Takahashi; Kyoji Moriya; Michihiro Suzuki; Kazuhiko Koike; Shiro lino

    2007-01-01

    We present a case of fetal liver failure caused by the activation of lamivudine-resistant hepatitis B virus (HBV) nine months after lamivudine treatment. A 57-year old man visited our hospital for the treatment of decompensated chronic hepatitis B. Lamivudine was started in December 2001. Subsequently, serum HBV was negative for HBV DNA with seroconversion from HBeAg to anti-HBe and improvement of liver function. However, HBV DNA and HBeAg were again detected in September 2002. He was complicated by breakthrough hepatitis and admitted to our hospital in November for severely impaired liver function. Vidarabine treatment was started and serum HBV DNA and alanine aminotransferase (ALT) decreased transiently. However, after the start of a-interferon treatment, HBV DNA level increased and liver function deteriorated. He died 1 mo after admission. An analysis of amino acid sequences in the polymerase region revealed that rtM204I/V with rtL80I/V occurred at the time of viral breakthrough. After the start of antiviral treatment, rtL180M was detected in addition to rtM204I/V and rtL80I/V, and became predominant in the terminal stage of the disease. HBV clone with a high replication capacity may be produced by antiviral treatment leading to the worsening of liver function. Antiviral therapy for patients with breakthrough hepatitis in advanced liver disease should be carefully performed.

  6. A case study of arithmetic facts dyscalculia caused by a hypersensitivity-to-interference in memory.

    Science.gov (United States)

    De Visscher, Alice; Noël, Marie-Pascale

    2013-01-01

    While the heterogeneity of developmental dyscalculia is increasingly recognized, the different profiles have not yet been clearly established. Among the features underpinning types of developmental dyscalculia suggested in the literature, an impairment in arithmetic fact retrieval is particularly prominent. In this paper, we present a case study of an adult woman (DB) with very good cognitive capacities suffering from a specific and developmental arithmetic fact retrieval deficit. We test the main hypotheses about developmental dyscalculia derived from literature. We first explore the influential hypothesis of an approximate number system deficit, through estimation tasks, comparison tasks and a priming comparison task. Secondly, we evaluate whether DB's mathematical deficiencies are caused by a rote verbal memory deficit, using tasks involving completion of expressions, and reciting automatic series such as the alphabet and the months of the year. Alternatively, taking into account the extreme similarity of the arithmetic facts, we propose that a heightened sensitivity to interference could have prevented DB from memorizing the arithmetic facts. The pattern of DB's results on different tasks supports this hypothesis. Our findings identify a new etiology of a specific impairment of arithmetic facts storage, namely a hypersensitivity-to-interference.

  7. Gastro-duodenal ulcers with perforation caused by short-term acetylsalicylic acid ingestion: Case report

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    Ćulafić Đorđe

    2009-01-01

    Full Text Available Introduction. Acetylsalicylic acid ingestion may cause serious gastrointestinal toxicity, in particular bleeding or perforated peptic ulcer. Case Outline. A 72-year-old male patient presented with diffuse abdominal pain, malaise, and dark stools. Several days before hospitalization, he had cerebrovascular insult and began to use acetylsalicylic acid of 100 mg per day. In physical findings a diffusely painful sensitivity of the abdomen was detected on palpation. Laboratory findings revealed hyposideremic anaemia with inflammatory syndrome. Native abdominal x-ray did not show the presence of pneumoperitoneum. Upper endoscopy of the gastric corpus and antrum revealed several ulcerations 10-11 mm in diameter covered with fibrin, with bleeding ulceration in the angulus region of the lesser gastric curvature. The bulbus was oedematous and hyperaemic with a perforated ulcer on the anterior wall. Upper central laparotomy showed a perforated duodenal bulbus. The posterior wall of the bulbus was normal, while the anterior wall was without scarring. Given the general condition of the patient and local findings, interrupted suture of the ulcer was performed with omentoplasty. Postoperative course was uneventful. A peroral diet was initiated on the 4th postoperative day, and the patient was discharged on the 8th postoperative day. Conclusion. Elderly people who use acetylsalicylic acid in prophylaxis should take it in lower doses, with proton pump inhibitors, especially during the first two months.

  8. [Hypertrophic cardiomyopathy: a rare cause of vascular dementia. A case report].

    Science.gov (United States)

    Ben Hamouda, Ibtissem; Tougourti, Mohamed Néjib; Hamza, Mohsen

    2002-07-01

    Herein, we report a case of a 51 year old man who experienced three ischemic cerebral infarcts in a time of few months. The patient consulted after the third accident. Neurological presentation included pseudobulbar syndrome with a mild cognitive deficit, aphasia, left hemiparesia, hemiasomatognosia and homonymous lateral hemianopsia. Cerebral tomodensitometry and magnetic resonance imaging evidenced large infarcts images involving right middle cerebral artery territory and bilateral borderline zones in the junction of the territories of the middle and posterior cerebral arteries. Ambulatory 24 hours ECG recording (Holter) revealed two hits of non-sustained ventricular tachycardia. Transoesophageal echocardiography conveyed to the diagnosis of hypertrophic cardiomyopathy and displayed the presence of a left auricular thrombus. Anticoagulant therapy and rehabilitation allowed a substantial recovering of the patient's cognitive functions and wasting of the intracardiac thrombus. The clinical features observed in our patient meet the recommended DSM IV diagnosis criteria of vascular dementia, an exceptional complication of HCM. The clinical findings, neuroimagery investigation results, and the chronological link between cerebral attacks and cognitive function deterioration argue for a demential syndrome of vascular origin resulting from multiple embolic infarcts involving medium sized arteries (multi-infarct dementia). The authors emphasize the rarity of such observation. HCM must be considered as a potential cause of embolic stroke and likewise a multi-infarct dementia.

  9. Considerações teóricas sobre a relação entre respiração oral e disfonia Theoretical considerations on the relationship between mouth breathing and dysphonia

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    Juliana Gomes Tavares

    2008-01-01

    Full Text Available Sabe-se que a respiração oral pode ocasionar diversas alterações ósseas, posturais, musculares e funcionais, como também, alterações na qualidade e/ou comportamento vocal. Estas alterações podem comprometer a comunicação oral, na qual a voz não consegue desempenhar seu papel básico de transmissão da mensagem verbal e emocional do indivíduo. O indivíduo com respiração oral pode apresentar ressonância nasalizada e a voz pode apresentar alterações no traço de sonoridade, hiper ou hiponasal, ou rouca. A partir de pesquisa nas bases de dados LILACS, SciELO, livros, revistas especializadas sobre o tema, buscamos fazer uma revisão na literatura sobre a relação entre respiração oral e disfonia, analisando a influência das alterações causadas pela respiração oral na qualidade e/ou comportamento vocal. No entanto, foi possível observar que a respiração oral promove uma série de alterações estruturais significativas que refletem nas funções estomatognáticas, interferindo também na fonação. Contudo, poucos autores relatam a possível correlação entre esses dois parâmetros (respiração oral e disfonia.It is known that mouth breathing can lead to several bone, postural, muscular and functional alterations, and also changes on vocal quality and/or vocal behavior. These alterations can compromise oral communication, in which the voice cannot perform its basic role on the transmission of an individual's verbal and emotional message. Individuals with mouth breathing can present hiper or hiponasal resonance, changes on voicing features and hoarseness. From researches on LILACS and SciELO databases, books and specialized magazines about the subject, it was carried a literature review about the relationship between mouth breathing and dysphonia, analyzing the influence of alterations caused by mouth breathing on vocal quality and/or vocal behavior. It was possible observe that mouth breathing promotes several

  10. An unusual case of duodenal perforation caused by a blister pack: A case report and literature review

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    Si-Yuan Yao

    2015-01-01

    Conclusion: Unnoticed ingestion of blister packs can cause duodenal perforation. Although prompt management is necessary, duodenal perforation, especially in the third portion, may be potentially fatal.

  11. [A difficult and complicated case study: neonatal intrahepatic cholestasis caused by citrin deficiency].

    Science.gov (United States)

    Song, Yuan-Zong; Hao, Hu; Ushikai, Miharu; Liu, Guo-Sheng; Xiao, Xin; Saheki, Takeyori; Kobayashi, Keiko; Wang, Zi-Neng

    2006-04-01

    Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is a kind of inborn errors of metabolism, with the main clinic manifestations of jaundice, hepatomegaly, and abnormal liver function indices. As a mitochondrial solute carrier protein, citrin plays important roles in aerobic glycolysis, gluconeogenesis, urea cycle, and protein and nucleotide syntheses. Therefore citrin deficiency causes various and complicated metabolic disturbances, such as hypoglycemia, hyperlactic acidemia, hyperammonemia, hypoproteinemia, hyperlipidemia, and galactosemia. This paper reported a case of NICCD confirmed by mutation analysis of SLC25A13, the gene encoding citrin. The baby (male, 6 months old) was referred to the First Affiliated Hospital with the complaint of jaundice of the skin and sclera, which it had suffered from for nearly 6 months. Physical examination showed obvious jaundice and a palpable liver 5 cm below the right subcostal margin. Liver function tests revealed elevated enzymatic activities, like GGT, ALP, AST, and ALT, together with increased levels of TBA, bilirubin (especially conjugated bilirubin), and decreased levels of total protein/albumin and fibrinogen. Blood levels of ammonia, lactate, cholesterol, and triglyceride were also increased, and in particular, the serum AFP level reached 319,225.70 microg/L, a extremely elevated value that has rarely been found in practice before. Tandem mass analysis of a dried blood sample revealed increased levels of free fatty acids and tyrosine, methionine, citrulline, and threonine as well. UP-GC-MS analysis of the urine sample showed elevated galactose and galactitol. The baby was thus diagnosed with suspected NICCD based on the findings. It was then treated with oral arginine and multiple vitamins (including fat-soluble vitamins A, D, E, and K), and was fed with lactose-free and medium-chain fatty acids enriched formula instead of breast feeding. After half a month of treatment, the jaundice disappeared

  12. Severe Community-Acquired Pneumonia Caused by Human Adenovirus in Immunocompetent Adults: A Multicenter Case Series.

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    Dingyu Tan

    Full Text Available Severe community-acquired pneumonia (CAP caused by human adenovirus (HAdV, especially HAdV type 55 (HAdV-55 in immunocompetent adults has raised increasing concerns. Clinical knowledge of severe CAP and acute respiratory distress syndrome induced by HAdV-55 is still limited, though the pathogen has been fully characterized by whole-genome sequencing.We conducted a multicentre retrospective review of all consecutive patients with severe CAP caused by HAdV in immunocompetent adults admitted to the Emergency Department Intensive Care Unit of two hospitals in Northern China between February 2012 and April 2014. Clinical, laboratory, radiological characteristics, treatments and outcomes of these patients were collected and analyzed.A total of 15 consecutive severe CAP patients with laboratory-confirmed adenovirus infections were included. The median age was 30 years and all cases were identified during the winter and spring seasons. HAdV-55 was the most frequently (11/15 detected HAdV type. Persistent high fever, cough and rapid progression of dyspnea were typically reported in these patients. Significantly increased pneumonia severity index (PSI, respiratory rate, and lower PaO2/FiO2, hypersensitive CRP were reported in non-survivors compared to survivors (P = 0.013, 0.022, 0.019 and 0.026, respectively. The rapid development of bilateral consolidations within 10 days after illness onset were the most common radiographic finding, usually accompanied by adjacent ground glass opacities and pleural effusions. Total mortality was 26.7% in this study. Corticosteroids were prescribed to 14 patients in this report, but the utilization rate between survivors and non-survivors was not significant.HAdV and the HAdV-55 sub-type play an important role among viral pneumonia pathogens in hospitalized immunocompetent adults in Northern China. HAdV should be tested in severe CAP patients with negative bacterial cultures and a lack of response to antibiotic

  13. Anterior Uveitis Caused by Ocular Side Effects of Afatinib: A Case Report

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    Daisuke Todokoro

    2016-02-01

    Full Text Available Afatinib is a second-generation epidermal growth factor receptor (EGFR inhibitor that has been shown to be effective against EGFR-mutated non-small cell lung cancer (NSCLC resistant to conventional EGFR inhibitors such as gefitinib and erlotinib. Although ocular side effects of gefitinib and erlotinib have been reported, those for afatinib have yet to be definitively established. This report presents details on the first case of unilateral iridocyclitis associated with the side effects of afatinib therapy. A 75-year-old Japanese male ex-smoker with EGFR-mutated NSCLC underwent afatinib therapy for multiple metastases. At 2 weeks, bilateral conjunctivitis developed. Topical medication and a 1-week afatinib washout period resulted in the improvement of the conjunctivitis. However, 3 days after the resumption of afatinib, the patient developed unilateral granulomatous anterior uveitis in his right eye. Best-corrected visual acuity (BCVA measurement indicated a decimal visual acuity of 0.2, while the slit-lamp findings were characterized by granulomatous inflammation, keratic precipitates, Koeppe nodules and posterior synechiae. There was no evidence suggesting other intraocular inflammatory disease or metastatic tumor. The left eye was intact. The use of topical medication including steroids and a washout of afatinib resulted in a gradual subsiding of the anterior uveitis. After resolution of the anterior uveitis, oral afatinib was resumed. BCVA of the right eye finally recovered to a decimal acuity of 1.0. Ophthalmologists should be aware of the possibility that side effects associated with afatinib could cause granulomatous anterior uveitis.

  14. Toxicidade ocular causada pela cloroquina: relato de caso Ocular toxicity caused by chloroquine: case report

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    Eliane Terumi Inada

    2005-06-01

    Full Text Available Relatar um caso de toxicidade ocular causada pela cloroquina. Aferiu-se a acuidade visual de ambos os olhos em tabela de Snellen. Foram realizados biomicroscopia do segmento anterior, refração, oftalmoscopia, angiofluoresceinografia e retinografia numa paciente de 53 anos, sexo feminino, portadora de artrite reumatóide. Fez uso de cloroquina por 6 anos e havia parado há um ano, quando veio ao nosso serviço. Apresentava acuidade visual corrigida de 20/200 e 20/40. À biomicroscopia do segmento anterior apresentava lente intra-ocular no olho direito e catarata nuclear 1+/4+ no olho esquerdo, com opacidade corneana subepitelial inferior ao eixo visual em ambos os olhos. À oftalmoscopia, apresentava mácula com aspecto de tacho batido (atrofia do epitélio pigmentar da retina. A angiofluoresceinografia mostrou maculopatia com aspecto de olho de boi. Relata-se um caso típico de ceratopatia e maculopatia causados pela cloroquina.To report a case of ocular toxicity due to chloroquine. The best visual acuity was measured in both eyes with the Snellen chart. Slit-lamp examination of anterior segment, refraction, dilated fundus examination, fluorescein angiography and retinography was done in a 53-year-old patient, female, with rheumatoid arthritis. She had used chloroquine during 6 years and had stopped for 1 year when she came to our service. She had best corrected visual acuity of 20/200 and 20/40. Slit-lamp examination showed intraocular lens in right eye and nuclear cataract (1+/4 in the other, and bilateral corneal subepithelial opacity inferior to the visual axis. Fundus examination showed macular area with retinal pigment epithelium atrophy. Fluorescein angiography showed a bull's eye maculopathy. Report of a typical keratopathy and maculopathy caused by chloroquine.

  15. SUBCUTANEOUS PHEOHYPHOMYCOSIS CAUSED BY Phoma cava: REPORT OF A CASE AND REVIEW OF THE LITERATURE

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    Clarisse ZAITZ

    1997-01-01

    Full Text Available We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B, followed by itraconazoleO presente trabalho registra um caso de feo-hifomicose subcutânea em paciente do sexo masculino com o diagnóstico de sarcoidose pulmonar, submetido à terapêutica por corticosteróides quando apresentou no dorso da mão direita lesões cutâneas nodulares, eritêmato-violáceas, de aspecto infiltrado, exigindo biópsia para o diagnóstico. O exame histopatológico revelou processo granulomatoso, com a presença de hifas e células arredondadas demácias. Cultivo positivo para fungo identificado com Phoma cava. Os Autores fizeram revisão da literatura sobre as infecções fúngicas provocadas por diversas espécies de Phoma, mostrando a raridade desta observação. A evolução foi favorável com a administração da anfotericina B (via venosa seguida do itraconazol (via oral

  16. Community Acquired Spondylodiscitis caused by Escherichia Coli; Case Report and Literature Review

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    F Javier Fonseca del Pozo

    2016-07-01

    Full Text Available Vertebral osteomyelitis, or spondylodiscitis, is a rare disease with increasing prevalence in recent years due to a greater number of spinal surgical procedures, nosocomial bacteraemia, an aging population and intravenous drug addiction. Haematogenous infection is the most common cause of spondylodiscitis. We report a 47-year-old man diagnosed with Escherichia coli spondylodiscitis. The patient initially presented with a 4-day history of inflammatory, mechanical pain in the lower back suggesting sciatica. Treatment included NSAIDs and opioids. Two days after discharge from hospital following an admission due to an upper GI bleeding, the back pain intensified, precipitating a new attendance to the emergency department; during which lumbosacral radiography showed marked reduction of L2/L3 intervertebral space. After a new admission to the rheumatology unit due to worsening of symptoms and raised inflammatory markers, an expedited MRI showed loss of intervertebral disc space at L2/L3, with an irregular high intensity area at L2; suggesting a fluid collection extending to adjacent soft tissues. Fluoroscopy-guided core needle bone biopsies were reported positive for Escherichia coli sensitive to ceftriaxone. The patient was treated (received treatment with a three week course of ceftriaxone following a formal diagnosis of E. coli spondylodiscitis. Follow-up MRI demonstrated complete recovery with the patient able to return (has returned to normal activity. In this case we highlight the importance of correct and timely diagnosis of spondylodiscitis. Diagnosis of spondylodiscitis is often difficult, delayed or even missed due to the rarity of the disease but can lead to devastating consequences. Therefore a high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes.

  17. [Case report: taeniasis, is it a cause of psychiatric and neural symptoms?].

    Science.gov (United States)

    Inceboz, Tonay; Yalçin, Gülter; Aksoy, Umit

    2006-01-01

    The most frequent symptom of taeniasis is the discharge of proglottids (93.7%). Gravid proglottids which do not have uterine pores are damaged when they exit the anus by their movement. Because of this damage most of the eggs contaminate the perianal tract. The cellophane tape technique that is used for getting perineum material is also a convenient technique for diagnosis of taeniasis. A 36 year-old woman was admitted to our parasitology clinic complaining of a watering mouth for one year, of abdominal pain, and of loss of appetite for 6 months, and who had discharged proglottids from time to time. She had been eating raw meat since her childhood and had had treatment for taeniasis fifteen years ago. She has also been under treatment for obsessive and compulsive neurosis and depression for two years and complained of constipation that was the side effect of the drug clomipramine HCL. She was given treatment with niclosamide and purgative treatment. The result of the treatment was incomplete because the patient refused to use the purgative. She was called for follow up controls two weeks and six months after treatment and after six months did not have any evidence of infection in her stools. When she was asked, the patient said that she did not need to use the drugs for the treatment of obsessive and compulsive neurosis and depression any more since her symptoms had decreased. According to various authorities, taeniasis is thought to be the cause of psychiatric symptoms due to its neural and psychological effects. These claims have been confirmed in our case because of her psychiatric symptoms decreased after the taeniasis treatment. Thus, the view that there is a relationship between intestinal parasites and psychiatric disease has been strengthened.

  18. Wildfires Caused by Formation of Small Impact Craters: A Kaali Crater Case

    Science.gov (United States)

    Losiak, Anna; Belcher, Claire; Hudspith, Victoria; Zhu, Menghua; Bronikowska, Malgorzata; Jõeleht, Argo; Plado, Juri

    2016-04-01

    Formation of ~200-km Chicxulub 65 Ma ago was associated with release of significant amount of thermal energy [1,2,3] which was sufficient to start wildfires that had either regional [4] or global [5] range. The evidence for wildfires caused by impacts smaller than Chicxulub is inconclusive. On one hand, no signs of fires are associated with the formation of 24-km Ries crater [6]. On the other hand, the Tunguska site was burned after the impact and the numerical models of the bolide-produced thermal radiation suggest that the Tunguska-like event would produce a thermal flux to the surface that is sufficient to ignite pine needles [7]. However, in case of Tunguska the only proof for the bolide starting the fire comes from an eyewitness description collected many years after the event. Some authors [8] suggest that this fire might have been caused "normaly" later during the same year, induced on dead trees killed by the Tunguska fall. More recently it was observed that the Chelyabinsk meteor [9] - smaller than Tunguska event - did not produced a fire. In order to explore this apparent relationship in more detail, we have studied the proximal ejecta from a 100-m in diameter, ~3500 years old [10] Kaali crater (Estonia) within which we find pieces of charred organic material. Those pieces appear to have been produced during the impact, according to their stratigraphic location and following 14C analysis [19] as opposed to pre- or post-impact forest fires. In order to determine the most probable formation mechanism of the charred organic material found within Kaali proximal ejecta blanket, we: 1) Analyzed charcoal under SEM to identify the charred plants and determine properties of the charcoal related to the temperature of its formation [11]. Detected homogenization of cell walls suggests that at least some pieces of charcoal were formed at >300 °C [11]. 2) Analyzed the reflectance properties of the charred particles in order to determine the intensity with which

  19. Panniculitis caused by Mycobacterium monacense mimicking erythema induratum: a case in Ecuador.

    Science.gov (United States)

    Romero, J J; Herrera, P; Cartelle, M; Barba, P; Tello, S; Zurita, J

    2016-03-01

    We report the first case of recently characterized species M. monacense associated with chronic nodular vasculitis, infecting a young woman. This case represents the first isolation of M. monacense from Ecuador. The isolate was identified by conventional and molecular techniques.

  20. Panniculitis caused by Mycobacterium monacense mimicking erythema induratum: a case in Ecuador

    OpenAIRE

    Romero, J.J.; Herrera, P.; Cartelle, M.; Barba, P.; Tello, S.; ZURITA, J.

    2016-01-01

    We report the first case of recently characterized species M. monacense associated with chronic nodular vasculitis, infecting a young woman. This case represents the first isolation of M. monacense from Ecuador. The isolate was identified by conventional and molecular techniques.

  1. 儿童昏迷210例原因分析%Causes analysis of 210 cases with pediatric coma

    Institute of Scientific and Technical Information of China (English)

    邸春阳; 张妮; 王爱华

    2015-01-01

    目的 研究儿童重症监护病房(PICU)昏迷患儿的病因分布,以指导临床治疗.方法 采用回顾分析方法对210例昏迷患儿的病因进行分析.结果 210例昏迷患儿中,内科疾病150例,占71.43%,外科疾病60例,占28.57%.感染引起者110例,占52.38%,颅脑外伤58例,占27.62%,其中车祸31例,占14.76%.结论 PICU收治的昏迷患儿中,以感染性疾病为主,但外伤,尤其是车祸外伤所致昏迷患儿有所增加.因昏迷就诊患儿,尽快明确病因,对正确治疗及改善预后有积极意义.%Objective To investigate the causes of coma children in Pediatric Intensive Care Unit (PICU).Methods The causes of 210 children with coma were retrospectively analyzed.Results Among 210 cases,150 cases attributed to medical disease (71.43 %),while 60 cases attributed to surgical disease (28.57 %).110 cases were caused by infection(52.38%),58 cases were caused by cranioeerebral trauma (27.62%),while 31 cases involved in traffic accident(14.76%).Conclusion The main cause of coma in PICU is infectious diseases,but traffic accident trauma coma has been increased.It is positive to correct treatment and improve prognosis to recognize the cause as soon as possible.

  2. Synovial cyst of the hip joint as a rare cause of unlateral leg edema; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Hun; Chang, Il Soo; Park, Sang Woo; Yun, Ik Jin; Park, Hyung Kyu; Kim, Wan Seop; Lee, Hui Jin; Kim, Na Ra; Moon, Sung Gyu [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    A synovial cyst of the hip joint is a rare cause of unilateral leg edema, and it is usually associated with arthropathies such as rheumatoid arthritis and osteoarthritis. An asymptomatic synovial cyst of the hip joint that is not associated with an arthritic condition occurs infrequently. In this paper, we described the case of a 52-year-old woman who presented with unilateral right leg edema caused by a synovial cyst of the hip joint.

  3. A case report: A rare case of infant gastrointestinal canthariasis caused by larvae of Lasioderma serricorne (Fabricius, 1792) (Coleoptera: Anobiidae)

    OpenAIRE

    Sun, Xi; Wang, Li-Fu; Feng, Ying; Xie, Hui; Zheng, Xiao-Ying; He, Ai; Karim, Md Robiul; Lv, Zhi-Yue; Wu, Zhong-Dao

    2016-01-01

    Background Canthariasis is a disease of humans caused by the infestation of beetle larvae. It is the second important insectal disease after myiasis. Several species of beetles are reported to cause the disease in gastrointestinal tract, urogenital system, nasal sinuses, ears and faces of mammals. The cigarette beetle Lasioderma serricorne is a widespread and destructive pest that usually feeds on tobacco, tea, beans, cereal grains, and animal and plant specimen. While there was no previous e...

  4. Appendiceal diverticulitis in a femoral hernia causing necrotizing fasciitis of the right inguinal region: report of a unique case.

    Science.gov (United States)

    Georgiou, G K; Bali, C; Theodorou, S J; Zioga, A; Fatouros, M

    2013-02-01

    De Garengeot's hernia--a rare finding occurring mostly in women--is defined by the presence of the vermiform appendix within the sac of a femoral hernia. The incidence of appendicitis is rarer still, with less than a 100 cases reported to date. We present a unique case of an 84-year-old male patient with perforated appendiceal diverticulitis within a De Garengeot's hernia causing abscess and necrotizing infection of the overlying soft tissues.

  5. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    OpenAIRE

    Bicaj Besnik X; Spahija Gazmend S; Salihu Lulzim M; Hamza Astrit R; Krasniqi Avdyl S; Krasniqi Selvete A; Kurshumliu Fisnik I; Gashi-Luci Lumturije H

    2011-01-01

    Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdom...

  6. Does hypernatremia cause subdural hematoma in children?: two case reports and a meta-analysis of the literature.

    Science.gov (United States)

    Ali, Syed Adnaan; Jaspan, Timothy; Marenah, Christine; Vyas, Harish

    2012-06-01

    Hypernatremia has been causally linked with subdural hematoma (SDH), but more recently this has been called into question. Conversely, there is a well-established link between SDH and injury. We wish to examine the evidence base that hypernatremia in infants and young children causes SDH.We present 2 cases of children with severe hypernatremia whose intracranial contents were assessed by imaging in the first case and postmortem examination in the second. Neither demonstrated SDH. The first case was important as the hypernatremia was iatrogenic occurring in a controlled hospital environment.We also searched the literature from 1950 to 2007, collecting data on all reported cases of hypernatremia in children younger than 7 years whose intracranial contents were examined by imaging, surgery, and/or postmortem examination. Of 124 cases reported in 31 articles, 112 cases developed hypernatremia in the community, and 12 in the hospital. Subdural hematoma was demonstrated in 7 cases, all of which had developed hypernatremia in the community under circumstances that would make it difficult to exclude nonaccidental injury. None of the 12 cases that developed hypernatremia in a controlled hospital environment had SDH.The evidence base supporting the hypothesis that hypernatremia causes SDH is poor, depending on isolated reports with uncertain histories.

  7. Hemoperitoneum Caused by Hepatic Necrosis and Rupture Following a Snakebite: a Case Report with Rare CT Findings and Successful Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Yoo, Dong Gon; Choi, Soo Jung; Lee, Jong Hyeog; Park, Man Soo; Kwak, Jin Ho; Jung, Seung Mun; Ryu, Dae Shick [GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2007-12-15

    Snakebites are a relatively common occurrence worldwide and are estimated to affect greater than 2.5 million humans annually, of whom more than 100,000 will die. Imaging manifestations associated with this entity have rarely been described in the scientific literature. We recently obtained a successful clinical outcome after gelatin sponge sheet embolization of the hepatic artery in the case of a snakebite which caused hemoperitoneum associated with hepatic necrosis and rupture. Until now, this type of complication after a snakebite has not been reported in the literature. We report the computed tomographic and angiographic findings in a case of a snakebite resulting in hemoperitoneum caused by hepatic rupture and necrosis with active bleeding. In conclusion, snakebites have complex venomous effects. They may lead to various changes in hemostasis. In our case, snakebite-induced coagulopathy by a Korean viper resulted in hepatic necrosis and rupture with active bleeding. To our knowledge, this is the first published case about CT findings of hepatic necrosis and rupture with active bleeding after a snakebite and should be recognized as a possible complication following snakebites. We report the computed tomographic and angiographic findings in the case of a recently obtained successful clinical outcome after embolization of the hepatic artery in the case of a snakebite causing hemoperitoneum associated with hepatic necrosis and rupture with active bleeding.

  8. A first meningococcal meningitis case caused by serogroup Ⅹ Neisseria meningitidis strains in China

    Institute of Scientific and Technical Information of China (English)

    CHEN Chao; UANG Ying-chun; ZHANG Tie-gang; HE Jing-guo; WU Jiang; CHEN Li-juan; LIU Jun-feng; PANG Xing-huo; YANG Jie; SHAO Zhu-jun

    2008-01-01

    @@ Neisseria meningitidis is the leading cause of bacterial meningitis and classified into 13 serogroups based on the immunological reactivity of the capsular polysaccharide.1 Serogroups A,B,C,W135 and Y are the most common causes of meningitis.2

  9. Tigecycline salvage therapy for necrotizing fasciitis caused by Vibrio vulnificus: Case report in a child.

    Science.gov (United States)

    Lin, Yu-San; Hung, Min-Hsiang; Chen, Chi-Chung; Huang, Kuo-Feng; Ko, Wen-Chien; Tang, Hung-Jen

    2016-02-01

    Necrotizing fasciitis caused by Vibrio vulnificus is rarely reported in children. We describe a 12-year-old immunocompetent boy with necrotizing fasciitis caused by V. vulnificus. He was cured by radical and serial debridement and salvage therapy with intravenous cefpirome plus tigecycline. The in vitro antibacterial activity of combination regimens and a literature review of pediatric V. vulnificus infection are described.

  10. Successful management of an aortoesophageal fistula caused by a fish bone--case report and review of literature.

    Science.gov (United States)

    Kelly, Stephen L; Peters, Paul; Ogg, Murray J; Li, Alan; Smithers, Bernard M

    2009-05-08

    We report a case of aortoesophageal fistula (AEF) caused by a fish bone that had a successful outcome. Aortoesophageal fistula is a rare complication of foreign body ingestion from which few patients survive. Over one hundred cases of AEF secondary to foreign body ingestion have been documented but only seven, including our case, have survived over 12 months. Treatment involved stabilising the patient with a Sengstaken-Blakemore tube and insertion of a thoracic aortic endovascular stent-graft. Unfortunately the stent became infected and definitive open surgical repair involved removing the stent, replacing the aorta with a homograft and coverage with a left trapezius flap while under deep hypothermic arrest.

  11. Case report: vitamin D-dependent rickets type 1 caused by a novel CYP27B1 mutation.

    Science.gov (United States)

    Füchtbauer, Laila; Brusgaard, Klaus; Ledaal, Pål; Frost, Morten; Frederiksen, Anja L

    2015-12-01

    Vitamin D-dependent rickets type 1 VDDR-1 is a recessive inherited disorder with impaired activation of vitamin D, caused by mutations in CYP27B1. We present long-time follow-up of a case with a novel mutation including high-resolution peripheral quantitative computed tomography of the bone. Adequate treatment resulted in a normalized phenotype.

  12. Firearm bullet settling into the lumbar spinal canal without causing neurological deficit: A report of two cases

    Directory of Open Access Journals (Sweden)

    Tayfun Hakan

    2016-01-01

    Conclusion: Bullet settling into the lumbar spinal canal without causing neurological deficit may require surgical intervention. Removal of bullets provided not only pain relief in both the cases but also prevented future complications such as migration of the bullets, plumbism, and neuropathic pain and instability.

  13. Necrotizing Fasciitis in a Pediatric Patient Caused by Lancefield Group G Streptococcus: Case Report and Brief Review of the Literature

    Directory of Open Access Journals (Sweden)

    John Rausch

    2011-01-01

    Full Text Available We report a case of necrotizing fasciitis with an accompanying toxic shock syndrome caused by Group G Streptococcus in a pediatric patient with a lymphatic malformation. Pediatricians need to be aware of the possibility of such infections, especially in those with vascular/lymphatic malformations, as early treatment is critical for survival.

  14. Causes of Sandstorm Disaster and Strategies against Desertification——A Case Study of Hexi Corridor in Northwest China

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    This case study outlines the problems faced by the peoples of the Hexi Corridor. These problems are serious and urgent, and are representative of those faced by other communities right across western China. The root causes are outlined and some remedies are suggested. The practical measures proposed under China's National Action Plan to Combat Desertification are described and discussed.

  15. Multidetector Row CT Detection of a Patent Foramen Ovale Causing Neurologic Deficits in an Adolescent: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Bin [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Dong Hun; Oh, Jae Hee [Dept. of Radiology, Chosun University College of Medicine, Gwangju (Korea, Republic of); Seo, Hye Sun [Dept. of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Suk, Eun Ha [Dept. of Anesthesiology and Pain Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2012-02-15

    A patent foramen ovale (PFO) is a persisting fetal circulation structural abnormality that can cause neurologic deficits such as migraine and cryptogenic stroke. Here we report a case of PFO diagnosed by cardiac multidetector row CT in an adolescent male with chronic migraine and stroke.

  16. Corruption in Higher Education: Causes, Consequences, Reforms. The Case of Georgia

    Science.gov (United States)

    Orkodashvili, Mariam

    2009-01-01

    Certain cases from any single country might provide examples for consideration of corruption issues for other countries or regions. Corruption cases and the strategies of fighting them in Georgian flagship universities might be noteworthy and useful for other countries facing similar problems. The paper discusses the features of corruption in…

  17. Compound odontoma causing airway obstruction of the newborn: a case report.

    Science.gov (United States)

    Tam, D; Francis, L; Perry, C; Thirwall, A

    2006-10-01

    A newborn presented with acute airway obstruction secondary to a compound odontoma of the hard palate/nasal floor. This is the first case recorded in the literature. We review the pathology of compound odontomas and discuss the management of this rare and interesting case.

  18. Pneumococcal pyomyositis. Case report, review of the literature, and comparison with classic pyomyositis caused by other bacteria.

    Science.gov (United States)

    Collazos, J; Fernández, A; Martínez, E; Mayo, J; de la Viuda, J M

    1996-07-01

    Pyomyositis is caused by staphylococci in 70% to 90% of patients. We report a case of pneumococcal pyomyositis (PP), review the 11 cases previously published, and compare the features of pneumococcal pyomyositis with those of classic (nonpneumococcal) pyomyositis. Several clinical characteristics have been identified that are notably different in both groups. Psoas muscle involvement was observed in two thirds of the patients with PP, and a source for the infection was identified in half of the patients. Patients with PP were older than those with classic pyomyositis. Men were affected less often than women with PP, but the opposite was the rule in classic pyomyositis. The systemic response to the infection was more prominent in patients infected with pneumococci than from other causes. Most patients with PP were successfully treated with antibiotics and drainage. Secondary meningitis was observed in 3 patients with psoas muscle abscess caused by pneumococci. Mortality is low in pyomyositis regardless of the causative pathogen.

  19. Axial torsion of meckel's diverticulum causing small bowel obstruction in adult: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Youn, In Kyung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2016-02-15

    Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract that is prevalent in 2–3% of the population. The lifetime risk of complications is estimated at 4%. Small bowel obstruction is the second most common complication of MD. Among the causes of bowel obstruction, axial torsion of MD is the rarest complication. Urgent surgical treatment is needed in cases of small bowel obstruction associated with torsion of MD. Pre-operative diagnosis of MD as a cause of small bowel obstruction is difficult, because the diagnosis can be made only if the diverticulum is delineated at the site of obstruction. We reported a case of axial torsion of MD with necrosis that caused proximal small bowel perforation in a 21 year old male.

  20. Tumor-Induced Osteomalacia Caused by Primary Fibroblast Growth Factor 23 Secreting Neoplasm in Axial Skeleton: A Case Report

    Directory of Open Access Journals (Sweden)

    Gunjan Y. Gandhi

    2012-01-01

    Full Text Available We report the case of a 66-year-old woman with tumor-induced osteomalacia (TIO caused by fibroblast growth factor 23 (FGF-23 secreting mesenchymal tumor localized in a lumbar vertebra and review other cases localized to the axial skeleton. She presented with nontraumatic low back pain and spontaneous bilateral femur fractures. Laboratory testing was remarkable for low serum phosphorus, phosphaturia, and significantly elevated serum FGF-23 level. Magnetic resonance imaging (MRI of the lumbar spine showed a focal lesion in the L-4 vertebra which was hypermetabolic on positron emission tomography (PET scan. A computed tomography (CT guided needle biopsy showed a low grade spindle cell neoplasm with positive FGF-23 mRNA expression by reverse transcriptase polymerase chain reaction (RT-PCR, confirming the diagnosis of a phosphaturic mesenchymal tumor mixed connective tissue variant (PMTMCT. The patient elected to have surgery involving anterior resection of L-4 vertebra with subsequent normalization of serum phosphorus. Including the present case, we identified 12 cases of neoplasms localized to spine causing TIO. To our knowledge, this paper represents the first documented case of lumbar vertebra PMT causing TIO. TIO is a rare metabolic bone disorder that carries a favorable prognosis. When a lesion is identifiable, surgical intervention is typically curative.