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Sample records for reported adult cases

  1. Nasopharyngeal Hemangioma in Adult: A Case Report

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    Khil, Eun Kyung; Hong, Hyun Sook; Park, Ji Sang; Chang, Kee Hyun; Kim, Hee Kyung; Byun, Jang Yul [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2013-03-15

    Nasopharyngeal masses are usually malignant, and benign nasopharyngeal tumors such as hemangioma are unusual. In adults, hemangiomas do not involute spontaneously, but progress. Imaging modalities are useful to rule out other malignancies and vascular lesions and to evaluate the lesion. Most hemangiomas require no therapy, but certain factors such as age of the patient and location and size of the lesion may make treatment necessary. We report a case of an unusual nasopharyngeal hemangioma treated with endoscopic excision in an adult who complained of hearing loss.

  2. Adult Pancreatic Hemangioma: Case Report and Literature Review

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    Gerhard S. Mundinger

    2009-01-01

    Full Text Available We report an adult pancreatic hemangioma diagnosed on pathological specimen review following pylorus preserving pancreaticoduodenectomy for a symptomatic cystic mass in the head of the pancreas. Eight cases of adult pancreatic hemangioma have been reported in literature since 1939. Presenting symptoms, radiographic diagnosis, pathologic characteristics, and treatment of adult pancreatic hemagiomas are discussed following review of all published cases.

  3. [Endogenous persistent hypoglicemia of adult: case report].

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    Costa, Raquel R; Maia, Frederico F R; Araújo, Levimar R

    2007-02-01

    Persistent Hyperinsulinemic Endogenous hypoglycemia in adults is, in most cases, due to Insulinoma. Nesidioblastosis, a peculiar functional hyperinsulinemia from hypertrophic beta cells, has been described mainly in newborns. This article describes a 34-year-old patient who presented hyperinsulinemic endogenous hypoglycemia clinical and laboratorial situation (Fasting glycemia: 54 mg/dl / Reference Interval (RI): 60-99 mg/dl; Serum insulin: 70.9 mcU/ml / RI: hypoglicemia.

  4. Cantrell Syndrome. Case report of an adult

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    João Luiz Alencar Araripe Falcão

    2000-10-01

    Full Text Available Cantrell syndrome is characterized by defects that involve the diaphragm, abdominal wall, pericardium, heart, and lower region of the sternum. It is a rare entity, usually diagnosed at birth and accompanied by high mortality due to the complexity and gravity of the anomalies. In this report, we present a 32-year-old male patient, who was diagnosed in infancy but who reached adult age asymptomatic.

  5. Adult Lymphangioma - A Rare Entity: A Report of Two Cases

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    Mary MATHEW

    2012-01-01

    Full Text Available Objective: Lymphangiomas are rare congenital malformations commonly seen in children. Its occurrence in adults is uncommon with very scarce reports in the literature. It mainly occurs in infants or children younger than two years of age. We report these cases to emphasize the need to consider cystic lymphangiomas in differential diagnosis of neck masses in adults.Case Reports: We describe two cases in adults, one a 27-year-old man and the other a 59-year-old male. The former presented with recurrent neck mass for 5 years, and the latter presented with asymptomatic neck mass of a short duration. Both were not associated with any pain, discoloration, discharge or sudden increase in size.Conclusion: The awareness of occurrence of cystic lymphangioma in adults is important for its proper management which includes complete surgical removal, to prevent recurrence.

  6. Adult hypophosphatemic osteomalacia: report of two cases.

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    Rico, H; Gomez-Castresana, F; Hernandez, E R; Matute, J A; Torrubiano, J; Nunez-Torrón, M

    1985-09-01

    Two cases of late hypophosphatemic osteomalacia are described: a male aged 30 who had the disease since he was 22 and a woman of 23 who had the disease since she was 14. Both presented with myopathy and bone pain, and showed hypophosphatemia, hyperglycinuria, reduced tubular phosphate reabsorption (TPR), increased hydroxyprolinuria and normal iPTH and iCT values. Radiologically the male had no Looser's zones and the woman did. Bone biopsy confirmed hypophosphatemic osteomalacia. Both cases were treated with vitamin D and oral phosphate and no improvement was observed. When treatment with 25(OH)D3 was initiated, no improvement was seen and afterwards this was combined with treatment using 1.25(OH)2D3 and from this time on a clinical improvement of the myopathy became evident in both patients. In the woman, healing of the bone lesions occurred at the same time as that of the myopathy, whereas in the male the bone lesions became worse. Healing of the myopathy was only obtained when treatment with 1.25(OH)2D3 was begun. Both patients had reduced values of 2.3 erythrocytic DPG and low level of serum phosphorus when the myopathy was cured, which suggests a lack of effect of 2.3 DPG or serum phosphorus as a cause of the myopathy. Although this had been attributed to a deficiency in the function of 25(OH)D3, the response to 1.25(OH)2D3 and due to the effects of this metabolite on calcium transport in muscle, suggests that the myopathy which occurs in late hypophosphatemic osteomalacia is a result of deficiency or resistance to the muscular effect of this metabolite. We cannot explain the lack of bone healing in the man and further therapeutic studies are required.

  7. Anaesthetic considerations of adults with Morquio's syndrome - a case report

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    Donnelly Maria B

    2010-02-01

    Full Text Available Abstract Background The anaesthetic management of patients with Morquio syndrome is complicated by a number of factors including odontoid hypoplasia, atlantoaxial instability, thoracic kyphosis, and deposition of mucopolysaccharides in the soft tissue of the oropharnyx. Case presentation Herein we describe the anaesthetic considerations and management of a 26 year old adult with Morquio syndrome, who presented for an elective hip replacement. Conclusion This report details an awake fiberoptic intubation in an adult with Morquio syndrome. We recommend that this approach be considered in patients with Morquio syndrome undergoing general anaesthesia.

  8. Giant Primary Retroperitoneal Teratoma in an Adult: A Case Report

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    Poonam Mathur

    2010-01-01

    Full Text Available Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Retroperitoneal teratomas are rare and present challenging management options. We report here the case of a histologically unusual retroperitoneal tumor detected on computed tomography during the workup of abdominal pain in a 32-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper.

  9. Mounier Kuhn syndrome in adult: a case report

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    Nabanita Deka

    2015-04-01

    Full Text Available Mounier-Kuhn syndrome or tracheobronchomegaly is a rare congenital abnormality of the trachea and main bronchi characterized by marked cystic dilatation of the tracheobronchial tree, associated with tracheal diverticulosis, bronchiectasis and recurrent lower respiratory tract infections. We report a case of 22 years adult male with history of recurrent lower respiratory tract infection. [Int J Res Med Sci 2015; 3(4.000: 987-989

  10. Adult Wilms' tumour: a case report with review of literature

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    Gowda KM Srinivasa

    2006-12-01

    Full Text Available Abstract Background Wilms' tumor is the commonest primary malignant renal tumor in childhood. Rarely, it may present in the adult age group. Case presentation We report a 48-year-old male presenting with flank pain and haematuria. Abdominal ultrasound revealed a right renal mass measuring 11 × 10 cms, and a clinical diagnosis of renal cell carcinoma was made. Nephrectomy was performed, and a final diagnosis of adult Wilms' tumor was made based on the criteria proposed by Kilton et al. Conclusion The possibility of an adult Wilms' tumor should be considered when a patient presents with pain in the flank and a renal mass. Rarity of the tumor favors documentation in literature.

  11. Localized Tetanus in an Adult Patient: Case Report

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    Gulamhussein, Mohamed Amirali; Li, Yueyang; Guha, Abhijit

    2016-01-01

    Introduction: Tetanus is a severe and potentially fatal infection caused by the bacterium Clostridium tetani. Of all the cases described in literature, generalized tetanus is by far the most common presentation, but it may also present as neonatal tetanus, cephalic tetanus, and localized tetanus, the latter two being much rarer. In this case report, we present the rare form of this disease, i.e., localized tetanus in an adult male with a history of minimal trauma as well as a late, unusual mode of presentation. Case Report: A 35-year-old Caucasian male presented with an acutely painful, swollen right thumb associated with a small superficial collection on the dorsal aspect of the base of the thumb. A formal wound exploration and washout were carried out in theater, however, at the time of tourniquet inflation, the right hand went into a carpopedal spasm and remained in that position until an infusion of a muscle relaxant was given. The findings were consistent with a case of localized tetanus. The patient was treated with human immunoglobulin and tetanus toxoid and safely discharged home 48 h later without any complications. Conclusion: This case report emphasizes the importance of the recognition of a rare form of this fatal infectious disease, which may present with prodromal symptoms before the generalized form shows its clinical effects. Moreover, the astute clinician should be aware of the variable presentations of this infectious disease, with early identification greatly reducing the associated risks of morbidity and mortality. PMID:28164065

  12. Adult pancreatoblastoma - Case report and review of literature

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    Vilaverde, Filipa; Reis, Alcinda; Rodrigues, Pedro; Carvalho, Ana; Scigliano, Horácio

    2016-01-01

    Most cases of pancreatoblastoma, a rare malignant epithelial tumor of the pancreas, are seen in the pediatric population. The rarity of pancreatoblastoma, the similar radiologic findings to those seen in other pancreatic lesions, and its histopathologic heterogeneity, make its preoperative diagnosis in adults a real challenge. We report ultrasound, computed tomography and magnetic resonance imaging correlative findings of a histologically proven pancreatoblastoma in a 37-year-old woman. Pancreatoblastoma should be considered in the differential diagnosis of a pancreatic mass presenting uncommon imaging features. PMID:27761191

  13. Hemorrhagic Bronchopneumonia in Adults with Chickenpox. A Case Report

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    Miguel Ángel Serra Valdés

    2012-11-01

    Full Text Available Chickenpox is an acute viral infectious disease that is highly contagious and very common in children. When it occurs in adults, age increases severity, with complications that can lead to death in a short period of time. Among the most lethal complications we can find pneumonia and bronchopneumonia, injuries overinfection caused by streptococci and staphylococci with severe sepsis, diverse bleeding, encephalitis, shock, hemorrhagic nephritis with renal failure and necrotizing fasciitis, among others. The case of an 83 years old male patient, with a history of chronic obstructive pulmonary disease and ischemic cerebrovascular atherosclerotic disease that contracted chickenpox and whose evolution was very rapid, with acute respiratory failure and bronchopneumonia massive hemorrhagic shock, to the point of death, is presented. Given the increased incidence of chickenpox, according to reports of the Pedro Kouri Institute of Tropical Medicine, we decided to have this case published.

  14. Localized Tetanus in an Adult Patient: Case Report.

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    Gulamhussein, Mohamed Amirali; Li, Yueyang; Guha, Abhijit

    2016-01-01

    Tetanus is a severe and potentially fatal infection caused by the bacterium Clostridium tetani. Of all the cases described in literature, generalized tetanus is by far the most common presentation, but it may also present as neonatal tetanus, cephalic tetanus, and localized tetanus, the latter two being much rarer. In this case report, we present the rare form of this disease, i.e., localized tetanus in an adult male with a history of minimal trauma as well as a late, unusual mode of presentation. A 35-year-old Caucasian male presented with an acutely painful, swollen right thumb associated with a small superficial collection on the dorsal aspect of the base of the thumb. A formal wound exploration and washout were carried out in theater, however, at the time of tourniquet inflation, the right hand went into a carpopedal spasm and remained in that position until an infusion of a muscle relaxant was given. The findings were consistent with a case of localized tetanus. The patient was treated with human immunoglobulin and tetanus toxoid and safely discharged home 48 h later without any complications. This case report emphasizes the importance of the recognition of a rare form of this fatal infectious disease, which may present with prodromal symptoms before the generalized form shows its clinical effects. Moreover, the astute clinician should be aware of the variable presentations of this infectious disease, with early identification greatly reducing the associated risks of morbidity and mortality.

  15. SCIWORA at Thoracic Level in an Adult: A Case Report

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    Seniz Akcay Yalbuzdag

    2016-02-01

    Full Text Available Although SCIWORA has been reported more prevalent in children, few case reports published SCIWORA in adults. Twenty seven year old man transferred to our rehabilitation unit with paraplegia arose after fall from height of 8 and concurrent blunt trauma to thoracic region. The neurological level was of T11 American Spinal Injury Association Impairment Scale (AIS C. Magnetic resonance imaging (MRI findings of both brain, and spine didn%u2019t prove any significant abnormalities except the protrusion of intervertebral discs at the levels of T8-9, and T9-10. Urodynamic study findings were compatible with flaccid neurogenic bladder. He enrolled in the neurological rehabilitation program. After neurological rehabilitation program partial improvement observed in his functional status. The diagnosis of SCIWORA without any abnormality in the spine with MRI may be challenging. Therefore the diagnosis might retard until the termination of spinal shock.

  16. Adult colocolic intussusception diagnosed by ultrasonography: a case report

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    Benazzouz Moustapha

    2011-07-01

    Full Text Available Abstract Introduction Intussusception is highly uncommon in adults and accounts for only 5% of all reported cases. It is more commonly secondary to an identifiable bowel lesion in 90% of cases, whereas 10% have no discernable cause. Diagnosis is difficult due to non-specific symptoms of the disease. Diagnostic imaging plays an important role in the diagnosis of the condition. Sonography and computed tomography are the most commonly used imaging techniques. In adults, intussusception usually requires treatment by surgical resection of the affected bowel. Case presentation A 35-year-old Moroccan woman presented with a five-month history of intermittent abdominal pain and one episode of bleeding from the rectum. At physical examination an abdominal mass was noted. Abdominal sonography revealed a 6.3 × 8.5 cm midline mass in her upper abdomen that was tender. In transverse section, the mass had the multiple concentric rings of hypoechoic and echogenic layers associated with the sonographic appearance of intussusception. In longitudinal section, the mass had the sonographic aspect of multiple parallel lines, giving the so-called "sandwich appearance". A corresponding contrast-enhanced abdominal computed tomography scan also demonstrated the intussusception. Surgery confirmed a colocolic intussusception with a large, firm, indurated mass as the lead point. A right hemicolectomy was undertaken because of concern about possible malignancy. The resected ascending colon was then opened up, to find a protruding tumor of the ascending colon that was acting as the lead point. It measured 7.6 × 6.9 × 2.4 cm. Pathology diagnosed an infiltrating, differentiated adenocarcinoma of the ascending colon invading through the muscularis propria. No lymphovascular invasion was seen. Our patient has recovered well. Conclusion Intussusception is relatively rare in the adult population, and this, along with the vague clinical features, makes diagnosis difficult

  17. Leg ulcer in Werner syndrome (adult progeria): a case report.

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    Fumo, Giuseppe; Pau, Monica; Patta, Federico; Aste, Nicola; Atzori, Laura

    2013-03-15

    Werner syndrome (WS; MIM#277700) or adult progeria, is a rare disease, associated with mutations of a single gene (RECQL2 or WRN), located on chromosome 8 (8p12). It codes a DNA-helicase, whose defects cause genomic instability. The highest incidences are reported in Japan and Sardinia (Italy). On this major island of the Mediterranean Basin, the WS cases have been observed in the northern areas. The authors describe the apparently first case reported in southern Sardinia, a 51-year-old woman, who was born in and resides in the province of Cagliari. She presented with a 9-year history of an intractable leg ulcer and other characteristic symptoms, including "bird-like" face, high-pitched voice, premature greying, short stature, abdominal obesity in contrast with thin body type, scleroderma-like legs, decreased muscle mass, diabetes, atherosclerosis, and premature menopause. A specialized genetic Institute of Research (IRCCS-IDI, Rome) confirmed the clinical diagnosis. There is no cure or specific treatment and patients must be periodically screened for an increased risk of cardiovascular and cerebrovascular disease and malignancies. Among the many findings, leg ulcers significantly affect the patient's quality of life. This problem may send the patient to the dermatologist, who finally suspects the diagnosis. Poor response to medical treatment may require aggressive repeated surgery, with poor or temporary results.

  18. Adult gaucher disease in southern Tunisia: report of three cases

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    Ben Rhouma Faten

    2012-01-01

    Full Text Available Abstract Background Gaucher disease (GD is the most frequent lysosomal storage disorder; type 1 is by far the most common form. It is characterized by variability in age of onset, clinical signs and progression. It is usually diagnosed in the first or second decade of life with the appearance of bone pains, splenomegaly and thrombocytopenia, but the disease may be diagnosed at any age between 1 and 73 years. In the present study, we report 3 cases with late onset of GD in whom the disease was a surprise finding including one patient with Parkinson disease. This late onset is described as an adult form of Gaucher disease. Findings Molecular investigation showed mutational homogeneity in Tunisian adult patients suffering from GD. Indeed, all patients carry the p.N370S mutation: two patients at a homozygous state and one patient at compound heterozygous state. Conclusion The p.N370S mutation presents a large variability in the onset of the disease and its clinical manifestation supporting the view that GD should be considered as a continuum phenotype rather than a predefined classification.

  19. Hepatoblastoma of the adult with pericardial metastasis: A case report

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    Andrea Celotti

    2016-01-01

    Conclusion: The hepatoblastoma of the adult is related to a poor prognosis with median survival time less than 5 months. Surgery is the only curative treatment, but in many cases tumor resection requires complex operations. Vascular and thoracic expertise could be useful in the management of hepatoblastoma.

  20. Gastroduodenal Intussusceptions in An Adult: Report of A Case.

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    Jerry G. Makama

    2012-06-01

    Full Text Available Gastroduodenal intussusceptions are an uncommon condition usually caused by the prolapse of a gastric tumor into the duodenum with subsequent invagination of a portion of the stomach wall. The diagnosis of adult intussusceptions can be delayed because it occurs infrequently and is nonspecific. The differential diagnosis of intermittent symptoms of pyloric stenosis in adults should include gastroduodenal intussusceptions.A rare case of this condition associated with a pedunculated gastric tumor is presented and relevant literature is discussed. [Arch Clin Exp Surg 2012; 1(3.000: 195-198

  1. Adult Mesoblastic Nephroma: ACase ReportAdult Mesoblastic Nephroma: A Case Report

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    Ghasem Sadeghi

    2010-07-01

    Full Text Available Mesoblastic nephroma is a rare entity in adulthood. We report a case of mesoblastic nephroma in a 35-year-old woman who presented with left flank pain. Computed tomography images favored a soft tissue mass in the upper pole of the left kidney. The lesion was excised and sent for pathological analysis. Pathological and immunohisto-chemical studies favored a diagnosis of mesoblastic nephroma.

  2. Latent Autoimmune Diabetes in Adults: a case report.

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    Bermúdez, Valmore; Aparicio, Daniel; Colmenares, Carlos; Peñaranda, Lianny; Luti, Yettana; Gotera, Daniela; Rojas, Joselyn; Cabrera, Mayela; Reyna, Nadia; Velasco, Manuel; Israili, Zafar H

    2010-01-01

    Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune endocrine disorder in which despite the presence of antipancreatic islets antibodies in the moment of diagnostics, the progression to beta-cell secretory insufficiency is slow. It is often confused with others types of diabetes and therefore the management is frequently inadequate. We report a clinical case of a 23-year-old man with diagnosis of type 2 diabetes since 6 months ago, poorly controlled with a sulfonylurea, who initially presented 2 months ago from polyuria, polydipsia, and asthenia and 6 kg weight loss. History of past illness was negative, however, his mother relates exclusive breastfeeding during the first 15 days of life and later (until the 6 months) he was fed with infant formula (S-26). Family history revealed a first-degree relative (father) with diabetes mellitus secondary to steroid administration due to diagnosis of bone marrow hypoplasia. Also presents second-degree family history (uncle and grandfather) of type 2 diabetes mellitus. There were no pathologic findings at the physical examination. Anthropometry and laboratory tests were as follows: body mass index (BMI) = 19.66 kg/m, basal and postprandial glycemia = 108, and 276 mg/dL respectively, glycated haemoglobin = 8.9%, basal and postprandial C-peptide (2 hours) = 1.9, and 3.2 ng/mL, homeostasis model assessment of beta cell function: 87.5%, homeostasis model assessment of insulin resistance: 1.6. LADA presumptive diagnosis was confirmed with presence of autoantibodies anti-tyrosin-phosphatase and GAD65. At the time of diagnosis, individuals with LADA present an onset age <50, BMI <25 kg/m2, low magnitude postprandial and basal hyperglycemia, normal or close to normal C-peptide values, and thus not occur with acute hyperglycemic crises. Insulin therapy preserves pancreatic b-cell function, at the point that eventually prescribed insulin doses need to be reduced.

  3. Congenital bronchoesophageal fistula in an adult: A case report

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    Lei Su; Xiu-Qin Wei; Xiu-Yi Zhi; Qing-Sheng Xu; Ting Ma

    2007-01-01

    Bronchoesophageal fistulas are usually diagnosed in the neonatal period. As such, the condition is rare in adults.We present a case of a congenital bronchoesophageal fistula in a 62-year-old man with the complaint of severe bouts of cough and choking after swallowing liquid. His workup included a barium esophagogram that revealed a fistula between the esophagus and a right lower lobe bronchus. The diagnosis should be considered in certain individuals with suggestive symptomatology and unexplained respiratory pathology. The fistula was divided and resected, The patient had an uneventful recovery.

  4. Case report

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    Cerebral venous sinus thrombosis in HIV-infected patients: report of 2 cases. Julius Chacha ... affected adults are women, and direct causes or predisposing risk factors can be .... Some studies have reported a high prevalence of antibodies.

  5. An adult case of urinary tract infection with Kingella kingae: a case report

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    Ramana KV

    2009-05-01

    Full Text Available Abstract Introduction Kingella kingae, though part of the normal upper respiratory tract and genitourinary tract, is increasingly being recognized as an important human pathogen. During the past decade, it has emerged as a significant pathogen in the pediatric age group primarily causing bacteremia and osteoarticular infections. Adult infection usually occurs in individuals who are severely immunocompromised and most infections have taken the form of septicemia or septic arthritis. Bacteremia due to K. kingae has been reported as the immediate cause of death in patients with acquired immunodeficiency syndrome. Case presentation We present a microbiologically confirmed urinary tract infection with K. kingae in an immunocompetent 45-year-old adult woman with post-menopausal bleeding and with a history of clots. Her urine was subjected to culture and sensitivity tests. The isolated colonies were identified as K. kingae because of their typical culture characteristics such as long incubation period required for growth, beta-hemolysis, positive oxidase and negative catalase, urease indole, nitrate and citrate tests. Penicillin G disc test was positive. They were sensitive to all conventional antibiotics. Conclusion K. kingae infection is a rare occurrence in immunocompetent adults. Very few cases of microbiologically confirmed infections have been reported so far. The isolation of K. kingae from urine sample has rarely been reported. K. kingae isolates are either missed or misinterpreted by clinical microbiologists. Therefore, K. kingae deserves recognition as a pathogen.

  6. Isolated adult hypoganglionosis presenting as sigmoid volvulus: a case report

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    Barakzai Abrar

    2011-09-01

    Full Text Available Abstract Introduction Isolated hypoganglionosis is a rare cause of intestinal innervation defects. It is characterized by sparse and small myenteric ganglia, absent or low acetylcholinesterase activity in the lamina propria and hypertrophy of the muscularis mucosae, principally in the region of the colon and rectum. It accounts for 5% of all intestinal neuronal malformations. To the best of our knowledge, only 92 cases of isolated hypoganglionosis were reported from 1978 to 2009. Isolated hypoganglionosis usually manifests as enterocolitis or poor bowel function, and is diagnosed in infancy or childhood. We report the first case of isolated hypoganglionosis presenting with sigmoid volvulus in a 34-year-old woman. Case presentation A 34-year-old Asian woman had progressively increasing abdominal pain and had not passed stool or flatus for two days. A physical examination revealed a distended abdomen with sluggish gut sounds. A computerized tomography (CT scan demonstrated gross dilatation of the sigmoid colon (maximal diameter 14.3 cm suggestive of sigmoid volvulus. During emergency laparotomy, sigmoidectomy with a side-to-side colorectal anastomosis was performed. Histopathology of the resected specimen showed occasional ganglion cells and hypertrophied nerve bundles in the muscle layers, suggesting hypoganglionosis. Colonoscopy was performed, and multiple full-thickness biopsies were taken that showed hypoganglionosis of the entire large bowel. Our patient underwent total colectomy with an ileorectal anastomosis. Subsequently our patient reported a dramatic improvement in her bowel function. Conclusions Isolated hypoganglionosis is a rare cause of intestinal dysganglionosis and cannot be differentiated from Hirschsprung's disease based on clinical presentation. This case report describes an atypical presentation of the disease. A definitive diagnosis requires histopathological analysis of full-thickness intestinal biopsies. Treatment should be

  7. ADULT VARIANT BARTTER’S SYNDROME- A CASE REPORT

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    Ishwar Sidappa Hasabi

    2017-02-01

    Full Text Available BACKGROUND Bartter syndrome is a group of channelopathies with different genetic origins and molecular pathophysiologies, but sharing common feature of decreased tubular transport of sodium chloride in thick ascending loop of Henle (TAL, 1 although more common in antenatal group. Classic adult variant of Bartter syndrome is a rare entity. We hereby present a rare adult variant of classic Bartter syndrome.

  8. An Adult Case of Kawasaki Disease in a Pregnant Japanese Woman: A Case Report

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    Kyoko Kanno

    2011-04-01

    Full Text Available Kawasaki disease is an acute febrile disease predominantly seen in young children. We report a case of Kawasaki disease in a 32-year-old pregnant woman. She developed a generalized erythematous skin rash accompanied by high fever. Bilateral conjunctival congestion, tender cervical lymphadenopathy, an edematous lower lip and peripheral edema followed by desquamation were observed. She was successfully treated with aspirin and intravenous gammaglobulin (1 g/kg/day. Her course was not complicated by coronary artery aneurysm and she delivered a healthy baby. To the best of our knowledge, this is the first case of Kawasaki disease in a pregnant woman. We suggest that Kawasaki disease should be included in the differential diagnosis of a generalized, erythematous skin rash accompanied by high fever in adults.

  9. Jarcho-Levin syndrome with diastematomyelia: Case report of an adult patient and review of literature

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    Kim, Young Seon; Lee, Ji Hae; Kang, Mi Jin; Baek Kyung Eun; Kim, Jae Hyung; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun; Lee, Han Bee [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    Jarcho-Levin syndrome (JLS) is a rare congenital dysostosis characterized by multiple vertebral and costal anomalies. The combination of JLS and neural tube defect is rare. Only six cases of JLS accompanying diastematomyelia have been reported; all were in infants or children. We present the case of a 37-year-old female patient with JLS who also had diastematomyelia in lumbar vertebral level. This is the seventh case of JLS with diastematomyelia, and the first adult case.

  10. Two case reports of toxocariasis mimicking endophthalmitis in immunosuppresed adults

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    Yuen Keat Gan; Syed Shoeb Ahmad; Sheena Mary Alexander

    2016-01-01

    This a case of 2 immunocompromised patients with a surprising ocular toxocariasis infestation. The first is a 23-year-old girl who is a known case of systemic lupus erythematosus, presenting with both eyes progressive blurring of vision for the past 3 months. Examinations showed bilateral panuveitis with posterior pole granuloma. She was treated as endogenous endophthalmitis as per protocol, but with limited improvement. To our surprise and with high index of clinical suspicion,Toxocara serology was positive. She was then started on oral albendazole for 4 weeks. The second case is a 51-year-old lady with end stage renal failure undergoing regular dialysis and on immunosuppressive therapy. She was warded for long duration for sepsis secondary to candidal fungal infection. Examinations revealed right peripheral and posterior pole granulomas almost exactly similar to the first patient. She was treated for endogenous endophthalmitis and again in close succession a positive serology was confirmed. Both cases since then showed gradual clinical improvement.

  11. Eosinophilic pneumonia due to toxocariasis: an adult case report.

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    Demirci, Mustafa; Unlü, Mehmet; Fidan, Fatma; Kaya, Selçuk

    2012-01-01

    Toxocara is a roundworm, a common parasite of dogs (T. canis) and cats (T. cati). Toxocariasis or Visceral larva migrans (VLM) are diseases caused by the larvae of Toxocara sp., which may involve many organs, but pulmonary symptoms such as coughing and wheezing and allergic symptoms are seen in more than 80% of patients. It is known that, although the risk of infection is present, the worldwide diagnosis of toxocariasis is difficult since clinical and laboratory data provide insufficient evidence for the diagnosis. Nowadays, the diagnosis of toxocariasis is performed by serologic methods. We describe herein a case of toxocariasis with eosinophilic pneumonia that was diagnosed using serologic methods.

  12. 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

    2013-12-01

    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.

  13. Discitis in an adult following acupuncture treatment: a case report.

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    Kim, Peter S Y; Hsu, William

    2004-06-01

    Recent papers, including a review conducted by van Tulder et al., have suggested that there is paucity of information as to the efficacy of acupuncture treatment. However, there has been a significant increase in the use of acupuncture therapy for treatment of various ailments, including lower back pain. Chiropractors, along with other health care professionals, are using acupuncture as an adjunct to their main therapeutic intervention as demonstrated by a recent survey by the Canadian Chiropractic Protective Association (CCPA). However, like many other interventions, including NSAIDs and spinal manipulations, signs of side effects should be monitored when acupuncture treatments are considered. Recent papers have noted such complications as pneumothorax and hepatitis following acupuncture treatments. A case is presented in which a patient, who received previous acupuncture treatments, presented to a chiropractic clinic complaining of low back and leg pain. Early recognition of potential complications after acupuncture treatment may minimize significant impairments and disability.

  14. Colonic duplication in adults: Report of two cases presenting with rectal bleeding

    Institute of Scientific and Technical Information of China (English)

    C Fotiadis; M Genetzakis; I Papandreou; EP Misiakos; E Agapitos; GC Zografos

    2005-01-01

    Gastrointestinal duplication is an uncommon congenital abnormality in two-thirds of cases manifesting before the age of 2 years. Ileal duplication is common while colonic duplication, either cystic or tubular, is a rather unusual clinical entity that remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients,colonic duplication is encountered in adults only in a few cases. This study reports two cases of colonic duplication in adults. Both cases presented with rectal bleeding on admission. The study was focused on clinical, imaging,histological, and therapeutical aspects of the presenting cases. Gastrografin enema established the diagnosis in both cases. The cystic structure and the adjacent part of the colon were excised en-block. The study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of rectal bleeding.

  15. Adult-onset Nemaline Myopathy Coexisting With Myasthenia Gravis: A Case Report.

    Science.gov (United States)

    Cao, Lingling; Wang, Yanling; Liu, Xiaofeng; Hu, Yanxia; Li, Nianchun; Qiu, Guoping; Luo, Yun; Li, Weidong

    2016-01-01

    Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder which is characterized by fluctuating muscle fatigue. However, the association of MG with nemaline myopathy is rarely reported. Here we report a case of MG coexisting with adult-onset nemaline myopathy. A 55-year-old man endured fluctuating muscle weakness with positive acetylcholine receptor and titin antibodies. After the patient was administrated cholinergic drugs and immunosuppression, the muscle weakness of the patient had mildly been alleviated. Electromyography showed a progressive decrement in the amplitude of muscle action potential at low frequency. Muscle biopsy showed numerous nemalines in the muscle fibers. This is the first reported case of nemalines present in the muscle fibers of adult patient with MG. The pathogenesis of nemaline may be related to titin antibody in adult-onset nemaline myopathy with MG.

  16. Sleeve fracture of the adult patella: Case report and review of the literature.

    Science.gov (United States)

    Xie, Linjun; Xu, Hong; Zhang, Lizhi; Xu, Rong; Guo, Yingkun

    2017-08-01

    The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group. Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella. Computed tomography and magnetic resonance imaging examination have been performed to further confirm the diagnosis of sleeve fracture, rupture of the quadriceps tendon and the cartilaginous injury. Under general anaesthesia, she underwent open surgical procedures for reconstituting anatomically the fracture and repairing the rupture of the quadriceps tendon. Six months after the operation, she could fully use her left knee without any pain and disability. Sleeve fractures of the patellar in adults are extremely rare, and our case is of interest for the first time occurring in healthy female adults. Our case report and literature review was aim to describe the clinic and imaging characteristics of superior pole sleeve fractures in adults, and highlight that physicians must be aware of this entity in adults so as to reduce misdiagnosis due to unfamiliarity.

  17. Ipsilateral Acute Monteggia Lesion and Malunion of Galeazzi Fracture in an Adult. A Case Report

    Directory of Open Access Journals (Sweden)

    JBS Essoh

    2010-10-01

    Full Text Available Presentation of Monteggia and Galeazzi fractures in the same limb is a rare injury. We report an unusual case in which an acute Monteggia fracture was associated with a malunited Galeazzi fracture in an adult patient. The mechanism of this complex injury is discussed.

  18. Primary Osteoblastic Osteosarcoma of the Rib in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Ah; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ryoo, In Seon [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Hyo Ah; Chung, Jin Haeng [Dept. of Patholgy, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Oh, Joo Han [Dept. of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-12-15

    We report the CT and magnetic resonance (MR) imaging appearances in an adult case of primary osteoblastic osteosarcoma of the rib. Osteosarcoma of the rib presents a diagnostic challenge because of the rarity of the lesion, especially with plain radiographs. The tumor should be suspected if CT and MR images demonstrate mineralization, suggestive of an osteoid matrix.

  19. Primitive Neuroectodermal Tumor of Mediastinum in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Young Jae; Kim, Jeung Sook [Dongguk University Ilsan Hospital, Goyang (Korea, Republic of)

    2009-11-15

    A peripheral primitive neuroectodermal tumor (PNET) is a rare and aggressive malignant tumor, which most frequently occurs in children and young adults. The most well described site of origin is the chest wall. We report the case of a primitive neuroectodermal tumor in the anterior mediastinum with unusual CT findings.

  20. Sternoclavicular joint septic arthritis with chest wall abscess in a healthy adult: a case report

    OpenAIRE

    Tanaka, Yoshihito; Kato, Hisaaki; SHIRAI, Kunihiro; NAKAJIMA, Yasuhiro; YAMADA, Noriaki; Okada, Hideshi; Yoshida, Takahiro; Toyoda, Izumi; Ogura, Shinji

    2016-01-01

    Background Septic arthritis of the sternoclavicular joint is rare. It can be associated with serious complications such as osteomyelitis, chest wall abscess, and mediastinitis. In this report, we describe a case of an otherwise healthy adult with septic arthritis of the sternoclavicular joint with chest wall abscess. Case presentation A 68-year-old Japanese man presented to our hospital complaining of pain and erythema near the right sternoclavicular joint. Despite 1 week of oral antibiotics,...

  1. Recurrent adult-onset hypophyseal Langerhans cell histiocytosis after radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Funk Ryan K

    2012-10-01

    Full Text Available Abstract Introduction Langerhans cell histiocytosis is a rare disease within the adult population, with very few cases reported as solitary hypophyseal lesions in adults. Of the reported cases, most have been treated successfully with surgery, radiotherapy, and/or chemotherapy. Radiotherapy has been thought to be curative at the relatively low dose of 20Gy. Here we report a case of recurrent hypophyseal Langerhans cell histiocytosis 9 months after radiotherapy with an interval period of symptomatic and radiographic response to therapy. Case presentation A 50-year-old Caucasian woman who had headaches, memory difficulties, and diabetes insipidus was found to have a 2.5cm suprasellar mass. Langerhans cell histiocytosis was diagnosed following stereotactic brain biopsy. Further workup revealed no other lesions. Initial radiation treatment succeeded in shrinking the tumor and relieving clinical symptoms temporarily; however, growth and recurrence of clinical symptoms was noted at 9 months. Re-irradiation was well tolerated and the patient had no acute side effects. Conclusion Isolated hypophyseal involvement by Langerhans cell histiocytosis in adults is a unique presentation of a rare disease. Although radiotherapy doses as low as 20Gy have been reported to offer control, this case demonstrates that higher doses may be warranted to ensure tumor control. With modern imaging and radiotherapy techniques higher doses should offer little increased more durable risk to surrounding critical structures.

  2. 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...

  3. Adult congenital diaphragmatic hernia of the liver: a rare case report

    Institute of Scientific and Technical Information of China (English)

    LIU LiGuo; XU YiYao; MAO YiLei; SANG XinTing; YANG ZhiYing; LU Xin; ZHONG ShouXian; HUANG JieFu

    2010-01-01

    @@ Congenital diaphragmatic hernia (CDH), which mainly occurs in the newborn or in childhood with severe respiratory distress and high mortality, is rarely found in adult, especially for those uncommon right CDH [1-4].Whereas, liver as the main hernial content has been reported only in two cases throughout the world [5-6].This is a report of a right-sided congenital diaphragmatic hernia of the liver in a 46-year-old woman.

  4. Case Report Case Report

    African Journals Online (AJOL)

    User

    2013-03-26

    Mar 26, 2013 ... at the time of diagnosis try various complementary and and palliation. ... c Medicine and Palliative Cancer Care: A Case Report ... us complementary and alternative therapies for treatment about the .... in nature. Upper GI ...

  5. Supratentorial primitive neuroectodermal tumor in an adult: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lawandy Shokry

    2012-10-01

    Full Text Available Abstract Introduction Supratentorial primitive neuroectodermal tumors predominantly occur in children, and are rare in the adult population. Less than 100 cases of supratentorial primitive neuroectodermal tumor have been reported in adults internationally. Our case study reports this rare incident. Case presentation A 22-year-old Hispanic man presented with headaches, blurry vision, diplopia, intermittent vomiting, and grossly decreased vision. A magnetic resonance image showed a left posterior parietal heterogeneously enhancing mass measuring 4.2cm × 7.2cm × 7.0cm. After craniotomy for resection and decompression, the mass was histologically revealed to be a supratentorial primitive neuroectodermal tumor. Standardized immunohistochemical studies for this mass were carried out. Conclusion We have concluded that immunohistochemical and genetic workup should be included in the standardized pathological workup for primitive neuroectodermal tumors in order to provide more prognostic information. Based on our current literature review, we propose an immunohistochemical panel.

  6. Otic Langerhans' Cell Histiocytosis in an Adult: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Anil Gungadeen

    2013-01-01

    Full Text Available Objective. To present a case of otic Langerhans' cell histiocytosis in an adult. Also included the diagnosis and management of the condition and a review of the relevant literature. Case Report. We report a case of a 41-year-old man with a history of persistent unilateral ear discharge associated with an aural polyp. Radiological imaging showed bony lesions of the skull and a soft-tissue mass within the middle ear. Histological analysis of the polyp demonstrated Langerhans' cell histiocytosis. His otological symptoms were completely resolved with the systemic therapy. Conclusions. Otic Langerhans' cell histiocytosis can present in adults. Persistent ear symptoms along with evidence of soft-tissue masses within the ear and bony lesions of the skull or elsewhere should prompt the otolaryngologists to include Langerhans' cell histiocytosis in their differential diagnosis. Management should be with systemic therapy rather than local surgical treatment.

  7. 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.

  8. Success of serial transverse enteroplasty in an adult with extreme short bowel syndrome: a case report.

    Science.gov (United States)

    Fan, Shengxian; Li, Yousheng; Zhang, Shaoyi; Wang, Jian; Li, Jieshou

    2015-04-01

    Since its introduction as an alternative intestinal lengthening technique, serial transverse enteroplasty has been increasingly used as the surgical treatment of choice for children with refractory short bowel syndrome, but there have been few reports about the adult patients. This report describes the case of a 71-year-old man with a short bowel after distal gastrectomy with Billroth II reconstruction for gastric cancer, followed by extensive intestinal resection. The serial transverse enteroplasty operation was performed and lengthened the small intestine from 49 to 67 cm. The patient tolerated the procedure well and weaned off total parenteral nutrition. Liver function also improved. This case shows that the serial transverse enteroplasty procedure increases intestinal length. This procedure should be considered a surgical option for adult patients with extreme short bowel syndrome.

  9. Adult-onset cystic hygroma: A case report of rare entity.

    Science.gov (United States)

    Bahl, Sumit; Shah, Vandana; Anchlia, Sonal; Vyas, Siddharth

    2016-01-01

    Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in infant or children younger than 2 years of age. Although cystic hygroma is well recognized in pediatric practice, it seldom presents de novo in adulthood. These are commonly present in head and neck but can be present anywhere. Cystic hygroma is very rare in adults, but it should be considered in the differential diagnosis of adult neck swellings. Patients presenting with a painless, soft, fluctuant, and enlarging neck mass should have a careful history and physical examination along with radiological imaging to assist with diagnosis. Surgical intervention is the treatment of choice for this rare condition. Here, we are reporting a case of cystic hygroma in a 32-year-old male patient in the neck region. The objectives of this case report are to discuss the clinical presentation, diagnosis, histopathological findings and management of this malformation.

  10. UNILOCULAR OMENTAL CYST IN ADULT FEMALE PRESENTING AS HUGE ABDOMINAL LUMP: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Himansu

    2015-05-01

    Full Text Available Omental cysts are rare entity with a prevalence of 1: 1,000,000 in adults and in 1: 20, 000 in children. We are reporting a case of a 30 year female patient with abdominal lump over epigastrium and left hypochondrium for 6 months; diagnosed on laparotomy as uniloculated omental cyst originating from lesser omentum. Omental cyst is a challenging diagnostic entity with varied presentations and a wide range of differential diagnosis has to be kept in mind.

  11. Polyarticular Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Annelise Miller

    2015-01-01

    Full Text Available Septic arthritis is a clinical emergency requiring prompt diagnosis and treatment to avoid significant morbidity and mortality. Polyarticular septic arthritis (PASA accounts for 15% of all infectious arthritides and rarely occurs in immunocompetent adults. Staphylococcus aureus is the most commonly isolated organism, with infection primarily affecting knees, shoulders, elbows, and hips. The morbidity associated with PASA is very high, and mortality in treated cases of PASA may be as high as 50% of cases. We report a case of PASA with associated epidural abscess in a healthy adult male, who presented with complaints of arthralgia and limited range of motion of his left shoulder, wrist, and ankle. He also presented with low back pain and motor weakness associated with an epidural abscess spanning L2-S1, with multilevel vertebral osteomyelitis. Surgical washout of the affected joints as well as decompressive laminectomies was performed, and he received a standard course of intravenous antibiotics. Staphylococcus aureus was isolated from joint aspirations and from blood cultures. The patient had a full neurological and functional recovery postoperatively with no sequelae. To the best of our knowledge this is the only case report of Staphylococcus aureus PASA with concomitant epidural abscess in an immunocompetent adult.

  12. Polyarticular Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of the Literature.

    Science.gov (United States)

    Miller, Annelise; Abduljabbar, Fahad; Jarzem, Peter

    2015-01-01

    Septic arthritis is a clinical emergency requiring prompt diagnosis and treatment to avoid significant morbidity and mortality. Polyarticular septic arthritis (PASA) accounts for 15% of all infectious arthritides and rarely occurs in immunocompetent adults. Staphylococcus aureus is the most commonly isolated organism, with infection primarily affecting knees, shoulders, elbows, and hips. The morbidity associated with PASA is very high, and mortality in treated cases of PASA may be as high as 50% of cases. We report a case of PASA with associated epidural abscess in a healthy adult male, who presented with complaints of arthralgia and limited range of motion of his left shoulder, wrist, and ankle. He also presented with low back pain and motor weakness associated with an epidural abscess spanning L2-S1, with multilevel vertebral osteomyelitis. Surgical washout of the affected joints as well as decompressive laminectomies was performed, and he received a standard course of intravenous antibiotics. Staphylococcus aureus was isolated from joint aspirations and from blood cultures. The patient had a full neurological and functional recovery postoperatively with no sequelae. To the best of our knowledge this is the only case report of Staphylococcus aureus PASA with concomitant epidural abscess in an immunocompetent adult.

  13. Treatment of paraphilia in young adults with leuprolide acetate: a preliminary case report series.

    Science.gov (United States)

    Saleh, Fabian M; Niel, Tracey; Fishman, Marc J

    2004-11-01

    Some juveniles who engage in sexual offenses may have a paraphilia, a psychiatric disorder characterized by a pervasive pattern of deviant and impairing sexual fantasies, thoughts, and/or behaviors. Though there is no known cure for these conditions, paraphilias can be effectively managed using a multimodal treatment approach. This may include the use of psychotherapeutic and pharmacological treatment interventions, including antiandrogen medications. One such agent, leuprolide acetate (leuprolide), a luteinizing hormone-releasing-hormone agonist, has been shown to be effective in reducing paraphilic symptoms in adult patients. To date, however, there is no published data on its use and effectiveness in adolescent and young adult paraphilic patients. This study consists of a case report series of six young adult patients treated with leuprolide. All subjects had been diagnosed with at least one paraphilia (i.e., Pedophilia, Sexual Sadism, Frotteurism, and Paraphilia Not Otherwise Specified). All subjects had been refractory to treatment in a residential program for adolescent sex offenders prior to initiation of leuprolide. All six subjects reported a reduction in sexually deviant symptoms following treatment with leuprolide. Clinicians rated four as much improved and two as moderately improved. The treatment was well tolerated in all six subjects. This preliminary case series supports the conclusion that leuprolide deserves further examination as a potentially safe and effective component in the treatment of young adult patients with paraphilia.

  14. Tuberculosis in a child - search for the infected adult nearby; case report, Portugal, 2007.

    Science.gov (United States)

    Duarte, R; Tavares, E; Miranda, A; Carvalho, A

    2009-09-10

    Tuberculosis (TB) transmission in a non-household setting is difficult to detect, because contact with the source case is often not obvious. Here, we report on a case of a four-year-old child who got infected through sporadic non-household exposure at a coffee shop. The source case was a woman who had suffered from weight loss, productive cough and fatigue for two months before being diagnosed with TB. Screening the child s contacts revealed two active TB cases within its family. Overall 148 contacts were screened for both cases and 18 cases of latent TB infection detected. The connection between the child and the source case, who were not aware of their contact, was confirmed by molecular fingerprinting. Our case report illustrates the difficulty in detecting non-household transmission between individuals that do not have significant contact, and draws attention to the need to look for the infected adult whenever a child falls ill with TB. This report is a reminder of the importance to consider possibly neglected ways of TB transmission and highlights once again the need of early diagnosis of TB.

  15. Adult Neuroblastoma Complicated by Increased Intracranial Pressure: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Patrick L. Stevens

    2014-01-01

    Full Text Available Neuroblastoma is the third most commonly occurring malignancy of the pediatric population, although it is extremely rare in the adult population. In adults, neuroblastoma is often metastatic and portends an extremely poor overall survival. Our case report documents metastatic neuroblastoma occurring in a healthy 29-year-old woman whose course was complicated by an unusual presentation of elevated intracranial pressures. The patient was treated with systemic chemotherapy, I131 metaiodobenzylguanidine (MIBG radiotherapy, and autologous stem cell transplant (SCT. Unfortunately the patient’s response to therapy was limited and she subsequently died. We aim to review neuroblastoma in the context of increased intracranial pressure and the limited data of neuroblastoma occurring in the adult population, along with proposed treatment options.

  16. Adult onset glycogen storage disease type II (adult onset Pompe disease): report and magnetic resonance images of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Del Gaizo, Andrew [Emory University School of Medicine, Radiology Resident, Atlanta, GA (United States); Banerjee, Sima [Emory University School of Medicine, Musculoskeletal Radiology Department, Atlanta, GA (United States); Terk, Michael [Emory University School of Medicine, Radiology, Division of Musculoskeletal Imaging, Atlanta, GA (United States)

    2009-12-15

    Glycogen storage disease type II (GSDII), also referred to as Pompe disease or acid maltase deficiency, is a rare inherited condition caused by a deficiency in acid alpha-glucosidase (GAA) enzyme activity. The condition is often classified by age of presentation, with infantile and late onset variants (Laforet et al. J Neurology 55:1122-8, 2000). Late onset tends to present with progressive proximal muscle weakness and respiratory insufficiency (Winkel et al. J Neurology 252:875-84, 2005). We report two cases of biopsy confirmed adult onset GSDII, along with key Magnetic Resonance (MR) images. (orig.)

  17. Adult Foot Macrodactyly: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Celalettin Sever

    2014-04-01

    Full Text Available Macrodactyly of the foot is a rare congenital anomaly characterized by an enlargement of the soft tissue and osseous elements. It is difficult to treat this disorder when both the functional and cosmetic problems are addressed simultaneously. In the presented case, we describe an adult male patient with macrodactyly of the great toe, who underwent surgical correction consisting of amputation with debulking of soft tissues. To our knowledge, only a few cases regarding adults with macrodactyly of the foot have been reported in the literature. We advocate early surgical treatment of macrodactyly of the foot to enhance the quality of social life. [Arch Clin Exp Surg 2014; 3(2.000: 123-128

  18. Unicameral bone cyst of the lunate in an adult: case report

    Directory of Open Access Journals (Sweden)

    Alici Tugrul

    2010-10-01

    Full Text Available Abstract We report a case of a symptomatic unicameral (simple bone cyst of the lunate in a 42-year- old woman. The lesion was treated with curettage and cancellous autogenous iliac bone grafting. At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity. To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult. Cysts with significant cavities at the carpal bones in an adult should be approached cautiously, as they may require early curettage and bone grafting for healing, before collapse and degenerative changes occur.

  19. 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

  20. 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.

  1. Acute symptomatic calcific discitis in adults: a case report and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Shah, A.; Botchu, R.; Davies, A.M.; James, S.L. [Royal Orthopaedic Hospital, Department of Musculoskeletal Radiology, Birmingham (United Kingdom); Grainger, M.F. [Royal Orthopaedic Hospital, Department of Spinal Oncology, Birmingham (United Kingdom)

    2015-12-15

    Symptomatic calcific discitis has been reported in the paediatric population but is a rare entity in adults with only eight cases reported in the English literature. We present a case of adult calcific discitis presenting with acute onset back pain. Radiographs and CT demonstrated central T11-T12 disc calcification with diffuse marrow oedema on subsequent MRI. The patient was referred to our spinal oncology unit due to the extensive marrow oedema as a possible underlying primary bone tumour. Review of the CT confirmed an end-plate defect with herniated calcific nucleus pulposus with no underlying bone lesion. Features were in keeping with acute calcific discitis. The patient was treated symptomatically and made an uneventful recovery. We discuss the characteristic imaging features seen on radiograph, CT and MRI and review the current literature. Calcific discitis is a self-limiting pathology requiring symptomatic management only. Radiologists need to be aware of this rare entity as it can occur in adults and may be mistaken for a more sinister pathology such as infective discitis or a bone tumour and lead to further unnecessary imaging or invasive procedures. (orig.)

  2. Adult Mesenchymal Hamartoma of the Liver: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Zachary Klaassen

    2010-03-01

    Full Text Available Mesenchymal hamartoma of the liver (MHL is a rare benign lesion occurring primarily in the pediatric population. While the precise pathogenesis of the tumor is not certain, the most common theory relates to aberrant mesenchyme development in the portal tract likely related to the bile ducts. A 53-year-old female was evaluated for an incidental liver mass. Initial CT scan showed a cystic lesion in the right lobe of the liver and follow-up imaging revealed an increase in size and the percent solid component within the mass. In view of these changes, a nondiagnostic biopsy was obtained followed by extirpation of the lesion. Gross pathological review of the lesion identified a 9 × 9 × 7.5 cm, pink-yellow-tan, gelatinous mass, with a >1 cm clear surgical margin. Histologically, the mass consisted of benign dilated bile ducts, as well as myxoid stroma with spindle cells showing smooth muscle differentiation. The patient was discharged home on postoperative day five. A review of the literature for MHL in adults reports 30 previous cases, predominantly published as individual case reports describing the size, lobe(s of the liver affected, and the cystic/solid nature of the tumor. MHL in adults may represent a potentially premalignant lesion, as the emerging literature supports a potential relationship between MHL and malignant undifferentiated embryonal sarcoma in regards to cytogenetic analysis. Aggressive surgical management of MHL in adults is mandated when feasible.

  3. Transhepatic approach to closure of patent foramen ovale: report of 2 cases in adults.

    Science.gov (United States)

    Hussain, Jamal; Strumpf, Robert; Ghandforoush, Aslan; Jamal, Ayman; Diethrich, Edward

    2010-01-01

    Patent foramen ovale is increasingly diagnosed in patients who are undergoing clinical study for cryptogenic stroke or migraine. In addition, patent foramen ovale is often suspected as a cause of paradoxical embolism in patients who present with arterial thromboembolism. The femoral venous approach to closure has been the mainstay. When the femoral approach is not feasible, septal occluder devices have been deployed via a transjugular approach.Herein, we describe 2 cases of patent foramen ovale in which the transhepatic approach was used for closure. To our knowledge, this is the 1st report of a transhepatic approach to patent foramen ovale closure in an adult patient. Moreover, no previous case of patent foramen ovale closure has been reported in a patient with interrupted inferior vena cava.

  4. Septic arthritis of the adult ankle joint secondary to Salmonella enteritidis: a case report.

    LENUS (Irish Health Repository)

    Munigangaiah, Sudarshan

    2011-09-01

    Salmonella septic arthritis in healthy individuals is a rare phenomenon. However, septic arthritis of the native adult ankle joint in healthy patients has not been previously described in the published data. This is a case report of a 70-year-old farmer who presented with a 2-week history of a painful, swollen right ankle and an inability to bear weight. He had no history of ankle injury or any predisposing conditions. Joint aspirations were positive for Salmonella enteritidis that was successfully treated with right ankle arthrotomy and washout, along with a 6-week course of intravenous antibiotic therapy.

  5. Langerhans Cell Histiocytosis of the Rib in an Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Sung Hyun Kim

    2016-01-01

    Full Text Available Single-site, single-system Langerhans cell histiocytosis (LCH of the rib is one of the rarest causes of bone tumor in adults. Herein, we report a case of a healthy 35-year-old male who presented with upper back pain that was attributed to a solitary osteolytic lesion at the posterolateral aspect of his sixth rib. For diagnostic confirmation and treatment, partial resection of the sixth rib was performed and pathologic finding was consistent with LCH. At the final follow-up after 2 years, no local recurrence or metastasis was observed.

  6. BILATERAL ASYMMETRIC TRAUMATIC HIP DISLOCATION IN AN ADULT - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Venkateswarlu

    2015-11-01

    Full Text Available Bilateral asymmetric traumatic hip dislocation without an associated fracture of the pelvis or femur occurring in an young adult with no previous history of hip abnormality or ligamentous laxity is a rarity. There were only 58 such cases reported in literature till date. Here is a 28 year old male patient presented to our Department of Orthopaedics and Traumatology, Rangaraya Medical College, Kakinada, Andhrapradesh, India with a history of fall from mango tree with bilateral asymmetric traumatic hip dislocation. The mode if injury is fall from a height. The dislocations were promptly reduced by closed method. Serial follow-up revealed no complications.

  7. Adrenal Ganglioneuroblastoma in Adults: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Stefano Benedini

    2017-01-01

    Full Text Available Incidentally discovered adrenal masses are very common given the increased number of imaging studies performed in recent years. We here report a clinical case of a 20-year-old woman who presented with left flank pain. Ultrasound examination revealed a contralateral adrenal mass, which was confirmed at computed tomography (CT scan. Hormonal hypersecretion was excluded. Given the size (11 × 10 × 7 cm and the uncertain nature of the mass, it was surgically removed and sent for pathological analyses. Conclusive diagnosis was ganglioneuroblastoma. Ganglioneuroblastoma is an uncommon malignant tumor, extremely rare in adults, particularly in females. This neoplasm is frequently localized in adrenal gland.

  8. Piriform sinus carcinoma with a paraneoplastic syndrome misdiagnosed as adult onset Still's disease: a case report.

    Science.gov (United States)

    Yang, Liu; Li, Wen; Du, Jintao

    2015-01-01

    Paraneoplastic syndromes (PS) occur less commonly in association with otolaryngologic neoplasms than other carcinomas such as those of lung or breast. Piriform sinus carcinoma with PS is extremely rare. We here report a case of piriform sinus carcinoma accompanied by PS that was initially misdiagnosed as adult onset Still's disease and describe our diagnosis and treatment. One lesson we have drawn from the experience of this misdiagnosis is that PS symptoms may manifest before the primary tumor is evident and complicate the diagnostic process.

  9. Traumatic atlantoaxial rotatory fixation associated with C2 articular facet fracture in adult patient: Case report

    Directory of Open Access Journals (Sweden)

    Mehdi Bellil

    2014-01-01

    Full Text Available Traumatic atlantoaxial rotatory fixation is a very rare injury in adults which is often misdiagnosed initially. Its combination with C2 fractures is predominated by dens lesions. Therapeutic management is challenging because of the difficulty to achieve optimal reduction and permanent stability. We report a rare case of traumatic atlantoaxial rotatory fixation in a 56-year-old women associated with C2 articular facet fracture successfully treated by conservative means after patient-awake manual reduction with optimal functional and radiographic outcome.

  10. Bruton’s agammaglobulinemia in an adult male due to a novel mutation: a case report

    Science.gov (United States)

    Xu, Yuanda; Qing, Qi; Liu, Xuesong; Chen, Sibei; Chen, Ziyi; Niu, Xuefeng; Tan, Yaxia; He, Weiqun; Liu, Xiaoqing; Li, Yimin

    2016-01-01

    X-linked agammaglobulinemia (XLA) is caused by mutation in the gene coding for Bruton’s tyrosine kinase (BTK), which impairs peripheral B cell maturation and hypogammaglobulinemia. In this report, we present a case of XLA in a 22-year-old adult male. Genetic testing revealed a novel mutation located at the conserved region (c.383T>C). The patient had a history of recurrent respiratory tract infection which eventually progressed to chronic type II respiratory failure. Several pathogenic bacteria were isolated on culture of respiratory secretions obtained on bronchoscopy. The patient improved on treatment with antibiotics. PMID:27867589

  11. Plastic Fibula Bone Deformity with Ipsilateral Fracture of Tibiain Adults: A Case Report

    OpenAIRE

    Abbas Abdoli Tafti; Sanazsadat Sajadi; Maryam Shahmoradi

    2015-01-01

    Plastic bowing is a constant deformation of long bones occurring after a long standing force to bone. This type of fracture is seen in children and is uncommon in the adults. In this paper we report a case of fibular plastic deformity with ipsilateral tibia fracture in a 20 years old man that occurred after a direct hit. At the initial examination vital signs were stable and radiography of tibia and fibula fracture with plastic deformation were clear. In order to treat him we performed fib...

  12. Langerhans Cell Histiocytosis of the Rib in an Adult: A Case Report

    Science.gov (United States)

    Kim, Sung Hyun; Choi, Moon Young

    2016-01-01

    Single-site, single-system Langerhans cell histiocytosis (LCH) of the rib is one of the rarest causes of bone tumor in adults. Herein, we report a case of a healthy 35-year-old male who presented with upper back pain that was attributed to a solitary osteolytic lesion at the posterolateral aspect of his sixth rib. For diagnostic confirmation and treatment, partial resection of the sixth rib was performed and pathologic finding was consistent with LCH. At the final follow-up after 2 years, no local recurrence or metastasis was observed. PMID:26933424

  13. Cutaneous manifestations of kwashiorkor: a case report of an adult man after abdominal surgery.

    Science.gov (United States)

    Mann, Danielle; Presotto, Carolina; Queen, Stella Maria Facó; Oliveira, Elisa Fontenelle de; Gripp, Alexandre Carlos

    2011-01-01

    Kwashiorkor is a type of protein-energy malnutrition where diet protein deficit is found, in spite of appropriate caloric intake. Cutaneous manifestations include xerosis, with abnormally dry skin that has a flaking enamel paint aspect, a typical red to gray-white hair color, the "flag sign" and more evident edema in lower limbs and face, giving it a full moon appearance. This article reports a case of a male adult patient who had undergone Whipple surgery for treatment of chronic pancreatitis associated with pseudotumor of the pancreatic head that progressed to cutaneous manifestations of kwashiorkor after pulmonary tuberculosis.

  14. Bruton's agammaglobulinemia in an adult male due to a novel mutation: a case report.

    Science.gov (United States)

    Xu, Yuanda; Qing, Qi; Liu, Xuesong; Chen, Sibei; Chen, Ziyi; Niu, Xuefeng; Tan, Yaxia; He, Weiqun; Liu, Xiaoqing; Li, Yimin; Chen, Rongchang; Chen, Ling

    2016-10-01

    X-linked agammaglobulinemia (XLA) is caused by mutation in the gene coding for Bruton's tyrosine kinase (BTK), which impairs peripheral B cell maturation and hypogammaglobulinemia. In this report, we present a case of XLA in a 22-year-old adult male. Genetic testing revealed a novel mutation located at the conserved region (c.383T>C). The patient had a history of recurrent respiratory tract infection which eventually progressed to chronic type II respiratory failure. Several pathogenic bacteria were isolated on culture of respiratory secretions obtained on bronchoscopy. The patient improved on treatment with antibiotics.

  15. Ultrasonographic follow-up of functional chronic constipation in adults: A report of two cases

    Science.gov (United States)

    Yabunaka, Koichi; Nakagami, Gojiro; Komagata, Kazunori; Sanada, Hiromi

    2017-01-01

    Chronic constipation is a disorder frequently encountered in clinical practice. Here, we describe the use of ultrasonography as a new approach to the follow-up of adult patients with functional chronic constipation. Specifically, we report two cases of functional chronic constipation: fecal retention in the rectum and not fecal retention in the rectum. In the not fecal retention in the rectum patient, ultrasonography showed no evidence of fecal retention in the rectum, including no rectal fecaloma, whereas in the fecal retention in the rectum patient, fecal retention in the rectum was clearly recognized. Moreover, ultrasonography can guide the choice of laxative, enema, or appropriate manual maneuver to treat chronic constipation. As a simple and noninvasive method for assessing functional chronic constipation in adults, ultrasonography not only provides important clinical information but can also aid in determining the location of fecal retention. PMID:28250918

  16. Suppurative necrotizing granulomatous lymphadenitis in adult-onset Still’s disease: a case report

    Directory of Open Access Journals (Sweden)

    Assimakopoulos Stelios F

    2012-10-01

    Full Text Available Abstract Introduction Lymphadenopathy is found in about 65% of patients with adult-onset Still’s disease and is histologically characterized by an intense, paracortical immunoblastic hyperplasia. Adult-onset Still’s disease has not been previously described as an etiology of suppurative necrotizing granulomatous lymphadenitis. Case presentation We describe a 27-year-old Greek man who manifested prolonged fever, abdominal pain, increased inflammatory markers, episodic skin rash and mesenteric lymphadenopathy histologically characterized by necrotizing granulomatous adenitis with central suppuration. Disease flares were characterized by systemic inflammatory response syndrome with immediate clinico-laboratory response to corticosteroids but the patient required prolonged administration of methylprednisolone at a dose of above 12mg/day for disease control. After an extensive diagnostic work-up, which ruled out any infectious, malignant, rheumatic or autoinflammatory disease the patient was diagnosed as having adult-onset Still’s disease. The patient is currently treated with 4mg of methylprednisolone, 100mg of anakinra daily and methotrexate 7.5mg for two consecutive days per week and exerts full disease remission for six months. Conclusion To the best of our knowledge this is the first report of suppurative necrotizing granulomatous lymphadenitis attributed to adult-onset Still’s disease. This case indicates that the finding of a suppurative necrotizing granulomatous lymphadenitis should not deter the consideration of adult-onset Still’s disease as a potential diagnosis in a compatible clinical context; however, the exclusion of other diagnoses is a prerequisite.

  17. Adult scoliosis can be reduced through specific SEAS exercises: a case report

    Directory of Open Access Journals (Sweden)

    Atanasio Salvatore

    2008-12-01

    Full Text Available Abstract Background It has been known since many years that scoliosis can continue to progress after skeletal maturity: the rate of progression has shown to be linear, and it can be used to establish an individual prognosis. Once there is progression there is an indication for treatment: usually it is proposed a surgical one. There are very few papers on an alternative rehabilitation approach; since many years we propose specific SEAS exercises and the aim of this study is to present one case report on this approach. Case presentation All radiographs have been measured blindly twice using the same protractor by one expert physician whose repeatability error proved to be Conclusion A scoliosis curve is made of different components: the structural bony and ligamentous components, and a postural one that counts up to 9° in children, while it has not been quantified in adults. This case shows that when adult scoliosis aggravates it is possible to intervene with specific exercises (SEAS not just to get stability, but to recover last years collapse. The reduction of scoliotic curve through rehabilitation presumably does not indicate a reduction of the bone deformity, but rely on a recovery of the upright postural collapse. This reduction can decrease the chronic asymmetric load on the spine and, in the long run, reduce the risks of progression.

  18. Posaconazole-Vincristine Coadministration Triggers Seizure in a Young Female Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Dalia A. Hamdy

    2012-01-01

    Full Text Available Coadministration of azoles and vincristine has been shown to increase vincristine neurotoxic effects due to the inhibition of cytochrome P450 (CYP isoform 3A4, for which vincristine is a substrate. Despite the absence of any casual relationship between seizure and coadministration of azoles, few case reports of vincristine-induced seizure have been documented after coadministration of fluconazole or posaconazole in children. In this paper we are reporting the first young female adult who experienced generalized seizure after coadministration of posaconazole and vincristine. The 19-year-old female was diagnosed with acute lymphoblastic leukemia. She started induction phase of Berlin Frankfurt Muenster protocol along with posaconazole 200 mg three times daily as prophylactic antifungal therapy. Five days after the third vincristine dose, she developed generalized seizure accompanied by high blood pressure and SIADH. Her neurological exam/CT scan did not show any abnormality. In conclusion, this study reports a novel finding in the sense that all previous case reports pertaining to posaconazole-vincristine-induced seizure in literature involved children. Physicians should be made aware of this rare possible outcome to closely monitor their patients and take appropriate measures to prevent such possible adverse effect.

  19. 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...

  20. Cutaneous manifestations of adult-onset Still's disease: a case report and review of literature.

    Science.gov (United States)

    Cozzi, Alessandra; Papagrigoraki, Anastasia; Biasi, Domenico; Colato, Chiara; Girolomoni, Giampiero

    2016-05-01

    Adult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology and pathogenesis characterized by high spiking fever, arthralgia or arthritis, sore throat, lymphadenopathy, hepatosplenomegaly, serositis, and transient cutaneous manifestations. Although more common in children, cases are seen also in adults. Cutaneous involvement is common and may be suggestive for the diagnosis. A case of AOSD in a 35-year-old man is reported here, presenting with urticarial maculopapular rash of trunk, high spiking fever, acute respiratory distress syndrome, and myopericarditis. Skin biopsy showed interstitial and perivascular mature CD15(+) neutrophils. A comprehensive review of literature showed that cutaneous involvement occurs in about 80 % of patients, with various clinical presentations. The most common skin manifestation is an evanescent salmon pink or erythematous maculopapular exanthema, predominantly on the trunk and proximal limbs, with rare involvement of face and distal limbs. Less common manifestations include persistent erythematous plaques and pustular lesions. A constant histopathologic finding is the presence of interstitial dermal neutrophils aligned between the collagen bundles. This pattern may provide an easy accessible clue for the definitive diagnosis of AOSD and exclude other diagnosis such as drug eruptions or infectious diseases.

  1. Langerhans cell histiocytosis in adults: a case report and review of the literature

    Science.gov (United States)

    2016-01-01

    Background Langerhans cell histiocytosis (LCH) is a proliferative disease of histiocyte-like cells that generally affects children. Immunohistochemistry is essential to obtain the correct diagnosis, and treatment protocols are controversial. Objective Langerhans cell histiocytosis (LCH) is easy to be misdiagnosed because of its various clinic features and laboratory results. This research focused on the clinicopathological, histopathological, immunohistochemical and other features of LCH and aimed to analyze LCH clinical features for improving diagnosis and decreasing misdiagnosis rate. Case report A case of rare adult LCH was reported and the clinicopathological features were summarized by literature review. The multifocal form of this case includes diabetes insipidus, exophthalmos and mucocutaneous lesions in axillae and anogenital regions, such as infiltrated nodules, extensive coalescing, scaling, crusted papules and ulcerated plaques. The Langerhans cells diffusely infiltrated in the dermis and the tumor cells were positive for CD1a and S-100 expression. The diagnosis was Langerhans cell histiocytosis based on the pathological and immunohistochemical changes. Conclusion LCH has high rate of misdiagnosis and definitive diagnosis depends on pathological biopsy and X-ray examination. The prognosis is related to the onset age and the quantity of affected organs. Although specific therapeutic approach hasn't been well established, combined chemotherapy for multisystem lesions and surgical operation or radiotherapy for unifocal lesions may improve the therapy. PMID:26942568

  2. Postural correction reduces hip pain in adult with acetabular dysplasia: A case report.

    Science.gov (United States)

    Lewis, Cara L; Khuu, Anne; Marinko, Lee N

    2015-06-01

    Developmental dysplasia of the hip is often diagnosed in infancy, but less severe cases of acetabular dysplasia are being detected in young active adults. The purpose of this case report is to present a non-surgical intervention for a 31-year-old female with mild acetabular dysplasia and an anterior acetabular labral tear. The patient presented with right anterior hip and groin pain, and she stood with the trunk swayed posterior to the pelvis (swayback posture). The hip pain was reproduced with the anterior impingement test. During gait, the patient maintained the swayback posture and reported 6/10 hip pain. Following correction of the patient's posture, the patient's pain rating was reduced to a 2/10 while walking. The patient was instructed to maintain the improved posture. At the 1 year follow-up, she demonstrated significantly improved posture in standing and walking. She had returned to recreational running and was generally pain-free. The patient demonstrated improvement on self-reported questionnaires for pain, function, and activity. These findings suggest that alteration of posture can have an immediate and lasting effect on hip pain in persons with structural abnormality and labral pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Bilateral acute angle closure glaucoma as a presentation of isolated microspherophakia in an adult: case report

    Directory of Open Access Journals (Sweden)

    Gupta Amod

    2006-07-01

    Full Text Available Abstract Background Bilateral simultaneous angle closure glaucoma is a rare entity. To our knowledge this is the first reported case of bilateral acute angle-closure glaucoma secondary to isolated microspherophakia in an adult. Case presentation A 45-year-old woman presented with bilateral acute angle closure glaucoma, with a patent iridotomy in one eye. Prolonged miotic use prior to presentation had worsened the pupillary block. The diagnosis was not initially suspected, and the patient was subjected to pars-plana lensectomy and anterior vitrectomy for a presumed ciliary block glaucoma. The small spherical lens was detected intraoperatively, and spherophakia was diagnosed in retrospect. She had no systemic features of any of the known conditions associated with spherophakia. Pars-plana lensectomy both eyes controlled the intraocular pressure successfully. Conclusion This case demonstrates the importance of considering the diagnosis of isolated microspherophakia in any case of bilateral acute angle closure glaucoma. Lensectomy appears to be an effective first-line strategy for managing these patients.

  4. [Primitive neuroectodermal tumour of soft tissue of the index finger in an adult. A case report].

    Science.gov (United States)

    Berrada, N; Bellarbi, S; El Mannouar, M; Errihani, H

    2012-12-01

    The primitive neuroectodermal tumours (PNET) of soft tissues belong to the Ewing's tumors family and affects particularly the child. The localization of the disease at the extremities is very rare within the adult population and raises the problem of differential diagnosis with others tumors of the soft tissues. We report the case of a 48-year-old patient with a localized tumor, at the level of the second right finger, of six months evolution. The biopsy showed the infiltrating nature of the tumour; and the diagnosis of (PNET) was confirmed after the histological and immunohistochemical study. The extension assessment was negative and the patient had an amputation of the second and third rays of the right hand. Four years afterwards, the patient showed no recurrence or metastases.

  5. Streptococcus gallolyticus meningitis in adults: report of five cases and review of the literature.

    Science.gov (United States)

    van Samkar, A; Brouwer, M C; Pannekoek, Y; van der Ende, A; van de Beek, D

    2015-12-01

    We describe the incidence and patient characteristics of Streptococcus gallolyticus meningitis. We identified S. gallolyticus meningitis in a nationwide cohort of patients with community-acquired bacterial meningitis, and performed a systematic review and meta-analysis of all reported adult cases in the literature. Five cases were identified (0.3%) in a cohort of 1561 episodes of bacterial meningitis. In one patient, bowel disease (colon polyps) was identified as a predisposing condition for S. gallolyticus infection, whereas no patients were diagnosed with endocarditis. In a combined analysis of our patients and 37 reported in the literature, we found that the median age was 59 years. Predisposing factors were present in 21 of 42 patients (50%), and mainly consisted of immunosuppressive therapy (seven patients), cancer (four patients), and alcoholism (four patients). Colon disease was identified in 15 of 24 patients (63%) and endocarditis in five of 27 patients (18%). Co-infection with Strongyloides stercoralis was identified in 14 of 34 patients (41%), ten of whom were infected with human immunodeficiency virus or human T-lymphotropic virus. Outcomes were described for 37 patients; eight died (22%) and one (3%) had neurological sequelae. S. gallolyticus is an uncommon cause of bacterial meningitis, with specific predisposing conditions. When it is identified, consultation with a cardiologist and gastroenterologist is warranted to rule out underlying endocarditis or colon disease. Stool examinations for Strongyloides stercoralis should be performed in patients who have travelled to or originate from endemic areas.

  6. Case report

    African Journals Online (AJOL)

    abp

    Primary omental torsion in children: case report ... Primary omental torsion is a rare cause of acute abdominal pain, we report a case of 10-year-old boy admitted with ... Pan African Medical Journal. ... nausea, vomiting, and diarrhea may occur.

  7. Mixed Hepatoblastoma in a Young Male Adult: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Valeria Fiaschetti

    2010-01-01

    Full Text Available Hepatoblastoma (HB is a rare malignant tumour of the liver and usually occurs in the first three years of life. Most of these tumours arise in the embryo; hence it seems to be unusual that hepatoblastoma occurs in adults and is an exceptional cause of primary malignant liver tumour in adult patients. The diagnosis is often overlooked, and patients might be diagnosed at late stages of the disease at risk of increased mortality. In this paper we report a case of a 30-year-old man with mixed hepatoblastoma and abdominal pain, hepatomegaly and fever. The patient under went noninvasive diagnostic methods: duplex scanning, Computed Tomography (CT, and Magnetic Resonance imaging (MRI. In our experience, despite the important role of histological sample provided by biopsy in defining the diagnosis, very important was the role of MRI, more than ultrasonography and enhanced CT. The MRI detects tumor features as size, margins, and ratio with neighboring organs in order to get the best surgical approach.

  8. A rare case report of patent vitellointestinal duct causing bowel obstruction in an adult.

    Science.gov (United States)

    Bhandari, Tika Ram; Shahi, Sudha; Gautam, Manish; Pandey, Sanjay

    2017-08-24

    Patent vitellointestinal duct occurs in about 2% of the population which unusually leads to small intestinal obstruction associated with high morbidity and mortality. Here we are reporting an unusual case of patent vitellointestinal duct causing small intestinal obstruction in an adult patient. A 22-year-old male without any medical illness presented as an emergency with a 3day hystory of abdominal pain, multiple episode of vomiting and abdominal distention. Distended abdomen and sign of peritonitis were found on abdominal examination. Abdominal X-rays revealed multiple small intestinal air-fluid levels. A patent vitellointestinal duct extending from distal ileum to the posterior wall of the umbilicus was found causing closed loop ileal obstruction during laparotomy. Resection of a vitellointestinal duct along with gangrenous distal ileum and cecum with ileocolostomy was performed. He was discharged on the 8 th postoperative day. Diagnosing and management of cause of intestinal obstruction in patients without history of abdominal surgery is very challenging. Early resuscitation and timely surgical intervention of intestinal obstruction due to a rare patent vitellointestinal duct can be life-saving measure. The patent vitellointestinal duct is an uncommon entity in adults and moreover this disorder leading to intestinal obstruction is very rare. Surgeons should be aware of this infrequent cause of small bowel obstruction to allow for early diagnosis and to facilitate better patient outcomes. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  9. Anesthesia for the adult patient with an unrepaired congenital cyanotic heart defect: a case report.

    Science.gov (United States)

    Cosgrove, Marianne S

    2012-06-01

    Adult congenital heart disease, previously considered a rare comorbidity, is increasingly becoming a reality for today's anesthesia providers. Improvements in prenatal diagnosis, sophisticated surgical techniques and equipment, advances in pediatric critical care, enhanced efficacy of cardiovascular pharmacologic agents, and an overall increase in postrepair survival rates have resulted in an estimated population of approximately 800,000 adults with congenital heart disease. Despite successful surgical repair or palliation, these individuals present the anesthesia provider with a multitude of challenges. Individualized care of these fragile patients should be approached with a keen understanding of the patient's underlying cardiac anomaly. This case report chronicles the anesthetic care of a 36-year-old woman presenting for left-sided ureteroscopy with laser lithotripsy and stent placement. Her medical history was remarkable for the presence of complex congenital heart disease consisting of multiple anomalies: a double-outlet right ventricle, transposition of the great arteries, pulmonary stenosis, atrial septal defect, and a hypoplastic left ventricle with concomitant mitral valve atresia. General anesthesia was successfully administered, with meticulous attention given to maintenance of systemic vascular resistance to minimize shunting, oxygenation, administration of preprocedure antibiotics, and judicious replacement of intravenous fluids via air-filtered tubing.

  10. High dose methylphenidate treatment in adult attention deficit hyperactivity disorder: a case report

    Directory of Open Access Journals (Sweden)

    Liebrenz Michael

    2012-05-01

    Full Text Available Abstract Introduction Stimulant medication improves hyperactivity, inattention, and impulsivity in both pediatric and adult populations with Attention Deficit Hyperactivity Disorder (ADHD. However, data regarding the optimal dosage in adults is still limited. Case presentation We report the case of a 38-year-old Caucasian patient who was diagnosed with Attention Deficit Hyperactivity Disorder when he was nine years old. He then received up to 10 mg methylphenidate (Ritalin® and 20 mg sustained-release methylphenidate (Ritalin SR® daily. When he was 13, his medication was changed to desipramine (Norpramin®, and both Ritalin® and Ritalin SR® were discontinued; and at age 18, when he developed obsessive-compulsive symptoms, his medication was changed to clomipramine (Anafranil® 75 mg daily. Still suffering from inattention and hyperactivity, the patient began college when he was 19, but did not receive stimulant medication until three years later, when Ritalin® 60 mg daily was re-established. During the 14 months that followed, he began to use Ritalin® excessively, both orally and rectally, in dosages from 4800-6000 mg daily. Four years ago, he was referred to our outpatient service, where his Attention Deficit Hyperactivity Disorder was re-evaluated. At that point, the patient’s daily Ritalin® dosage was reduced to 200 mg daily orally, but he still experienced pronounced symptoms of, Attention Deficit Hyperactivity Disorder so this dosage was raised again. The patient’s plasma levels consistently remained between 60–187 nmol/l—within the recommended range—and signs of his obsessive-compulsive symptoms diminished with fluoxetine 40 mg daily. Finally, on a dosage of 378 mg extended-release methylphenidate (Concerta®, his symptoms of Attention Deficit Hyperactivity Disorder have improved dramatically and no further use of methylphenidate has been recorded during the 24 months preceding this report. Conclusions Symptoms of

  11. The Senses Disease: a Refsum adult disease case report and a revision of literature

    Directory of Open Access Journals (Sweden)

    Filippo Camerota

    2014-06-01

    Full Text Available Refsum Disease is a rare autosomal recessive error of lipid metabolism; onset of symptoms in "classic Refsum disease" or "adult Refsum disease" ranges from age seven months to after age 50 years. The identification of symptoms, that interest all the senses, is essential for the management. We briefly describe a case occasionally diagnosed in adult life and analyzed the main aspects of this rare disease.

  12. Undifferentiated liver embryonal sarcoma in adults: A report of four cases and literature review

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To evaluate the undifferentiated embryonal sarcoma of liver (UESL) in adults in order to improve its diagnosis and treatment. METHODS: Four primary and one recurrent cases of UESL were clinicopathologically evaluated and immunohistochemically investigated with a panel of antibodies using the EnVision+ system. Relevant literature about UESL in adults was reviewed. RESULTS: Three males and one female were enrolled in this study. Their chief complaints were abdominal pain, weight loss, or fever. Laborator...

  13. 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

    2013-01-01

    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

  14. Adult Ileo-Ileo-Caecal Intussusception: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Sanjeev Singhal

    2012-01-01

    Full Text Available Adult intussusception is a rare entity accounting for only 5% of all intussusceptions and causes approximately 1% of all adult intestinal obstructions. Unlike paediatric intussusceptions which are usually idiopathic, there is usually a lead point pathology which might be malignant in up to 50% cases. We present an unusual case of adult intussusception which was not diagnosed on any investigation including computerized tomographic (CT scan and magnetic resonance imaging (MRI. It was a case of ileo-ileo-cecal intussusception caused by a large lipoma 38 mm×43 mm×61 mm. It was treated by emergency laparotomy for acute intestinal obstruction. A conservative resection with ileostomy was performed with good postoperative recovery.

  15. Adult-onset NREM parasomnia with hypnopompic hallucinatory pain: a case report.

    Science.gov (United States)

    Mantoan, Laura; Eriksson, Sofia H; Nisbet, Angus P; Walker, Matthew C

    2013-02-01

    We report the case of a 43-year-old woman presenting with nocturnal episodes of pain and screaming during sleep starting at age 30. There was no childhood or family history of parasomnia. The events had gradually become more frequent over the years, occurring in the first half of the night within 2 h of sleep onset. There were no triggers, and she had partial amnesia for the events. A diagnosis of adult-onset sleep terrors was made on clinical grounds and supported polysomnographically. Seizures and periodic limb movements were excluded as triggering factors. There was some mild sleep disordered breathing (predominantly non-desaturating hypopnea with a propensity for REM sleep of debatable significance). Imaging of the brain and spine and neurophysiological investigations ruled out lesions, entrapments, or neuropathies as possible causes of pain. Treatment (clonazepam, paroxetine, or gabapentin) was poorly tolerated and made no difference to the nocturnal episodes, while trazodone worsened them. This is the first report of hypnopompic psychic pain in association with a NREM parasomnia. We hypothesize that the pain may represent a sensory hallucination analogous to the more commonly recognized visual NREM parasomnia-associated hypnopompic visual hallucinations and that, as such, it may arise during arousal of the sensory neocortex as confabulatory response.

  16. [Hemorrhagic Adult Unilateral Moyamoya Disease with Multiple Unruptured Intracranial Aneurysms: A Case Report].

    Science.gov (United States)

    Ozaki, Saya; Inoue, Akihiro; Miyazaki, Hajime; Onoue, Shinji; Ichikawa, Haruhisa; Fukumoto, Shinya; Iwata, Shinji; Kohno, Kanehisa

    2016-02-01

    Adult unilateral moyamoya disease with intracranial aneurysm is frequently reported in the literature, but there is much variation in its treatment. In this case report, we describe the time course and treatment regimen of a patient with moyamoya disease and review the literature regarding moyamoya disease with intracranial aneurysm. A 64-year-old man had untreated intracranial aneurysm and unilateral moyamoya disease for 10 years. He presented with sudden-onset right hemiparesis and aphasia due to a subcortical hemorrhage. He was admitted to the local neurosurgical unit, and upon resolution of symptoms, he was admitted to our hospital. A cerebral angiogram revealed the champagne bottleneck sign of the left carotid artery and obliteration of the top of the left intracranial carotid artery with a moyamoya phenomenon. Two unruptured intracranial aneurysms were identified in the anterior communicating artery(Acom A) and the right intracranial carotid artery(C3). We performed superficial temporal artery-middle cerebral artery anastomosis followed by aneurysmal neck clipping of the Acom A aneurysm. Postoperative imaging showed no new ischemic damage and improved cerebral blood flow. Although the patient experienced temporal worsening of aphasia, his function recovered a few months later and he was able to resume his normal daily life activities. The combination of direct bypass surgery and aneurysmal neck clipping might be a therapeutic option for hemorrhagic unilateral moyamoya disease with unruptured intracranial aneurysm.

  17. Glomerulocystic kidney disease in an adult with enlarged kidneys: a case report and review of the literature.

    Science.gov (United States)

    Obata, Y; Furusu, A; Miyazaki, M; Nishino, T; Kawazu, T; Kanamoto, Y; Nishikido, M; Taguchi, T; Kohno, S

    2011-02-01

    We report the case of a 31-year-old male with enlarged kidneys and glomerulocystic kidney disease (GCKD). The patient had no family history of renal disease or other diseases. On initial presentation he complained of poor eyesight, and hypertensive retinopathy and elevated serum creatinine (5.0 mg/dl) were found at that time. Renal biopsy showed cystic dilatation of Bowman's capsule and atrophy of the glomerular tuft. Thus, an adult case of sporadic GCKD was diagnosed. Based on previous reports, kidney size in patients with adult type GCKD varies from small to large. Our patient's kidneys are the largest ever reported (right kidney was 22 cm×10 cm, left kidney was 19 cm×10 cm). A review of the literature dealing with sporadic adult GCKD suggested that it is difficult to diagnose this disease early in its course.

  18. Ambiguity in the Manifestation of Adult Separation Anxiety Disorder Occurring in Complex Anxiety Presentations: Two Clinical Case Reports

    Science.gov (United States)

    Dudaee-Faass, Sigal; Marnane, Claire; Wagner, Renate

    2009-01-01

    Two case reports are described in which patients presented for the treatment of multiple comorbid anxiety disorders, all of which appeared to derive from prolonged separation anxiety disorder. In particular, these adults had effectively altered their lifestyles to avoid separation, thereby displaying only ambiguous separation anxiety symptoms that…

  19. Ambiguity in the Manifestation of Adult Separation Anxiety Disorder Occurring in Complex Anxiety Presentations: Two Clinical Case Reports

    Science.gov (United States)

    Dudaee-Faass, Sigal; Marnane, Claire; Wagner, Renate

    2009-01-01

    Two case reports are described in which patients presented for the treatment of multiple comorbid anxiety disorders, all of which appeared to derive from prolonged separation anxiety disorder. In particular, these adults had effectively altered their lifestyles to avoid separation, thereby displaying only ambiguous separation anxiety symptoms that…

  20. Case report

    African Journals Online (AJOL)

    abp

    2017-05-05

    May 5, 2017 ... Chondroblastic osteosarcoma of the distal tibia: a rare case report ... 1Department of Orthopaedic Surgery, University Hospital, Monastir, Tunisia .... number of published reports describe pulmonary tumour metastasis.

  1. Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hawes Martha C

    2009-12-01

    Full Text Available Abstract Background Some patients with mild or moderate thoracic scoliosis (Cobb angle Case presentation A diagnosis of thoracic scoliosis (Cobb angle 45 degrees with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52 was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996; outpatient psychological therapy (1992-1993; a daily home exercise program focused on mobilization of the chest wall (1992-2005; and manipulative medicine (1994-1995, 1999-2000. Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature. Conclusion This report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis.

  2. SPONTANEOUS SPINAL EPIDURAL ABSCESS FOLLOWING TRAUMA TO BACK IN A HEALTHY ADULT WITHOUT PREDISPOSING FACTORS - A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Shanmuga Sundaram

    2014-02-01

    Full Text Available Spinal epidural abscess due to its varied presentation , poses a great challenge, more so in a healthy adult, without any predisposing factors. Early diagnosis and treatment is paramount, as late diagnosis and delayed treatment result in increased mortality and morbidity. In this case report, we are presenting a case of spinal extradural abscess in a healthy young adult without predisposing factors, provisionally diagnosed as extradural hematoma and early surgical intervention confirmed the diagnosis of spinal epidural abscess and prevented any devastating consequence

  3. Urolithiasis in an Adult with Primary Obstructive Megaureter: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammed S. Al-Marhoon

    2013-09-01

    Full Text Available This is a rare case of adult primary obstructive megaureter complicated by combined uric acid-oxalate lithiasis of the ureter and renal stones. A 24-year-old male patient presented with frank hematuria on exercise of 4 years duration. The patient had an open surgery in the form of excision of stenotic segment of ureter and left ureteric re-implantation with removal of ureteric and renal stones. Congenital megaureter is a diagnosis that urologists and radiologists need to consider in the setting of isolated distal ureteral dilation, as the diagnosis of adult megaureter may require more involved surgical measures to prevent recurrence of adverse symptoms.

  4. Solitary, adult-onset, intraosseous myofibroma of the finger: report of a case and review of literature.

    Science.gov (United States)

    Ma, Yihong; Siegal, Gene P; Wei, Shi

    2015-09-01

    Myofibroma is a rare benign neoplasm of myofibroblastic origin. It typically occurs in the skin and subcutaneous tissues of the head and neck in infants and young children as multicentric lesions known as infantile myofibromatosis. Intraosseous myofibromas are very rare and are typically destructive lesions that predominantly affect craniofacial bones in the setting of myofibromatosis. Solitary, intraosseous myofibromas in adults are exceedingly rare. Herein, we report a myofibroma involving the middle phalanx of the right index finger in a 58-year-old man who presented with a pathologic fracture. Twelve other cases of adult-onset, intraosseous myofibroma were compiled from the English language literature and integrated with this report.

  5. Acute tubulointerstitial nephritis and uveitis syndrome: A report on four adult cases

    Directory of Open Access Journals (Sweden)

    Yosra Ben Ariba

    2017-01-01

    Full Text Available Acute tubulointerstitial nephritis and uveitis (TINU syndrome is a rare disease, generally presenting in children and young women. The interstitial nephritis may precede, follow, or develop concurrent to the uveitis. We report the clinical features and outcomes of four adult patients, aged 41-70 years with the TINU syndrome.

  6. Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Malhotra R

    2016-11-01

    Full Text Available We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

  7. Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report.

    Science.gov (United States)

    Malhotra, R; Chua, W L; O'Neill, G

    2016-11-01

    We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

  8. Radiologic Findings of Reversed Intestinal Rotation in Adults: 3 Cases Report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hyeon Seok; Cho, Jae Ho; Chang, Jay Chun; Kim, Jae Woon; Kim, Kum Rae [Yeungnam University, Gyeongsan (Korea, Republic of); Park, Won Kyu [Suh Joo Mir Radiologic Clinic, Daegu (Korea, Republic of); Kim, Jong Yeol [Gumi CHA University Medical Center, Gumi (Korea, Republic of)

    2009-12-15

    Most anomalies of intestinal rotation are detected during the postneonatal period. In adults, the diagnosis and treatment of patients with a congenital anomaly of the midgut can be difficult because of their extremely rarity. Based on embryology, anomalies of intestinal rotation can be divided into non-rotation, reversed rotation and malrotation. Reversed rotation of the midgut is the rarest of all anomalies of intestinal rotation. Although this anomaly is rare, it can be diagnosed by a detailed knowledge of embryology and anatomy. We report three adult patients with reversed intestinal rotation and review the embryology, clinical presentation and radiographic findings of this disorder

  9. Polyarticular Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of the Literature

    OpenAIRE

    Annelise Miller; Fahad Abduljabbar; Peter Jarzem

    2015-01-01

    Septic arthritis is a clinical emergency requiring prompt diagnosis and treatment to avoid significant morbidity and mortality. Polyarticular septic arthritis (PASA) accounts for 15% of all infectious arthritides and rarely occurs in immunocompetent adults. Staphylococcus aureus is the most commonly isolated organism, with infection primarily affecting knees, shoulders, elbows, and hips. The morbidity associated with PASA is very high, and mortality in treated cases of PASA may be as high as ...

  10. Treatment and restoration of adult dentoalveolar trauma: A clinical case report

    OpenAIRE

    2016-01-01

    Adult dentoalveolar trauma most often occurs in the context of sports activities and traffic accidents. Coronal fractures are the most common type of lesion, followed by tooth luxation. We present the case of a 25-year-old woman who suffered alveolar bone damage and coronal fractures of the upper incisors, with extrusive luxation of the right central incisor, as the result of a fall. On the first visit, manual reduction of the buccal plate was carried out under local anesthesia, with repositi...

  11. Linear IgA dermatosis adult variant with oral manifestation: A rare case report

    Directory of Open Access Journals (Sweden)

    T Isaac Joseph

    2015-01-01

    Full Text Available Linear immunoglobulin A (IgA dermatosis (LAD is a rare autoimmune disorder that presents as a vesiculo-bullous lesion with cutaneous manifestations, but rare oral mucosal involvement. Here we discuss a case of a vesiculobullous lesion with severe oral and ocular mucosal involvement mimicking pemphigoid with histopathological evidence of subepithelial blisters. Direct immunofluorescence (DIF confirmed the lesion as LAD of adult variant, although with atypical clinical features.

  12. Linear IgA dermatosis adult variant with oral manifestation: A rare case report.

    Science.gov (United States)

    Joseph, T Isaac; Sathyan, Pradeesh; Goma Kumar, K U

    2015-01-01

    Linear immunoglobulin A (IgA) dermatosis (LAD) is a rare autoimmune disorder that presents as a vesiculo-bullous lesion with cutaneous manifestations, but rare oral mucosal involvement. Here we discuss a case of a vesiculobullous lesion with severe oral and ocular mucosal involvement mimicking pemphigoid with histopathological evidence of subepithelial blisters. Direct immunofluorescence (DIF) confirmed the lesion as LAD of adult variant, although with atypical clinical features.

  13. CASE REPORT

    African Journals Online (AJOL)

    DR ABDUL

    reported a case of Ogilvie's syndrome following a caesarean delivery ... perinatal mortality has been attributed to the difficulty in the early diagnosis ... The abdomen was full, moved with respiration and soft. There .... Acute intestinal obstruction.

  14. Case report

    African Journals Online (AJOL)

    abp

    2017-06-29

    Jun 29, 2017 ... Von Willebrand's disease: case report and review of literature. Hanae Echahdi1 ... glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include .... minor surgery including dental work.

  15. Case report

    African Journals Online (AJOL)

    abp

    2017-06-13

    Jun 13, 2017 ... Enterobiasis (oxyuriasis) is a common infection in human caused by Enterobius vermicularis (E. ... We report a case of oxyuriasis that took place in the refugee camp ... slightly painful, especially in the lower right quadrant.

  16. Case report

    African Journals Online (AJOL)

    ebutamanya

    2016-04-06

    Apr 6, 2016 ... A case of Kartagener syndrome with rhinolalia clausa. Mohammed ... ciliary movement; it was described by manes kartagener in 1933 comprising a triad of ... The speech therapy examination report revealed the presence ...

  17. Case report

    African Journals Online (AJOL)

    abp

    2017-07-14

    Jul 14, 2017 ... In this report, we present a case of osteogenesis imperfecta (OI) type IV, seen in a female fetus with ... without fractures, short stature, dentinogenesis imperfecta and ... curvature of the femurs were detected (Figure 2A).

  18. 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...

  19. Neem oil poisoning: Case report of an adult with toxic encephalopathy.

    Science.gov (United States)

    Mishra, Ajay; Dave, Nikhil

    2013-09-01

    Neem oil has widespread use in Indian subcontinent due to its many bioactive properties. Azadirachtin, an active ingredient, is implicated in causing the effects seen in neem oil poisoning. Neem oil poisoning is rare in adults. This report highlights the toxicity associated with neem oil poisoning in an elderly male. The patient presented with vomiting, seizures, metabolic acidosis, and toxic encephalopathy. The patient recovered completely with symptomatic treatment.

  20. Neem oil poisoning: Case report of an adult with toxic encephalopathy

    OpenAIRE

    Mishra, Ajay; Dave, Nikhil

    2013-01-01

    Neem oil has widespread use in Indian subcontinent due to its many bioactive properties. Azadirachtin, an active ingredient, is implicated in causing the effects seen in neem oil poisoning. Neem oil poisoning is rare in adults. This report highlights the toxicity associated with neem oil poisoning in an elderly male. The patient presented with vomiting, seizures, metabolic acidosis, and toxic encephalopathy. The patient recovered completely with symptomatic treatment.

  1. Use of Adult Fibreoptic Bronchoscope for Difficult Paediatric Intubation: A Case Report

    Directory of Open Access Journals (Sweden)

    Kundan Sandugir Gosavi

    2015-06-01

    Full Text Available Difficult airway management in paediatric patients may require a technique different from the standard one. We report the use of an adult fibreoptic bronchoscope and J tipped guidewire to intubate a child having temporo-mandibular joint ankylosis. Spontaneous respiration was maintained and local anaesthesia was provided to the upper airway during the procedure and the successful use of this technique avoided the requirement of surgical airway.

  2. Adult Onset Still’s Disease: A Case Report with a Rare Clinical Manifestation and Pathophysiological Correlations

    Directory of Open Access Journals (Sweden)

    Katerina M. Antoniou

    2013-01-01

    Full Text Available Adult-onset Still’s disease is an inflammatory multisystemic disease of unknown etiology. Pleuritis is the most common pulmonary manifestation and pleural effusions are usually exudates with a predominance of neutrophils. We report a case of an eosinophilic pleural effusion as a novel and hitherto unrecognized manifestation of active adult-onset Still’s disease. We also observed a marked NLRP3 inflammasome activation with increased production of IL-1β which coincided with the development and resolved upon remission of the pleural effusion suggesting a possible novel pathogenetic pathway for the development of pleural effusions in the context of the auto-inflammatory disorders.

  3. Giant Mature Primary Retroperitoneal Teratoma in a Young Adult: Report of a Rare Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Walid Sasi

    2014-01-01

    Full Text Available Teratomas are neoplasms of the embryonic tissues that typically arise in the gonadal and sacrococcygeal regions of adults and children. Primary adult retroperitoneal teratomas are rare and demand challenging management options. We report a case of a unilateral primary retroperitoneal mature cystic teratoma mimicking an adrenal mass in a 28-year-old female patient. Complete resection of the mass was performed by a laparotomy approach. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient remains free of recurrence to date.

  4. Azelaic acid in the treatment of acne in adult females: case reports.

    Science.gov (United States)

    Vargas-Diez, E; Hofmann, M A; Bravo, B; Malgazhdarova, G; Katkhanova, O A; Yutskovskaya, Y

    2014-01-01

    Acne, one of the most common skin problems in dermatological practice, is a condition that affects not only adolescents but also adults. While approximately 80% of cases occurring in adulthood are persistent from teenage years, around 20% are described as 'late-onset' disease, appearing for the first time in adulthood. The disease can be triggered by hormonal changes (including a change from one contraceptive to another), or it can be induced by certain nonhormonal medications, emotional stress, and various underlying diseases such as polycystic ovary syndrome. In many cases acne becomes a chronic skin condition with undulating activity, including improvement and relapse phases, and is often experienced as a major psychological burden. It is, therefore, even more important to provide an effective as well as a safe and tolerable treatment. The spectrum of topical acne treatments has expanded substantially in recent years and various topical medications are available, ranging from azelaic acid, antibiotics, retinoids and benzoyl peroxide to several fixed combinations of these active compounds. The following case collection illustrates how 15% azelaic acid gel, as a well-established monotherapy, can be successfully employed to treat mild-to-moderate forms of adult female acne.

  5. Backpack palsy: A rare complication of backpack use in children and young adults - A new case report.

    Science.gov (United States)

    Rose, Katy; Davies, Anne; Pitt, Matthew; Ratnasinghe, Didi; D'Argenzio, Luigi

    2016-09-01

    Backpack palsy is a well-recognised, albeit rare, complication of carrying backpacks. Although it has been mostly described in cadets during strenuous training, sporadic cases of brachial nerve impairment have been reported in children and young adults. Here we reported the case of a 15-year-old girl who presented with a left-side brachial palsy with axonal denervation of C5C7 motor roots following a school challenge for the Duke of Edinburgh Award. Her symptoms began soon after starting the challenge and included weakness of shoulder abduction and elevation, as well as forearm, wrist and fingers extension. After 6 months of physiotherapy her motor function was completely restored. Backpack palsy can sometimes present in children and young adults. This disorder should be taken in consideration when planning for daily, as well as more challenging, physical activities in these age groups.

  6. Ileoileal intussusception caused by ileal lymphangioma in an adult: A rare case report

    Directory of Open Access Journals (Sweden)

    Omer Topuz

    2015-02-01

    Full Text Available We experienced a case of intussusception caused by ileal lymphangioma in a 26-year-old female who was referred to emergency service with acute abdominal pain. Abdominal ultrasonography and computed tomography revealed ileoileal intussusception. An emergent operation was performed. On histopathologic examination, cystically dilated spaces lined by endothelium and septated by fibrous septa were present. The pathological diagnosis was lymphangioma of the ileum. Al- though intussusceptions due to lymphangioma in an adult are rare, it should be kept in mind that it is a possible diagnosis. [Arch Clin Exp Surg 2015; 4(1.000: 57-59

  7. Cystic lymphangioma of the jejunal mesentery in an adult: A case report

    Institute of Scientific and Technical Information of China (English)

    Chuang-Wei Chen; Sheng-Der Hsu; Chien-Hua Lin; Ming-Fang Cheng; Jyh-Cherng Yu

    2005-01-01

    We herein describe the case of a 27-year-old female, who presented with a large mass of the upper left abdominal cavity discovered incidentally, through an annual health examination. Preoperative studies including abdominal ultrasonography and magnetic resonance imaging were performed, but they could not accurately determine the nature of the tumor. At laparotomy, a large cystic tumor of the small bowel mesentery was found. Histopathologic examination diagnosed the tumor as a cystic lymphangioma.Although lymphangiomas are rare, especially in the abdomen of adults, they may sometimes present as acute abdomen,causing complications that require emergent surgery.

  8. Type 1 diabetes complicated with uncontrollable adult cyclic vomiting syndrome: a case report

    OpenAIRE

    Ogiso, Kazuma; Koriyama, Nobuyuki; Akao, Ayako; Otsuji, Mayumi; Goto, Takahiko; Fujisaki, Natsuko; Minobe, Machiko; Kinowaki, Mayumi; Matsuki, Shigeru

    2015-01-01

    We herein describe the case of a 29-year-old woman with type 1 diabetes from 10 years of age who developed adult cyclic vomiting syndrome. Beginning at 25 years of age, she was frequently hospitalized for stress-induced vomiting. Her vomiting episodes developed acutely and remitted after severe vomiting of more than 30 times a day for a few days. The vomiting periods were accompanied by leukocytosis with a predominance of neutrophils, high blood pressure and fever. In addition, it was noted t...

  9. Primary Langerhans cell histiocytosis (LCH in the adult cervical spine: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sang-Deok Kim, M.D.

    2017-03-01

    Full Text Available Langerhans cell histiocytosis (LCH of the spine is a common benign disease in children and adolescents that rarely affects adults. Main management of single lesion (unifocal vertebral LCH is conservative method, unless there is neurological deficit due to mass effect, surgery must be considered. This is an interesting and rare case report of the patient with LCH at C5 vertebral body who underwent fusion surgery.

  10. Adult Presentation of Dyke-Davidoff-Masson Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Ujjawal Roy

    2016-01-01

    Full Text Available Dyke-Davidoff-Masson syndrome (DDMS is a rare disease which is clinically characterized by hemiparesis, seizures, facial asymmetry, and mental retardation. The classical radiological findings are cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses. This disease is a rare entity, and it mainly presents in childhood. Adult presentation of DDMS is unusual and has been rarely reported in the medical literature. Key Messages: DDMS is a rare disease of childhood. However, it should be kept in mind as a diagnostic possibility in an adult who presents with a long duration of progressive hemiparesis with seizures and mental retardation. Cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses are diagnostic for this illness on brain imaging.

  11. Adult-Onset Type 1 Diabetes and Pregnancy: Three Case Reports

    Directory of Open Access Journals (Sweden)

    Barbara Bonsembiante

    2013-01-01

    Full Text Available From 5% to 10% of diabetic patients have type 1 diabetes. Here we describe three cases of adult-onset type 1 diabetes in pregnancy treated at our clinic between 2009 and 2012. Two patients came for specialist examination during pregnancy, the third after pregnancy. These women had no prior overt diabetes and shared certain characteristics, that is, no family diabetes history, age over 35, normal prepregnancy BMI, need for insulin therapy as of the early weeks of pregnancy, and high-titer anti-GAD antibody positivity. The patients had persistent diabetes after delivery, suggesting that they developed adult-onset type 1 diabetes during pregnancy. About 10% of GDM patients become pancreatic autoantibody positive and the risk of developing overt diabetes is higher when two or more autoantibodies are present (particularly GAD and ICA. GAD-Ab shows the highest sensitivity for type 1 diabetes prediction. We need to bear in mind that older patients might conceivably develop an adult-onset type 1 diabetes during or after pregnancy. So we suggest that women with GDM showing the described clinical features shall be preferably tested for autoimmunity. Pregnant patients at risk of type 1 diabetes should be identified to avoid the maternal and fetal complications and the acute onset of diabetes afterwards.

  12. Adult brain abscess associated with patent foramen ovale: a case report

    Directory of Open Access Journals (Sweden)

    Stathopoulos Georgios T

    2007-08-01

    Full Text Available Abstract Brain abscess results from local or metastatic septic spread to the brain. The primary infectious site is often undetected, more commonly so when it is distant. Unlike pediatric congenital heart disease, minor intracardiac right-to-left shunting due to patent foramen ovale has not been appreciated as a cause of brain abscess in adults. Here we present a case of brain abscess associated with a patent foramen ovale in a 53-year old man with dental-gingival sepsis treated in the intensive care unit. Based on this case and the relevant literature we suggest a link between a silent patent foramen ovale, paradoxic pathogen dissemination to the brain, and development of brain abscess.

  13. Persistent bilateral anterior hip pain in a young adult due to meralgia paresthetica: a case report.

    Science.gov (United States)

    Shetty, Vijay D; Shetty, Gautam M

    2008-12-15

    We describe a case report where a young woman presented with persistent bilateral anterior hip pain whose diagnosis was obscure for many months. The symptoms started three months after she underwent laparoscopic surgery, with entry portals on both iliac regions of her abdomen. After a thorough clinical examination, a working diagnosis of "Meralgia paresthetica" was made. She responded well to diagnostic block supplemented with local steroids. To our knowledge, this is the first ever case report of a bilateral meralgia paresthetica presenting as bilateral persistent anterior hip pain following a laparoscopic procedure.

  14. Orthodontic treatment in adult with type I temporomandibular dysfunction : A case report

    Directory of Open Access Journals (Sweden)

    A Sai Prakash

    2012-01-01

    Full Text Available The relationship between occlusion and TMJ has been the subject of considerable controversy. It is widely believed that the TMJ signs and symptoms such as Joint pain, clicking, locking and headaches are secondary to abnormalities of occlusion, with actual derangement being uncommon. This case report is to put forward the hypothesis that, type I TMD is often due primarily to occlusal interferences for which orthodontic treatment is generally effective. This case report underlines the significance of fixed orthodontic appliance along with the anterior bite plane splint used in correction of type I TMD.

  15. Low grade astrocytoma transformating primitive neuroectodermal tumour in an adult? A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Xiaofeng Wang; Yuqiang Sun; Zeshi Tan; Anlong Ji; Xu Sun; Xinyu Li; Ningwei Che

    2016-01-01

    Background:Supratentorial primitive neuroectodermal tumors (sPNET) are rarely occurred in adults.Only 39 cases have been reported in the past decade.The transformation from low grade to aggressive astrocytoma is well known.However,such convert from a low-grade astrocytoma (LGA) into a sPNET between two completely different tumors is rarer.Case Presentation:This report discussed a 36-year-old male,who presented with the chief complaint of partial seizures and left limbs dysfunction and Magnetic resonance imaging (MRI) of whom revealed right frontal lesions which was operated to resect accompanied by the histological diagnosis of sPNET.The patient underwent operation 2.5 years ago because of seizures and was diagnosed with right frontal astrocytoma confirmed by pathology.However,radiotherapy was not preformed on him after the primary surgery.Histology now revealed high grade PNET.Conclusion:It is exactly uncertain that reports revelant to transformation from low-grade astrocytoma to a new kind of tumor or neoplasm induced by radiotation have been published.This case report is accompanied by a review of 39 cases of adult sPNET in the past decade,especially discussing about the transformation of low grade glioma into sPNET.

  16. Case Report

    DEFF Research Database (Denmark)

    Søborg, Marie-Louise Kulas; Rosenberg, Jacob; Burcharth, Jakob

    2016-01-01

    neuropathy (AMSAN). Reports of AMSAN with onset after epidural anesthesia and spinal surgery are extremely rare, and the linkage between development of GBS and neuroaxial anesthesia remains conclusively unconfirmed. We present a case in which the patient developed subacute motor and predominantly sensory...... neuropathy following epidural blockade. The case emphasizes the need of including AMSAN in differential diagnostic considerations to changes in motor and sensory function following epidural anesthesia, allowing accelerated rehabilitation and relevant alleviating therapy....

  17. Hyperinsulinemic hypoglycemia due to diffuse nesidioblastosis in adults: A case report

    Institute of Scientific and Technical Information of China (English)

    Ran Hong; Dong-Youl Choi; Sung-Chul Lim

    2008-01-01

    Persistent hyperinsulinemic hypoglycemia is caused most commonly by an insulinoma in adults or by nesidioblastosis in neonates. In adults, nesidioblastosis is a rare disorder characterized by diffuse or disseminated proliferation of islet cells. We recently encountered a case of nesidioblastosis in an adult. A 71-year-old man was admitted due to intermittent general weakness, abdominal pain, and mild dyspnea. The patient underwent a subtotal gastrectomy for a gastric adenocarcinoma two years ago. After 5 d of admission, the patient showed symptoms of cold sweating, chilling, and hypotension 30 rain after eating. Thereafter,he frequently showed similar symptoms accounting for hypoglycemia regardless of food consumption. Laboratory findings revealed a low fasting blood glucose level (25 mg/dL), and a high insulin level (47 μIU/mL). Selective intra-arterial calcium stimulation with hepatic venous sampling (ASVS) was performed to localize a mass and revealed an increased insulin level about four-fold that of the normal fasting level at 60 s in the splenic artery, which suggested the presence of an insulinoma in the tail of pancreas. A distal pancreatectomy was performed. Neither intraoperative exploration nor a frozen biopsy specimen detected any mass-forming lesion. On the histological examination, many of the islets were enlarged and irregularly shaped in all specimens, the arrangement of which was a Iobulated islet pattern. Cytologically, a considerable subpopulation of endocrine cells showed enlarged and hyperchromatic nuclei. By immunohistochemistry, the cells were identified as β-cells. These clinical, radiological, microscopic and immuno-histochemical findings are consistent with diffuse nesidioblastosis in adults.

  18. Right pulmonary artery agenesis presenting with uncontrolled asthma in an adult: a case report

    Directory of Open Access Journals (Sweden)

    Thammasitboon Supat

    2011-08-01

    Full Text Available Abstract Introduction Unilateral absence of the pulmonary artery (UAPA or pulmonary artery agenesis is a rare congenital disorder presenting with a wide spectrum of symptoms. The clinical presentation is variable and many patients can be asymptomatic for many years and even throughout their lives. Case presentation We report the case of a 53-year-old African-American woman who was diagnosed with right pulmonary artery agenesis after presenting with uncontrolled asthma and recurrent bronchopulmonary infections. Conclusion In an unexplained case of recurrent respiratory infections and shortness of breath, the possibility of a rare congenital anomaly like UAPA should be considered and an appropriate evaluation should be done.

  19. Isolated jejunal perforation following bicycle handlebar injury in adults: a case report.

    Science.gov (United States)

    Neofytou, Kyriakos; Michailidou, Maria; Petrou, Athanasios; Loizou, Sakis; Andreou, Charalampos; Pedonomou, Marios

    2013-01-01

    The small intestine is the third in frequency intraperitoneal organ which is injured after blunt trauma of the abdomen. In most of the cases, this type of injuries is accompanied by other injuries, which make it more difficult to diagnose. Failure of diagnosis and delay in treating these injuries significantly increase the morbidity and mortality of these patients. Abdominal visceral injuries after flipping the handlebar of the bike are common in children. Such injuries can cause injury to both solid and hollow abdominal viscera. Unlike children, adults' abdominal visceral injuries after flipping the bike's handlebar are extremely rare. A 25-year-old man was admitted to our department due to progressively abdominal pain after an accident with the handlebar of his bike. The subsequent CT scan after per os administration of contrast medium revealed the presence of free intraperitoneal contrast. It is a rare case of jejunal perforation after flipping the handlebar of the bicycle which was treated by partial removal of the injured part of jejunum and end-to-end anastomosis. To the best of our knowledge this is the first time we describe such an injury with this mechanism to an adult.

  20. Renal carcinoma with (6;11)(p21;q12) translocation: report of an adult case.

    Science.gov (United States)

    Ishihara, Akira; Yamashita, Yasuhiro; Takamori, Hiroki; Kuroda, Naoto

    2011-09-01

    An extremely rare adult example of renal carcinoma with t(6;11)(p21;q12 or q13) is presented here. The tumor of a 45-year-old Japanese male, excised under the diagnosis of renal cell carcinoma, was a well circumscribed 7 cm mass with light brown sectioned surfaces. Histologically, it was composed of a major population of large polygonal epithelioid cells in a nested alveolar growth and a subpopulation of smaller cells clustering around hyaline basement membrane material. The former cells possessed ample, clear to eosinophilic granular cytoplasm with well-defined cell borders and the latter was frequently accompanied by psammomatous calcification. These tumor cells exhibited immunoreactivity for melanoma markers, transcription factor EB and cathepsin K, but were not reactive for epithelial markers and transcription factor E3. While pulmonary metastatic foci that were noted preoperatively progressed rapidly following interferon-based therapy, subsequent sunitinib malate yielded a partial response and stabilized the lung metastasis for 6 months after surgery. We could trace 20 cases of 6p21 translocation renal carcinoma, among which only four were in individuals older than 40 years. Description of a new case like this is important since little is known about the prognosis and treatment of adult patients with this condition.

  1. Advanced and recurrent testicular rhabdomyosarcoma in a young adult: A rare case report

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    L Purnima Devi

    2015-01-01

    Full Text Available Rhabdomyosarcoma (RMS is one of the most frequent soft tissue sarcomas. Pure testicular RMS is a very rare tumor and a few cases have been reported in the literature. We report a 16-year-old male patient with a painless right testicular swelling who underwent high inguinal orchiectomy and diagnosed as testicular embryonal RMS. The patient had a rare recurrence at the scrotal site with inguinal and retroperitoneal metastasis.

  2. Chronic intussuception due to ileocaecal tuberculosis in a young adult with severe anemia: Case report with literature review

    Directory of Open Access Journals (Sweden)

    Mahesh Gupta

    2010-01-01

    Full Text Available Context : Intestinal intussuception in an adult is a rare entity that differs in etiology from its pediatric counterpart owing to underlying pathologic lead points in adults, mostly neoplasms. The main clinical presentation in chronic intussuception in adults remains dull abdominal pain, and acute intussuception is uncommon. Computed tomography (CT remains the diagnostic modality of choice and surgical resection is the optimal treatment. Case Report : We report a case of chronic intussuception in a young adult presenting with severe anemia and chronic abdominal pain in right hypochondrium and lumbar region. Pre operative diagnosis of chronic ileocolocolic intussuception was made on the basis of ultrasound, barium and CT scan findings. Exploratory laparotomy was done and right hemicolectomy with end to end anastomosis was performed. Histopathological examination of resected specimen revealed presence of tuberculosis in the mass along with mesenteric lymph nodes involvement. Postoperative recovery was uneventful and he was put on antitubercular drugs. In follow-up the patient is asymptomatic. Conclusion : Chronic ileocolocolic intussuception due to tuberculosis should be considered as a possible cause of intestinal obstruction in young patients presenting with vague abdominal pain and severe anemia even in the absence of any specific medical history.

  3. An Interdisciplinary Approach in Rehabilitation of an Adult Mutilated Dentition with Multiple Missing Permanent Teeth--A Case Report.

    Science.gov (United States)

    Agrawal, Sarvesh; Jose, Nidhin Philip; Bandi, Rohan S; Jain, Nimit; Rodrigues, Shobha J

    2015-01-01

    Adult orthodontics has been an area of increasing focus in recent times. Comprehensive treatment of adults is more challenging due to a myriad of problems that coexist in an adult that makes treatment planning more challenging. A large number of individuals seek dental care because of aesthetic reasons, that is, the desire to look more attractive by improving their smiles. The role an attractive smile plays on a person's self-image and confidence cannot be overemphasized. Evaluating and treating patients for the purpose of smile design often involves a multi-discipline approach. Achieving an ideal smile may require orthodontics, orthognathic surgery, periodontal therapy, including soft tissue repositioning and bone re-contouring, cosmetic dentistry, and plastic surgery. This aesthetic approach to patient care produces the best dental and dental-facial beauty. This paper describes a case report in which an orthodontist, an endodontist, and a prosthodontist worked as a team to improve the patients smile and confidence.

  4. Liver transplant for adult hemophagocytic lymphohistiocytosis: case report and literature review.

    Science.gov (United States)

    Wright, Gavin; Wilmore, Stephanie; Makanyanga, Jessica; McKerrell, Thomas; Watkins, Jennifer; Patch, David; Burroughs, Andrew K

    2012-10-01

    We report the case of a middle-aged man who died from multiorgan failure 3 weeks after orthotopic liver transplant for fulminant hepatic failure, associated with a rare, often fatal, hematologic condition that usually presents in childhood. We discuss the importance of its diagnosis, treatment, and implications for liver transplant.

  5. 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.

  6. Case report

    African Journals Online (AJOL)

    abp

    16 déc. 2015 ... C'est un cancer à évolution locorégionale, rarement extra pelvienne ... carcinomateux TTF1 négatif, p63 négatif et p16 fortement positif compatible .... cervix presenting as lymphangiticcarcinomatosis: a case report and reviex ...

  7. OK432 (picibanil) efficacy in an adult with cystic cervical lymphangioma. A case report.

    Science.gov (United States)

    Alonso, Juan; Barbier, Luis; Alvarez, Julio; Romo, Laura; Martín, Jesús C; Arteagoitia, Iciar; Santamaría, Joseba

    2005-01-01

    Cervical cystic lymphangioma (CCL) is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. The most accepted treatment continues to be surgical excision. However, when this infiltrates vital neurovascular neck structures, complete excision is difficult and if only partial, the recurrence rate is very high. The most frequently used alternative treatment is to inject sclerosants into the lesion. The use of these techniques has reported good results in children; however, there are few references thereof with regard to adults. We are reporting on a cervical cystic lymphangioma in a male aged 22, treated with an intra-lesion injection of 20 cc with 0.01 mg/cc dilution of OK-432 (picibanil) in physiological serum. Sole complications were fever and local reaction where the solution was injected. One month after treatment the lymphangioma had totally remitted and sixteen months later continues in remittance.

  8. Acute hemicerebellitis in a young adult: a case report and literature review.

    Science.gov (United States)

    Suzuki, Keisuke; Nakamura, Toshiki; Numao, Ayaka; Fujita, Hiroaki; Komagamine, Tomoko; Nagashima, Takahide; Asakawa, Yohei; Watanabe, Yuji; Takekawa, Hidehiro; Hirata, Koichi

    2014-12-15

    Acute hemicerebellitis, marked by headache with or without cerebellar signs, is a rare clinical entity involving a unilateral cerebellar hemisphere. The pathogenesis of acute hemicerebellitis remains unclear, and the disease rarely occurs in adults. Here, we report an 18-year-old woman who presented with a lack of coordination of the right hand and leg lasting longer than one week, following a pulsatile headache. A neurological examination disclosed ocular dysmetria, right-sided limb ataxia and slight truncal ataxia. Cerebrospinal fluid analysis showed mononuclear pleocytosis. The serology and autoimmune studies were unremarkable. Brain magnetic resonance imaging (MRI) revealed a focal signal change in the right cerebellar hemisphere and vermis. Acute hemicerebellitis was diagnosed, and the patient was treated with intravenous methylprednisolone sodium succinate and acyclovir. Subsequently, the headache resolved, and the cerebellar signs were markedly improved. Twenty days after admission, she became asymptomatic and brain MRI showed resolution of cerebellar hyperintensity on the right side. In conclusion, we identified only 6 additional patients with adult-onset acute hemicerebellitis from previous reports, highlighting the importance of recognizing this rare clinical entity. Its clinical outcome is usually favorable, but in the acute phase, attention should be directed toward clinical symptoms that are suggestive of increased intracranial pressure.

  9. GATA1 mutation negative acute megakaryoblastic leukemia with acquired trisomy 21 presenting with extensive bone marrow necrosis in an adult: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Todd P. Williams

    2016-03-01

    Conclusions: To our knowledge, this is the first reported case of an adult with AMKL with acquired trisomy 21 in which the GATA1 mutation was investigated and the second reported case of AMKL presenting with extensive bone marrow necrosis. We will present a diagnostic approach to AMKL in which extensive bone marrow necrosis renders examination of the bone marrow difficult. Furthermore, we will examine the absence of the GATA1 mutation in a case of AMKL with trisomy 21 in an adult.

  10. Invasive polyarticular septic arthritis caused by nontypeable haemophilus influenzae in a young adult: a case report and literature review.

    Science.gov (United States)

    Kim, Jong Hun; Muto, Carlene A; Pasculle, A William; Vergis, Emanuel N

    2011-10-01

    Nontypeable Haemophilus influenzae is a rare cause of septic arthritis in adults and has been reported to be associated with underlying medical conditions. We present a case of nontypeable H. influenzae-infected severe invasive polyarticular septic arthritis in a young adult without any underlying predisposing medical conditions. Diagnosis was made from both positive blood culture and joint aspiration culture. The patient was successfully treated with employment of aggressive surgical debridement of multiple affected septic joints as well as prolonged antibiotic treatment. Further laboratory testing did not reveal significant underlying medical conditions including negative HIV, normal levels of complement and IgG subclasses, and normal-appearing spleen on computed tomography. This case illustrates that nontypeable H. influenzae can cause serious invasive septic arthritis infection in both patients with and without predisposing underlying medical conditions and that prompt diagnosis with aggressive treatment of combined surgical and medical treatment can result in optimal recovery.

  11. Adult proximal humerus locking plate for the treatment of a pediatric subtrochanteric femoral nonunion: a case report.

    Science.gov (United States)

    Cortes, Luis E; Triana, Miguel; Vallejo, Francisco; Slongo, Theddy F; Streubel, Philipp N

    2011-07-01

    Nonunions of pediatric subtrochanteric femur fractures are exceedingly rare and have to date not been reported in the literature. We present the case of an 11-year-old boy who developed such a nonunion after open reduction internal fixation using a pediatric locked proximal femur plate. Using an adult proximal humerus locking plate, adequate proximal fixation of the nonunion was obtained. Furthermore, previously placed distal screw holes were safely bridged and the biomechanical environment around the nonunion site improved. Uneventful healing was possible with the use of adjuvant bone grafting. No short- or midterm complications occurred. Although other implants can certainly be adapted to a use different than that of its original design, the present case suggests that adult proximal humerus locking plates may be a safe option for revision surgery of the proximal pediatric femur.

  12. Bradycardia Associated with Steroid Use for Laryngeal Edema in an Adult: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Preeti R. John

    2016-01-01

    Full Text Available Steroids are used for specific indications in the perioperative period to reduce laryngeal or spinal cord edema, or for prophylaxis and treatment of postoperative nausea and vomiting. Given the other potential causes for hemodynamic alterations in the perioperative setting, it is important for physicians to be aware of cardiovascular side effects of short term steroids. Changes in blood pressure and heart rate, cardiac dysrhythmias, and even death have been described in patients receiving short term intravenous steroids. Bradycardia has been reported following short term methylprednisolone and dexamethasone therapy in both adult and pediatric patients. There are only two case reports in the literature of bradycardia following short term intravenous dexamethasone use in adult patients. This is the first case report that describes bradycardia following the use of dexamethasone in the postoperative setting for management of laryngeal edema in an adult. Telemetry and twelve lead electrocardiograms revealed sinus bradycardia and correlated directly with administration of dexamethasone in our patient. Bradycardia resolved following discontinuation of dexamethasone. We advocate for hemodynamic monitoring in patients receiving more than one dose of intravenous steroid therapy in the perioperative period, especially those with known cardiac and hepatic comorbidities and those taking medications with negative chronotropic effects.

  13. CAVERNOUS LYMPHANGIOMA OF THE TONGUE IN AN ADULT: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Selin EREN

    2017-04-01

    Full Text Available Lymphangioma is a benign hamartomatous lesion caused by congenital malformation of the lymphatic system. This benign tumor is detected most commonly at birth or in early childhood but rarely in adults. On clinical examination, most lymphangiomas contain clear lymph fluid, but some may present as transparent vesicles containing red blood cells due to hemorrhage. In addition, lymphangioma may occur in association with hemangioma. This tumor occurs most commonly in the head and neck area, but rarely in the oral cavity. The dorsum of the tongue is the most common location in the mouth, followed by the lips, buccal mucosa, soft palate, and floor of the mouth. There are various treatment approaches for lymphangioma, but surgical excision is the preferred method. We present a case of a 26-year-old man with lymphangioma on the anterior dorsal part of the tongue, not associated with any dysfunction in mastication or speech disorders.

  14. [Case report - Intraosseous infusion as an alternative solution in the therapy of septicaemia in an adult].

    Science.gov (United States)

    Lingner, Manuel; Niederer, Oliver; Majolk, Jürgen; Krombholz, Karsten

    2014-02-01

    The intraosseous access can be more often found in the guidelines and recommendations of the medical societies when an peripheral or central venous catheter cannot be established. For the adult this can mostly be found for the cardiopulmonary resuscitation or the patient with major trauma. In pediatrics and neonatology it is a reliable solution for the child in septic shock. In our case a 36 year old presented with an endocarditis and tricuspid valve insufficiency III° by known intravenous drug-abuse and septic shock. It was initially impossible to establish an adequate peripheral or central venous catheter. For this reason a humeral intraosseous access was established. After stabilizing circulatory function and volume replacement a central-venous catheter could be placed and the patient was successfully surgically sanified. We used the EZ-IO((Vidacare Corporation, San Antonio/USA). Appropriate systems should extensively be available in the clinical setting.

  15. 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.

  16. Atlanto axial rotatory dislocation in adults: a rare complication of an epileptic seizure--case report.

    Science.gov (United States)

    Tarantino, Roberto; Donnarumma, Pasquale; Marotta, Nicola; Missori, Paolo; Viozzi, Ilaria; Landi, Alessandro; Delfini, Roberto

    2014-01-01

    Atlanto Axial Rotatory Dislocations (AARDs) are a heterogeneous group of post-traumatic pathologies typical of the pediatric age, and rare in adults. We describe the case of a 34-year-old woman, developing Atlanto Axial Rotatory Fixation (AARF) after a generalized tonic-clonic epileptic seizure, an extremely rare traumatic cause never described in literature. AARF was detected only 1 month after the accident and nonsurgical treatment was attempted at the beginning. The patient underwent surgery only 2 months after the accident. The best treatment should be conservative reduction within 1 month; when it is not possible, it is advisable to perform surgery as soon as possible. C1-C2 fixation with Harm's technique is the gold standard for fixed luxations. Delay of treatment makes intraoperative reduction more difficult and increase the establishment of the chronic permanent change of neck muscles and ligaments.

  17. Atlanto Axial Rotatory Dislocation in Adults: A Rare Complication of an Epileptic Seizure—Case Report

    Science.gov (United States)

    TARANTINO, Roberto; DONNARUMMA, Pasquale; MAROTTA, Nicola; MISSORI, Paolo; VIOZZI, Ilaria; LANDI, Alessandro; DELFINI, Roberto

    2014-01-01

    Atlanto Axial Rotatory Dislocations (AARDs) are a heterogeneous group of post-traumatic pathologies typical of the pediatric age, and rare in adults. We describe the case of a 34-year-old woman, developing Atlanto Axial Rotatory Fixation (AARF) after a generalized tonic-clonic epileptic seizure, an extremely rare traumatic cause never described in literature. AARF was detected only 1 month after the accident and nonsurgical treatment was attempted at the beginning. The patient underwent surgery only 2 months after the accident. The best treatment should be conservative reduction within 1 month; when it is not possible, it is advisable to perform surgery as soon as possible. C1–C2 fixation with Harm's technique is the gold standard for fixed luxations. Delay of treatment makes intraoperative reduction more difficult and increase the establishment of the chronic permanent change of neck muscles and ligaments. PMID:24201098

  18. Preformed stainless steel crown in special conditions in adults: Two case reports.

    Science.gov (United States)

    Madhu, S

    2015-01-01

    Stainless steel crowns (SSC) are extensively used in child patients. They are mainly used following the pulp therapy in deciduous teeth. They are also used in multi-surface restoration, as an abutment in space maintainers, correction of anterior tooth cross bite, restoration of hypoplasic teeth, etc. In permanent teeth, they are mainly used as interim restorations following root canal treatment in first molars prior to the eruption of permanent second molars. The main advantage of SSC is its limited chair side time, durability and ease of placement. Patients with conditions such as pregnancy and old age who cannot tolerate multiple and long appointments can greatly benefit from the use of SSC. Though SSC can be used by other dental specialties very effectively, its use seems to be limited to pediatric dentistry. Presented here are few adult cases in which SSC is given with good success.

  19. Preformed stainless steel crown in special conditions in adults: Two case reports

    Directory of Open Access Journals (Sweden)

    S Madhu

    2015-01-01

    Full Text Available Stainless steel crowns (SSC are extensively used in child patients. They are mainly used following the pulp therapy in deciduous teeth. They are also used in multi-surface restoration, as an abutment in space maintainers, correction of anterior tooth cross bite, restoration of hypoplasic teeth, etc. In permanent teeth, they are mainly used as interim restorations following root canal treatment in first molars prior to the eruption of permanent second molars. The main advantage of SSC is its limited chair side time, durability and ease of placement. Patients with conditions such as pregnancy and old age who cannot tolerate multiple and long appointments can greatly benefit from the use of SSC. Though SSC can be used by other dental specialties very effectively, its use seems to be limited to pediatric dentistry. Presented here are few adult cases in which SSC is given with good success.

  20. Adult-onset juvenile xanthogranuloma of the external auditory canal: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hur, Joon Ho; Kim, Jae Kyun; Seo, Gi Young; Choi, Woo Sun; Byun, Jun Soo; Lee, Woong Jae; Lee, Tae Jin [Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul (Korea, Republic of); Kim, Na Ra [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2016-05-15

    Juvenile xanthogranuloma (JXG) is a benign, spontaneously regressing lesion that usually occurs during the first year of life, but may also occur in adulthood. Although the most common presentation of JXG is the cutaneous lesion, it can also manifest in various visceral organs. JXG of the external auditory canal is extremely rare, and there have been only a few reports of those cases in the English literature. In this study, we present a case of pathologically proven JXG that occurred in the external auditory canal with a symptomatic clinical presentation.

  1. [Tongue retraining and occlusal stability in a young adult. Case report].

    Science.gov (United States)

    Houb-Dine, Afaf; Bahije, Loubna; Zaoui, Fatima

    2012-01-01

    The clinical observation describes the case of a 20-year-old woman who has consulted for aesthetic and functional reasons. She presents a skeletal class III normodivergent, an occlusal class III with a lower proalveoli quite marked. In addition, a lingual dysfunction which manifests itself by important anterior diastema and dento-dental disharmony at the upper jaw complicates the case. The undertaken therapeutic project starts with a first step of a lingual praxis rehabilitation, followed by an orthodontic step and upper lateral incisors-plasty. The purpose of those results is the evaluation of the stability two years later, which was reported positive.

  2. Kidney and Pancreatic Extramedullary Relapse in Adult Acute Lymphoblastic Leukemia: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Leslie Skeith

    2013-01-01

    Full Text Available Extramedullary relapse of acute lymphoblastic leukemia (ALL is rare and has been primarily reported in pediatric patients or hematopoietic stem cell transplant recipients. We report a case of a 62-year-old woman who presented with relapsed ALL involving her kidneys, pancreas, and bone marrow 2 years after completing chemotherapy with a standard ALL protocol. Unfortunately, her extramedullary disease progressed despite treatment. To the best of our knowledge, this is the first reported case of extramedullary relapse of B-cell ALL to the kidneys and pancreas occurring in an adult patient who had not previously undergone a hematopoietic stem cell transplant. A literature review of kidney and pancreatic extramedullary relapse in ALL is also included.

  3. Primary extraskeletal peripheral primitive neuroectodermal tumor of subcutaneous tissue neck in a young adult: A rare case report

    Directory of Open Access Journals (Sweden)

    Sumeet Aggarwal

    2016-01-01

    Full Text Available Primitive neuroectodermal tumors (PNETs are poorly differentiated small round cell neoplasms which primarily affect childhood age and very rarely seen in adults. Peripheral PNET (pPNET cases are very rare compared to central PNET, and most of them originate from neural crest cells located outside the central nervous system. We report a case of large extraosseous pPNET arising from subcutaneous tissue of left side neck in a young male patient. Despite aggressive inherent nature of histology, structural complexity of neck area and poor predictors like tumor size >6 cm, extraosseous nature, this case advocate that complete resolution is possible with aggressive multimodal treatment including surgery, radiation therapy, and chemotherapy. Other major concerns in such cases of pPNET are difficulty in diagnosis due to low incidence, unpredictable site involvement, histological similarity with other round cell tumors and lack of established treatment guidelines.

  4. Cystic dilatation of the common bile duct in adults: report of five cases and review of literature

    Directory of Open Access Journals (Sweden)

    Arruda Pedro Carlos Loureiro de

    2000-01-01

    Full Text Available The authors report five cases of cystic dilatation of the common bile duct Type I (Todani?s classification in adults patients, in Division of General Surgery of a University Hospital, treated over a- 25-year- period from 1974 to 1999, among 16.057 operations, and not previously published. Diagnosis was obtained by operative cholangiogram (OC in the first case, percutaneous transhepatic cholangiogram on the second one (PTHC and by ultrasonography (US, endoscopic retrograde cholangiopancreatography (ERCP, and operative cholangiogram (OC, respectively, on the last three cases. The second patient had an adenocarcinoma arising in the cystic wall associated with peritoneal metastasis. The first two cases were treated by internal drainage and the last three by excision of the cysts and bilioenteric anastomoses. Classification, incidence, etiology, diagnosis, malignization and surgical treatment of biliary cystic disease (BCD were revised, with the conclusion that resection must be the preferable method of treatment, when possible, especially due to the concern of malignization.

  5. Adult Patients with Congenital Muscular Torticollis Treated with Bipolar Release: Report of 31 Cases

    Science.gov (United States)

    Lee, Gun Sang; Lee, Myung Ki; Kim, Woo Jae; Kim, Ho Sang; Kim, Jeong Ho; Kim, Yun-Suk

    2017-01-01

    Objective We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. Methods Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12–30). The mean age at time of surgery was 30.3 years (range, 20–54). Patients were evaluated with a modified Lee’s scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting. Results The modified Lee’s scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (pSCM is a safe and reliable technique for the treatment of CMT in adults. PMID:28061496

  6. Barber Pole Sign in CT Angiography, Adult Presentation of Midgut Malrotation: A Case Report

    Science.gov (United States)

    Garcelan-Trigo, Juan Arsenio; Tello-Moreno, Manuel; Rabaza-Espigares, Manuel Jesus; Talavera-Martinez, Ildefonso

    2015-01-01

    Adult midgut volvulus is a challenging diagnosis because of its low incidence and nonspecific symptoms. Diagnostic delay and long-term complaints are frequent in this clinical scenario. We reported a patient referred to our diagnostic imaging unit with intermittent abdominal pain, bloating and episodic vomiting for several years. He underwent barium gastrointestinal transit and abdominal ultrasound, which revealed severe gastric dilatation, food retention and slow transit until a depressed duodenojejunal flexure, with malrotation of the midgut and jejunal loops being located in the right upper quadrant. Computed tomography angiography was performed, showing rotation of the small intestine around the mesentery root, suggestive of midgut malrotation. In addition, an abnormal twisted disposition of superior mesenteric artery with corkscrew appearance was seen, shaping the pole-barber sign which was evident in volume rendering three-dimensional reconstructions. The patient underwent scheduled surgical treatment without any complication and had good outcome after hospital discharge and follow-up. Computed tomography plays an important role in evaluation of adult midgut volvulus. In addition, angiographic reconstructions can help us to assess the anatomic disposition of mesenteric vascular supply. Both of these assessments are useful in preoperative management. PMID:26557278

  7. Barber Pole Sign in CT Angiography, Adult Presentation of Midgut Malrotation: A Case Report

    Directory of Open Access Journals (Sweden)

    Garcelan-Trigo

    2015-07-01

    Full Text Available Adult midgut volvulus is a challenging diagnosis because of its low incidence and nonspecific symptoms. Diagnostic delay and long-term complaints are frequent in this clinical scenario. We reported a patient referred to our diagnostic imaging unit with intermittent abdominal pain, bloating and episodic vomiting for several years. He underwent barium gastrointestinal transit and abdominal ultrasound, which revealed severe gastric dilatation, food retention and slow transit until a depressed duodenojejunal flexure, with malrotation of the midgut and jejunal loops being located in the right upper quadrant. Computed tomography angiography was performed, showing rotation of the small intestine around the mesentery root, suggestive of midgut malrotation. In addition, an abnormal twisted disposition of superior mesenteric artery with corkscrew appearance was seen, shaping the pole-barber sign which was evident in volume rendering three-dimensional reconstructions. The patient underwent scheduled surgical treatment without any complication and had good outcome after hospital discharge and follow-up. Computed tomography plays an important role in evaluation of adult midgut volvulus. In addition, angiographic reconstructions can help us to assess the anatomic disposition of mesenteric vascular supply. Both of these assessments are useful in preoperative management.

  8. MULTIPLE CEREBRAL TUBERCULOMAS WITHOUT FOCAL NEUROLOGICAL DEFICIT IN AN IMMUNOCOMPETENT ADULT NIGERIAN:A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Peter Okokhere O.

    2016-12-01

    Full Text Available Multiple cerebral tuberculomas complicating miliary tuberculosis are a rare occurrence. It is rarer still for multiple cerebral tuberculomas to present without focal neurological deficits. We report the case of a middle-aged Nigerian male with the co-morbidity of miliary tuberculosis and multiple cerebral tuberculomaswho presented without focal neurological deficits buthad complete resolution of symptoms and signs following a 6-month course of antituberculous therapy. This unique case emphasizes the need for a high index of suspicion in the diagnosis of atypical presentations of cerebral tuberculomas while also further illustrating the place of computed tomographic scan of the brain in diagnosis. The case also illustrates the place of therapeutic trial in management.

  9. Left paraduodenal hernia in an adult complicated by ascending colon cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Kiyotaka Kurachi; Toshio Nakamura; Tadataka Hayashi; Yosuke Asai; Takayuki Kashiwabara; Akihito Nakajima; Shohachi Suzuki; Hiroyuki Konno

    2006-01-01

    Paraduodenal hernia is the most common internal hernia. The clinical symptoms of paraduodenal hernia may be intermittent and nonspecific. Therefore, it is difficult to diagnose preoperatively. Abdominal computed tomography (CT) scan currently plays an important role in the evaluation and management of paraduodenal hernia before surgical operation. We report one unique case of preoperatively diagnosed left paraduodenal hernia complicated by advanced ascending colon cancer and reviews of Japanese literature.

  10. A HUGE SILENT INTRACRANIA L HYDATID CYST IN AN ADULT MALE: A CASE REPORT

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    Sonal

    2015-04-01

    Full Text Available Hydatid disease of the brain is a rare parasitic infestation caused by larval stage of Echinococcus granulosus. It has an insidious onset with a slow rate of growth resulting in late diagnosis. Its occurence is rare in India, being endemic in Mediterranean countries and Middle East. We report a case of a huge, slow - growing, silent intracranial left parieto - temporo - occipital hydatid cyst in an 18 year old male presenting as a large cystic space occupying lesion.

  11. Adult onset Still's disease accompanied by acute respiratory distress syndrome: A case report.

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    Xi, Xiao-Tu; Wang, Mao-Jie; Huang, Run-Yue; Ding, Bang-Han

    2016-09-01

    Adult onset Still's disease (AOSD) is a systemic inflammatory disorder characterized by rash, leukocytosis, fever and arthralgia/arthritis. The most common pulmonary manifestations associated with AOSD are pulmonary infiltrates and pleural effusion. The present study describes a 40-year-old male with AOSD who developed fever, sore throat and shortness of breath. Difficulty breathing promptly developed, and the patient was diagnosed with acute respiratory distress syndrome (ARDS). The patient did not respond to antibiotics, including imipenem, vancomycin, fluconazole, moxifloxacin, penicillin, doxycycline and meropenem, but was sensitive to glucocorticoid treatment, including methylprednisolone sodium succinate. ARDS accompanied by AOSD has been rarely reported in the literature. In conclusion, in a patient with ARDS who does not respond to antibiotic treatment, the involvement of AOSD should be considered.

  12. Adult Onset Still's Disease With Different Antibodies: A Case Report and Review of Literature

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    Maryam Mobini

    2016-11-01

    Full Text Available  Adult-onset Still’s disease (AOSD is a rare systemic inflammatory disorder of unknown etiology. There is not currently any specific serological markers for AOSD , and  diagnosis still relying on the exclusion of other likely diagnoses. Yamaguchi’s criteria are used as a diagnostic criterion which contains negative serologic markers for other collagen vascular diseases including systemic lupus erythematosus and rheumatoid arthritis. Here we report a 28-year-old woman with arthralgia, fever, rash, leukocytosis, lymphadenopathy, sore throat, abnormal liver function and negative rheumatoid factor and ANA but  seropositive for anti-CCP, anti-dsDNA, and C-ANCA. It seems that despite AOSD is considered as a seronegativedisorder; it should be remembered in patients with compatible findings who are seropositive.

  13. Retroperitoneal primitive neuroectodermal tumor in an adult: A rare case report and review of the literature

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    Kavita Mardi

    2016-01-01

    Full Text Available Primitive neuroectodermal tumor (PNET and Ewing's sarcoma (EWS are small round cell tumors occurring mainly in children and adolescents. Their occurrence in adults is rare. The abdominal cavity and retroperitoneal PNET/EWS are also relatively rare, grow rapidly in size, compressing surrounding organs/large vessels, and make surgical resection difficult. We report one such rare occurrence of a retroperitoneal PNET in 41-year-old male who presented with abdominal pain and constipation. Contrast enhanced computed tomography abdomen showed large lobulated necrotic hypodense enhancing lesion extending from epigastrium to hypogastrium and involving entire abdomen. Excision of retroperitoneal mass with omentectomy was done. Microscopic examination revealed a malignant small round cell tumor with homer wright rosettes and the tumor cells were positive for CD99.

  14. Adult Onset Still's Disease With Different Antibodies: A Case Report and Review of Literature.

    Science.gov (United States)

    Mobini, Maryam; Ghasemian, Roya; Zameni, Fatemeh

    2016-10-01

     Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. There is not currently any specific serological markers for AOSD , and  diagnosis still relying on the exclusion of other likely diagnoses. Yamaguchi's criteria are used as a diagnostic criterion which contains negative serologic markers for other collagen vascular diseases including systemic lupus erythematosus and rheumatoid arthritis. Here we report a 28-year-old woman with arthralgia, fever, rash, leukocytosis, lymphadenopathy, sore throat, abnormal liver function and negative rheumatoid factor and ANA but  seropositive for anti-CCP, anti-dsDNA, and C-ANCA. It seems that despite AOSD is considered as a seronegativedisorder; it should be remembered in patients with compatible findings who are seropositive.

  15. Scorpion sting envenomation presenting with pulmonary edema in adults: A report of seven cases from Nepal

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    Bhadani Umesh

    2006-01-01

    Full Text Available Scorpion sting is a common problem in villages of Eastern Nepal. The life-threatening complications of myocarditis and pulmonary edema is known in red scorpion in India but not reported in Nepal. This condition requires urgent attention and ICU care from few hours to days. Delay in recognition and the hypoxemia increase the morbidity and mortality. Illiteracy, ignorance, poverty, traditional faith healers trying treatment in remote areas, lack of transport in difficult terrains and the non availability of ventilation facility in nearby hospital, add to delay in appropriate treatment. Seven young adult patients admitted in a span of two years with history of scorpion sting presenting with pulmonary edema required ICU care. They were successfully managed with the positive pressure ventilation with PEEP, cardiac support with inotropes and fluid balance. Magnitude of problem, clinical presentation and management done is emphasized.

  16. Isolated Jejunal Perforation Following Bicycle Handlebar Injury in Adults: A Case Report

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    Kyriakos Neofytou

    2013-01-01

    Full Text Available The small intestine is the third in frequency intraperitoneal organ which is injured after blunt trauma of the abdomen. In most of the cases, this type of injuries is accompanied by other injuries, which make it more difficult to diagnose. Failure of diagnosis and delay in treating these injuries significantly increase the morbidity and mortality of these patients. Abdominal visceral injuries after flipping the handlebar of the bike are common in children. Such injuries can cause injury to both solid and hollow abdominal viscera. Unlike children, adults’ abdominal visceral injuries after flipping the bike’s handlebar are extremely rare. A 25-year-old man was admitted to our department due to progressively abdominal pain after an accident with the handlebar of his bike. The subsequent CT scan after per os administration of contrast medium revealed the presence of free intraperitoneal contrast. It is a rare case of jejunal perforation after flipping the handlebar of the bicycle which was treated by partial removal of the injured part of jejunum and end-to-end anastomosis. To the best of our knowledge this is the first time we describe such an injury with this mechanism to an adult.

  17. Calcified amorphous tumor of the heart in an adult female: a case report

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    Gupta Ruchika

    2010-08-01

    Full Text Available Abstract Introduction Cardiac calcified amorphous tumor is a rare, non-neoplastic intra-cavity cardiac mass composed of calcium deposits in a background of amorphous degenerating fibrinous material. Only a few cases of this rare lesion have been reported in the available literature. Clinico-pathological differentiation of this lesion from calcified atrial myxoma, calcified thrombi or other cardiac neoplasms is extremely difficult; hence pathologic examination is the mainstay of diagnosis. To the best of our knowledge this entity has not been reported in the Indian literature. Case presentation A 40-year-old woman of Indian origin presented with progressive dyspnea, fatigue and cough. She was diagnosed as having a calcified right atrial mass. The mass was excised. Histologic examination revealed the mass to be composed of amorphous eosinophilic fibrin with dense calcification. No myxomatous tissue was seen and a final diagnosis of calcified amorphous tumor of the heart was rendered. Conclusions Calcified amorphous tumor is a rare cardiac lesion with an excellent outcome following complete surgical removal. Since clinico-radiologic differentiation from other cardiac masses is not possible in most cases, histopathological examination is the only modality for diagnosis. Hence, histopathologists should be aware of this rare entity in the differential diagnoses of cardiac mass.

  18. Antiangiogenic Therapy in the Treatment of Recurrent Medulloblastoma in the Adult: Case Report and Review of the Literature

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    Giuseppe Privitera

    2009-01-01

    Full Text Available Medulloblastoma is a rare tumor in central nervous system, with an even rarer occurrence in adulthood. The management of a recurrent disease is a medical challenge; chemotherapy has been used as the treatment of choice, while reirradiation has been employed in selected cases. We report the case of a 51-year-old man with recurrent medulloblastoma. He was treated with local reirradiation, chemotherapy, and antiangiogenic drug, with the latter giving the longer progression-free interval. The aim of this report is to show that recurrent medulloblastoma in adults can be approached with a multimodality treatment and that antiangiogenic therapy should have a role in the management of this disease.

  19. Fatal nosocomial meningitis caused by Mycoplasma hominis in an adult patient: case report and review of the literature

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    Sophie Reissier

    2016-07-01

    Full Text Available Meningitis due to Mycoplasma hominis in adults is rarely described, with only three cases having been reported to date. A case of fatal meningitis in a 39-year-old patient after a neurosurgical procedure for a subarachnoid haemorrhage is reported herein. Identification and treatment were significantly delayed because of the rarity of the aetiology and difficulty identifying this organism with the routinely used conventional methods, such as Gram staining and agar growth on standard agar plates. Clinical procedures and the treatment of ‘culture-negative’ central nervous system infections is a real challenge for clinical microbiologists and clinicians, and M. hominis has to be considered as a potential, although very uncommon, pathogen.

  20. Adult diagnosis of Swyer-James-MacLeod syndrome: a case report

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    Gouveia Paulo

    2011-01-01

    Full Text Available Abstract Introduction Swyer-James-MacLeod syndrome or unilateral hyperlucent lung syndrome is a rare entity associated with postinfectious bronchiolitis obliterans occurring in childhood. It is characterized by hypoplasia and/or agenesis of the pulmonary arteries resulting in pulmonary parenchyma hypoperfusion. Case presentation Here we report the case of a 53-year-old Caucasian woman with Swyer-James-MacLeod syndrome found in the differential diagnosis workup for a new onset of heart failure, secondary to pulmonary arterial hypertension complicated by a patent ductus arteriosus. Conclusion Typically, this disorder is diagnosed in childhood after evaluation for recurrent respiratory infections, but sometimes an indolent course means diagnosis is not made until adulthood.

  1. Adult-onset vanishing white matter disease as differential diagnosis of primary progressive multiple sclerosis: a case report.

    Science.gov (United States)

    Herwerth, Marina; Schwaiger, Benedikt J; Kreiser, Kornelia; Hemmer, Bernhard; Ilg, Rüdiger

    2015-04-01

    We report the case of a 42-year-old woman with a slowly progressive cerebellar syndrome. In contrast to a relatively mild clinical presentation, the magnetic resonance imaging (MRI) showed extensive leukencephalopathy with cystic degeneration. Initially primary progressive multiple sclerosis (PPMS) was suspected. Additional diffusion-weighted imaging revealed restricted diffusion in the white matter lesions with a reduced apparent diffusion coefficient. Genetic testing showed vanishing white matter disease (VWM) with c.260C>T EIF2B3 mutation. In conclusion, in cases with relatively mild symptoms and extensive white matter lesions, adult-onset VWM should be considered as differential diagnosis of PPMS and diffusion-weighted imaging may be helpful to identify suspected cases.

  2. Acute seronegative hepatitis C manifesting itself as adult giant cell hepatitis--a case report and review of literature.

    Science.gov (United States)

    Kryczka, Wiesław; Walewska-Zielecka, Bozena; Dutkiewicz, Ewa

    2003-08-01

    Adult giant cell hepatitis (AGCH) is a rare event and only about 100 cases have been reported within the last 20 years. The AGCH has been observed in association with viral infection, drug reactions or autoimmune disorders but in many cases its etiology remains unclear. AGCH manifests clinically as severe form of hepatitis histologically characterized by diffuse giant cell transformation of hepatocytes. We report the case of a 39-yr-old man with acute community-acquired hepatitis without previous pathology of the liver. Laboratory data revealed slight hypergammaglobulinemia and high titer of anti-smooth-muscle antibody with negative serology of hepatotropic viruses and absence of other known causes of hepatitis. Preliminary diagnosis of autoimmune hepatitis was established, additionally confirmed by excellent clinical and biochemical improvement during corticosteroid treatment. A liver biopsy showed the typical findings of panlobular syncytial giant cell hepatitis and positive HCV-RNA both in serum and liver. The above verified the diagnosis of acute type C hepatitis manifested histologically as adult giant cell hepatitis. After three months of treatment we withdrew corticosteroids as spontaneous clearance of HCV occurred and the lack of autoantibodies in serum as well as significant improvement of liver histology was ascertained. Within 30 months of the follow-up we have not observed biochemical and immunological abnormalities and control liver biopsy has shown no signs of hepatitis.

  3. Tuberculous otitis media in an adult in a primary care setting:A case report

    Institute of Scientific and Technical Information of China (English)

    Paul O Dienye; Geraldine U Ndukwu

    2010-01-01

    Tuberculous otitis media is a rare disease, hence not often considered in the differential diagnosis of otorrhea. This results in late diagnosis with resulting complications such as irreversible hearing loss. A case report with review of the literature is presented, emphasizing that tuberculosis should be considered in the differential diagnosis of otorrhea not responding to commonly prescribed antibiotics. We also emphasize the importance of awareness creation in the management of such a disease, involving family members to oversee treatment and also research on ways of shortening duration of treatment to avoid default in treatment.

  4. Alveolar-type rhabdomyosarcoma of nasal cavity and paranasal sinus in adult with pulmonary metastasis: A case report

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    S. Rajinder

    2016-11-01

    Full Text Available Alveolar-type rhabdomyosarcoma of head and neck region in adult is extremely rare. We report a case of a 33-year-old lady who presented with persistent right unilateral nasal obstruction and epistaxis for one months’ duration. Examination showed a fleshy, irregular-surfaced mass occupying the whole right nasal cavity and histopathological examination revealed alveolar-type rhabdomyosarcoma. Metastatic work-up showed pulmonary metastasis. After 3 months following completion of four cycles of chemotherapy, a repeated scan showed significant shrinkage of the tumor.

  5. Acute rheumatic fever in adults: case report together with an analysis of 25 patients with acute rheumatic fever.

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    Kasitanon, Nuntana; Sukitawut, Waraporn; Louthrenoo, Worawit

    2009-07-01

    We reported the oldest acute rheumatic fever (ARF) patient with initial attack at the age of 90 years and experience with ARF in adults in 20 years of observation. The case files of all ARF patients treated by rheumatology unit, Chiang Mai University, were reviewed. Demographic data and clinical profile were recorded and compared between patients with initial attack and patients with recurrent attack. A total of 25 patients with ARF were included. There was no different incidence of arthritis and carditis between two groups. Initial attack patients have higher incidence of prolonged PR-interval (67 vs. 12%, P = 0.049) and longer duration of admission to diagnosis (5 vs. 2 days, P = 0.05). Thirty percent presented initial attack after 30 years of age. ARF is more common in adults than previously recognized. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patients with arthritis.

  6. Treatment and restoration of adult dentoalveolar trauma: A clinical case report.

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    Serra-Pastor, Blanca; Penarrocha-Diago, Miguel; Penarrocha-Diago, María; Agustín-Panadero, Rubén

    2016-12-01

    Adult dentoalveolar trauma most often occurs in the context of sports activities and traffic accidents. Coronal fractures are the most common type of lesion, followed by tooth luxation. We present the case of a 25-year-old woman who suffered alveolar bone damage and coronal fractures of the upper incisors, with extrusive luxation of the right central incisor, as the result of a fall. On the first visit, manual reduction of the buccal plate was carried out under local anesthesia, with repositioning of the right central incisor and splinting to the neighboring teeth. Composites were used to restore the coronal fractures. After one month, both upper central incisors and the right lateral incisor were subjected to endodontic treatment. Internal bleaching of the right lateral incisor was also carried out, due to pigmentation secondary to pulp necrosis. At follow-up 5 months later, the alveolar bone fracture was seen to have healed. Definitive anterior restorative treatment with porcelain veneers was therefore carried out. After two years the patient remains asymptomatic and in good dental condition. Key words:Dental trauma, extrusive luxation, dento-alveolar fracture, esthetic restoration.

  7. Treatment and restoration of adult dentoalveolar trauma: A clinical case report

    Science.gov (United States)

    Penarrocha-Diago, Miguel; Penarrocha-Diago, María; Agustín-Panadero, Rubén

    2016-01-01

    Adult dentoalveolar trauma most often occurs in the context of sports activities and traffic accidents. Coronal fractures are the most common type of lesion, followed by tooth luxation. We present the case of a 25-year-old woman who suffered alveolar bone damage and coronal fractures of the upper incisors, with extrusive luxation of the right central incisor, as the result of a fall. On the first visit, manual reduction of the buccal plate was carried out under local anesthesia, with repositioning of the right central incisor and splinting to the neighboring teeth. Composites were used to restore the coronal fractures. After one month, both upper central incisors and the right lateral incisor were subjected to endodontic treatment. Internal bleaching of the right lateral incisor was also carried out, due to pigmentation secondary to pulp necrosis. At follow-up 5 months later, the alveolar bone fracture was seen to have healed. Definitive anterior restorative treatment with porcelain veneers was therefore carried out. After two years the patient remains asymptomatic and in good dental condition. Key words:Dental trauma, extrusive luxation, dento-alveolar fracture, esthetic restoration. PMID:27957283

  8. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

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    Bicaj Besnik X

    2011-09-01

    Full Text Available 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 abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum. Conclusions Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.

  9. Conservative treatment of neuromuscular scoliosis in adult tetraplegia: a case report.

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    Hastings, Jennifer D; Dickson, Julie; Tracy, Linsey; Baniewich, Christine; Levine, Cedar

    2014-12-01

    We report successful correction of new onset neuromuscular scoliosis without spinal surgery in a man who is 30-years post-American Spinal Injury Association Impairment Scale grade A C6 injury with new onset of left neuromuscular scoliosis (Cobb angle 45°) after a motor vehicle collision. Interventions included nightly low-load prolonged stretching (LLPS) (4h left side lying over bolster), a series of 6 botulinum toxin injections (BTIs) at 3-month intervals, and progressive seating adjustments to counteract the spinal curvature. Monthly seating adjustments included rear quadrant wedging, lateral supports, and hip blocking to promote erect and symmetrical posture. A normative Cobb angle (5°) was achieved after 8 months of treatment. Improvements in alignment were demonstrated in physical examination outcome measures at the final session and follow-up. LLPS, seating adjustments, and paraspinal BTI are nonsurgical options for treating neuromuscular scoliosis in adults with tetraplegia. Further studies are necessary to determine optimum protocols and examine generalizability of these treatment methods.

  10. The Coexistence of Generalized and Lateralized Periodic Discharges: Report of Two Adult Cases with SSPE and MELAS Syndrome

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    Aslıhan Taşkıran

    2011-09-01

    Full Text Available Generalized and lateralized periodic discharges have not been reported previously in the same EEG simultaneously. Here, we report two adult patients who suffered from rare clinical conditions [subacute sclerosing panencephalitis (SSPE and nitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome]. Their EEGs showed the same pattern consisting of generalized periodic discharges and lateralized periodic discharges in the same EEG simultaneously. Although the appearances of the EEG were very similar, discharges became more prominent after intravenous diazepam injection in the case with SSPE but were suppressed in the case with MELAS. Lesions in the magnetic resonance imaging (MRI were located posteriorly in both patients, involving mainly subcortical white matter in the case with SSPE, but mainly the cortical area in the case with MELAS. Generalized periodic discharges are also reported in MELAS for the first time. The underlying mechanisms of the genesis of periodic discharges are still not known, and these two patients may help us to learn more about these rare patterns.

  11. Primary tubercular liver abscess in an immunocompetent adult: a case report

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    Baveja CP

    2009-10-01

    Full Text Available Abstract Introduction Isolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis. A greater awareness of this rare clinical entity may help in commencing specific evidence-based therapy quickly and preventing undue morbidity and mortality. Case presentation A 30-year-old man, of Asian origin, developed a hepatic tubercular abscess which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram of the abdomen showed an abscess in the right lobe of his liver which was initially diagnosed as an amoebic liver abscess. Subsequently, the pus from the lesion yielded Mycobacterium tuberculosis using the BACTEC TB 460 instrument and Mycobacterium tuberculosis deoxyribonucleic acid by polymerase chain reaction. The patient was started on systemic antitubercular therapy to which he responded favorably. Conclusion This report emphasizes the fact that, although a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions.

  12. [Duplication of the anus and rectum in an adult. Report of 1 case].

    Science.gov (United States)

    Labastida Muñoz, H; Tamayo Pérez, R; Corichi Barceinas, R

    1978-01-01

    It is reported a case of duplication of the anus and rectum. A 48 year old man, had two functioning rectae, one ending in its normal anatomical topography and the functioning but nor functional supernumerary rectum exteriorized in the left gluteal region trough a rudimentary anus. Histological studys demonstrated a rudimentary sphincter in the ectopic anus, and focal carcinamotous transformation of one of the four adenomatous polyps, encountered protruding through the normally located anus. The anal anomaly was associated with partial agenesis of the sacrum, absence of coccyx, sacral anterior meningomyelocele and hypoplasia of the twelve right rib. The frequency of the anomaly, its histology and embriology, as well as its classification within the malformations of the terminal gut, were revised in the medical bibliography. It is concluded that this type of anomaly has not been classified or describe, before.

  13. Cavernous hemangioma of adult pancreas: A case report and literature review

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    Mondal, Utpal; Henkes, Nichole; Henkes, David; Rosenkranz, Laura

    2015-01-01

    Pancreatic hemangioma is a rare type of benign vascular tumor. Low clinical suspicion and inability of current cross sectional imaging techniques to differentiate it from other pancreatic lesions, contribute to the difficulty in making the correct diagnosis. Without a definitive diagnosis, and due to concern for malignancy, in many instances, surgery is performed. We report a case of pancreas cavernous hemangioma in an 18-year-old female. The patient presented with three-month history of epigastric pain. Physical examination and routine blood tests were normal. Abdominal Computed Tomography scan revealed a 5 cm × 6 cm complex non-enhancing cystic mass in the head of pancreas. Magnetic resonance imaging, endoscopic ultrasonography (EUS) and EUS guided fine needle aspiration cytology were non-diagnostic. Because of uncontrolled symptoms, the patient underwent surgical resection. Histopathology and Immunohistochemical staining confirmed the diagnosis of cavernous hemangioma of pancreas. PMID:26361427

  14. A reversible lesion of the corpus callosum splenium with adult influenza-associated encephalitis/encephalopathy: a case report

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    Kimura En

    2008-06-01

    Full Text Available ABstract Introduction Influenza virus-associated encephalitis/encephalopathy is a severe childhood illness with a poor prognosis. Adult case reports are rare and, to date, there have been no reports of adults with a mild subcortical encephalopathy with reversible lesions of the corpus callosum splenium. Case presentation A previously healthy 35-year-old man presented with acute progressive tetraplegia, transcortical motor aphasia and a mild decrease in his consciousness during his recovery after receiving oseltamivir phosphate treatment, and influenza type A antiviral medication. The initial magnetic resonance imaging study at day 1 showed symmetrical diffuse lesions in the white matter and a lesion on the central portion of the corpus callosum splenium. These findings had resolved on follow-up studies at day 8 and day 146. His neurological deficits mostly recovered within 12 hours following methylprednisolone pulse therapy. The levels of interleukin-6 and interleukin-10 in his blood and cerebrospinal fluid were initially elevated, but rapidly decreased to normal levels by day 8. Conclusion It is important for clinicians to recognize that even in adulthood, the subcortical encephalopathy observed during the therapeutic treatment for influenza type A infection can occur in conjunction with a reversible lesion of the corpus callosum, which may recover quickly. In addition, the cytokine storm in the blood system and the corticospinal cavity may play an important role in the etiology of the disease process.

  15. Primary extranodal soft-tissue B-cell lymphoma with abundant immunoglobulin inclusions mimicking adult rhabdomyoma: a case report

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    Wang Zhe

    2011-02-01

    Full Text Available Abstract Introduction Immunoglobulin inclusions are found in B-cell neoplasms as well as in crystal-storing histiocytosis associated with B-cell lymphoproliferative disorders. At times, the deposits may be so profound as to obscure the diagnosis and may even lead to misdiagnosis. We report one case of low-grade extranodal lymphoplasmacytic lymphoma with abundant immunoglobulin inclusions and emphasize the need for immunophenotyping and molecular assay to make the right decision in diagnosis. To the best of our knowledge, this is the first report of extranodal B-cell lymphoma with abundant intracellular immunoglobulin accumulation. Case presentation A 62-year-old Asian man from China presented with a 13-year history of a right shoulder mass with recent ongoing pain. A desmoplastic fibroma located in the posterior muscles of the neck was suggested by magnetic resonance imaging, and extended local excision was performed. A biopsy, however, revealed large, isolated rhabdoid cells in a diffuse pattern with mild atypia and eosinophilic cytoplasm. Clustered lymphoid cells were interspersed among these cells. The diagnosis was initially suggested to be adult rhabdomyoma. The final diagnosis of lymphoma was made after immunohistochemical, ultrastructural and molecular studies. Conclusion We emphasize this histopathologic and immunohistochemical finding because of the potential for confusion with other tumors or disorders, such as adult rhabdomyoma or crystal-storing histiocytosis.

  16. Anesthesia for pacemaker implant in an adult patient with unoperated univentricular heart. Case report.

    Science.gov (United States)

    Hobaika, Adriano Bechara de Souza; Procópio, André Luís Pontes; Pereira, Marcelo Luiz Souza; Coimbra, Aristóteles Pereira; Fernandes, Magda Lourenço; Pires, Kleber Costa de Castro

    2007-02-01

    Single ventricle is a rare abnormality, affecting 1% of the patients with congenital cardiopathy. Only 11 cases of patients with unoperated univentricular heart older than 50 years were reported in the literature. The aim of this report was to describe the anesthetic conduct in a patient with univentricular heart undergoing pacemaker implant. A female patient, 47 years old, with double outlet left ventricle, L-transposition of the great vessels, and pulmonary stenosis, without prior surgical correction, was scheduled for definitive implant of a sequential dual-chamber pacemaker. The ABPM demonstrated second degree atrioventricular block and a mean heart rate of 45 bpm. Preoperative exams showed a hematocrit of 57%, normal coagulation studies, and preserved ventricular function. Monitoring consisted of pulse oxymeter, ECG on D(II) and V5, IBP, capnograph, and gas analyzer. A temporary transcutaneous pacemaker was available in case of severe bradycardia. Anesthesia was induced with fentanyl (0.25 mg), etomidate (20 mg), and atracurium (35 mg). Four minutes after anesthetic induction, the heart rate decreased to 30 bmp and 1 mg of atropine was administered with reversal of the bradycardia. Anesthesia was maintained with 2.5% sevoflurane, 60% room air, and 40% oxygen. Hemodynamic parameters and oxygen saturation remained stable. The patient was transferred to the intensive care unit in stable condition and extubated at the end of the procedure. The anesthetic conduct for pacemaker implant in a 47-year old patient with non-operated double outlet left ventricle and pulmonary stenosis was appropriate, since it allowed the procedure to be performed.

  17. Fall prevention among older adults: Case reports exemplifying the value of incorporating lumbar stabilization training during balance exercises

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    P. Van Der Merwe

    2013-12-01

    Full Text Available Background: Older adults are at risk of fallingeach year. Fall injuries results in many health care expenses anddisabilities, yet non-western countries lack the infra-structure andresources for prevention programs. Balance exercises have beenfound to be a cost effective evidence-based intervention in treatingand preventing falls among older adults in western countries.Purpose: The aim of this report was to show that lumbar stabilizationexercises are not only a beneficial addition to a balanceprogram for the prevention and treatment of falls in older adults,but to demonstrate that these exercise can more rapidly improve thefunctional status of older adults, limiting healthcare costs.Case description: Two high functional older adults with a historyof falls presented with poor balance and fear of falling. Both patientsreceived the same balance exercise regime however lumbar stabilization exercises were added to one of the patient’s exerciseprograms. Gait speed, lower extremity strength and balance were assessed with the Balance Evaluation systems test (BESTest,figure-of-eight, four-step-square (FSST, five-time-sit-to-stand tests (5TSTS after two weeks and four weeks of treatment.Outcomes. All the outcome measures showed statistically significant improvements. Greater improvements in vertical stabilitylimits (14%, gait speed (9%, stability during gait (20% and five-time-sit-to-stand test were seen with the addition of lumbarstabilization exercises.Discussion. The addition of lumbar stabilization exercises during balance training is of value to improve gait speed, balancetesting scores in stability in gait and vertical stability limits.

  18. Elbow fracture-dislocation combined with Galeazzi fracture in adult: A case report and literature review.

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    Asadollahi, Saeed; Shepherd, David; Hau, Raphael C

    2013-01-01

    Galeazzi fracture associated with ipsilateral posterior elbow dislocation and radial head fracture is a rare pattern of injury. Few reports exist that describes this injury pattern and its treatment. We describe a case report of simultaneous occurrence of Galeazzi fracture and ipsilateral dislocation of elbow. A 58 year-old female presented with Galeazzi fracture and posterior elbow dislocation associated with radial head fracture of left upper extremity. This was managed with closed reduction of the elbow, open reduction and internal fixation of the radial shaft fracture and K-wire stabilisation of the unstable distal radioulnar joint. Prophylactic fasciotomy was performed. At 10 months follow-up, the outcome was favourable with the American shoulder and elbow surgeon score of 92 and the disabilities of the arm, shoulder and hand score of 18. The presumed mechanism of the injury was a forceful axial loading of a hyperpronated forearm and extended elbow. Our literature review shows that this pattern of injury occurs as a result of high energy trauma in young individuals, and successful outcome can be achieved by addressing each component of this complex injury individually. Simultaneous occurrence of elbow dislocation and Galeazzi fracture seems to be the result of extreme axial force and unique position of upper extremity at the time of impact. Individualised approach to each component of this injury can result in favourable outcome. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  19. Adult congenital diaphragmatic hernia of the liver: a rare case report

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Congenital diaphragmatic hernia (CDH), which mainly occurs in the newborn or in childhood with severe respiratory distress and high mortality, is rarely found in adult, especially for those uncommon right CDH [1–4]. Whereas, liver as the main hernial

  20. Primary adult midgut volvulus mimicking acute appendicitis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Leow

    2016-01-01

    Conclusion: While rare, adult midgut volvulus has the potential for morbidity and mortality if not diagnosed early with intestinal ischaemia and related sequlae. Clinicians should consider this and if in doubt, perform an early contrast CT scan.

  1. Delayed post-traumatic spinal cord infarction in an adult after minor head and neck trauma: a case report

    Directory of Open Access Journals (Sweden)

    Bartanusz Viktor

    2012-09-01

    Full Text Available Abstract Introduction Delayed post-traumatic spinal cord infarction is a devastating complication described in children. In adults, spinal cord ischemia after cardiovascular interventions, scoliosis correction, or profound hypotension has been reported in the literature. However, delayed spinal cord infarction after minor head trauma has not been described yet. Case presentation We report the case of a 45-year-old Hispanic man who had a minor head trauma. He was admitted to our hospital because of paresthesias in his hands and neck pain. A radiological workup showed cervical spinal canal stenosis and chronic cervical spondylotic myelopathy. Twelve hours after admission, our patient became unresponsive and, despite full resuscitation efforts, died. The autopsy revealed spinal cord necrosis involving the entire cervical spinal cord and upper thoracic region. Conclusions This case illustrates the extreme fragility of spinal cord hemodynamics in patients with chronic cervical spinal canal stenosis, in which any further perturbations, such as cervical hyperflexion related to a minor head injury, can have catastrophic consequences. Furthermore, the delayed onset of spinal cord infarction in this case shows that meticulous maintenance of blood pressure in the acute post-traumatic period is of paramount importance, even in patients with minimal post-traumatic symptoms.

  2. Two cystic cavernous angiomas after radiotherapy for atypical meningioma in adult woman : case report and literature review.

    Science.gov (United States)

    Ruggeri, Andrea Gennaro; Donnarumma, Pasquale; Pichierri, Angelo; Delfini, Roberto

    2014-01-01

    A correlation between radiation therapy and cavernoma has been suspected since 1994. Since then, only a few cases of radio-induced cavernomas have been reported in the literature (85 patients). Most of them were children, and the most frequent original tumour had been medulloblastoma. The authors report a case of two cystic cavernous angiomas after radiation therapy for atypical meningioma in adult woman. This is the first case of cavernous angioma after radiotherapy for low grade meningioma. A 39-year-old, Latin american woman was operated on for a frontal atypical meningioma with intradiploic component and adjuvant radiotherapy was delivered (6000 cGy local brain irradiation, fractionated over 6 weeks). Follow-up MR imaging showed no recurrences of the tumour and no other lesions. Ten years later, at the age of 49, she consulted for progressive drug-resistant headache. MR imaging revealed two new well defined areas of different signal intensity at the surface of each frontal pole. Both lesions were surgically removed; the histopathological diagnosis was cavernous angioma. This is the first case of cavernous angioma after radiation therapy for atypical meningioma : it confirms the development of these lesions after standard radiation therapy also in patients previously affected by non-malignant tumours.

  3. Acute Pancreatitis Complicated with Diabetic Ketoacidosis in a Young Adult without Hypertriglyceridemia: A Case Report.

    Science.gov (United States)

    Kim, Jung Hyun; Oh, Myung Jin

    2016-11-25

    Systemic complications related to acute pancreatitis include acute respiratory distress syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation, hypocalcemia, hyperglycemia, and insulin dependent diabetes or diabetic ketoacidosis. In practice, the development of diabetic ketoacidosis induced by acute pancreatitis is rare and generally associated with hypertriglyceridemia. However, herein we report a case of a 34-year-old female without hypertriglyceridemia, who was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis. The patient was admitted with complaints of febrile sensation, back pain, and abdominal pain around the epigastric area. Levels of serum amylase and lipase were elevated to 663 U/L and 3,232 U/L. Contrast-enhanced abdominal CT showed pancreatic swelling, peri-pancreatic fat infiltration and fluid collection. The patient was initially diagnosed with simple acute pancreatitis. Though the symptoms were rapidly relieved after initiation of treatment, severe hyperglycemia (575 mg/dL), severe metabolic acidosis (pH 6.9), and ketonuria developed at four days after hospitalization. However, serum triglyceride levels remained within the normal range (134 mg/dL). Finally, the patient was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis unrelated to hypertriglyceridemia. She recovered through insulin and fluid therapy, and receives insulin therapy at the outpatient clinic.

  4. [Recurrent hyperperfusion after revascularization surgery for adult moyamoya disease: a case report].

    Science.gov (United States)

    Hayashi, Tomohide; Kashiwazaki, Daina; Akioka, Naoki; Kuwayama, Naoya; Kuroda, Satoshi

    2014-07-01

    Direct bypass surgery for moyamoya disease is quite useful for rapidly improving cerebral hemodynamics and resolving ischemic attacks but may induce hyperperfusion syndrome. In this report, we present a rare case of recurrent hyperperfusion after surgery for moyamoya disease. A 47-year-old woman developed left homonymous hemianopsia and was admitted to our hospital. Magnetic resonance(MR)imaging/angiography revealed definitive moyamoya disease presenting with acute cerebral infarction in the right temporoparietal lobe. She was treated with anti-hypertensive agents because she had severe hypertension. She successfully underwent right superficial temporal artery-middle cerebral artery double anastomosis and indirect bypass. A cerebral blood flow study just after surgery demonstrated marked hyperperfusion in the operated hemisphere. A repeat study 2 days later revealed that the hyperperfusion was dramatically improved. Subsequently, however, she developed a severe ipsilateral headache and focal seizure regardless of the blood pressure control. She complained of the headache for >2 weeks. Follow-up MRI showed a small subcortical hemorrhage in the right frontal lobe. Single-photon emission computed tomography revealed that the hyperperfusion relapsed 9 days after surgery and then gradually disappeared. This study shows that preoperative severe hypertension may induce uncontrollable hyperperfusion after direct bypass surgery for moyamoya disease.

  5. Hybrid Surgery Options for Complex Clinical Scenarios in Adult Patients with Congenital Heart Disease: Three Case Reports

    Science.gov (United States)

    Rapetto, Filippo; Kenny, Damien; Turner, Mark; Parry, Andrew; Stoica, Serban; Uzun, Orhan; Caputo, Massimo

    2017-01-01

    The strategy for the management of adult patients with congenital heart disease (CHD) often represents a challenge for cardiac surgeons and cardiologists due to complex anatomy, wide range of clinical presentations, and a high-risk profile. However, hybrid approach may represent an attractive solution. We report three cases of adult patients previously operated for CHD and recently treated with a hybrid approach in our institution. Case 1: a 76-year-old woman with permanent atrial fibrillation, lung disease, chronic kidney disease, microcytic anemia, and type II diabetes mellitus, previously operated for atrial septal defect closure and pulmonary valvotomy, presented with severe pulmonary regurgitation and advanced right ventricular failure. In order to minimize the surgical risk, a hybrid approach was used: an extensive right ventricular outflow tract (RVOT) plication was followed by implantation of an Edwards Sapien XT prosthesis in the RVOT through the right ventricular apex, without cardiopulmonary bypass. Case 2: a 64-year-old man with previous atrial septum excision and pericardial baffle for partial anomalous pulmonary venous drainage with intact interatrial septum, presented with worsening dyspnea, right ventricular failure, and pulmonary hypertension caused by baffle stenosis. His comorbidities included coronary artery disease, atrial flutter, and previous left pneumonectomy. After performing a redo longitudinal median sternotomy, a 20-mm stent was implanted in the baffle with access through the superior vena cava. Case 3: a 50-year-old man, with previous atrioventricular septal defect repair, followed by mitral valve replacement with a mechanical prosthesis, subsequently developed a paravalvular leak (PVL) with severe mitral regurgitation and severe left ventricular dysfunction. He underwent a transapical PVL device closure with two Amplatzer Vascular Plugs. In our opinion, hybrid surgery is a promising therapeutic modality that increases the available

  6. Case report

    African Journals Online (AJOL)

    abp

    2 mai 2017 ... ans, cependant des présentations à l'âge adulte peuvent être rencontrées. ... activités sociales. L'examen physique était normal sans souffle à ... considérer le VDDC comme diagnostic différentiel de l'hypertension.

  7. Case report

    African Journals Online (AJOL)

    raoul

    12 janv. 2012 ... issu d´un mariage non consanguin, d´une grossesse non suivie estimée à terme, ... Chez le nourrisson, microcéphalie, hypertélorisme, micrognathie sont des .... The cri du chat syndrome in adolescents and adults: clinical.

  8. Metastatic Tumor of the Spermatic Cord in Adults: A Case Report and Review

    Directory of Open Access Journals (Sweden)

    Daisaku Hirano

    2015-01-01

    Full Text Available Metastatic spermatic cord (SC tumor is extremely rare. Recently, we experienced a case of late-onset metastatic SC tumor from cecal cancer. This case is a 68-year-old man presenting with a painless right SC mass. He had undergone a right hemicolectomy for cecal cancer 6 years ago. Radical orchiectomy and adjuvant chemotherapy with S-1 were performed. No recurrence was found after one year of follow-up. We identified a total of 25 cases, including our case, on a literature search via PubMed from January 2000 to April 2015. The most frequent primary sites of the tumors metastasizing to the SC were the stomach (8 cases, 32% and the colon (8 cases, 32%, next the liver (2 cases, 8%, and kidney (2 cases, 8%. The majority of the cases underwent radical orchiectomy for the metastatic tumors of the SC. Over half of the cases received adjuvant interventions based on the regimens for the primary tumors. Prognosis in the patients with metastatic tumor of the SC was unfavorable except for late-onset metastasis. In patients with a mass in the SC and a history of neoplasm, especially in gastrointestinal tract, the possibility of metastasis from the primary cancer should be considered.

  9. Histoplasmosis-Induced Hemophagocytic Lymphohistiocytosis in an Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ramona Vesna Untanu

    2016-01-01

    Full Text Available Hemophagocytic lymphohistiocytosis (HLH is an aggressive and life-threating immune dysregulation syndrome characterized by persistent activation of the mononuclear phagocytic system leading to uncontrolled systemic hyperinflammatory response. The proliferation and activation of histiocytes and lymphocytes lead to production of large amounts of cytokines, also called cytokine storm. Hematopoietic and lymphoid tissues are directly involved while other organs are damaged by circulating cytokines. Primary HLH is attributed to genetic defects of the immune system and secondary HLH is usually seen in adults secondary to malignancy, infection, or autoimmune diseases. Zoonotic diseases including fungal infections are an important cause of HLH. Secondary HLH can delay the recognition of the underlying zoonoses. We report the case of a 61-year-old female with history of rheumatoid arthritis with histoplasmosis associated hemophagocytic lymphohistiocytosis.

  10. Adult intussusception caused by Meckel's diverticulum complicated by anisakiasis of the small intestine: report of a case.

    Science.gov (United States)

    Furukawa, Kenei; Yoshida, Kazuhiko; Nojiri, Takuya; Ogawa, Masaichi; Kohno, Shuzou; Yanaga, Katsuhiko

    2014-08-01

    We report an extremely rare case of adult intussusception caused by Meckel's diverticulum complicated by anisakiasis of the small intestine. A 48-year-old female was admitted to our hospital with vomiting and abdominal pain 3 days after eating raw fish. The abdomen was distended with tenderness. Computed tomography demonstrated a target-shaped mass in the ileum and wall thickness of the distal ileum. We diagnosed intussusception and performed emergency surgery. At laparotomy, intussusception was already released. Since Meckel's diverticulum was observed at 40 cm and wall thickness was observed at 20 cm from the terminal ileum, we performed partial ileal resection including these lesions. On pathology, the anisakis body was found in the resected specimen of the ileum with wall thickness. The patient was discharged 8 days after surgery.

  11. Organic depression and Terson′s syndrome in adult polycystic kidney disease: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ranganath R Kulkarni

    2014-01-01

    Full Text Available Depressive symptoms are common in neurological diseases, at times posing dilemma in organic or functional origin. Cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes that resemble primary depressions both clinically and therapeutically in about half of the patients following acute stroke. Terson′s syndrome is the direct occurrence of vitreous hemorrhage following subarachnoid/subdural hemorrhage, often overlooked in the acute setting. Autosomal dominant (adult polycystic kidney disease may be associated with berry aneurysms and hypertension, and may lead to intracranial bleeds. We report an unusual case of organic depression and Terson′s syndrome in a 50-year-old female with polycystic kidney disease and hypertension, following anterior communicating artery aneurysmal subarachnoid bleed with bilateral subdural extension. Management included anti-hypertensives, antiepileptics, neodymium: YAG laser photocoagulation, and aneurysmal clipping.

  12. Histoplasmosis-Induced Hemophagocytic Lymphohistiocytosis in an Adult Patient: A Case Report and Review of the Literature

    Science.gov (United States)

    Untanu, Ramona Vesna; Akbar, Syed; Graziano, Stephen

    2016-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threating immune dysregulation syndrome characterized by persistent activation of the mononuclear phagocytic system leading to uncontrolled systemic hyperinflammatory response. The proliferation and activation of histiocytes and lymphocytes lead to production of large amounts of cytokines, also called cytokine storm. Hematopoietic and lymphoid tissues are directly involved while other organs are damaged by circulating cytokines. Primary HLH is attributed to genetic defects of the immune system and secondary HLH is usually seen in adults secondary to malignancy, infection, or autoimmune diseases. Zoonotic diseases including fungal infections are an important cause of HLH. Secondary HLH can delay the recognition of the underlying zoonoses. We report the case of a 61-year-old female with history of rheumatoid arthritis with histoplasmosis associated hemophagocytic lymphohistiocytosis. PMID:27830097

  13. Penfigoide bolhoso no adulto mais jovem: relato de três casos Bullous pemphigoid in younger adults: three case reports

    Directory of Open Access Journals (Sweden)

    Roberta Richter Zanella

    2011-04-01

    Full Text Available O penfigoide bolhoso é uma dermatose bolhosa autoimune subepidérmica, mais comumente observada na população idosa (acima dos 70 anos. Autoanticorpos são formados contra antígenos específicos da zona de membrana basal: BP180 e BP230 (proteínas do hemidesmossomo. Apresentamos três casos de penfigoide bolhoso, em adultos com menos de 50 anos de idade, destacan do as peculiaridades clínicas na faixa etária mais jovem.Bullous pemphigoid is an autoimmune subepidermal bullous dermatosis more commonly observed in the elderly (over 70 years old. Autoantibodies are produced for specific antigens of the epidermal basement membrane zone: BP 180 and BP 230 (hemidesmosome proteins. We report three cases of bullous pemphigoid in adults younger than 50 years old, discussing the clinical characteristics of the disease in younger patients.

  14. Lineage switch from acute myeloid leukemia to acute lymphoblastic leukemia: report of an adult case and review of the literature.

    Science.gov (United States)

    Lounici, A; Cony-Makhoul, P; Dubus, P; Lacombe, F; Merlio, J P; Reiffers, J

    2000-12-01

    Lineage switch from AML to ALL is an extremely rare phenomenon, and we report the case of an adult diagnosed with AML at 46 years of age who relapsed with ALL. At initial diagnosis, blast cell morphology and immunophenotyping were consistent with the diagnosis of M4-AML. Complete remission was achieved, and the patient underwent autologous BMT. At relapse, six months after ABMT, blast cells were different from those seen at initial diagnosis, for morphology (L2-ALL), cytochemistry, and immunophenotyping. The karyotype was normal at both diagnosis and relapse. No evidence of bcr-abl fusion genes was found by RT-PCR. Monoclonal IgH and TCR gamma gene rearrangement were evidenced by PCR analysis at relapse but not on blast cells at AML diagnosis.

  15. Brodie bite with an extracted mandibular first molar in a young adult: a case report.

    Science.gov (United States)

    Chugh, Vinay K; Sharma, Vijay P; Tandon, Pradeep; Singh, Gyan P

    2010-05-01

    Total buccal crossbites are rare, but, when they occur, they can be extremely difficult to correct, even with surgery and orthodontics. In most patients with in-locking crossbites, the maxillary teeth erupt past their mandibular antagonists, creating severe occlusal difficulties. This article presents an adult patient with scissors-bite or partial telescoping bite bilaterally in the posterior region and an extracted mandibular first molar on the right side. She was treated with expansion of the mandibular arch, and the subsequent open bite was closed with the help of masticatory muscle exercises and high-pull headgear. The second and third molars were uprighted and moved mesially to close the extraction spaces.

  16. Asymptomatic Primary Isolated Pulmonary Vein Stenosis in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyun; Lee, Ho Sung; Choi, Jae Sung; Na, Ju Ock; Kim, Yong Hoon; Jou, Sung Shick; Seo, Ki Hyun [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2010-08-15

    A 31-year-old man without respiratory symptoms was transferred to our clinic with incidentally detected small nodular densities in both the upper lung zones on chest radiography. Chest computed tomography and pulmonary angiography demonstrated that the entrance of the right inferior pulmonary vein to the left atrium was completely blocked, and the venous return of the right lower lobe was achieved through the right superior pulmonary vein with a tortuous venous collateral complex in the venous phase. With echocardiography, mild pulmonary hypertension was detected. Here, we present an asymptomatic adult with isolated stenosis of the pulmonary vein with chronic compensation by venous collateral circulation in spite of mild pulmonary hypertension

  17. Gingival juvenile xanthogranuloma in an adult patient: case report with immunohistochemical analysis and literature review.

    Science.gov (United States)

    Consolaro, Alberto; Sant'Ana, Eduardo; Lawall, Melaine A; Consolaro, Maria Fernanda M O; Bacchi, Carlos Eduardo

    2009-02-01

    Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis (nonLCH). It is a benign and self-healing disorder that generally affects infants and children. Oral lesions in adult patients are rare, although the microscopic findings are similar to those observed in other locations. A 56-year-old white man presented with a chief complaint of a gingival mass that had appeared 6 months before and had grown slowly. An intraoral examination revealed the presence of a solitary, softened gingival mass affecting the mandibular lingual gingiva at the right central incisor area. A biopsy of the lesion showed multiple large macrophages and numerous giant cells of Touton type. The immunohistochemistry positivity for CD68, fascin, factor XIIIa, alpha-antitrypsin and negativity for S-100, beta-actin, CD1a, and desmin confirmed the diagnosis of JXG. The occurrence of adult oral JXG is extremely rare. It is a nonLCH that may present variable clinical and microscopic aspects, which leads to a diversity of clinical misdiagnoses. A precise diagnosis of these lesions requires an accurate evaluation of clinical, microscopic, and immunohistochemical features.

  18. Case report

    African Journals Online (AJOL)

    abp

    2014-03-28

    Mar 28, 2014 ... Iatrogenic cushing's syndrome in children following nasal steroid. Isaac Oludare .... which a diagnosis of adenoidal hypertrophy was made and he was ... Oyenusi participated in patients' management and review of case.

  19. Case report

    African Journals Online (AJOL)

    ebutamanya

    2016-03-24

    Mar 24, 2016 ... Meknes, Morocco, 3Department of Radiology, Military Hospital Moulay Ismail, Meknes, ... Our case raises the awareness among health professionals about ... abdomen was sensitive and on the digital rectal examination the.

  20. Case Report

    African Journals Online (AJOL)

    Arab Journal of Nephrology and Transplantation. 2013 Sep;6(3):177-9 ... Further systemic clinical examination ... Sternal marrow aspiration revealed slight myelodysplasia consistent ... case, renal biopsy findings and clinical follow-up made.

  1. Synthetic Cannabis Overdose and Withdrawal in a Young Adult: A Case Report, Commentary on Regulation, and Review of the Literature

    Directory of Open Access Journals (Sweden)

    John Samaan

    2016-01-01

    Full Text Available Introduction. Marijuana has been used for its psychotropic effects including enhanced relaxation and perceptual alterations. However, the use of synthetic marijuana (SM leads to more frequent and drastic side effects than the typical use of regular marijuana, owing to the fact that SM has a shorter duration and an earlier peak of action. Despite all the potential adverse health effects associated with SM use, current health policies on SM are very limited. It is believed that the popularity of SM has increased, due to its easy accessibility in the US and lack of detection in typical urine drug screens for THC. Case Report. One case presented is of a young adult patient, with histories of recurrent synthetic cannabis and recreational cannabis use, who had developed drastic physiological and psychiatric symptoms, including the development of acute-onset psychosis. Conclusion/Discussion. This case, as many others nationwide, exemplifies the impact of synthetic cannabinoid use and abuse in adolescents. Side effects and adverse health consequences of synthetic cannabinoid use warrant stricter regulations and policies in order to decrease psychiatric hospital admissions and associated healthcare costs.

  2. Synthetic Cannabis Overdose and Withdrawal in a Young Adult: A Case Report, Commentary on Regulation, and Review of the Literature

    Science.gov (United States)

    Ferrer, Gerardo F.; Akinyemi, Boye; Junquera, Patricia; Oms, Juan; Dumenigo, Rhaisa

    2016-01-01

    Introduction. Marijuana has been used for its psychotropic effects including enhanced relaxation and perceptual alterations. However, the use of synthetic marijuana (SM) leads to more frequent and drastic side effects than the typical use of regular marijuana, owing to the fact that SM has a shorter duration and an earlier peak of action. Despite all the potential adverse health effects associated with SM use, current health policies on SM are very limited. It is believed that the popularity of SM has increased, due to its easy accessibility in the US and lack of detection in typical urine drug screens for THC. Case Report. One case presented is of a young adult patient, with histories of recurrent synthetic cannabis and recreational cannabis use, who had developed drastic physiological and psychiatric symptoms, including the development of acute-onset psychosis. Conclusion/Discussion. This case, as many others nationwide, exemplifies the impact of synthetic cannabinoid use and abuse in adolescents. Side effects and adverse health consequences of synthetic cannabinoid use warrant stricter regulations and policies in order to decrease psychiatric hospital admissions and associated healthcare costs. PMID:27777807

  3. Synthetic Cannabis Overdose and Withdrawal in a Young Adult: A Case Report, Commentary on Regulation, and Review of the Literature.

    Science.gov (United States)

    Samaan, John; Ferrer, Gerardo F; Akinyemi, Boye; Junquera, Patricia; Oms, Juan; Dumenigo, Rhaisa

    2016-01-01

    Introduction. Marijuana has been used for its psychotropic effects including enhanced relaxation and perceptual alterations. However, the use of synthetic marijuana (SM) leads to more frequent and drastic side effects than the typical use of regular marijuana, owing to the fact that SM has a shorter duration and an earlier peak of action. Despite all the potential adverse health effects associated with SM use, current health policies on SM are very limited. It is believed that the popularity of SM has increased, due to its easy accessibility in the US and lack of detection in typical urine drug screens for THC. Case Report. One case presented is of a young adult patient, with histories of recurrent synthetic cannabis and recreational cannabis use, who had developed drastic physiological and psychiatric symptoms, including the development of acute-onset psychosis. Conclusion/Discussion. This case, as many others nationwide, exemplifies the impact of synthetic cannabinoid use and abuse in adolescents. Side effects and adverse health consequences of synthetic cannabinoid use warrant stricter regulations and policies in order to decrease psychiatric hospital admissions and associated healthcare costs.

  4. Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Dhanoa Amreeta

    2012-10-01

    Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA has of late emerged as a cause of community-acquired infections among immunocompetent adults without risk factors. Skin and soft tissue infections represent the majority of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA clinical presentations, whilst invasive and life-threatening illness like necrotizing pneumonia, necrotizing fasciitis, pyomyositis, osteomyelitis and sepsis syndrome are less common. Although more widely described in the pediatric age group, the occurrence of CA-MRSA osteomyelitis in adults is an uncommonly reported entity. Case presentation We describe an invasive CA-MRSA infection in a 28 year-old previously healthy male, manifesting with bacteraemia, osteomyelitis of femur, pyomyositis and septic arthritis of the knee. Initially a preliminary diagnosis of osteosarcoma was suggested by imaging studies and patient underwent a bone biopsy. MRSA was subsequently isolated from blood cultures taken on day of admission, bone, tissue and pus cultures. Incision and drainage of abscess was performed and patient was treated with vancomycin, with fusidic acid added later. It took 6 months for the inflammatory markers to normalize, warranting 6-months of anti-MRSA therapy. Patient was a fervent deer hunter and we speculate that he acquired this infection from extensive direct contact with deer. Molecular characterization of this isolate showed that it belonged to multilocus sequence type (MLST ST30 and exhibited the staphylococcal chromosome cassette mec (SCCmec type IV, staphylococcus protein A (spa type t019, accessory gene regulator (agr type III and dru type dt10m. This strain harbored Panton-Valentine leukocidin (pvl genes together with 3 other virulent genes; sei (enterotoxin, hlg (hemolysin and fnbA (fibronectin binding protein. Conclusion This case study alerts physicians that beyond the most commonly encountered skin and soft tissue

  5. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-01-22

    Jan 22, 2015 ... Bell reported death in his patient by spinal cord compression due to atlanto-axial subluxation and autopsy report showed the erosion ... loss of appetite was admitted with painful torticollis on the postoperative one week. .... CT and magnetic resonance imaging (MRI) are excellent diagnostic tools to show the.

  6. Congenital Right Morgagni Hernia Presenting in an Adult-a Case Report.

    Science.gov (United States)

    Pillai, Sastha Ahanatha; Chinnappan, Santhanakrishnan

    2016-06-01

    Patients with congenital diaphragmatic hernias (CDH) usually present in the neonatal period with respiratory distress. Delayed presentation of CDH in adults is rare and difficult to diagnose. We present a 42-year-old female patient who came with complaints of epigastric pain and breathlessness on exertion. X-ray and CT scan of the chest revealed a right-sided Morgagni hernia. The contents of the hernia were reduced and a primary tension free repair of the hernia defect was done through laparotomy. The postoperative course was uneventful. A strong clinical suspicion and good interpretation of radiological images help diagnose CDH which present late. Prompt surgical repair is mandatory and the outcomes are usually favorable. Primary repair is usually successful; however, mesh repair may be required for larger defects.

  7. Rituximab in Adult –Onset Still’s Disease: Case Report

    Directory of Open Access Journals (Sweden)

    G Mehrpoor

    2009-01-01

    Full Text Available Summary: Adult-onset Still’s disease (AOSD is a rare systemic inflammatory disorder of unknown etiology. It is characterized by high grade fever, skin rash, arthritis, leukocytosis, increased ESR, CRP and liver enzyme levels and high levels of ferritin. The treatment of AOSD includes NSAIDs, steroids, and disease-modifying antirheumatic drugs (DMARDs. Recently biologic agents have been used for treatment of some rheumatologic disorders. Rituximab(MabThera, an anti-CD20 monoclonal antibody is one of the biologic agents which is used by only a few researchers for treatment of refractory AOSD. Herein, we describe a 23 year old woman, who was treated with Rituximab ,three years after diagnosis of AOSD .She did not respond to Metotroxate and Cellcept .After administration of Rituximab, clinical and laboratory remission was achieved .

  8. Exposure Therapy for Fear of Spiders in an Adult with Learning Disabilities: A Case Report

    Science.gov (United States)

    Cowdrey, Felicity A.; Walz, Linda

    2015-01-01

    The evidence-base for exposure therapy in people with learning disabilities experiencing specific phobias is sparse. This case study describes the assessment, formulation and treatment of spider phobia in a woman with learning disabilities using an exposure-based intervention augmented with mindfulness practice and bereavement work. To evaluate…

  9. Exposure Therapy for Fear of Spiders in an Adult with Learning Disabilities: A Case Report

    Science.gov (United States)

    Cowdrey, Felicity A.; Walz, Linda

    2015-01-01

    The evidence-base for exposure therapy in people with learning disabilities experiencing specific phobias is sparse. This case study describes the assessment, formulation and treatment of spider phobia in a woman with learning disabilities using an exposure-based intervention augmented with mindfulness practice and bereavement work. To evaluate…

  10. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-01-07

    Jan 7, 2015 ... Published in partnership with the African Field Epidemiology Network (AFENET). ... out intracranial hemorrhage, brain tomography (CT) was obtained. It revealed no ... admission, control EEG was reported as normal.

  11. Case report

    African Journals Online (AJOL)

    abp

    2013-01-27

    Jan 27, 2013 ... 1Resident of Clinical Pharmacology, Department of Clinical Pharmacology, Faculty of .... the best of our knowledge, co-amoxiclav has never been reported to ... electrolyte replacement, acid-base and metabolic equilibrium.

  12. Case report

    African Journals Online (AJOL)

    iamong

    2016-08-11

    Aug 11, 2016 ... clinical and radiological features other diagnosis as pneumopathy. We herein report the .... Goodpasture syndrome, Churg–Strauss syndrome, systemic lupus erythematosus or idiopathic pulmonary hemosiderosis, which are.

  13. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-02-27

    Feb 27, 2015 ... Key words: Headache, spinal analgesia, epidural anaesthesia, post-dural ... Clinical features the typical positional headache, a procession of ... The immediate postoperative analgesia was ... However, the day after surgery, the patient complained of ... In case of epidural analgesia, a prophylactic blood.

  14. Case report

    African Journals Online (AJOL)

    abp

    15 juin 2017 ... Primary squamous cell carcinoma of the colon: about a case .... des cancers extradigestifs ; des cas de carcinomes ovarien, endométrial, prostatique et ... tumeur (peu différenciée et indifférenciée) et le stade IV de TNM. [1,10].

  15. Case report

    DEFF Research Database (Denmark)

    Füchtbauer, Laila; Brusgaard, Klaus; Ledaal, Pål;

    2015-01-01

    ey Clinical Message 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...

  16. Case report

    African Journals Online (AJOL)

    abp

    2015-11-24

    Nov 24, 2015 ... the first molecularly confirmed case of FOP in sub-Saharan Africa outside South ... She is the seventh child in her family of eight children and the only affected in ... mobility, weight loss due to ankylosis of the jaw and thoracic.

  17. Fever of Unknown Origin in Adults: Two Case Reports and Review

    Directory of Open Access Journals (Sweden)

    Magdalena Baymakova

    2014-06-01

    Full Text Available Fever of unknown origin (FUO is a diagnostic challenge. The list of causing disorders of FUO is probably the longest in the medicine. The active searching of diagnostic clues of history and physical examination is the base to the correct diagnosis. We present two cases of FUO. The finding reason of the febrile syndrome is infection with Human immunodeficiency virus (HIV. The detailed approach in clinical manifestation and laboratory investigation should be the key to final diagnosis with beneficial outcome.

  18. Combined anterior and posterior cruciate ligaments avulsion from the tibial side in adult patient: case report

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    2013-12-01

    Full Text Available The authors describe a rare case of a 28-year-old male patient, victim of motorcycle crash, with direct impact on the right knee, who sustained a bicruciate ligament fracture avulsion from the tibial side, dislocated and with large dimensions, without associated ligamentary lesions; he has undergone surgical treatment - open reduction and internal fixation, of the avulsions, and the follow up was at least six months, presenting good outcome using the Tegner -Lysholm scale.

  19. NEURORETINITIS : A RARE CASE REPORT OF SUDDEN LOSS OF VISION IN YOUNG ADULT

    Directory of Open Access Journals (Sweden)

    Padmini

    2015-05-01

    Full Text Available Neuro retinitis (NR though a rare disease occurring in young adults , mostly unilateral is an inflammatory disorder characterized by swelling of optic nerve head and adjoining retinal nerve fibre layer resulting in a typical Macular star configuration due to lipid exudation within macula and fovea. Neuroretinitis can be due to an infectious process involving the disc , a post viral event , of an autoimmune inflammatory mechanism or sometimes idiopathic in nature resulting in a sudden loss of vision in affected eye along with multiple pupillary defects in form of Anisokoria ( dilated on affected side , Marcus Gunn pupil or ill sustained pupillary reactions . Patients may also present with painful ocular movements mostly adduction and elevation of the eye . Features common to above all 3 groups included age , absence of pain and fundus findings . Preceding systemic symptoms and visual field loss are more common in patient with Cat scratch disease and Multiple Sclerosis and uncommon in those with recurrences . With today’s technological advances , decision making regarding evaluation and treatment of NR is made accurately to reduce the incidence of optic atrophy which leads to total loss of vision

  20. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Report of an Adult Case

    Directory of Open Access Journals (Sweden)

    Celso K. Takimura

    2002-03-01

    Full Text Available We report the clinical findings, pathophysiology, diagnostic characteristics, and surgical repair of anomalous origin of the left coronary artery from the pulmonary artery in a 26-year-old female patient with a clinical diagnosis of coronary heart disease.

  1. The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report

    Directory of Open Access Journals (Sweden)

    Qian Yimei

    2009-01-01

    Full Text Available Abstract Introduction Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidney injury, an association not previously reported in the literature. Case presentation A 60-year-old Indian-American woman with a history of hypertension and diabetes mellitus for 10 years presented with progressive oliguria over 2 days. Laboratory data revealed severe hyperkalemia, azotemia, heavy proteinuria and progressively worsening anemia. Urine eosinophils were not seen. Emergent hemodialysis, erythropoietin and blood transfusion were initiated. Serologic tests for hepatitis B, hepatitis C, anti-nuclear antibodies, anti-glomerular basement membrane antibodies and anti-neutrophil cytoplasmic antibodies were negative. Complement levels (C3, C4 and CH50 were normal. Renal biopsy unexpectedly displayed 100% foot process effacement. A 24-hour urine collection detected 6.38 g of protein. Proteinuria and anemia resolved during six weeks of steroid therapy. Renal function recovered completely. No signs of relapse were observed at 8-month follow-up. Conclusion Adult minimal change disease should be considered when a patient presents with proteinuria and severe acute kidney injury even when accompanied by severe anemia. This report adds to a growing body of literature suggesting that in addition to steroid therapy, prompt initiation of erythropoietin therapy may facilitate full recovery of renal function in acute kidney injury.

  2. Acute Bochdalek hernia in an adult:A case report of a 3D image

    Institute of Scientific and Technical Information of China (English)

    Rejeb Imen; Chakroun-Walha Olfa; Ksibi Hichem; Nasri Abdennour; Chtara Kamilia; Chaari Adel; Rekik Noureddine

    2016-01-01

    A 61-year-old male was found to have a bilateral Bochdalek hernia on routine CT during admission for acute respiratory failure. The chest X-ray showed a left paracardiac mass having a diameter of 6 cm. This mass was initially considered as a mediastinal tumor. However, CT scan showed a bilateral large defect of the posteromedial portion of the diaphragm and mesenteric fat. 3D imaging was also useful for the stereographic perception of Bochdalek hernia. Although Bochdalek hernia is not rare, to our knowl-edge, this is the first case of Bochdalek hernia continued transverse colon observed by spiral CT 3D imaging.

  3. Adult-onset Kaposiform hemangioendothelioma of the tongue: case report and review of the literature

    Science.gov (United States)

    Vashi, P.; Abboud, E.; Bier-Laning, C.; Gupta, D.

    2016-01-01

    We present here a very rare clinical case of a 38-year-old man with Kaposiform hemangioendothelioma (khe) of the tongue who presented to our institution with a growth under the left side of the tongue with no pain or discomfort. There were no enlarged lymph nodes and no significant neurologic findings. Diagnostic histopathology confirmed the lesion to be khe. The tumour was removed surgically, and the surgical specimen confirmed the diagnosis. Follow-up at 3 months shows no clinical evidence of recurrence. PMID:27803613

  4. Unmasking a young adult migratory deep venous thrombosis--case report.

    Science.gov (United States)

    Haliga, Raluca; Drug, V L; Negru, D; Ambarus, V; Neghina, Ionela; Sorodoc, L

    2013-01-01

    Venous thromboembolism is a known complication of cancer which impacts on patient mortality and quality of life. The primary site of cancer is an important risk factor, with highest rates observed in patients with brain, pancreas, gastric, kidney, ovary and lung cancers. The extent of metastatic spread further adds to the risk. In this article, we present the case of a young patient who was diagnosed with an aggressive form of pancreatic neoplasm with secondary determinations, without any previous digestive symptoms, with the occasion of a recurrent and migratory deep venous thrombosis (DVT).

  5. Case report

    African Journals Online (AJOL)

    raoul

    2011-07-18

    Jul 18, 2011 ... Page number not for citation purposes. 1 ... Lipomas are the most common soft tissue tumor of non-neural origin in the body however they ... patient reported burning pain in the same area – causing him to wake up frequently ... Soft tissue lipomas are true benign neoplasms originating from adipose cells.

  6. Anaesthetic management of an adult patient with DOOR syndrome: a case report

    OpenAIRE

    Michalek, Pavel; Donaldson, William; Abraham, Alexander

    2009-01-01

    We report the anaesthetic management of a 48-year-old male patient with Deafness, Onycho-Osteodystrophy and mental Retardation syndrome, epilepsy and cerebral palsy who had two dental procedures under anaesthetic care. For the first short examination sedoanalgesia was employed and the second, longer, procedure was performed under general anaesthesia. His airway management was moderately difficult and the postoperative period was complicated by partial seizures involving the upper extremity an...

  7. Mycotic skin lesions in an adult reindeer caused by Debaryomyces bansenii. A case report

    Directory of Open Access Journals (Sweden)

    Claes Rehbinder

    1994-12-01

    Full Text Available This report apparently is the first to describe candidosis in reindeer. It is imperative that reindeer kept in corrals during winter and spring for supplementary feeding, are provided clean, dry conditions and that strict hygenic measures are followed. If reindeer on the other hand are kept in dirty, wet and muddy corrals, among other things, skin lesions due to fungal infections may possibly appear rather frequently.

  8. Bipartite patella causing knee pain in young adults: a report of 5 cases.

    Science.gov (United States)

    Vaishya, Raju; Chopra, Surender; Vijay, Vipul; Vaish, Abhishek

    2015-04-01

    We report on 5 patients who underwent arthroscopic excision or open reduction and internal fixation for bipartite patella. All patients presented with refractory anterior knee pain. The diagnosis of bipartite patella was made using radiography, and confirmed with magnetic resonance imaging or computed tomographic arthrography. All 5 patients achieved complete resolution of symptoms after surgery, and remained pain-free after a mean followup period of 13 months.

  9. [Acute myocardial infarct in young adults. A report of 142 cases].

    Science.gov (United States)

    Badui, E; Rangel, A; Valdespino, A; Graef, A; Plaza, A; Chávez, E; Ramos, M A; Lepe, L; Cruz, H; Enciso, R

    1993-01-01

    We present 142 cases of myocardial infarction in the young (MIY) which correspond to 5.6% of a total of 2525 patients with MI hospitalized in the past 5 years at the Hospital de Especialidades del Centro Médico La Raza, IMSS. Among them, 124 (87%) were males and 18 (13%) females. The age varied from 25-40 years, average 35 years for both sexes. Occupational labor: 56 (39.5%) were workers, 27 (19%) officemen, 22 (15.5%) professionals, 20 (14%) taxi drivers, 15 (10.5%) merchants and 2 (1.5%) students. Personal cardiac history: 42 (30%) had history of angor pectoris and 5 (3.5%) of MI. Coronary risk factors: 106 patients (75%) had emotional stress due to type "A" personality, 101 (71%) cigarette smoking, 59 (42%) systemic arterial hypertension, 35 (25%) diabetes mellitus, 35 (25%) hyperlipidemias and 28 (20%) obesity. Among them, 34 (24%) had no risk factors. MI localization: 48 (34%) anteroseptal, 37 (26%) anterolateral, 36 (25%) posteroinferior and 21 (15%) inferior. Only in 83 cases coronary angiogram was performed, among them: 34 (41%) had disease of the left coronary artery and 18 (22%) of the right; 33 (40%) had one vessel, 15 (18%) 2 vessel and 4 (5%) 3 vessel disease. In 31 (37%) the coronary angiogram was normal.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report

    Science.gov (United States)

    Choi, Yeun Seoung; Lim, Jung Soo; Kwon, Woocheol; Jung, Soon-Hee; Park, Il Hwan; Lee, Myoung Kyu; Lee, Won Yeon; Yong, Suk Joong; Lee, Seok Jeong; Jung, Ye-Ryung; Choi, Jiwon; Choi, Ji Sun; Jeong, Joon Taek; Yoo, Jin Sae

    2015-01-01

    Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus. PMID:26508947

  11. Paradoxical embolism associated with Ebstein's anomaly in an adult: case report.

    Science.gov (United States)

    Melão, Filipa; Correia, Ana Sofia; Maciel, Maria Júlia

    2013-12-01

    Ebstein's anomaly (EA) is a rare congenital malformation of the tricuspid valve, often associated with other cardiac malformations, especially atrial septal defect, which is present in 80-90% of patients and predisposes to paradoxical embolization. We describe the case of a 47-year-old male, a drug abuser, with a known but not investigated cardiac murmur. He presented to the emergency department with worsening exertional dyspnea and fatigue associated with recent recurrent transient ischemic attacks. On brain computed tomography there were multiple non-recent ischemic infarctions. Transthoracic echocardiography showed EA with severely dilated right cardiac chambers, right systolic dysfunction and severe tricuspid regurgitation. Contrast and transesophageal echocardiography revealed a patent foramen ovale with right-to-left shunt. After exclusion of other potential causes of the neurologic events, they were assumed to be the consequence of paradoxical embolism.

  12. Familial adult spinal muscular atrophy associated with the VAPB gene: report of 42 cases in Brazil

    Directory of Open Access Journals (Sweden)

    Victor Kosac

    2013-10-01

    Full Text Available Familial spinal muscular atrophy (FSMA associated with the vesicle-associated membrane protein-associated protein B (VAPB gene is a rare autosomal dominant disease with late onset and slow progression. We studied 10 of 42 patients from 5 families by taking clinical histories and performing physical exams, electrophysiological studies, and genetic tests. All patients presented late onset disease with slow progression characterized by fasciculations, proximal weakness, amyotrophy, and hypoactive deep tendon reflex, except two who exhibited brisk reflex. Two patients showed tongue fasciculations and respiratory insufficiency. Electrophysiological studies revealed patterns of lower motor neuron disease, and genetic testing identified a P56S mutation of the VAPB gene. Although it is a rare motor neuron disease, FSMA with this mutation might be much more prevalent in Brazil than expected, and many cases may be undiagnosed. Genetic exams should be performed whenever it is suspected in Brazil.

  13. Orbito-Ethmoidal Rhabdomyosarcoma in an Adult Patient: A Case Report and Review of the Literature

    Science.gov (United States)

    Sepúlveda, Ilson; Spencer, M. Loreto; Cabezas, Claudia; Platino, Maria Olga; Schorwer, Max; Ortega, Pablo; Ulloa, David

    2014-01-01

    Abstract We report a patient who presented to the ENT service complaining of nasal obstruction, exophthalmos, edema and ipsilateral facial congestion. Imaging studies revealed an aggressive noncalcified solid mass centered in the left nasoethmoidal region and heterogeneous avid enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of solid alveolar rhabdomyosarcoma. The patient was treated with chemoradiation therapy for 7 weeks. Due to the advanced stage of the disease, the patient was enrolled in a palliative care and pain control program. PMID:25232320

  14. Anaesthetic management of an adult patient with DOOR syndrome: a case report.

    Science.gov (United States)

    Michalek, Pavel; Donaldson, William; Abraham, Alexander

    2009-05-18

    We report the anaesthetic management of a 48-year-old male patient with Deafness, Onycho-Osteodystrophy and mental Retardation syndrome, epilepsy and cerebral palsy who had two dental procedures under anaesthetic care. For the first short examination sedoanalgesia was employed and the second, longer, procedure was performed under general anaesthesia. His airway management was moderately difficult and the postoperative period was complicated by partial seizures involving the upper extremity and a short period of decreased oxygen saturation. The potential anaesthetic implications of Deafness, Onycho-Osteodystrophy and mental Retardation syndrome are highlighted.

  15. Orbito-Ethmoidal Rhabdomyosarcoma in an Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ilson Sepúlveda

    2014-07-01

    Full Text Available We report a patient who presented to the ENT service complaining of nasal obstruction, exophthalmos, edema and ipsilateral facial congestion. Imaging studies revealed an aggressive noncalcified solid mass centered in the left nasoethmoidal region and heterogeneous avid enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of solid alveolar rhabdomyosarcoma. The patient was treated with chemoradiation therapy for 7 weeks. Due to the advanced stage of the disease, the patient was enrolled in a palliative care and pain control program.

  16. Askin's Tumor in an Adult: Case Report and Findings on 18F-FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Gonca Kara Gedik

    2009-01-01

    Full Text Available Primitive neuroectodermal tumor (PNET of the chest wall or Askin's tumor is a rare neoplasm of chest wall. It most often affects children and adolescents and is a very rare tumor in adults. In this case report, we present an Askin's tumor occurred in a 73-year-old male. The patient was admitted with a history of 3-month lower back pain and cough. In computed tomography, there was a lesion with dimensions of 70×40×65 mm in the superior segment of the lower lobe of the left lung. Positron emission tomography/computed tomography with 18F-flourodeoxyglucose revealed a pleural-based tumor in the left lung with a maximum standardized uptake value of 4.36. No distant or lymph node metastases were present. The patient had gone through surgery, and wedge resection of the superior segment of left lobe and partial resection of the ipsilateral ribs were performed. Pathology report with immunocytochemistry was consistent with PNET and the patient received chemotherapy after that.

  17. A rare presentation of subcutaneous granuloma annulare in an adult patient; A case report

    Directory of Open Access Journals (Sweden)

    Waleed Alajroush

    2016-07-01

    Full Text Available We are reporting a 33-year old woman with multiple skin-colored, firm, non-tender nodules of varying sizes (ranging between 1 and 1.5 cm, with limited mobility and normal overlying skin. They were distributed mainly on the palmer side of the fingers. History and laboratory examination indicated lack of systemic diseases such as diabetes, rheumatoid arthritis, and tuberculosis. Histopathologic examination confirmed the subcutaneous granuloma annulare (SGA diagnosis by showing a normal epidermis with palisading granulomas (histocytes and giant cells surrounding small areas of connective tissue degeneration (central necrobiosis and mucin accumulation in the reticular dermis and subcutaneous tissues. The patient responded well to two-session course of intra-lesional steroid injections. SGA should be considered by dermatologists in the differential diagnosis of subcutaneous nodules even without concomitant systemic disease and with rare presentation.

  18. A case report of herpetic and candidal esophagitis in an immunocompetent adult

    Institute of Scientific and Technical Information of China (English)

    Vishwanath Sathyanarayanan; Abdul Razak; M Mukhyprana Prabhu; Kavitha Saravu; Ganesh Pai C; Anuradha K Rao

    2011-01-01

    Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic. A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia, odynophagia and fever. Esophagogastroduodenoscopy (EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm. Histopathological examination revealed ulcerated and inflamed squamous epithelium with the margin of ulcer showing a few overhanging squamous cells with dense eosinophilic cytoplasm, multinucleated and faceted nuclei with glassy chromatin, and an occasional Cowdry type A intranuclear inclusion bodies. Few candidal spores were seen in the underlying stroma. Intravenous acyclovir, fluconazole and pantoprazole were initiated. Oral analgesics were given for pain relief. She was treated for a total of 14 days. She showed significant improvement and was tolerating oral intake after discharge. The patient was asymptomatic with no evidence of recurrence at a 2-month follow-up.

  19. Fraccaro syndrome: report of two Iranian cases: an infant and an adult in a family.

    Directory of Open Access Journals (Sweden)

    Fatemeh Hadipour

    2013-12-01

    Full Text Available 49,XXXXY is rare chromosomal pattern and these patients have mental retardation, small penis, cryptorchidism and skeletal anomalies. We reported a 10 month-old boy who has hypotonia, microcephaly, hypertelorism, depressed nasal bridge, epicanthic folds and bilateral multiple ear tags, high arched palate, down set ears, micrognathia and congenital heart disease such as patent ductus arteriosus (PDA, Atrial septal defect (ASD, mild pulmonary stenosis. Among the skeletal anomalies, he has kyphoscoliosis, clinodactyly of the fourth and fifth fingers of both hands, and bilateral club foot and unilateral dysplasia of the hip. Karyotype was found as 49,XXXXY[44]/48,XXXY[6] and this cytogenetic analysis was help to establish clinical diagnosis Fraccaro syndrome.

  20. Acute mercury poisoning presenting as fever of unknown origin in an adult woman: a case report.

    Science.gov (United States)

    Cicek-Senturk, Gonul; Altay, Fatma Aybala; Ulu-Kilic, Aysegul; Gurbuz, Yunus; Tutuncu, Ediz; Sencan, Irfan

    2014-08-01

    Mercury intoxication may present in a wide range of clinical forms from a simple disease to fatal poisoning. This article presents a case of acute mercury poisoning, a rare condition that presents challenges for diagnosis with fever of unknown origin. A 52-year-old Caucasian woman was admitted to the hospital with high fever, sore throat, a rash over her entire body, itching, nausea, and extensive muscle pain. She had cervical, bilateral axillary and mediastinal lymphadenopathies. We learned that her son and husband had similar symptoms. After excluding infectious pathologies, autoimmune diseases and malignancy were investigated. Multiple organs of our patient were involved and her fever persisted at the fourth week of admission. A repeat medical history elicited that her son had brought mercury home from school and put it on the hot stove, and the family had been exposed to the fumes for a long period of time. Our patient's serum and urine mercury levels were high. She was diagnosed with mercury poisoning and treated accordingly. Mercury vapor is a colourless and odorless substance. Therefore, patients with various unexplained symptoms and clinical conditions should be questioned about possible exposure to mercury.

  1. Case Report Serious pulmonary infection in a splenectomized patient with adult type 1 Gaucher disease.

    Science.gov (United States)

    Zhang, Y; Mao, Y F; Du, J M

    2015-04-13

    A 49-year-old man with a history of Gaucher disease type 1, resulting in serious splenomegaly and eating disorder, was referred to our department and underwent a splenectomy under general anesthesia. Gaucher disease is very rare, and its first signs are unexplained splenomegaly and hypersplenism. On preoperative examination, the patient's platelet count was slightly low, and his other test results were normal. Surprisingly, on the first postoperative day, the patient developed a lung infection. This gradually progressed to acute respiratory distress syndrome with respiratory failure, requiring intubation and mechanical ventilation. The patient eventually recovered, and he was discharged after receiving antibiotics and other treatments to enhance immunity. However, his postoperative lung infection led to a significantly prolonged and expensive hospital stay. This case suggests that we must pay close attention to the immune dysfunction of patients with Gaucher disease type 1. Anesthesia and surgery with accompanying post-traumatic stress can weaken patients' immunity and cause susceptibility to severe lung infections. Pulmonary signs and functions should be monitored closely during the perioperative period, and, if necessary, gamma globulin and thymosin should be administered early in the preoperative or postoperative period to enhance immunity.

  2. Henoch-Schönlein purpura with intracerebral haemorrhage in an adult patient: a case report

    Directory of Open Access Journals (Sweden)

    Karamadoukis Lazarus

    2008-06-01

    Full Text Available Abstract Introduction Henoch-Schönlein purpura is a small vessel vasculitis that affects mainly the skin, joints, gastrointestinal tract and kidneys. The central nervous system is also occasionally affected, although the majority of patients experience only mild symptoms such as headaches and behavioural changes. Intracerebral haemorrhage is a rare complication of Henoch-Schönlein purpura that so far has mainly been described in children and young adolescence. Case presentation We describe a 42-year-old man with Henoch-Schönlein purpura who developed an acute intracerebral haemorrhage that coincided with a reactivation of his vasculitis and the development of renal failure following discontinuation of steroids. In this patient, both the Henoch-Schönlein purpura and his neurological symptoms were successfully treated with intravenous cyclophosphamide and methylprednisolone, followed by a short course of oral cyclophosphamide and long-term oral prednisolone. His renal function also recovered sufficiently not to require renal replacement therapy. Conclusion The management of Henoch-Schönlein nephritis remains unclear, especially in the presence of severe complications such as intracerebral haemorrhage. We describe a successful outcome in such a patient.

  3. Visceral cat scratch disease with endocarditis in an immunocompetent adult: a case report and review of the literature.

    Science.gov (United States)

    Shasha, David; Gilon, Dan; Vernea, Fiona; Moses, Allon E; Strahilevitz, Jacob

    2014-03-01

    Infective endocarditis and hepatosplenic abscesses are rare manifestations of cat scratch disease (CSD), especially among immunocompetent adults. An otherwise healthy woman who presented with fever and abdominal pain was diagnosed with multiple abscesses in the spleen and the liver, as well as a mitral valve vegetation. PCR on spleen tissue was positive for Bartonella henselae. Prolonged treatment with doxycycline and gentamicin led to complete recovery. Review of the literature revealed 18 cases of hepatosplenic CSD in immunocompetent adults; the majority presented with fever of unknown origin and abdominal pain. In most cases the causative organism was B. henselae and the pathological findings were necrotizing granulomas, similar to the pathological features in classic CSD. Concomitant endocarditis was diagnosed in one case. Because Bartonella is one of the leading pathogens of culture-negative endocarditis, we raise the question of whether a comprehensive evaluation for endocarditis is needed in cases of systemic CSD.

  4. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report

    DEFF Research Database (Denmark)

    Kristensen, Thomas; Kofoed, Klaus Fuglsang; Helqvist, Steffen;

    2008-01-01

    the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion...

  5. Muscle-invasive bladder cancer in a young adult: a case report and a review of the literature.

    Science.gov (United States)

    Nabbout, Philippe; Eldefrawy, Ahmed; Engles, C Dirk; Culkin, Daniel J; Slobodov, Gennady

    2013-01-01

    The peak incidence of bladder cancer (BC) is in the sixth decade of life. Muscle-invasive bladder cancer (MIBC) in young adults is extremely rare. We report a case of MIBC in a 28-year-old smoking male patient. The patient presented with hematuria and flank pain for which he underwent a computerized tomography (CT) scan of the abdomen and pelvis with and without contrast. The CT scan showed a 6 cm mass on the left side of the trigone extending to the left urteric orifice and left hydronephrosis, but no lymphadenopathy was noted. The patient then underwent a left nephrostomy tube placement followed by trans-urethral resection of bladder tumor (TURBT). The tumor involved both ureteric orifices and extended to the prostatic urethra. Complete resection was not feasible. Pathology showed high-grade T1 urothelial carcinoma. CT scan of the chest showed no distant lung metastasis. The patient then elected to undergo radical cystectomy with ileal conduit urinary diversion. Final pathology revealed T2a N0 urothelial carcinoma of the bladder. Our aim is to present our experience and review the literature for the natural history and oncological and quality of life outcomes of urothelial carcinoma of the bladder in young patients.

  6. Isolated Endobronchial Mycobacterium avium Disease Associated with Lobar Atelectasis in an Immunocompetent Young Adult: A Case Report and Literature Review.

    Science.gov (United States)

    Kim, Hye In; Kim, Ji Won; Kim, Jun Young; Kim, Young Nam; Kim, Jin Hae; Jeong, Byeong-Ho; Chung, Myung Jin; Koh, Won-Jung

    2015-10-01

    The prevalence of lung diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. Unlike pulmonary tuberculosis, endobronchial NTM diseases are very rare with the majority of cases reported in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome. We reported a rare case of endobronchial Mycobacterium avium disease associated with lobar atelectasis in a young immunocompetent patient and reviewed the relevant iterature.

  7. Proximal junctional vertebral fracture-subluxation after adult spine deformity surgery. Does vertebral augmentation avoid this complication? A case report

    Directory of Open Access Journals (Sweden)

    Fernández-Baíllo Nicomedes

    2012-09-01

    Full Text Available Abstract Background To report to the orthopedic community a case of vertebral fracture and adjacent vertebral subluxation through the upper instrumented vertebra after thoracolumbar fusion with augmentation of the cranial level. Methods This report reviewed the patient`s medical record, her imaging studies and related literature. The possible factors contributing to this fracture are hypothesized. Results A 70-year-old woman underwent decompressive surgery and posterolateral fusion for adult lumbar scoliosis. We used pedicular screws from T10 to S1 and iliac screw at the right side, augmented with cement at T10, T11, L1, L5 and S1; and prophylactic vertebroplasty at T9 to avoid the "topping-off syndrome". Thirty days after discharge, without recognizable inciting trauma, the patient complained of pain in the lower thoracic area. The exam revealed overall neurological deficit below the level of fracture. CT scan and MRI demonstrated a T10 vertebral collapse and T9 vertebral subluxation with morphologic features of flexion-distraction fracture through the upper edge of the screw. At this point, the authors performed posterior decompression at T9 to T10 and extended posterolateral arthrodesis from T2 to T10. To our knowledge, this is an unreported fracture. Conclusions Augmentation of the cranial level in a long thoracolumbar fusion has been developed to avoid the junctional kyphosis and compression fractures at that level. We alert the orthopedic community that this augmentation may lead to further and more severe fractures, although this opinion requires investigation for confirmation.

  8. ROLLER COASTER RETINOPATHY: CASE REPORT OF SYMPTOMATIC BILATERAL INTRARETINAL HEMORRHAGES AFTER SHAKING INJURY IN AN OTHERWISE HEALTHY ADULT

    OpenAIRE

    Yogin P. Patel; Saraf, Steven S.; Desai, Ankit; Desai, Uday R.

    2016-01-01

    Purpose: Traumatic head injuries not involving the eye have been known to cause retinal injury through multiple mechanisms. Abusive head trauma remains the prototypical example. We propose to demonstrate the first case of bilateral multiple retinal hemorrhages in a young healthy adult related to riding multiple theme park roller coasters. Methods: The patient was evaluated with a complete ophthalmic examination including dilated extended ophthalmoscopy, fluorescein angiography, optical cohere...

  9. Langerhans Cell Histiocytosis of the Clavicle in an Adult: A Case Report and Review of the Literature

    Science.gov (United States)

    Udaka, Toru; Susa, Michiro; Kikuta, Kazutaka; Nishimoto, Kazumasa; Horiuchi, Keisuke; Sasaki, Aya; Kameyama, Kaori; Nakamura, Masaya; Matsumoto, Morio; Chiba, Kazuhiro; Morioka, Hideo

    2015-01-01

    Langerhans cell histiocytosis (LCH) usually occurs in children under the age of 10 years with a predilection for the skull, spine, rib and humerus. Solitary LCH occurring in an adult clavicle is uncommon with limited reports to date. The lesion in our patient was curetted with the intent to make a diagnosis, which subsequently lead to the remission of the symptom and the disease. At the final follow-up after 1 year, no local recurrence or metastasis is observed. PMID:26600774

  10. Epstein-Barr virus-associated adult respiratory distress syndrome in a patient with AIDS: a case report and review

    DEFF Research Database (Denmark)

    Stopyra, G A; Multhaupt, H A; Alexa, L

    1999-01-01

    such reported case, along with a survey of archival autopsy cases to assess baseline expression of EBV in AIDS patients. DESIGN: The case patient's autopsy material was studied exhaustively for infectious agents by culture, histochemistry, and immunohistochemistry, with negative results. Formalin-fixed paraffin....... RESULTS: Strikingly numerous lymphocytes were positive for EBV early RNA in the case patient's spleen, lymph nodes, and hepatic portal areas. In addition to positive lymphocytes in the lung, EBV-infected pneumocytes were also present. Electron microscopy also demonstrated viral material in lymphocytes...

  11. A report on case reports

    Directory of Open Access Journals (Sweden)

    Gopikrishna Velayutham

    2010-01-01

    Full Text Available Case reports are defined as the scientific documentation of a single clinical observation and have a time-honored and rich tradition in medicine and scientific publication. This article discusses the role and relevance of case reports in the current evidence-based medical literature. It also seeks to help and guide authors to understand how to prepare a reasonable and well-written case report and how they may anticipate concerns that peer reviewers may express when scrutinizing their manuscript. An overview of the Journal of Conservative Dentistry′s review process of a manuscript submission is provided for the benefit of future authors. It is important to be able to read a case report critically and to use the information they contain appropriately. This article also discusses the factors to consider in evaluating individual case reports, and discusses a practical conceptual scheme for evaluating the potential value and educational content of a case report.

  12. Dermoid cyst of the anterior fontanelle in adults: case report Cisto dermóide na fontanela anterior de adulto: relato de caso

    OpenAIRE

    Ricardo Antônio Gênova de Castro; Afonso de Souza Ribeiro Filho; Valderi Vieira da Silva Jr.

    2007-01-01

    Head and neck dermoid cysts are lesions relatively rare, which usually occur during childhood as solitary lesions. They are often identified and surgically removed at birth, being uncommon in adults. A 23-year-old male presented with a congenital tumor of the anterior fontanelle, which histopathological examination revealed a dermoid cyst. Surgical intervention is the treatment of choice to remove this lesion. The objective of this study is to report the case, once this type of lesion is rare...

  13. Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia linked CSF1R mutation: Report of four Korean cases.

    Science.gov (United States)

    Kim, Eun-Joo; Shin, Jin-Hong; Lee, Jeong Hee; Kim, Jong Hun; Na, Duk L; Suh, Yeon-Lim; Hwang, Sun Jae; Lee, Jae-Hyeok; Lee, Young Min; Shin, Myung-Jun; Lee, Myung Jun; Kim, Seong-Jang; Yoon, Uicheul; Park, Do Youn; Jung, Dae Soo; Ahn, Jae Woo; Sung, Suk; Huh, Gi Yeong

    2015-02-15

    We describe detailed clinical, biochemical, neuroimaging and neuropathological features in adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), encompassing hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) and pigmentary orthochromatic leukodystrophy (POLD), linked to colony-stimulating factor 1 receptor (CSF1R) mutations in four Korean cases. Clinical, biochemical, neuroimaging and neuropathological findings were obtained by direct evaluation and from previous medical records. The genetic analysis of the CSF1R gene was done in two autopsy-confirmed ALSP cases and two cases where ALSP was suspected based on the clinical and neuroimaging characteristics. We identified two known mutations: c.2342C>T (p.A781V) in one autopsy-proven HDLS and clinically ALSP-suspected case and c.2345G>A (p.R782H) in another autopsy-proven POLD case. We also found a novel mutation (c.2296A>G; p.M766V) in a patient presenting with hand tremor, stuttering and hesitant speech, and abnormal behavior whose father died from a possible diagnosis of spinocerebellar ataxia. To the best of our knowledge, this is the first documented ALSP-linked CSF1R mutation in Korea and supports the suggestion that HDLS and POLD, with pathological characteristics that are somewhat different but which are caused by CSF1R mutations, are the same spectrum of disease, ALSP. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Jejunal intussusception in an adult due to small intestine lipomatosis: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Bhavana Venkata Satya Raman

    2015-06-01

    Full Text Available Intussusception is rare in adults. Benign neoplasm are common causes for intussusception in adults, lipoma is the commonest. Lipomas are usually solitary but 5% are multiple. Lipomatosis of small bowel is rare condition and presenting, as intestinal obstruction is even rarer. A 55 year old male patient presented with pain abdomen, distention and constipation. CECT revealed intussusception due to multiple lipomas of jejunum causing jejunojejunal intussusception. On exploratory laparotomy bowel was gangrenous and hence a resection and anastomosis was done. On 12 months fallow up patient was normal. First described by Helmstrom in 1906. Fat deposition in intestine are classified as isolated lipoma, multiple lipomas, nodular lipomatosis and diffuse fatty infiltration of wall without projecting into lumen. Usually present as malena or intussusception, volvulus. Radiologically identified by and ldquo;pseudo kidney sign and rdquo; and and ldquo;target sign and rdquo;. Reduction should not be attempted in the signs of ischemia or malignancy. Lipomatosis should kept in mind as one of the cause for intussusception in adults and CECT is the best modality to ascertain the nature of lesion in most of the cases. [Int J Res Med Sci 2015; 3(3.000: 771-773

  15. Encephalitis, acute renal failure, and acute hepatitis triggered by a viral infection in an immunocompetent young adult: a case report

    Directory of Open Access Journals (Sweden)

    Khattab Mahmoud

    2009-11-01

    Full Text Available Abstract Introduction Cytomegalovirus generally causes self-limited, mild and asymptomatic infections in immunocompetent patients. An aggressive course in immunocompetent healthy patients is unusual. Case presentation We report the case of an immunocompetent 16-year-old Egyptian boy with encephalitis, acute renal failure, and acute hepatitis triggered by viral infection with a complete recovery following antiviral treatment. Conclusion We believe that this case adds to the understanding of the molecular biology, clinical presentation and increasing index of suspicion of many viral infections.

  16. Adult-onset Alexander disease with typical "tadpole" brainstem atrophy and unusual bilateral basal ganglia involvement: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sakoe Kumi

    2010-04-01

    Full Text Available Abstract Background Alexander disease (ALX is a rare neurological disorder characterized by white matter degeneration and cytoplasmic inclusions in astrocytes called Rosenthal fibers, labeled by antibodies against glial fibrillary acidic protein (GFAP. Three subtypes are distinguished according to age at onset: infantile (under age 2, juvenile (age 2 to 12 and adult (over age 12. Following the identification of heterozygous mutations in GFAP that cause this disease, cases of adult-onset ALX have been increasingly reported. Case Presentation We present a 60-year-old Japanese man with an unremarkable past and no family history of ALX. After head trauma in a traffic accident at the age of 46, his character changed, and dementia and dysarthria developed, but he remained independent. Spastic paresis and dysphagia were observed at age 57 and 59, respectively, and worsened progressively. Neurological examination at the age of 60 revealed dementia, pseudobulbar palsy, left-side predominant spastic tetraparesis, axial rigidity, bradykinesia and gaze-evoked nystagmus. Brain MRI showed tadpole-like atrophy of the brainstem, caused by marked atrophy of the medulla oblongata, cervical spinal cord and midbrain tegmentum, with an intact pontine base. Analysis of the GFAP gene revealed a heterozygous missense mutation, c.827G>T, p.R276L, which was already shown to be pathogenic in a case of pathologically proven hereditary adult-onset ALX. Conclusion The typical tadpole-like appearance of the brainstem is strongly suggestive of adult-onset ALX, and should lead to a genetic investigation of the GFAP gene. The unusual feature of this patient is the symmetrical involvement of the basal ganglia, which is rarely observed in the adult form of the disease. More patients must be examined to confirm, clinically and neuroradiologically, extrapyramidal involvement of the basal ganglia in adult-onset ALX.

  17. Using self-reported health measures to predict high-need cases among Medicaid-eligible adults.

    Science.gov (United States)

    Wherry, Laura R; Burns, Marguerite E; Leininger, Lindsey Jeanne

    2014-12-01

    To assess the ability of different self-reported health (SRH) measures to prospectively identify individuals with high future health care needs among adults eligible for Medicaid. The 1997-2008 rounds of the National Health Interview Survey linked to the 1998-2009 rounds of the Medical Expenditure Panel Survey (n = 6,725). Multivariate logistic regression models are fitted for the following outcomes: having an inpatient visit; membership in the top decile of emergency room utilization; and membership in the top cost decile. We examine the incremental predictive ability of six different SRH domains (health conditions, mental health, access to care, health behaviors, health-related quality of life [HRQOL], and prior utilization) over a baseline model with sociodemographic characteristics. Models are evaluated using the c-statistic, integrated discrimination improvement, sensitivity, specificity, and predictive values. Self-reports of prior utilization provide the greatest predictive improvement, followed by information on health conditions and HRQOL. Models including these three domains meet the standard threshold of acceptability (c-statistics range from 0.703 to 0.751). SRH measures provide a promising way to prospectively profile Medicaid-eligible adults by likely health care needs. © Health Research and Educational Trust.

  18. A case report of successful treatment of 90° knee flexion contracture in a patient with adult-onset Still's disease.

    Science.gov (United States)

    He, Qiang; Xiao, Lin; Ma, Jianbing; Zhao, Guanghui

    2016-02-09

    Severe knee flexion contractures greater than 80° are rare and challenging to manage. Previous studies have demonstrated unsatisfactory clinical results after correcting these deformities because residual flexion contractures were not corrected within a short period of time. We herein report the case of a patient with adult-onset Still's disease with 90° of bilateral knee flexion contracture, which was successfully corrected by total knee arthroplasty and serial casting over a period of five weeks. A 47-year-old male was admitted to our orthopedic department for bilateral knee pain and a preoperative fixed flexion contracture of 90°. A diagnosis of adult-onset Still's disease was made based on the patient's medical history of a high spiking fever, salmon-colored rash and bilateral knee and wrist pain. Bilateral total knee arthroplasty was carried out to address these deformities, but residual flexion contracture was present. Subsequently, serial casting was used to achieve full extension at four weeks after surgery. Excellent function and patient satisfaction were observed at two years of follow-up. The new protocol of total knee arthroplasty with subsequent serial casting seems to be an efficient solution for knee flexion contractures greater than 80°. This report adds to the very small number of reported cases of adult-onset Still's disease with severe knee flexion contractures and describes a patient who was successfully treated with a new protocol.

  19. Weaknesses in the reporting of cross-sectional studies according to the STROBE statement the case of metabolic syndrome in adults from Peru

    Directory of Open Access Journals (Sweden)

    Jose Carlos Tapia

    2015-12-01

    Full Text Available Introduction:The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies.Objective:To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations.Methods:We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation.Results:Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17, participant flowchart (18%, n= 3/17, missing data analysis (24%, n= 4/17, and number of participants in each study phase (24%, n= 4/17.Conclusion:Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.

  20. ROLLER COASTER RETINOPATHY: CASE REPORT OF SYMPTOMATIC BILATERAL INTRARETINAL HEMORRHAGES AFTER SHAKING INJURY IN AN OTHERWISE HEALTHY ADULT.

    Science.gov (United States)

    Patel, Yogin P; Saraf, Steven S; Desai, Ankit; Desai, Uday R

    2016-01-01

    Traumatic head injuries not involving the eye have been known to cause retinal injury through multiple mechanisms. Abusive head trauma remains the prototypical example. We propose to demonstrate the first case of bilateral multiple retinal hemorrhages in a young healthy adult related to riding multiple theme park roller coasters. The patient was evaluated with a complete ophthalmic examination including dilated extended ophthalmoscopy, fluorescein angiography, optical coherence tomography, and fundus photography. The patient was found to have a bilateral symptomatic macular retinopathy characterized by multiple intraretinal hemorrhages. Given the lack of other systemic findings and negative medical workup, her signs and symptoms were thought to be attributed to the same day attendance of a theme park and riding of multiple roller coasters. Theme park roller coasters, as well as other attractions, may affect the eye at the vitreoretinal interface. This type of acceleration-deceleration injury should be considered in the differential of an adolescent or adult patient with retinal hemorrhage in the absence of other pathologic processes to explain clinical findings.

  1. Multifocal Langerhans cell histiocytosis in an adult with a pathological fracture of the mandible and spontaneous malunion: A case report

    Science.gov (United States)

    SHI, SAILANG; LIU, YANMING; FU, TAO; LI, XIUZHEN; ZHAO, SHIFANG

    2014-01-01

    Langerhans cell histiocytosis (LCH) is rare in the adult population and even rarer with jaw involvement. The current study presents the case of a 39-year-old male who complained of recurrent pain, swelling of the gingiva and an occasional pus-like discharge in the right mandible for one year. The patient was previously prescribed antibiotics, but this did not resolve the problem. An initial panoramic radiograph showed an osteolytic lesion and bone fracture in the right mandible. Eight months later, a new radiograph showed the spontaneous malunion of the fractured mandible. The patient was eventually diagnosed with Langerhans cell histiocytosis by histopathology and immunohistochemistry. Further lesions were found in the ribs and ilium by nuclear bone scanning. The patient was subsequently treated with systemic chemotherapy, and the lesions are currently effectively being controlled. This study is the first to show that spontaneous intralesional bone regeneration may lead to reunification of the mandible fracture caused by LCH in an adult. PMID:25120660

  2. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult: A Case Report of CT and MRI Findings.

    Science.gov (United States)

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings.A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180 s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation.Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH.

  3. Acquired port-wine stain in an adult male: First reported case from India with review of literature

    Directory of Open Access Journals (Sweden)

    Shuchi Bansal

    2015-01-01

    Full Text Available Port-wine stains (PWSs are congenital vascular lesions caused by progressive ectasia of blood vessels located in the vascular plexus of the dermis. Acquired PWSs develop later in life but are identical in morphology and histology to the congenital PWSs. Less than 75 cases of acquired PWSs have been reported in the published literature, of which there has not been a single report from India so far. Various factors have been proposed for its pathogenesis like trauma, actinic exposure, drugs, tumors, and herpes zoster infection. We report an acquired port-wine stain in a 41-year-old male. The causative factors, treatment, and previous reports of this uncommon entity have also been reviewed.

  4. Acquired Port-wine Stain in an Adult Male: First Reported Case from India with Review of Literature

    Science.gov (United States)

    Bansal, Shuchi; Garg, Vijay K; Wadhwa, Bhawna; Khurana, Nita

    2015-01-01

    Port-wine stains (PWSs) are congenital vascular lesions caused by progressive ectasia of blood vessels located in the vascular plexus of the dermis. Acquired PWSs develop later in life but are identical in morphology and histology to the congenital PWSs. Less than 75 cases of acquired PWSs have been reported in the published literature, of which there has not been a single report from India so far. Various factors have been proposed for its pathogenesis like trauma, actinic exposure, drugs, tumors, and herpes zoster infection. We report an acquired port-wine stain in a 41-year-old male. The causative factors, treatment, and previous reports of this uncommon entity have also been reviewed. PMID:25657428

  5. LICHEN STRIATUS – CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Caius Solovan

    2013-07-01

    Full Text Available Lichen striatus is an acquired linear inflammatory dermatosis, not frequently reported, with a peculiar clinical aspect, most often described in adults, with a poor response to treatment. We described 4 cases of lichen striatus diagnosed over an 8-month period of time.

  6. Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report

    OpenAIRE

    Hai Sherng Lee; Abdul Azeez Ahamed Riyaaz; Seng Hong Yeoh

    2015-01-01

    Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Results: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associa...

  7. Ischemic stroke in a young adult with extremely elevated lipoprotein(a): A case report and review of literature.

    Science.gov (United States)

    Lakshminarayan, Dharshan; Elajami, Tarec K; Devabhaktuni, Suresh; Welty, Francine K

    2016-01-01

    Lipoprotein(a) [Lp(a)] is an apolipoprotein(a) molecule bound to 1 apolipoprotein B-100. Elevated levels of Lp(a) are thought to be an independent risk factor for atherosclerosis and to promote thrombosis through incompletely understood mechanisms. We report a 34-year-old man with an ischemic stroke in the setting of an extremely high Lp(a) level-212 mg/dL. He developed severe carotid artery stenosis over a 6-year period and had thrombus formation post-carotid endarterectomy. To our knowledge, this case is unique because the Lp(a) is the highest reported level in a patient without renal disease. Moreover, this is the first reported case of the youngest individual with a stroke presumably related to development of carotid plaque over a 6-year period. The thrombotic complication after endarterectomy may have been related to the prothrombotic properties of Lp(a). Of note, the Lp(a) level did not respond to atorvastatin but did decrease 15% after aspirin 325 mg was added although his Lp(a) levels were variable, and it is not clear that this was cause and effect. This case highlights the need to better understand the relation between Lp(a) and vascular disease and the need to screen family members for elevated Lp(a). We also review treatment options to lower Lp(a) and ongoing clinical trials of newer lipid-lowering drugs that can also lower Lp(a).

  8. Suprasellar pilocytic astrocytoma in an adult with hemorrhage and leptomeningeal dissemination: case report and review of literature.

    Science.gov (United States)

    Soliman, Radwa K; Budai, Caterina; Mundada, Pravin; Aljohani, Bakar; Rushing, Elisabeth J; Kollias, Spyros S

    2016-12-01

    Pilocytic astrocytoma (PA) is a low-grade tumor. It has an excellent prognosis after total resection. Leptomeningeal dissemination and hemorrhage are very rare to be associated with PA and lead to unfavorable prognosis. A 35-year-old man was diagnosed with a hemorrhagic suprasellar PA in 2006. Subsequent examination in 2007 revealed another large subdural hemorrhagic lesion in the sacral region, which proved to be PA by histopathologic assessment. Other leptomeningeal foci were discovered mainly at the craniocervical junction. The patient underwent subtotal resection and received chemotherapy with disease control for 7 years. Progression of the disseminated disease has recently occurred; however, the patient is still alive with stable disease after radiotherapy. The radiological features, management, and relevant literature are also presented. Our report heightens the awareness of PA in the adult population and the importance of close surveillance for the leptomeningeal spread, especially for sellar region tumors.

  9. Glucokinase mutation–a rare cause of recurrent hypoglycemia in adults: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Oluremi N. Ajala

    2016-10-01

    Full Text Available Background: Hypoglycemia occurs frequently in patients both in the inpatient and outpatient settings. While most hypoglycemia unrelated to diabetes treatment results from excessive endogenous insulin action, rare cases involve functional and congenital mutations in glycolytic enzymes of insulin regulation. Case: A 21-year-old obese woman presented to the emergency department with complaints of repeated episodes of lethargy, syncope, dizziness, and sweating. She was referred from an outside facility on suspicion of insulinoma, with severe hypoglycemia unresponsive to repeated dextrose infusions. Her plasma glucose was 20 mg/dl at presentation, 44 mg/dl on arrival at our facility, and remained low in spite of multiple dextrose infusions. The patient had been treated for persistent hyperinsulinemic hypoglycemia of infancy at our neonatal facility and 4 years ago was diagnosed as having an activating glucokinase (GCK mutation. She was then treated with octreotide and diazoxide with improvement in symptoms and blood glucose levels. Conclusion: Improved diagnostication and management of uncommon genetic mutations as typified in this patient with an activating mutation of the GCK gene has expanded the spectrum of disease in adult medicine. This calls for improved patient information dissemination across different levels and aspects of the health care delivery system to ensure cost-effective and timely health care.

  10. [Malignant fibrous histiocytoma. Case report].

    Science.gov (United States)

    Morlino, A; Rossi, M T; Fabrizio, T; Scutari, F

    2010-03-01

    Malignant fibroous histiocytoma (MFH) is an aggressive soft tissue sarcoma, that most frequently occurs in the muscles of the extremities and in abdominal or in retroperitoneal space of young adults. It is seldom confined to the skin and subcutaneous tissue. It is rarely diagnosed before excision and pathological exam, and has an unfavorable prognostic in some cases. This work reports the case of a 94 years old patient with originally cutaneous MFH stressing the importance of the early diagnosis.

  11. LASIK em pacientes adultos com alta anisometropia: relato de casos LASIK for high anisometropia in adults: case report

    Directory of Open Access Journals (Sweden)

    Patrícia Ioschpe Gus

    2006-04-01

    Full Text Available OBJETIVO: Avaliar a eficácia da técnica laser in situ keratomileusis (LASIK na redução de anisometropia em adultos, para os quais os tratamentos convencionais não tiveram sucesso. MÉTODOS: Série de casos de três olhos de três pacientes adultos, dois do sexo feminino e um do sexo masculino, com idade entre 28 e 49 anos (média de 38,3 anos, os quais foram submetidos à técnica de LASIK. Dois pacientes foram acompanhados por dezoito meses e um por seis meses após a cirurgia. RESULTADOS: Comparando a acuidade visual corrigida do pré-operatório com a acuidade visual não corrigida do pós-operatório, um olho ganhou duas linhas de visão, um olho manteve-se igual e um olho perdeu uma linha de visão. Todos os olhos se mantiveram sem ametropia esférica, e o astigmatismo não excedeu -0,75 D no pós-operatório. CONCLUSÃO: A técnica LASIK mostrou-se eficaz na correção de alta anisometropia em adultos, melhorando a acuidade visual e as queixas astenopéicas, e diminuindo a anisometropia.PURPOSE: To evaluate the efficacy of the laser in situ keratomileusis (LASIK technique in the reduction of anisometropy in adults, for whom conventional treatment was not successful. METHODS: A sequence of cases of three eyes of three adult patients, two females and one male, age ranging from 28 and 49 years (average 38.3 years, who underwent LASIK. Two patients were followed up for eighteen months and one for six months. RESULTS: Comparing the corrected visual acuity before surgery with the non-corrected visual acuity after surgery, one eye gained two lines of vision, one eye remained the same and one eye lost one line of vision. All eyes remained without spheric refraction, and astigmatism did not exceed - 0.75 D after surgery. There has been an improvement in the symptoms of asthenopia in the three patients. CONCLUSION: The LASIK technique proved to be efficient in the correction of anisometropy in adults, improving visual accuity and asthenopia

  12. Histological examination and clinical evaluation of the jawbone of an adult patient with cleidocranial dysplasia: a case report

    Science.gov (United States)

    Schnutenhaus, Sigmar; Luthardt, Ralph G; Rudolph, Heike; Götz, Werner

    2015-01-01

    Objectives: Cleidocranial dysplasia (CCD) is a rare congenital malformation syndrome, inherited autosomal-dominantly. During a course of treatment including surgical, implantological and restorative procedures, an opportunity arose to histologically examine biopsies of the maxilla and mandible of a CCD patient 47 years of age. Case report: The aim of this case report is to present the results of the histological evaluation of the alveolar bone and the surgical pretreatment for and placement of six implants each in the maxilla and the mandible. The implants were inserted in a minimally invasive procedure using 3D template guidance. Following uneventful healing of the implants, ceramically veneered bridges were cemented on individual titanium abutments. Since the patient had not received orthodontic treatment in childhood-which would have been the treatment modality of choice-this implantological and prosthodontic approach was necessary. Biopsies were taken from the maxilla and the mandible before placing the implants. Histological evaluation showed bone with strong, coarsely interconnecting trabeculae, especially in the maxilla. Both the bone and the gingiva otherwise exhibited a normal structure without pathological features or anomalies. Conclusion: The clinical parameters and histological evaluation of this one clinical case suggest that the concepts familiar from general oral implantology in terms of surgical and prosthetic procedures can be adopted for older patients with CCD. PMID:26339428

  13. Infratentorial low-grade oligoastrocytoma with aggressive clinical behavior in an adult: a case report with genetic characterization.

    Science.gov (United States)

    Sano, Keisho; Toda, Masahiro; Sasaki, Hikaru; Kitamura, Yohei; Mikami, Shuji; Hirato, Junko; Inoue, Satoshi; Kawase, Takeshi; Yoshida, Kazunari

    2013-04-01

    Oligoastrocytoma preferentially arises in the cerebral hemisphere, and a cerebellar location is unusual. We report the case of a 35-year-old woman with an aggressive cerebellar tumor histopathologically diagnosed as oligoastrocytoma World Health Organization (WHO) grade II. After partial removal of the tumor, she underwent concomitant temozolomide (TMZ) therapy with local irradiation followed by additional TMZ monotherapy. However, her symptoms gradually worsened, and chronological magnetic resonance imaging showed remarkable tumor enlargement. In accordance with the aggressive clinical course, unfavorable genetic characteristics such as the gain of the entire chromosome 7, loss of 9p, absence of 1p/19q codeletion, absence of methylation of the O6-methylguanine-deoxyribonucleic acid methyltransferase promoter, and absence of the isocitrate dehydrogenase-1 mutation were observed. The present case illustrates that these molecular characteristics represent the biological features of gliomas more closely than the histopathological diagnosis and may also suggest that infratentorial gliomas arise through a distinct tumorigenic pathway from their supratentorial counterparts.

  14. 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.

  15. Report of 1 case of adult nasopharyngeal gland polyposis%成人鼻咽部腺体样息肉1例报告

    Institute of Scientific and Technical Information of China (English)

    王成义; 张梅

    2015-01-01

    收治成人鼻咽部腺体息肉患者1例,给予手术治疗。根据病理回报,有腺体组织分布,考虑为咽部黏膜固有层组织及腺体增生、肥大,突出于上皮组织形成。该病例报道较少,还需进一步积累病例及研究。%1 case of adult nasopharyngeal gland polyposis was treated in our hospital.According to the pathological changes of the glandular tissue distribution,taking into account the inherent layer of the pharyngeal mucosa tissue and glandular hyperplasia, hypertrophy,the formation of the epithelial tissue.The case report is less,but also need to further accumulate cases and research.

  16. Cystic lung changes in a thin section CT in an asymptomatic young adult with unilateral pulmonary vein atresia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Choul; Yi, Jeong Geun; Park, Jeong Hee [Konkuk Univ. Medical Center, Seoul (Korea, Republic of)

    2012-07-15

    Unilateral pulmonary vein atresia is a rare anomaly, usually associated with symptoms of recurrent hemoptysis and pneumonia in early childhood. Only one report of an asymptomatic adult patient can be found in the literature. We present the case of an asymptomatic patient with unilateral right pulmonary vein atresia in a 20 year old man. Chest radiograph and multidetector computed tomography showed not only pulmonary vein atresia, pulmonary artery hypoplasia, but also cystic lung changes on thin section CT, along with septal and bronchovascular bundle thickening, and ground-glass opacity. Unilateral pulmonary vein atresia could be another disease which can show cystic lung changes on thin section chest CT.

  17. Young adult patient with two palatally maxillary impacted canines and forced traction on rigid arches of stabilization. Case report

    Science.gov (United States)

    MUCEDERO, M.; PEZZUTO, C.; ROZZI, M.; RICCHIUTI, M.R.; COZZA, P.

    2016-01-01

    SUMMARY Objective Young adult patient treated for impaction of two maxillary canines. Methods C.S., 15 years, female. Diagnostic evaluation by clinical and radiographic examinations shows permanent dentition with persistence of 5.3 and 6.3, impaction of 1.3 and 2.3, dento-skeletal Cl I malocclusion, normodivergence of bone bases. Analysis of TC dentalscan confirms the palatal impaction of 1.3 and 2.3. The treatment plan provided an orthodontic-surgical approach for adequate space management in dental arch, evaluation of eruption movements, choice of anchorage device, surgical exposure and application of the brackets. Results Deciduous canines have been extracted and an edgewise appliance with rigid rectangular full thickness archwires has been used to align the arches and to obtain maximum anchorage during the forced traction. The surgical phase, for exposure of 1.3 and 2.3 respectively, performed an open technique by excisional uncovering and a close technique by a repositioned flap. The case has been finalized for the achievement of the right occlusal keys. Conclusion The possibility to choose the surgical technique depending on the intraosseous position of impacted teeth in association to the edgewise therapy with full thickness arches allows to realize an effectiveness surgical-orthodontic approach for the forced traction of impacted teeth in a favourable position. PMID:28042427

  18. Comorbidity between HTLV-1-associated adult T-cell lymphoma/leukemia and verrucous carcinoma: a case report.

    Science.gov (United States)

    Valencia, Miller; Moreno, Luis

    2017-03-30

    Adult T-cell Leukemia/Lymphoma (ATLL) is classified as a peripheral CD4+ T-cell neoplasm caused by the human T-cell lymphotropic virus type 1 (HTLV-1). Typical symptoms are associated with leukemic infiltration; however, atypical and exaggerated manifestations of verrucous carcinoma have also been described. We present here the case of a patient with multiple skin lesions, ischemic necrosis in the hallux and lymphadenopathies. Biopsies were taken, which showed verrucous epidermal carcinoma and cutaneous lymphoma. Splenomegaly and adenopathy in mesentery, retro peritoneum and lymph node chains in the limbs were observed. Bone marrow examination showed findings compatible with T-cell leukemia/lymphoma; and it was ELISA positive for HTLV-1/2. The patient had a good initial response to a CHOP scheme (cyclophosphamide, doxorubicin, vincristine and prednisone) with filgrastim. However, the patient had a relapse and died before the second cycle. Comorbidity could lead to the associated risk factors model. According to this model, secondary immunodeficiency caused by HTLV-1 may induce the development of verrucous carcinomas; alternatively, the disease could be due to a correlation between HTLV-1 and the human papillomavirus (HPV).

  19. Portal cholangiopathy: case report

    Directory of Open Access Journals (Sweden)

    Maria Cecilia Almeida Maia

    2014-01-01

    Full Text Available The present report describes the case of a child that after blunt abdominal trauma presented with portal thrombosis followed by progressive splenomegaly and jaundice. Ultrasonography and percutaneous cholangiography revealed biliary dilatation secondary to choledochal stenosis caused by dilated peribiliary veins, characterizing a case of portal biliopathy. The present case report is aimed at presenting an uncommon cause of this condition.

  20. Serous papillary adenocarcinoma possibly related to the presence of primitive oocyte-like cells in the adult ovarian surface epithelium: a case report

    Directory of Open Access Journals (Sweden)

    Virant-Klun Irma

    2011-08-01

    Full Text Available Abstract Introduction The presence of oocytes in the ovarian surface epithelium has already been confirmed in the fetal ovaries. We report the presence of SSEA-4, SOX-2, VASA and ZP2-positive primitive oocyte-like cells in the adult ovarian surface epithelium of a patient with serous papillary adenocarcinoma. Case presentation Ovarian tissue was surgically retrieved from a 67-year old patient. Histological analysis revealed serous papillary adenocarcinoma. A proportion of ovarian cortex sections was deparaffinized and immunohistochemically stained for the expression of markers of pluripotency SSEA-4 and SOX-2 and oocyte-specific markers VASA and ZP2. The analysis confirmed the presence of round, SSEA-4, SOX-2, VASA and ZP2-positive primitive oocyte-like cells in the ovarian surface epithelium. These cells were possibly related to the necrotic malignant tissue. Conclusion Primitive oocyte-like cells present in the adult ovarian surface epithelium persisting probably from the fetal period of life or developed from putative stem cells are a pathological condition which is not observed in healthy adult ovaries, and might be related to serous papillary adenocarcinoma manifestation in the adult ovarian surface epithelium. This observation needs attention to be further investigated.

  1. Physical Therapy for an Adult with Chronic Stroke after Botulinum Toxin Injection for Spasticity: A Case Report

    Science.gov (United States)

    Phadke, Chetan P.; Ismail, Farooq; Boulias, Chris

    2015-01-01

    ABSTRACT Purpose: In this case report, we describe the type and duration of a physical therapy and botulinum toxin type A (BoNTA) intervention directed at lower limb spasticity and the gait and balance improvement in a patient post-stroke. Treatment of focal spasticity with BoNTA intramuscular injections combined with physical therapy is recommended by rehabilitation experts. However, the optimal type and duration of physical therapy intervention to optimize any functional gains that follow chemodenervation induced by BoNTA has not been established. Method: One individual with chronic stroke who received BoNTA injections for upper and lower extremity spasticity was included. Physical therapy intervention consisted of 45- to 60-min sessions twice weekly for 12 weeks, based on the Bobath–neurodevelopmental therapy approach, and an activity-based home program. Results: After BoNTA injections and physical therapy, the patient made clinically significant improvements in balance and gait speed and became more independent with his ambulation. Conclusions: This case report demonstrates that physical therapy after BoNTA injections can result in significant functional improvements for individuals with spasticity after chronic stroke that may not be possible with BoNTA injections alone. PMID:25931655

  2. β-human chorionic gonadotropin-secreting intracranial germ-cell tumor associated with high testosterone in an adult man: A case report.

    Science.gov (United States)

    Yang, Wen-Ping; Chien, Hung-Yu; Lin, Yi-Chun

    2017-07-01

    A 38-year-old male patient presented with general weakness, polydipsia and a body weight loss of 10 kg in two years. Hypopituitarism with central hypothyroidism and central adrenal insufficiency were noted at Taipei City Hospital (Taipei, Taiwan). However, hypogonadotropic hypergonadism was also observed. The patient was diagnosed with an intracranial β-human chorionic gonadotropin (β-hCG) secreting germ-cell tumor, and brain magnetic resonance imaging revealed that the tumor involved the pineal gland, stalk, posterior pituitary gland, right basal ganglion, hypothalamus, corpus callosum and posterior hippocampus. The cerebrospinal fluid (CSF) β-hCG level was 1936 IU/l, while the α-fetoprotein (AFP) level was 2:1. The patient was successfully treated with chemotherapy and radiotherapy, as demonstrated by a marked decrease in size of the tumor and in the serum β-hCG levels. Intracranial β-hCG secreting germ-cell tumors are rare in adults and manifest differently compared with patients of early pubertal age. In contrast with the precocious puberty frequently observed in young patients, the diagnosis of adult patients is often delayed and the symptoms are associated with tumor size and location. The present case report described an adult male with an intracranial β-hCG secreting GCT, demonstrating hypopituitarism and asymptomatic hyperandrogenemia, and reviews and discusses the literature relevant to the case.

  3. A Case for Case Report

    Directory of Open Access Journals (Sweden)

    Vivek Gharpure

    2010-11-01

    Full Text Available Evidence based medicine (EBM is becoming popular among clinicians and medical publishers; as clinical research is tested against the touchstone of EBM. Theory of Quality of Evidence, considers randomized controlled trials to be the best quality evidence, while case reports and expert opinions are considered at the lowest ebb

  4. Hormone and thalidomide may be effective in the treatment of adult mediastinal T-cell lymphoblastic lymphoma:a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Wu Hongyang; Zhao Chenchen; Gu Kangsheng; Jiao Yang; Hao Jiqing; Sun Guoping

    2013-01-01

    A case of a 53-year-old man with adult T-lymphoblastic lymphoma (T-LBL) in mediastinum who survived more than 33 months in our hospital was reported. LBL was more common in school-age and teenage boys than adults. The reported patient manifested progressive dyspnea. Chest CT scanning showed a huge irregular soft tissue shadow in anterior mediastinum which extended into posterior mediastinum and left chest wall. The tumor was 20 cm×15 cm×15 cm in size in left upper mediastinum and its boundaries with pericardium and left lower lung were unclear. The diagnosis of T-lymphoblastic lymphoma was confirmed by immunohistochemical staining. After surgery, he received five chemotherapy courses including Gem, CTX and VCR and biological therapies with IL-2 and IFN-α2b. About 16 months later, he complained of diplopia in the left eye without any evidence of recurrence. Blood examination which showed leukemoid reaction twice returned to normal after dehydration, hormone and thalidomide treatments. Finally, his condition became worse and died of pulmonary infection 33 months after ifrst medical service. In summary, T-LBL is a rare disease which may result in poor prognosis even if the patient has received immediate chemotherapy. Hormone and thalidomide can be applied to treat adult T-LBL.

  5. Hormone and thalidomide may be effective in the treatment of adult mediastinal T-cell lymphoblastic lymphoma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hongyang Wu

    2013-06-01

    Full Text Available A case of a 53-year-old man with adult T-lymphoblastic lymphoma (T-LBL in mediastinum who survived more than 33 months in our hospital was reported. LBL was more common in schoolage and teenage boys than adults. The reported patient manifested progressive dyspnea. Chest CT scanning showed a huge irregular soft tissue shadow in anterior mediastinum which extended into posterior mediastinum and left chest wall. The tumor was 20 cm×15 cm×15 cm in size in left upper mediastinum and its boundaries with pericardium and left lower lung were unclear. The diagnosis of T-lymphoblastic lymphoma was confirmed by immunohistochemical staining. After surgery, he received five chemotherapy courses including Gem, CTX and VCR and biological therapies with IL-2 and IFN-α2b. About 16 months later, he complained of diplopia in the left eye without any evidence of recurrence. Blood examination which showed leukemoid reaction twice returned to normal after dehydration, hormone and thalidomide treatments. Finally, his condition became worse and died of pulmonary infection 33 months after first medical service. In summary, T-LBL is a rare disease which may result in poor prognosis even if the patient has received immediate chemotherapy. Hormone and thalidomide can be applied to treat adult T-LBL.

  6. Esotropia do adulto durante o período gestacional: relato de caso Adult esotropia during pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Luciana Negrão Frota de Almeida

    2007-02-01

    Full Text Available Os autores relatam o caso de uma paciente que apresentou quadro reincidente de esotropia aguda e diplopia durante o período gestacional. Não havia história de trauma ou qualquer alteração sistêmica, excetuando-se a gravidez. Tratamento oclusivo alternado foi instituído, e após o parto houve remissão espontânea dos sinais e sintomas.The authors report a case of a female patient who presented, for the second time, diplopia and acute esotropia during pregnancy. There was no trauma involved neither was systemic disease. The patient was treated with conventional occlusion, and, soon after delivery, the squint was resolved.

  7. Mixed Cutaneous Infection Caused by Mycobacterium szulgai and Mycobacterium intermedium in a Healthy Adult Female: A Rare Case Report.

    Science.gov (United States)

    Singh, Amresh Kumar; Marak, Rungmei S K; Maurya, Anand Kumar; Das, Manaswini; Nag, Vijaya Lakshmi; Dhole, Tapan N

    2015-01-01

    Nontuberculous mycobacteria (NTMs) are ubiquitous and are being increasingly reported as human opportunistic infection. Cutaneous infection caused by mixed NTM is extremely rare. We encountered the case of a 46-year-old female, who presented with multiple discharging sinuses over the lower anterior abdominal wall (over a previous appendectomy scar) for the past 2 years. Microscopy and culture of the pus discharge were done to isolate and identify the etiological agent. Finally, GenoType Mycobacterium CM/AS assay proved it to be a mixed infection caused by Mycobacterium szulgai and M. intermedium. The patient was advised a combination of rifampicin 600 mg once daily, ethambutol 600 mg once daily, and clarithromycin 500 mg twice daily to be taken along with periodic follow-up based upon clinical response as well as microbiological response. We emphasize that infections by NTM must be considered in the etiology of nonhealing wounds or sinuses, especially at postsurgical sites.

  8. Acute Liver Failure in an Adult, a Rare Complication of Alagille Syndrome: Case Report and Brief Review.

    Science.gov (United States)

    Frongillo, F; Bianco, G; Silvestrini, N; Lirosi, M C; Sanchez, A M; Nure, E; Gaspari, R; Avolio, A W; Sganga, G; Agnes, S

    2015-09-01

    Alagille syndrome (AS) is an autosomal-dominant, multisystem disorder affecting the liver, heart, eyes, skeleton, and face. The manifestations are predominantly pediatric. Diagnosis is based on findings of a paucity of bile ducts on liver biopsy combined with ≥3 of 5 major clinical criteria. Orthotopic liver transplantation (OLT) is the only option for treating patients who developed liver failure, portal hypertension, severe itching, and xanthomatosis. It is difficult to establish clear criteria for OLT; indications are controversial because of the wide variety of clinical symptoms and the multisystem involvement. Generally, AS-associated liver disease is never an acute illness. We report the case of a 28-year-old woman with AS who underwent urgent OLT for acute liver failure. At 24 months posttransplant, the patient is in good clinical condition and with normal hepatic and renal function.

  9. Multidetector-Row CT Findings of a Preduodenal Portal Vein Associated with Polysplenic Syndrome in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Hyun; Lee, Su Lim; Ku, Young Mi; Chun, Chang Woo [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Uijeongbu (Korea, Republic of)

    2012-03-15

    Preduodenal portal vein (PDPV) is a rare developmental anomaly in which the portal vein runs at the ventral side of the duodenum instead of at an intrapancreatic location. Understanding of this anomaly is of considerable surgical importance, because it may cause unintended portal vein injury during operations involving the gall bladder or duodenum. We recently experienced PDPV associated with polysplenia syndrome in a 49-year-old male patient who complained of persistent epigastric pain. CT portal venography with thin slab maximal intensity projection and volume rendering demonstrated the unique feature of convex anastomosis between the L-shaped mesenterico-portal vein and mesenterico-splenic vein in the mid abdomen. We report here the Multidetector-row CT findings of a rare case of PDPV.

  10. Unusual cause of exercise-induced ventricular fibrillation in a well-trained adult endurance athlete: a case report

    Directory of Open Access Journals (Sweden)

    Vogt Stefan

    2008-04-01

    Full Text Available Abstract Introduction The diseases responsible for sudden deaths in athletes differ considerably with regard to age. In young athletes, congenital malformations of the heart and/or vascular system cause the majority of deaths and can only be detected noninvasively by complex diagnostics. In contrast, in older athletes who die suddenly, atherosclerotic disease of the coronary arteries is mostly found. Reports of congenital coronary anomalies as a cause of sudden death in older athletes are rare. Case presentation A 48-year-old man who was a well-trained, long-distance runner collapsed at the finish of a half marathon because of a myocardial infarction with ventricular fibrillation. Coronary angiography showed an anomalous origin of the right coronary artery from the left sinus of Valsalva with minimal wall alterations. Multislice computed tomography of the coronary arteries confirmed these findings. Cardiomagnetic resonance imaging demonstrated a mild hypokinesia of the basal right- and left-ventricular posterior wall. An electrophysiological study showed an inducible temporary polymorphic ventricular tachycardia and an inducible ventricular fibrillation. The athlete was subsequently treated by acetylsalicylic acid 100 mg (0-1-0, bisoprolol 2.5 mg (1-0-0 and atorvastatin 10 mg (0-0-1 and was instructed to keep his training intensity under the 'individual anaerobic threshold'. Intense and long-lasting exercise under extreme environmental conditions, particularly heat, should also be avoided. Conclusion This case report presents a coronary anomaly as the most likely reason for an exercise-induced myocardial infarction with ventricular fibrillation in a well-trained 48-year-old endurance athlete. Therefore, coronary anomalies have also to be considered as a possible cause of cardiac problems in older athletes.

  11. Atypical Teratoid/Rhabdoid Tumor of the Pineal Region in a Young Adult Male Patient: Case Report and Review of the Literature.

    Science.gov (United States)

    Liebigt, Susan; Florschütz, Axel; Arndt, Nicole; Stock, Karsten; Renner, Christof

    2017-01-01

    Atypical teratoid/rhabdoid tumor (AT/RT) represents a highly malignant and aggressive embryonal neoplasm of the central nervous system (CNS). Histologically it consists of rhabdoid cells with a varying combination of neuroectodermal, epithelial, and mesenchymal tissue. Histologic features and the poor clinical outcome indicate that this tumor corresponds to World Health Organization grade IV. AT/RT mainly occurs in children adults. It often arises from the posterior fossa of infants and has the tendency to spread through the subarachnoid space. In contrast to pediatric cases, most of the AT/RTs in adults are located in the cerebral hemispheres; infratentorial appearance or localization in the spinal cord is relatively uncommon. Likewise there are only a few reports of AT/RT in the pineal region. We present another interesting case of this tumor occurring in the pineal region of a 19-year-old man and discuss our case in the context of the current literature. The patient is alive 18 months since his initial diagnosis without any signs of tumor relapse.

  12. Breakthrough Lactobacillus rhamnosus GG bacteremia associated with probiotic use in an adult patient with severe active ulcerative colitis: case report and review of the literature.

    Science.gov (United States)

    Meini, Simone; Laureano, Raffaele; Fani, Lucia; Tascini, Carlo; Galano, Angelo; Antonelli, Alberto; Rossolini, Gian Maria

    2015-12-01

    Probiotics are widely investigated in the treatment of various bowel diseases. However, they may also have a pathogenic potential, and the role of Lactobacillus spp. as opportunistic pathogens, mostly following disruption of the intestinal mucosa, is emerging. We report on a case of bacteremia caused by L. rhamnosus GG in an adult patient affected by severe active ulcerative colitis under treatment with corticosteroids and mesalazine. Lactobacillus bacteremia was associated with candidemia and occurred while the patient was receiving a probiotic formulation containing the same strain (as determined by PFGE typing), and was being concomitantly treated with i.v. vancomycin, to which the Lactobacillus strain was resistant. L. rhamnosus GG bacteremia, therefore, was apparently related with translocation of bacteria from the intestinal lumen to the blood. Pending conclusive evidence, use of probiotics should be considered with caution in case of active severe inflammatory bowel diseases with mucosal disruption.

  13. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report

    DEFF Research Database (Denmark)

    Kristensen, T.; Kofoed, Klaus Fuglsang; Helqvist, S.;

    2008-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. The usual clinical course is severe left sided heart failure and mitral valve insufficiency presenting during the first months of life. However, in some cases collateral blood supply from...... the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion....... Coronary angiography and CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images before and after surgery...

  14. Beneficial effects following microsurgical decompression in an adult with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele: an interesting case report.

    Science.gov (United States)

    Ghani, Imtiaz; Kroeber, Markus

    2012-08-01

    Case report. To report successful surgical therapy for spinal canal stenosis in an adult patient with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele. A 65-year-old woman with a history of congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele presented with severe radicular pain and weakness in her left lower limb. The patient underwent microsurgical decompression at the level of L3/S1 on the left side. Postsurgery, the patient showed significant amount of pain relief and improvement in weakness in the left lower limb. Surgery for spinal canal stenosis in patients with severe thoraco-lumbar scoliosis can be effective in relieving radicular pain, weakness and numbness, and while not curative can greatly improve the quality of life.

  15. Essential trichomegaly: case report

    Directory of Open Access Journals (Sweden)

    Julia Dutra Rossetto

    2013-02-01

    Full Text Available The present study reports two cases of symptomatic essential trichomegaly. Trichomegaly may develop in various diseases, including anorexia nervosa, hypothyroidism, pregnancy, pretibial myxedema, systemic lupus erythematosus, vernal keratoconjunctivitis, and uveitis. The exact incidence trichomegaly is unknown, and the condition remains sporadically reported. Two cases of symptomatic trichomegaly without any associated systemic disorder are presented in this paper.

  16. Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Hai Sherng Lee

    2015-03-01

    Full Text Available Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Results: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associated with chills, rigors and night sweats, and a productive cough. Examination revealed active synovitis with effusion involving his left knee, ankle and elbow joints and scattered crackles over both lung fields. Chest X-ray showed diffuse pulmonary consolidation. Abdominal ultrasound showed splenic micro-abscesses. The diagnosis was made based on a positive blood culture for Burkholderia pseudomallei. He was started on appropriate antibiotics and responded well, becoming afebrile after 48 hours, while his joint effusions disappeared after one week. A repeat chest X-ray after two weeks of intensive antibiotic therapy showed marked improvement. At the time of writing, he was under uneventful outpatient follow-up and still had 12 weeks to complete his course of antibiotics. Conclusion: Septic arthritis only occurs in 4% of patients with melioidosis. When there is diffuse pulmonary involvement, melioidosis may mimic disseminated tuberculosis, other acute disseminated or focal sepsis syndromes, and systemic vasculitis syndromes. This case is relevant for medical literature as melioidosis is emerging and is expanding its known territories worldwide. It should be considered early in the differential diagnoses of patients presenting with constitutional symptoms in endemic areas, so that treatment can be started early to reduce its high mortality and morbidity.

  17. Case report on the use of the Waldon Approach on an adult with severe to moderate intellectual disability with autistic tendencies.

    Directory of Open Access Journals (Sweden)

    Walter G Solomon

    2016-03-01

    Full Text Available This clinical case report describes a patient diagnosed with severe to moderate intellectual disability with autistic tendencies, resident in a home for adults with a range of disabilities. She had been resident for 18 years prior to intervention by the author when she was 48 years of age. The author worked with her from June 25th 2013 until January 12th 2015 for a total of 55 Waldon Approach1, movement based lessons each of about 45 minutes of which 33 were documented by video. This report describes changes in her cognition and her social behaviour at a time when there were no other changes in her life. As far as the author is aware this is the first clinical case report on the Waldon Approach to appear in a peer reviewed journal and is unique in that most of the work using the approach is with children who are usually receiving other therapies at the same time as their Waldon Lessons, making it harder to evaluate the attribution of change. During the period of this report she received no other therapy or intervention beyond that provided at Maon Roglit which itself had not changed during this period. The patient remains without speech but there has been real, meaningful and noticeable change in her life from which she appears to derive pleasure. There has been a significant improvement in the patient’s group participation, facial expression and general demeanour.

  18. Mixed Cutaneous Infection Caused by Mycobacterium szulgai and Mycobacterium intermedium in a Healthy Adult Female: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Amresh Kumar Singh

    2015-01-01

    Full Text Available Nontuberculous mycobacteria (NTMs are ubiquitous and are being increasingly reported as human opportunistic infection. Cutaneous infection caused by mixed NTM is extremely rare. We encountered the case of a 46-year-old female, who presented with multiple discharging sinuses over the lower anterior abdominal wall (over a previous appendectomy scar for the past 2 years. Microscopy and culture of the pus discharge were done to isolate and identify the etiological agent. Finally, GenoType Mycobacterium CM/AS assay proved it to be a mixed infection caused by Mycobacterium szulgai and M. intermedium. The patient was advised a combination of rifampicin 600 mg once daily, ethambutol 600 mg once daily, and clarithromycin 500 mg twice daily to be taken along with periodic follow-up based upon clinical response as well as microbiological response. We emphasize that infections by NTM must be considered in the etiology of nonhealing wounds or sinuses, especially at postsurgical sites.

  19. Post-infection immunocomplex glomerulonephritis and Legionnaires' disease in a patient with adult Still's disease during treatment with interleukin 1 receptor antagonist anakinra: a case report

    Directory of Open Access Journals (Sweden)

    Imhof Alexander

    2011-07-01

    Full Text Available Abstract Introduction Legionellosis is a systemic disease that primarily affects the lungs. However, dysfunction in many organ systems, including the kidneys, has also been described. There are only a few reported cases of renal dysfunction in patients with legionellosis. Case presentation A 27-year-old Caucasian woman with known adult Still's disease was admitted to our hospital for community-acquired pneumonia, due to Legionella infection, with acute renal failure. Although her respiratory symptoms responded well to antibiotic treatment, her renal function worsened, with severe proteinuria and edema. A renal biopsy showed extracapillary and endocapillary proliferative glomerulonephritis with accompanying chronic and acute interstitial nephritis. This was consistent with a post-infection immunocomplex glomerulonephritis. After initiation of steroid therapy, her renal function improved. Additionally, therapy with diuretics and an angiotensin-converting enzyme inhibitor was initiated because of persistent proteinuria. Under this treatment regimen, her severe edema and proteinuria disappeared. Conclusion To the best of our knowledge, there is only a handful of reported cases of post-infection glomerulonephritis with a nephrotic syndrome in a patient with legionellosis. Our findings suggest that, in patients with Legionnaires' disease with renal failure, post-infection immunocomplex glomerulonephritis should be considered and steroid therapy may be an effective modality to treat the renal complication.

  20. Adult T-cell leukaemia and lymphoma: report of two cases and a brief review of the literature

    NARCIS (Netherlands)

    H.C. van Zaanen; J.G. Pegels

    2002-01-01

    textabstractHuman T-cell lymphotropic virus type 1 (HTLV-1) can cause adult T-cell leukaemia/lymphoma (ATLL). Two patients originating from the Caribbean area with ATLL are described. The first patient developed respiratory insufficiency due to acute T-cell leukaemia. The diagnosis

  1. Ligation of huge spontaneous porto-systemic collaterals to avoid portal inflow steal in adult living donor liver transplantation: A case-report.

    Science.gov (United States)

    Elshobary, Mohamed; Shehta, Ahmed; Salah, Tarek; Sultan, Ahmed Mohamed; Shiha, Usama; Elghawalby, Ahmed Nabieh; Monier, Ahmed; Elsadany, Mohamed; AmrYassen; Fathy, Omar; Wahab, Mohamed Abdel

    2017-01-01

    In adult living donor liver transplantation (LDLT), maintenance of adequate portal inflow is essential for the graft regeneration. Portal inflow steal (PFS) may occur due to presence of huge spontaneous porto-systemic collaterals. A surgical procedure to increase the portal inflow is rarely necessary in adult LDLT. A 52 years male patient with end-stage liver disease due to chronic hepatitis C virus infection. Preoperative portography showed marked attenuated portal vein and its two main branches, patent tortuous splenic vein, multiple splenic hilar collaterals, and large lieno-renal collateral. He received a right hemi-liver graft from his nephew. Exploration revealed markedly cirrhotic liver, moderate splenomegaly with multiple collaterals and large lieno-renal collateral. Upon dissection of the hepato-duodenal ligament, a well-developed portal vein could be identified with a small mural thrombus. The recipient portal vein stump was anastomosed, in end to end fashion, to the graft portal vein. Doppler US showed reduced portal vein flow, so ligation of the huge lieno-renal collateral that allows steal of the portal inflow. After ligation of the lieno-renal collateral, improvement of the portal vein flow was observed in Doppler US. There is no accepted algorithm for managing spontaneous lieno-renal shunts before, during, or after liver transplantation, and evidence for efficacy of treatments remains limited. We report a case of surgical interruption of spontaneous huge porto-systemic collateral to prevent PFS during adult LDLT. Complete interruption of large collateral vessels might be needed as a part of adult LDLT procedure to avoid devastating postoperative PFS. Copyright © 2016. Published by Elsevier Ltd.

  2. Single ventricle, bicuspid aorta and interatrial wall aneurysm as a rare complex adult congenital heart disease: a case report

    OpenAIRE

    Berisha, Blerim; Krasniqi, Xhevdet; Thaqi, Agim; Gashi, Masar; Ko?inaj, Dardan

    2009-01-01

    Background Single ventricle, bicuspid aortic valve and interatrial wall aneurysm in adulthood are a rare and unique case in medical literature. This presented case with congenital heart disease has never been treated surgically and clinical consequences seriously presented in adulthood. Case presentation A 27 year old man with complex congenital heart disease presented. At the age of six, the single ventricle was ultrasonographly diagnosed, but at age 27 clinical consequences started to be se...

  3. Case report: Perinephric lymphangiomatosis

    Directory of Open Access Journals (Sweden)

    Gorantla Rajani

    2010-01-01

    Full Text Available Perirenal lymphangiomatosis is a rare benign malformation of the lymphatic system. We report here a case of bilateral perirenal and parapelvic involvement with a normal excretory collecting system.

  4. PARAPHILLIA : A CASE REPORT

    Science.gov (United States)

    Pawar, A.A.; Valdiya, P.S.; Chaudhury, S.

    2001-01-01

    A case of paraphilia presenting with multiple sexual deviations is reported. The disorder occurred against a background of disordered childhood and was later associated with alcohol abuse. PMID:21407845

  5. Paraendodontic surgery: case report

    OpenAIRE

    Letícia Marchetti LODI; Sheila POLETO; Renata Grazziotin SOARES; Luis Eduardo Duarte IRALA; Salles, Alexandre Azevedo; Limongi,Orlando

    2008-01-01

    Introduction: Paraendodontic surgery is a procedure that aims problemsresolution that couldn’t be solved by the conventional endodontictreatment, or when the accomplishment conventional treatment is notpossible. Case report and conclusion: The aim of this study was to report a clinical case where was made apicectomy on the teeth 11, 21 and 22.The tooth 22 was sealing of root-end cavity MTA retrofilling.

  6. Perforated Meckel’s diverticulum in an adult due to faecolith: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Sunny Modi

    2015-01-01

    Full Text Available Meckel’s diverticulum (MD is a persistent remnant of the vitelointestinal duct and is present in 2% of population [1]. It is the most common congenital malformation of the gastrointestinal tract. It can present clinically as haemorrhage, diverticulitis, intussusception, chronic ulceration, intestinal obstruction and perforation. Complicated presentation, especially bleeding, tends to be more common in the paediatric group, whereas intestinal obstruction is more common in adults [2]. Patients with a perforation of Meckel’s diverticulum by an enterolith are rare and may present with right iliac fossa pain, which mimics acute appendicitis.

  7. Salmonella osteomyelitis of the distal radius in a healthy young adult patient: Report of a rare case and literature review

    National Research Council Canada - National Science Library

    Tonogai, Ichiro; Hamada, Yoshitaka; Hibino, Naohito; Sato, Ryosuke; Henmi, Tatsuhiko; Sairyo, Koichi

    2015-01-01

    Salmonella osteomyelitis of the radius in a healthy individual is very rare. We present such a case involving the distal radius of a healthy 23-year-old man without underlying disease or possible episode...

  8. Cerebral Alveolar Echinococcosis Concomitant with Liver and Lung Lesions in a Young Adult Patient: Case Report and Literature Review.

    Science.gov (United States)

    Batçık, Osman Ersegun; Öğrenci, Ahmet; Koban, Orkun; Ekşi, Murat Şakir; Bilge, Turgay

    2016-09-01

    We present the case of a 25-year-old male harboring multiple brain lesions mimicking tumor metastasis that were revealed to be caused by Echinococcus multilocularis. Cerebral echinococcosis with multiple lesions is rare and might be confused with a brain abscess, tuberculoma, or metastatic tumor disease. Brain magnetic resonance imaging and serological studies are helpful in the differential diagnosis. In case of E. multilocularis, cerebral invasion is the late stage of the disease that necessitates an aggressive treatment protocol.

  9. Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Lee Min

    2012-07-01

    Full Text Available Abstract Background Fusobacterium species are uncommon causes of osteomyelitis. These organisms are normal flora of the oral cavity. Therefore, they mostly cause osteomyelitis of the head and neck. Hematogenous osteomyelitis at distant sites other than the head and neck has rarely been reported in pediatric or immunocompromised patients. Here, we report the first case of osteomyelitis of a long bone combined with a muscle abscess due to Fusobacterium nucleatum in an otherwise healthy adult. Case presentation A 59-year-old Korean man was admitted for pain and swelling of the right lower leg, which had been persistent for two weeks. Magnetic resonance imaging showed osteomyelitis of the right fibula with a surrounding muscle abscess of the right lower leg. Incision and drainage was performed, and repetitive tissue cultures grew F. nucleatum. In this patient, it was presumed that recurrent periodontitis caused hematogenous seeding of F. nucleatum to a distant site leading to osteomyelitis with a muscle abscess. The patient was successfully treated with intravenous ampicillin-sulbactam for three weeks and oral amoxicillin-clavulanate for eight weeks. He also underwent repeated surgical drainage. He has no evidence of recurrence after seven months of follow-up. Conclusions Clinicians should be aware that F. nucleatum could be the etiologic agent of hematogenous osteomyelitis of a long bone in an immunocompetent patient.

  10. Potential use of {sup 18}F-FDG-PET/CT to visualize hypermetabolism associated with muscle pain in patients with adult spinal deformity: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Yuki [The University of Tokyo Hospital, Department of Orthopedic Surgery, Bunkyo-ku, Tokyo (Japan); Takahashi, Miwako; Momose, Toshimitsu [The University of Tokyo, Division of Nuclear Medicine, Department of Radiology, Graduate School of Medicine, Tokyo (Japan); Matsudaira, Ko; Oka, Hiroyuki [The University of Tokyo, Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, Tokyo (Japan)

    2016-11-15

    Patients with adult spinal deformity (ASD) are surgically treated for pain relief; however, visualization of the exact origin of the pain with imaging modalities is still challenging. We report the first case of a 60-year-old female patient who presented with painful degenerative kyphoscoliosis and was evaluated with flourine-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) preoperatively. Because her low back pain was resistant to conservative treatment, she was treated with posterior spinal correction and fusion surgery from Th2 to the ilium. One year after the surgery, her low back pain had disappeared completely. In accordance with her clinical course, {sup 18}F-FDG-PET imaging revealed the uptake of {sup 18}F-FDG in the paravertebral muscles preoperatively and showed the complete absence of uptake at 1 year after surgery. The uptake site coincided with the convex part of each curve of the lumbar spine and was thought to be the result of the increased activity of paravertebral muscles due to their chronic stretched state in the kyphotic posture. This case report suggests the possibility of using {sup 18}F-FDG-PET/CT to visualize increased activity in paravertebral muscles and the ensuing pain in ASD patients. (orig.)

  11. Dermoid cyst of the anterior fontanelle in adults: case report Cisto dermóide na fontanela anterior de adulto: relato de caso

    Directory of Open Access Journals (Sweden)

    Ricardo Antônio Gênova de Castro

    2007-03-01

    Full Text Available Head and neck dermoid cysts are lesions relatively rare, which usually occur during childhood as solitary lesions. They are often identified and surgically removed at birth, being uncommon in adults. A 23-year-old male presented with a congenital tumor of the anterior fontanelle, which histopathological examination revealed a dermoid cyst. Surgical intervention is the treatment of choice to remove this lesion. The objective of this study is to report the case, once this type of lesion is rare in adults.Cistos dermóides de cabeça e pescoço são relativamente raros e, usualmente, ocorrem na infância como lesões solitárias. Eles são diagnosticados e operados ao nascer, na maioria dos casos; portanto, essa é uma lesão incomum no adulto. Um homem de 23 anos apresentava tumoração congênita na fontanela anterior, cujo exame histopatológico revelou ser cisto dermóide. Foi submetido a tratamento cirúrgico. O objetivo desse estudo é relatar o caso, uma vez tratar-se de condição rara no adulto.

  12. Lung contusion and cavitation with exudative plural effusion following extracorporeal shock wave lithotripsy in an adult: a case report

    Directory of Open Access Journals (Sweden)

    Nouri-Majalan Nader

    2010-08-01

    Full Text Available Abstract Introduction Among the complications of extracorporeal shock wave lithotripsy are perinephric bleeding and hypertension. Case presentation We describe the case of a 31-year-old Asian man with an unusual case of hemoptysis and lung contusion and cavitation with exudative plural effusion due to pulmonary trauma following false positioning of extracorporeal shock wave lithotripsy. Differential diagnoses included pneumonia and pulmonary emboli, but these diagnoses were ruled out by the uniformly negative results of a lung perfusion scan, Doppler ultrasound, and culture of bronchoalveolar lavage and plural effusion, and because our patient showed spontaneous improvement. Conclusions False positioning of extracorporeal shock wave lithotripsy can cause lung trauma presenting as pulmonary contusion and cavitation with plural effusion.

  13. Unusual case of mixed form of femoroacetabular impingement combined with nonspecyfic synovitis of the hip joint in a young adult: A case report

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

    Full Text Available Introduction. Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. Case report. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Conclusion. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.

  14. Gluteal neuralgia - unusual presentation in an adult with intrasacral meningocele : a case report and review of literature.

    Directory of Open Access Journals (Sweden)

    Mishra G

    2000-07-01

    Full Text Available A nineteen year old man with intrasacral meningocele is reported, who presented with long standing episodic gluteal pain and progressive muscle wasting. Magnetic resonance imaging established the diagnosis. Surgical excision relieved the pain but muscle wasting persisted. Pertinent literature is reviewed.

  15. One cases report:adult clear cell sarcoma of kidney%成人肾透明细胞肉瘤1例病例报道

    Institute of Scientific and Technical Information of China (English)

    江冬梅; 王凤玮

    2015-01-01

    Clear cell sarcoma of kidney(CCSK) is a rare and malignant sarcoma, whose the origin of organization is not clear,and most reports indicated the patients is children,but not adults.The sarcoma has hard prognosis and poor sur-vival rate.CCSK is similar to other renal malignant tumors very much in clinical and histological aspects,therefore,the differential diagnosis with other renal malignant tumor is very important.Now we report a case of an adult female pa-tients who was already diagnosed with CCSK of the kidney,and state the discrimination with CCSK of kidney and Wilms’tumor.%肾透明细胞肉瘤(CCSK)是一种组织来源尚未十分清楚的罕见软组织恶性肿瘤,该病多见于儿童,成人患者罕见。成人CCSK预后极差,生存期短。 CCSK临床表现和组织形态学与多种肾恶性肿瘤相似,误诊率较高,在患者预后和治疗方面,CCSK与其他肾恶性肿瘤差别较大,因此,CCSK与其他肾恶性肿瘤的鉴别诊断对于CCSK的确诊至关重要。本文报道我院1例已确诊为CCSK的成年女性患者,简要阐述该疾病与肾透明细胞癌、肾母细胞瘤的鉴别。

  16. Salmonella osteomyelitis of the distal radius in a healthy young adult patient: report of a rare case and literature review.

    Science.gov (United States)

    Tonogai, Ichiro; Hamada, Yoshitaka; Hibino, Naohito; Sato, Ryosuke; Henmi, Tatsuhiko; Sairyo, Koichi

    2015-01-01

    Salmonella osteomyelitis of the radius in a healthy individual is very rare. We present such a case involving the distal radius of a healthy 23-year-old man without underlying disease or possible episode. He had right wrist pain for approximately 3 years, and osteolytic lesion was seen in the right distal radius. He underwent surgical treatment, and salmonella was isolated from pus in the lesion. Postoperative antibiotics successfully treated his infection. He had no sign of recurrence, but the point of entry for infection remains unknown.

  17. ACROMEGALY: A CASE REPORT

    OpenAIRE

    -()

    2015-01-01

    Acromegaly is a rare disease caused due to hyper secretion of growth hormone. Most of the cases of acromegaly are caused by pitutary adenoma which can be microadenoma or macroadenomas. These adenomas are never malignant, but can have significant morbidity and mortality. We report a 35 year old female patient presented herewith classical presentation of acromegaly with chief complain of weight gain, excessive sweating , widening of both hands and feet and was diagnosed as a case of acromega...

  18. Rituximab use in young adults diagnosed with juvenile idiopathic arthritis unresponsive to conventional treatment: report of 6 cases.

    Science.gov (United States)

    Sakamoto, Ana Paula; Pinheiro, Marcelo M; Barbosa, Cássia Maria Passarelli Lupoli; Fraga, Melissa Mariti; Len, Claudio Arnaldo; Terreri, Maria Teresa

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Without an effective therapy, patients may progress quickly to functional disability. Recently, depletion of B cells emerged as a new approach for the treatment of autoimmune diseases, including JIA. We describe six cases of JIA patients followed at a referral center for Rheumatology and Pediatric Rheumatology, submitted to treatment with rituximab (RTX) after refractoriness to three anti-TNF agents. Patients received RTX cycles with two infusions every six months. Response to treatment was assessed by DAS28, HAQ/CHAQ, and an overall assessment by the doctor and the patient. Of our six patients, four were girls (mean age at onset of disease: 6.1 years; mean disease evolution time: 15.1 years; mean age upon receiving RTX: 21.6 years). Four patients belonged to polyarticular subtype (1 rheumatoid factor [RF]-negative, 3 FR-positive), a patient with systemic JIA subtype with a polyarticular course and arthritis related to enthesitis. Of our six patients, five responded to treatment; and during the course of 12 months, the clinical response was maintained, although not sustained. However, discontinuation by infusion reactions caused the withdrawal of RTX in two patients. The use of RTX in JIA is restricted to cases refractory to other biological agents and, even considering that this study was held in a small number of advanced patients, RTX proved to be an effective therapeutic option.

  19. Treatment paradox in musculo-skeletal tuberculosis in an immunocompetent adult male; a case report from a tertiary care hospital.

    Science.gov (United States)

    Chaskar, Priyanka; Rana, Geetika; Anuradha; Duggal, Nandini; Arora, Jyoti

    2015-04-01

    Paradoxical reactions like immune reconstitution inflammatory syndrome (IRIS) as seen with patients on retroviral treatment in HIV infection, have also been identified in HIV sero-negative patients with extra pulmonary tuberculosis especially lymph-node tuberculosis. Musculo-skeletal tuberculosis presenting as a cold abscess of the anterior chest wall is a rare entity which poses diagnostic and therapeutic challenge. A 35-year-old immunocompetent male came with complains of painless lump on right side of his chest over 9th and 10th intercostal space which gradually increased and extended upto 11th rib area. Clinically, diagnosis of cold abscess was made and anti-tubercular therapy (ATT) was started. Despite of being on ATT for 3 weeks, patient developed pain and signs of inflammation. Fluid was aspirated and sent for biochemical and microbiological investigations. The aspirated fluid was positive for acid fast bacilli by ZN stain and grew Mycobacterium tuberculosis in culture, sensitive to first line ATT. Pyogenic and fungal culture was negative. This case presented as an anterior chest wall cold abscess which deteriorated on initiation of first line ATT, thus creating a suspicion of resistance to ATT which was cleared on ATT susceptibility testing. Hence, this case underlines the possibility of treatment paradoxes seen in immunocompetent musculo-skeletal tuberculosis.

  20. Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Angelina Maria Martins Lino

    2014-03-01

    Full Text Available Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF, intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks and doxycycline (200 mg/day/2 mo was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome.

  1. Melioidosis: A case report

    Directory of Open Access Journals (Sweden)

    Purabi Barman

    2011-01-01

    Full Text Available Burkhloderia pseudomallei has recently gained importance as an emerging pathogen in India. It causes various clinical manifestations like pneumoniae, septicaemia, arthritis, abscess etc. Cases have been reported from Southeast Asia mainly Thailand, Malaysia, Vietnam, etc. In India, few cases have been reported mainly from the southern part of the country. Patient was a 65-year-old male and presented with fever 1 month back, cough and breathlessness for same period, swelling on both ankles from 7 days. B. pseudomallei was isolated from endotracheal secretions, blood cultures, leg wound. He was successfully treated with Imipenem and Doxycycline and put on maintenance therapy now, and is currently doing well.

  2. Melioidosis: a case report.

    Science.gov (United States)

    Barman, Purabi; Sidhwa, Harish; Shirkhande, Pinak A

    2011-04-01

    Burkhloderia pseudomallei has recently gained importance as an emerging pathogen in India. It causes various clinical manifestations like pneumoniae, septicaemia, arthritis, abscess etc. Cases have been reported from Southeast Asia mainly Thailand, Malaysia, Vietnam, etc. In India, few cases have been reported mainly from the southern part of the country. Patient was a 65-year-old male and presented with fever 1 month back, cough and breathlessness for same period, swelling on both ankles from 7 days. B. pseudomallei was isolated from endotracheal secretions, blood cultures, leg wound. He was successfully treated with Imipenem and Doxycycline and put on maintenance therapy now, and is currently doing well.

  3. Gardner's syndrome: Genetic testing and colonoscopy are indicated in adolescents and young adults with cranial osteomas: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We present a case of a 25-year-old female with diagnosed familial adenomatous polyposis and elevated carcinoembryonic antigen with negative family history.The suspicion of Gardner's syndrome was raised because extirpation of an osteoma of the left temporo-occipital region was made 10 years ago. Restorative proctocolectomy and ileal pouch anal anastomosis was made but histology delineated adenocarcinoma of the rectum (Dukes C stage). We conclude that cranial osteomas often precede gastrointestinal manifestations of familial adenomatous polyposis or Gardner's syndrome and such patients should be evaluated with genetic testing followed by colonoscopy if results are positive to prevent the development of colorectal carcinoma. If the diagnosis is positive all family members should be evaluated for familial adenomatous polyposis.

  4. Severe abdominal injuries sustained in an adult wearing a pelvic seatbelt: a case report and review of the literature.

    LENUS (Irish Health Repository)

    O'Kelly, F

    2008-12-01

    In automobile accidents, the "seatbelt syndrome" (SBS) consists of a constellation of injuries, predominantly involving thoraco-lumbar vertebral fractures and intraabdominal organ injury. A recent amendment to Irish legislation has made the wearing of seatbelts mandatory for all rear seated passengers in an effort to protect children. Whilst rear seatbelts result in a significant reduction in morbidity and mortality following road traffic accidents (RTA), we present a case in which the rear lap seatbelt caused severe abdominal injuries. It is evident that the current rear seat lapbelt system is an inferior design associated with a significant morbidity and mortality when compared to three-point harness system and consideration should be given to replacing them in all motor vehicles.

  5. Haemophagocytic syndrome in an adult suffering from pyrexia of unknown origin: an uncommon presentation of tuberculosis: a case report.

    Science.gov (United States)

    Haque, Wasim Md Mohosin Ul; Shuvo, Md Erfanur Rahman; Rahim, Muhammad Abdur; Mitra, Palash; Samad, Tabassum; Haque, Jalaluddin Ashraful

    2017-02-27

    Tuberculosis is common, can involve various organs of the body and may have diverse presentations. Haemophagocytic syndrome is one of the rare presentations of tuberculosis carrying a very high mortality. Early detection and institution of anti-tuberculosis medications can be life-saving. A 23-year-old Bengali man presented with prolonged fever, weight loss, hepatosplenomegaly, pancytopenia and altered liver function. He had high erythrocyte sedimentation rate, positive tuberculin test, granuloma in liver biopsy, and haemophagocytosis was evidenced by histopathological examination of bone marrow. He recovered with anti-tuberculosis therapy. This case demonstrates that consideration of tuberculosis as an underlying cause of haemophagocytic syndrome could be rewarding and life-saving in this rapidly fatal condition.

  6. 08 Case report 356

    African Journals Online (AJOL)

    Marinda

    Mediastinitis after oesophagoscopy: A case report. ABSTRACT. A 50-year-old male presented with signs and symptoms of oesophageal perforation after a biopsy. Suggestive symptoms and signs were pain in the neck radiating to the back, a rise in temperature ... On the second postoperative day his blood pressure was still.

  7. [Renal leiomyoma. Case report].

    Science.gov (United States)

    Joual, A; Guessous, H; Rabii, R; Benjelloun, M; Benlemlih, A; Skali, K; el Mrini, M; Benjelloun, S

    1999-01-01

    The authors report a case of renal leiomyoma observed in a 56-year-old man. This cyst presented in the from of loin pain. Computed tomography revealed a homogeneous renal tumor. Treatment consisted of radical nephrectomy. Histological examination of the specimen showed benign renal leiomyoma.

  8. Nasal tooth: case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Si Hyun; Kim, Ji Hye; Hwang, Hee Young; Yang, Dal Mo; Kim, Hyung Sik; Park, Chol Heui [Gachon Medical School, Inchon (Korea, Republic of)

    2002-12-01

    Ectopic tooth is not uncommon and usually occurs in the palate and maxillary sinus. We report a case of ectopic tooth located in the nasal cavity, a rare site. The mass depicted by CT was highly attenuated, and central lucency was observed.

  9. a case report

    African Journals Online (AJOL)

    2015-03-26

    Mar 26, 2015 ... The speculated mechanism of SDH involves tear of the Falx ... The cause of this haemor- rhage was not known. Case Description. A female term Neonate with a birth weight of 3.2kg ... abnormalities6 such as fetal or maternal thrombocyto- penia7 or exposure to low molecular weight heparin as reported by ...

  10. Case report 537: Chondroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pignatti, G.; Nigrisoli, M.

    1989-05-01

    A case is reported of a 10-year-old girl who presented with pain in the left hip. Radiologically, a well-defined lytic lesion with a sclerotic border was present in the neck of the femur, with no epiphyseal involvement. The rarity of a metaphyseal site of origin of a chondroblastoma was stressed and the literature reviewed. (orig./GDG).

  11. Vein of Galen aneurysm in an adult: case report Aneurisma da veia de Galeno em adulto: relato de caso

    Directory of Open Access Journals (Sweden)

    Robinson M. Marques

    2006-09-01

    Full Text Available Vein of Galen aneurysm is a rare pathology, representing less than 1% of intracranial vascular malformations. We report on a 65 years-old man who experienced a generalized tonic-clonic seizure. Brain imaging showed a large calcified expanding mass in the pineal region, confirming the diagnosis of a vein of Galen aneurysm. Because of the spontaneous thrombosis of the malformation, there was no need for microsurgical or endovascular treatment and he is been regularly followed since that.Aneurisma da veia de Galeno é patologia rara, representando menos de 1% das malformações vasculares intracranianas. Apresentamos o caso de um homem de 65 anos que teve episódio de crise convulsiva tônico-clônica generalizada. Exames de imagem evidenciaram grande processo expansivo calcificado na região pineal, confirmando o diagnóstico de aneurisma trombosado de veia de Galeno. Devido à trombose espontânea da malformação, foi excluída a possibilidade de tratamento endovascular bem como microcirúrgico, mantendo-se o acompanhamento clínico.

  12. Rare Elizabethkingia meningosepticum meningitis case in an immunocompetent adult

    Science.gov (United States)

    Hayek, Salim S; Abd, Thura T; Cribbs, Sushma K; Anderson, Albert M; Melendez, Andre; Kobayashi, Miwako; Polito, Carmen; (Wayne) Wang, Yun F

    2013-01-01

    Though Elizabethkingia meningosepticum typically causes meningitis in neonates, its occurrence in adult is rare, with sixteen cases described worldwide. We report a case of E. meningosepticum meningitis in an immunocompetent adult. Bacterial identification was made a day earlier than conventional method by using matrix assisted laser desorption ionization time-of-flight (MALDI-TOF) Vitek mass spectrometry RUO (VMS), which resulted in successful treatment with rifampin, trimethoprim-sulfamethoxazole, levofloxacin and minocycline. PMID:26038458

  13. Migraine Infarction. Case Report

    Directory of Open Access Journals (Sweden)

    Yoany Mesa Barrera

    2015-03-01

    Full Text Available Migraine is considered like a risk factor for ischemic ictus in adult young people. In spite of the criteria established for the treatment of the migraine infarct, they are not always fulfilled strictly, permitting certain flexibility in the aforementioned treatment. The case of a patient with a background of migraine with auras, who suffers an ischemic cerebral migraine infarct at the course of a migraine crisis, is presented. The ictus was manifested like an especial right hemiparesis of the female sex in fertile age. The prognosis is good with low risk of recurrence, with unstable disorders and dysarthria. The laboratories studies were normal and the cerebral infarct was detected in the magnetic resonance, at the half left cerebral artery's territory. The patient had favorable evolution without sequel.

  14. Case report: Morgagni hernia.

    Science.gov (United States)

    Rogers, Frederick B; Rebuck, Jill A

    2006-03-01

    The case reported here is a 32-year-old man with a sudden onset of chest pain and an acute deterioration of lung function. An incarcerated Morgagni hernia was diagnosed with a computer tomographic CT scan, and repaired electively via a midline laparotomy. Morgagni hernia is a rare type of congenital diaphragmatic hernia, which may not be symptomatic until adulthood when the patient presents with acute symptoms or incarceration.

  15. [Central neurocytoma: case report].

    Science.gov (United States)

    Bouaziz, M; Mansour, A; Feknous, S; Yassi, F; Smati, S; Belhouchet, S; Lankar, A

    2009-12-01

    In this study, we report one case of central neurocytoma treated in our department. It is a benign tumor of the lateral ventricles of the brain with neuronal differentiation. The clinical symptoms mainly consisted in intracranial hypertension syndrome. Immunohistochemical studies are necessary for the histopathological diagnosis. The treatment of choice is surgical. To guarantee good progression, complete ablation is necessary. The clinical progression, radiological aspects, treatment, histopathology, and postoperative progression will be discussed.

  16. Esthesioneuroblastoma A Case Report

    OpenAIRE

    Chadha, Snya; Pannu, Kulwant Kaur

    2011-01-01

    Esthesioneuroblastoma (ENB) also known as olfactory neuroblastoma is an uncommon malignant neoplasm arising in the roof of nasal cavity. It is now understood to originate from the olfactory epithelium. Case reports published worldwide have been very few. Common presenting symptoms of Esthesioneuroblastoma include nasal obstruction, epistaxis, facial pain, diplopia, proptosis, and anosmia. Apart from being locally aggressive, it metastasizes widely by both hematogenous and lymphatic routes.

  17. Gastric syphilis - Case report*

    Science.gov (United States)

    Guimarães, Tais Ferreira; Novis, Camila Freitas Lobo; Bottino, Caroline Bertolini; D'Acri, Antonio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José

    2016-01-01

    Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described. PMID:27828649

  18. Alkaptonuria: A case report

    Directory of Open Access Journals (Sweden)

    Nirupama Damarla

    2017-01-01

    Full Text Available Alkaptonuria is a rare inborn error of metabolism with autosomal recessive inheritance with a mutation in homogentisate 1,2-dioxygenase. It results in accumulation of homogentisic acid in connective tissues (ochronosis. Most common ocular manifestations are bluish-black discoloration of the conjunctiva, cornea, and sclera. In this case report, a 39-year-old Indian male patient with additional ocular features in the retina is described.

  19. LARYNGOCELE: A CASE REPORT

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    Umakanth Goud

    2015-04-01

    Full Text Available Laryngoceles are rare, cystic dilatation of saccule of ventricle of larynx. Three types are recognized – internal, external and mixed types. Many of the laryngoceles are asymptomatic; few require surgical excision via internal/endoscopic or external approach. Contrast CT is the investigation of choice. A 40year old male presented to our OPD with a neck Scar, later diagnosed as laryngocele. Here is the case report about presentation, di agnosis and management of a large mixed layngocele.

  20. Cystic fibrosis: case report

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    Park, Si Hyun; Lee, Hyun Ju; Kim, Ji Hye; Park, Chol Heui [Gachon Medical School, Inchon (Korea, Republic of)

    2002-12-01

    Cystic fibrosis is an autosomal recessive genetic disease. Among Caucasians, it is the most common cause of pulmonary insufficiency during the first three decades of life. The prevalence of cystic fibrosis varies according to ethnic origin: it is common among Caucasians but rare among Asians. We report a case in which cystic fibrosis with bronchiectasis and hyperaeration was revealed by high-resolution CT, and mutation of the cystic fibrosis conductance transmembrane regulator gene (CFTR) by DNA analysis.

  1. ACROMEGALY: A CASE REPORT

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    10.5958/2319-5886.2015.00183.6

    2015-10-01

    Full Text Available Acromegaly is a rare disease caused due to hyper secretion of growth hormone. Most of the cases of acromegaly are caused by pitutary adenoma which can be microadenoma or macroadenomas. These adenomas are never malignant, but can have significant morbidity and mortality. We report a 35 year old female patient presented herewith classical presentation of acromegaly with chief complain of weight gain, excessive sweating , widening of both hands and feet and was diagnosed as a case of acromegaly due to macroadenoma of pirtutary gland, on the basis of typical clinical features and hormonal parameters also radiological findings. Patient underwent transsphenoidal surgical resection of macroadenoma and recovered completely from the disease. Early recognition and diagnosis will help to avoid the complications of disease.

  2. Eagle syndrome: case report.

    Science.gov (United States)

    Uludağ, İrem Fatma; Öcek, Levent; Zorlu, Yaşar; Uludağ, Burhanettin

    2013-01-01

    Eagle syndrome is an aggregate of symptoms caused by an elongated styloid process, most frequently resulting in headache, facial pain, dysphagia and sensation of foreign body in throat. The proper diagnosis is not difficult with clinical history, physical examination and radiographic assessment if there is a sufficient degree of suspicion. The treatment is very effective. We report here a typical case of Eagle syndrome which was misdiagnosed as trigeminal neuralgia for many years and was treated with carbamazepine. We aim to point the place of Eagle syndrome in the differential diagnosis of facial pain. We also re-emphasize the usefulness of the three-dimensional computed tomography in the diagnosis of Eagle syndrome. Even though Eagle syndrome is a rare condition, in cases of facial pain refractory to treatment or unexplained complaints of the head and neck region, it should be considered in the differential diagnosis as it has therapeutic consequences.

  3. SCLERODERMA: A CASE REPORT*

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    Gülay Altan

    2015-04-01

    Full Text Available Scleroderma is an autoimmune connective tissue disorder which is characterized by fibrosis of visceral organs, skin and blood vessels. This condition can be localized or systemic. Its estimated prevalence is 250 cases in a million and it is more common in women than in men. Resorption of the mandibular angle and coronoid process can be observed in patients with scleroderma. Pressure of fibrous mucocutaneous tissues is thought to be the cause of the resorption. Decreased number of wrinkles due to sclerosis and distinct facial features because of the atrophy of ala nasi are among common clinical characteristics of this condition. The aim of this case report is to present a 40-year-old female patient with scleroderma who presented with signs of resorption at the angle of mandible, coronoid process, as well as widening of the periodontal space.

  4. Hypertrophic pachymeningitis: case report

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    Deus-Silva Leonardo de

    2003-01-01

    Full Text Available Hypertrophic pachymeningits is an unusual cause of neurological symptoms and is often secondary to infections, carcinomatosis or inflammatory diseases. It may also be idiopathic. We report a case of pachymeningitis which was manifested primarily by psychosis and visual loss with optic atrophy and destruction of nasal septum. The patient, a 45 year old woman was submitted to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed a mostly unspecific inflammatory process with extensive fibrosis of the dura and few early stage granulomas. These findings suggest either neurosarcoidosis or idiopathic hypertrophic pachymeningitis.

  5. OBSESSIONS: CASE REPORT STUDY

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    Miloš Židanik

    2004-01-01

    Full Text Available Background. Obsessions are one of the most refractory psychiatric disorders. The therapeutic guidelines include a psychopharmacotherapy and the use of behavioural and supportive psychotherapy.Methods. This case report study presents a patient with a homicide obsessions at the forefront and narcissistic personality disorder in background. The use of analytical oriented psychotherapy, which helped to resolve axis-1 symptoms, is described.Conclusions. In the therapy of patients it is important to have the knowledge about the national therapeutic guidelines and critical distance toward them as well. Which therapy to use should be decided by the individual patient’s needs.

  6. Neuromyelitis Optica. Case Report

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    Patricia Quintero Cusguen

    2009-04-01

    Full Text Available Neuromyelitis Optica, also known as Devic’sSyndrome, is a disease which combines opticneuritis and transverse myelitis. Some years ago it was considered as a form of multiple sclerosis.Actually, it is consider as a different disease, onthe basis of the clinical, imaging, serology andimmunopatholoy profile.A case of 29 years old female patient is reported,based on her clinical findings which beganin the fifth postpartum month, with progressivelower limb paresis, associated with bilateralvision loss.This paper attempts giving a synoptic overviewof this uncommon immune mediateddemyelinating condition; it summarises themost important epidemiological parameters andpresents the diagnostic and therapeutic possibilitiesavailable today.

  7. Choroidal osteoma - case reports.

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    Khan, N; Rahman, N A; Uddin, M S

    2014-07-01

    Choroidal osteoma is a rare disease. In this article four case histories were described. All were female and young patient. One patient had bilateral and other three had unilateral involvement. They had no family history. One patient reported at eye department in Bangabandhu Sheikh Mujib Medical University (BSMMU) and the other three patients reported in Bangladesh Eye Hospital. Choroidal osteoma is a benign tumor. It is diagnosed by fundoscopy, ocular B-scan ultrasonography, x-ray orbit, FFA, OCT and CT-scan of orbit. Most patients do not require treatment. Hemorrhage on the lesion suggests the presence of sub-retinal neovascularization which are typically treated with laser or intra-vitreal anti-VEGF.

  8. Acute adult-onset still’s disease presenting as pulmonary hemorrhage, urticaria, angioedema and leukemoid reaction: a case report and literature review

    OpenAIRE

    Mora Alfonso, Sergio A; Rodríguez, Daniel M Cuestas; Londoño, John D; Valle-Oñate, Rafael; Quintana, Gerardo

    2015-01-01

    Introduction Adult-onset Still’s disease is a rare systemic inflammatory disorder of unknown aetiology characterized by the classic triad of persistent high spiking fevers, joint pain and a distinctive salmon-colored bumpy rash however, the multiorgan involvement can be present. Case description A 40-year-old woman previously healthy was referred to our hospital with 7 days of high fever and generalized arthralgia, The physical exam revealed angioneurotic edema detected on soles, palms and to...

  9. Fantom pain: Case report

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    Marić Sanja S.

    2017-01-01

    Full Text Available Background Phantom limb pain is a common problem after limb amputation (41-85%. It is described as an extremely painful sensation in the missing part of the body that can last for hours, days or even years. It is considered to arise from cortical reorganization, although many factors can increase the risk of phantom limb pain: pain before surgery, age and sex of the patients, the time elapsed since surgery, stump pain, inadequate prosthesis. Phantom limb pain therapy is very complicated. Case report We reported a case of 80-year-old patient suffering from phantom limb pain and phantom sensation 25 years after the amputation of his left leg due to the injury. The patient has pain at the site of amputation, sensation that he has the leg and that it occupies an unusual position and almost daily exhausting phantom limb pain (6-9 visual analogue scale - VAS with disturbed sleep and mood. We managed to reduce the pain under 4 VAS and decrease the patient suffering by combining drugs from the group of coanalgetics (antidepressants, antiepileptics, non-pharmacological methods (transcutaneous electroneurostimulation - TENS, mirror therapy and femoral nerve block in the place of disarticulation of the left thigh. Conclusion Phantom limb pain therapy is multimodal, exhausting for both the patient and the physician and it is often unsuccessful. The combination of different pharmacological and non-pharmacological modalities can give satisfactory therapeutic response.

  10. Coinfection: A Case Report

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    Huldah I. Nwokeukwu

    2013-01-01

    Full Text Available Background. Tuberculosis is a major public health problem, and its control has been facing a lot of challenges with emergence of HIV. The occurrence of multidrug-resistant strain has also propounded the problem especially in children where diagnosis is difficult to make. Multidrug-resistant tuberculosis (MDR-TB is in vitro resistant to isoniazid (H and rifampicin (R. Paediatric multi-drug resistant tuberculosis with HIV coinfection is rare, and there is no documented report from Nigeria. Objective. To report a case of paediatric MDR-TB in Nigeria about it. Methods. The case note of the patient was retrieved, and relevant data were extracted and summarized. Results. A 9-year-old female HIV-positive pupil with a year history of recurrent cough, 3 months history of recurrent fever, and generalized weight loss was diagnosed and treated for tuberculosis but failed after retreatment. She was later diagnosed with MDR-TB and is presently on DOT-Plus regimen. Conclusion. Paediatric MDR-TB with HIV co-infection is rare. Early diagnosis and treatment is important to prevent spread of the disease. The use of Isoniazid preventive therapy is recommended for children who come in contact with patients with active tuberculosis and also for HIV patients without active tuberculosis.

  11. Boerhaave syndrome - case report

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    Biljana Radovanovic Dinic

    Full Text Available ABSTRACT CONTEXT: Boerhaave syndrome consists of spontaneous longitudinal transmural rupture of the esophagus, usually in its distal part. It generally develops during or after persistent vomiting as a consequence of a sudden increase in intraluminal pressure in the esophagus. It is extremely rare in clinical practice. In 50% of the cases, it is manifested by Mackler's triad: vomiting, lower thoracic pain and subcutaneous emphysema. Hematemesis is an uncommon yet challenging presentation of Boerhaave's syndrome. Compared with ruptures of other parts of the digestive tract, spontaneous rupture is characterized by a higher mortality rate. CASE REPORT: This paper presents a 64-year-old female patient whose vomit was black four days before examination and became bloody on the day of the examination. Her symptoms included epigastric pain and suffocation. Physical examination showed hypotension, tachycardia, dyspnea and a swollen and painful abdomen. Auscultation showed lateral crackling sounds on inspiration. Ultrasound examination showed a distended stomach filled with fluid. Over 1000 ml of fresh blood was extracted by means of nasogastric suction. Esophagogastroduodenoscopy was discontinued immediately upon entering the proximal esophagus, where a large amount of fresh blood was observed. The patient was sent for emergency abdominal surgery, during which she died. An autopsy established a diagnosis of Boerhaave syndrome and ulceration in the duodenal bulb. CONCLUSION: Boerhaave syndrome should be considered in all cases with a combination of gastrointestinal symptoms (especially epigastric pain and vomiting and pulmonary signs and symptoms (especially suffocation.

  12. An Adult Case of Diabetic Ketoacidosis Presenting with Cerebral Edema

    OpenAIRE

    Barış Akıncı; Abdurrahman Çömlekçi; Serkan Yener; Süleyman Men

    2009-01-01

    Cerebral edema is a life-threatening complication of diabetic ketoacidosis (DKA) which may predominantly develop in pediatric cases during the management of DKA.. Symptomatic cerebral edema in children is rarely detected at admission, before initiation of the treatment. Cerebral edema associated with DKA is extremely rare in adults. Here, we report an adult patient with DKA who presented with symptomatic cerebral edema. Turk Jem 2009; 13: 16-8

  13. Bilateral pertrochanteric fractures with bilateral patellar fractures with missed medial process fracture of talus in a young adult: a case report and review of literature.

    Science.gov (United States)

    Bali, Kamal; Krishnan, Vibhu; Sen, Ramesh

    2011-12-01

    Management of polytrauma patients is one the most difficult and challenging tasks for an orthopaedic surgeon, and it includes different aspects of intervention: emergent resuscitative care, early surgical care, post-operative care and delayed rehabilitative care. We report an interesting case of multiple skeletal injuries with a coexisting pattern of fractures of bilateral patellae with bilateral pertrochanteric fractures of femur with a missed talar fracture following a dashboard type of injury in a road traffic accident. We are not aware of a similar case reported in literature in the past. We highlight the management protocol in such a case and review the available literature regarding such a presentation.

  14. Rib plating of acute and sub-acute non-union rib fractures in an adult with cystic fibrosis: a case report.

    Science.gov (United States)

    Dean, Nathan C; Van Boerum, Don H; Liou, Theodore G

    2014-10-01

    Rib fractures associated with osteoporosis have been reported to occur ten times more frequently in adults with cystic fibrosis. Fractures cause chest pain, and interfere with cough and sputum clearance leading to worsened lung function and acute exacerbations which are the two main contributors to early mortality in cystic fibrosis. Usual treatment involves analgesics and time for healing; however considerable pain and disability result due to constant re-injury from chronic repetitive cough. Recently, surgical plating of rib fractures has become commonplace in treating acute, traumatic chest injuries. We describe here successful surgical plating in a White cystic fibrosis patient with multiple, non-traumatic rib fractures. A-37-year old White male with cystic fibrosis was readmitted to Intermountain Medical Center for a pulmonary exacerbation. He had developed localized rib pain while coughing 2 months earlier, with worsening just prior to hospital admission in conjunction with a "pop" in the same location while bending over. A chest computerized tomography scan at admission demonstrated an acute 5th rib fracture and chronic non-united 6th and 7th right rib fractures. An epidural catheter was placed both for analgesia and to make secretion clearance possible in preparation for the surgery performed 2 days later. Under general anesthesia, he had open reduction and internal fixation of the right 5th, 6th and 7th rib fractures with a Synthes Matrix rib set. After several days of increased oxygen requirements, fever, fluid retention, and borderline vital signs, he stabilized. Numerical pain rating scores from his ribs were lower post-operatively and he was able to tolerate chest physical therapy and vigorous coughing. In our case report, rib plating with bone grafting improved rib pain and allowed healing of the fractures and recovery, although the immediate post-op period required close attention and care. We believe repair may be of benefit in selected cystic

  15. CADASIL: case report

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    Julio Cesar Vasconcelos da Silva

    Full Text Available ABSTRACT Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL is a hereditary cerebral arteriopathy caused by mutations in the Notch-3 gene. The diagnosis is reached by skin biopsy revealing presence of granular osmiophílic material (GOM, and/or by genetic testing for Notch-3. We report a case of a 52-year-old man with recurrent transient ischemic attacks (TIA, migraine, in addition to progressive sensory, motor and cognitive impairment. He was submitted to a neuropsychological assessment with the CERAD (Consortium to Establish a Registry for Alzheimer's Disease battery along with other tests, as well as neuroimaging and genetic analysis for Notch-3, confirming the diagnosis. Executive function, memory, language and important apraxic changes were found. Imaging studies suggested greater involvement in the frontal lobes and deep areas of the brain.

  16. Alcoholic hallucinosis: case report

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    Bárbara Werner Griciunas

    2017-03-01

    Full Text Available Case report of patient who has been an alcoholic for 40 years and, after reducing alcohol intake, developed auditory and visual hallucinations, which caused behavior change. Neurological issues, electrolyte disturbances and other organ dysfunctions were excluded as cause of said change. After intake of haloperidol and risperidone, the patient had regression of symptoms and denied having presented hallucinatory symptoms. The Manual Diagnóstico e Estatístico de Transtornos Mentais – 5ª edição (DSM-V includes alcoholic hallucinosis in the Substance-Induced Psychotic Disorder (alcohol, beginning during abstinence; however, the document is not yet very well accepted among the medical community. The difficulty of the team to confirm the diagnosis of alcoholic hallucinosis lies in the differential diagnosis, as Delirium tremens and severe withdrawal syndrome with psychotic symptoms. Thus, psychopathological differentiation is important, as well as continuity of research and collaboration of other clinical teams in the evaluation.

  17. Agressive angiomyxoma: Case report

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    Fatma Eskicioğlu

    2012-09-01

    Full Text Available Aggressive angiomyxoma is a rare benign mesenchymal neoplasm. It is often diagnosed in genital, pelvic and perineal region of women in reproductive ages. Aggressive angiomyxoma is associated with a high risk of local recurrence. Aggressive angiomyxoma is mixed with Bartholin’s gland cyst, lipoma and vaginal cysts in diagnosis. Generally, stromal invasion is detected in these benign neoplasms. Therefore, wide local excision should be performed to treat. GnRH agonists could be administered in patient with aggressive angiomyxoma, either primary or recurrent. We reported a case with vulvar aggressive angiomyxoma presented with vulvar mass and treated with wide local excision. J Clin Exp Invest 2012; 3 (3: 420-422Key words: Angiomyxoma, myxoma, vulvar mass

  18. Lamellar Ichtyosis: Case Report

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    Kamer Gündüz

    2009-12-01

    Full Text Available Introduction: Ichtyosiform dermatoses are a group of hereditary disorders characterized by excessive scaling on the skin. Lamellar ichtyosis is an autosomal recessive disorder. The clinical findings are seen at birth and become widespread and prominent in time; gray-brown scales are seen all over the body. Emollients and keratolytics containing salicylic acid or glycolic acid are used topically. Symptoms are improved significantly by acitretin usage. Case Report: Here we present a 5-year-old girl with lamellar ichtyosis. She was born in a collodion membrane. Besides the skin scales, ectropion and deformities of the nails and ears were observed. Significant clinical improvement was seen with acitretin (10 mg/day therapy. Conclusion: Lamellar ichtyosis is a severe form of ichtyosiform dermatoses and topical agents may be insufficient. Systemic acitretin treatment improves the symptoms significantly but long term side effects limit its usage. (Journal of Current Pediatrics 2009; 7: 154-7

  19. [Ureteropelvic junction syndrome in adults. 108 cases in 102 adults].

    Science.gov (United States)

    Joual, A; Aboutaeib, R; Rabii, R; el Mrini, M; Benjelloun, S

    1996-01-01

    We report 108 cases of ureteropelvic junction obstruction corresponding 54 males and 48 females, with a mean age of 33 years. Pain was the commonest symptom. Delay in diagnosis was 3 and a half years. The diagnosis was made by IVP allowing our patients to be in different stages : Stage I (12 cases), stage II (39 cases), stage III (25 cases), stage IV (32 cases). We did not operate on 10 patients presenting with allow stage. 61 patients were operated by a conservative procedure : dismembered pyeloplasty (58 cases), YV pyeloplasty (3 cases). Nephrectomy was performed in 37 patients (34%). This high nephrectomy rate was due to be delayed in diagnosis.

  20. Adenoid Hypertrophy in Adults: A case Series.

    Science.gov (United States)

    Rout, Manas Ranjan; Mohanty, Diganta; Vijaylaxmi, Y; Bobba, Kamlesh; Metta, Chakradhar

    2013-07-01

    Adenoid hypertrophy is common in children. Size of the adenoid increases up to the age of 6 years, then slowly atrophies and completely disappears at the age of 16 years. Adenoid hypertrophy in adults is rare. Present study shows that adenoid hypertrophy is now increasing in adults because of various causes. Study has been conducted in the Department of ENT and Head & Neck Surgery, Alluri Sitarama Raju Academy of Medical science, Eluru, Andhra Pradesh, India. Study shows that incidence of adenoid hypertrophy is increasing as the cause of nasal obstruction in adults. This study identified the different causes of adenoid hypertrophy in adult patients. The common causes of adenoid hypertrophy in adults are chronic infection and allergy. Pollution and smoking are also important predisposing factors. Sometimes it is also associated with sinonasal malignancy, lymphoma and HIV infection. Study shows that 21 % of adult nasal obstruction is due to adenoid hypertrophy. But in case of the patient with chronic tonsillitis only 9 % were associated with adenoid hypertrophy. Males are more commonly involved (70 %) then female, may be because of out door activities and more commonly exposed to pollutants. And most commonly involved age group is 16-25 years (60 %). Majority of the cases with adenoid hypertrophy are associated with infection and allergy i.e. descending infection in 33.3 % cases, ascending infection in 20 % cases and allergic rhinitis in 30 % cases. Association of malignant sinonasal tumors, non Hodgkin's lymphoma and HIV infections are rare i.e. 3.3 % each. So any cases of adult adenoid hypertrophy should be treated seriously to exclude the dangerous causes.

  1. Anterior Chamber Live Loa loa: Case Report.

    Science.gov (United States)

    Kagmeni, G; Cheuteu, R; Bilong, Y; Wiedemann, P

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis.

  2. [Yolk sac tumor. Report of a case].

    Science.gov (United States)

    Debbagh, A; Bennani, S; Jouhadi, H; Joual, A; el Mrini, M; Kahlain, A; Benjelloun, S

    2001-11-01

    Yolk sac tumor is rare in adult. We report a case in a young man aged of 23 years treated by orchiectomy, chemotherapy and retroperitoneal lymphadenectomy. Diagnosis is based on pathology who shows other cellular contingents. Treatment is based on orchiectomy and chemotherapy is indicated for residula masses. The prognosis is bad because metastasis is frequent.

  3. Ureterocele. A Case Report

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    Andrés Gualpa Jácome

    2013-12-01

    Full Text Available Ureterocele is a dilation of the distal end of the ureter that occurs during fetal stage. Its incidence varies according to the series between 1/500 to 1/4000 patients, predominantly in girls. A case of a 50-year-old white female patient with a history of recurrent urinary tract infections is presented. She attended the family doctor’s office due to the exacerbation of her condition by some episodes of dysuria, urinary frequency and urgency for several months. Abdominal ultrasound was recommended. A complex structure in the middle part of the right kidney was disclosed by a multislice ultrasonography of the abdominal region performed in the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos. Ureteropyelocaliectasis with good corticomedullary differentiation was observed in the left kidney, as well as dilation of the ureter until its entry into the bladder as a cystic intravesical mass. It was decided to report this case given its rare occurrence.

  4. Regional odontodysplasia: case report

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    Ana Carolina Magalhães

    2007-12-01

    Full Text Available Regional odontodysplasia (RO is a rare developmental anomaly involving both mesodermal and ectodermal dental components in a group of contiguous teeth. It affects the primary and permanent dentitions in the maxilla and mandible or both jaws. Generally it is localized in only one arch. The etiology of this dental anomaly is uncertain. Clinically, affected teeth have an abnormal morphology, are soft on probing and typically discolored, yellow or yellowish-brown. Radiographically, the affected teeth show a "ghostlike" appearance. This paper reports the case of a 5-year-old girl presenting this rare anomaly on the left side of the maxillary arch, which crossed the midline. The primary maxillary left teeth (except for the canine and the primary maxillary right central incisor were missing due to previous extractions. The permanent teeth had a "ghostlike" appearance radiographically. The treatment performed was rehabilitation with temporary partial acrylic denture and periodic controls. In the future, the extraction of affected permanent teeth and rehabilitation with dental implants will be evaluated. The presentation of this case adds valuable information to pediatric dentists to review special clinical and radiographic features of RO, which will facilitate the diagnosis and treatment of patients with this condition.

  5. Otocephaly: a case report

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    Anshu Sharma

    2016-04-01

    Full Text Available A case of otocephaly was reported in 26+/-4 week's female fetus during routine fetal autopsy at GMCH, Chandigarh, India. Mother was 25 years old, second gravid. The first child is one year old normal male baby. Present pregnancy resulted in spontaneous abortion. Antenatal history, past history, family history and medical history of mother was not suggestive of any ethiological factor responsible for the defect. The external examination showed 2 vessels in umbilical cord. There was anteroposterior lengthening of skull, mouth was in the form of a proboscis with a small opening in the centre, the right ear was absent. The left pinna was low placed and had small tags. On internal examination oral cavity was found small with hypoplastic mandible, tongue was absent (aglossia, thoracic cavity was small, left lung was absent, right lung had only single lobe, heart dilated with normal position of major vessels, In abdominal cavity gut was opening in a dilated cloaca like chamber. X-ray examination revealed small hypoplastic mandible and maxilla. Otocephaly is a rare lethal syndrome of microstomia, agnatia and ear anomalies. Other anomalies associated are holoprosenxcephaly, skeletal, genitourinary, cardiovascular system, endocrine gland hypoplasia etc. The differential diagnosis includes Treacher Collins syndrome, Goldenhar syndrome and Mobius syndrome. The etiology, incidence, causative factors of this case will be discussed in light of available literature. [Int J Res Med Sci 2016; 4(4.000: 1286-1289

  6. Scleroderma: a case report

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    Prachi Sankhe

    2015-06-01

    Full Text Available Scleroderma is systemic multi organ autoimmune disorder characterized by hardening of skin. Also known as systemic sclerosis. Estimated annual incidences of approximately 19 cases per million persons. The limited skin disease has a 10-year survival rate of 71%, whereas those with diffuse skin disease have a 10-year survival rate of just 21%. Risk is higher in women than men and peak in individuals aged 30-50 years. It has no definitive treatment. It may be limited or diffuse depending upon manifestations of symptoms or signs affecting internal organs especially lungs, heart, or kidney. We report a case of scleroderma with pulmonary hypertension and interstitial lung disease in our hospital who presented with tightening of skin, joint pain, dysphagia, and breathlessness. On examination skin appeared dark, shiny, and tight, with loss of hair, paraesthesia and digital ulceration. Patient also has history of Raynauds phenomenon. On investigation, Scl-70 and ANA (antinuclear antibodies by enzyme immunoassay came positive. HRCT thorax was suggestive of interstitial fibrosis and PFT revealed moderate restriction. On 2D echocardiography, mild pulmonary hypertension was present while barium swallow showed motility disorder involving oesophagus. On view of extensive systemic involvement like skin, respiratory system, gastrointestinal system and heart, we would like to present this rare disorder. [Int J Res Med Sci 2015; 3(3.000: 802-804

  7. Pseudohypoaldosteronism: Case Report

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    Kazım Küçüktaşçı

    2009-12-01

    Full Text Available Introduction: Pseudohypoaldosteronism is a disease which occurs as a result of peripheral resistance to aldosterone and is characterised by salt wasting. Case Report: Hyponatremia, hyperkalemia, metabolic acidosis, high renin and aldosterone levels were determined in the patient admitted with decrease in sucking and getting sleepy during breast-feeding. The case was diagnosed as systemic form of pseudohypoaldosteronism. His treatment was continued with oral salt. Conclusion: Pseudohypoaldosteronism has three types as primary, secondary and Gordon syndrome. Primary form is due to epithelial sodium channel and mineralocorticoid receptor gene mutation, whilst secondary form is frequently caused by urinary malformation and urinary tract infections. In Gordon syndrome, plasma aldosterone level is usuallly normal, and plasma renin activity is depressed, there is an adequate response to mineralocorticoids. Probability of secondary pseudohypoaldosteronism was investigated at the same time because of the urinary infection present in our subject. The patient was accepted as systemic form of primary pseudohypoaldosteronism because of positive sweat test result and prolonged salt necessity. (Journal of Current Pediatrics 2009; 7: 151-3

  8. A Case of Nasal Glial Heterotopia in an Adult

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    Akira Hagiwara

    2014-01-01

    Full Text Available We report a rare case of nasal glial heterotopia in an adult. After the surgery, frontal lobe cerebral hemorrhage developed. A 58-year-old man had unilateral nasal obstruction that progressed for one year. He had been treated for hypertension, chronic heart failure, and cerebral infarction with aspirin and warfarin. A computed tomography scan showed that the tumor occupied the right nasal cavity and the sinuses with small defect in the cribriform plate. The tumor was removed totally with endoscopy. After the operation, the patient developed convulsions and frontal lobe cerebral hemorrhage. The hemorrhage site was located near a defect in the cribriform plate. Nasal glial heterotopia is a rare developmental abnormality, particularly rare in adult. Only few cases were reported. We could not find any report of adult nasal glial heterotopias that developed cerebral hemorrhage as a complication of the surgery.

  9. Celiac disease - case report

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    Bojković Gradimir

    2002-01-01

    Full Text Available Introduction Celiac disease (nontropical sprue, gluten-sensitive enteropathy, chronic intestinal malabsorption disorder is caused by gluten intolerance. This hereditary disorder is caused by sensitivity to gliadin. Because the body's own immune system causes the damage, celiac disease is considered to be an autoimmune disorder. However, it is also classified as a disease of malabsorption because nutrients are not absorbed. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Specifically, tiny finger-like protrusions, called villi, on the lining of the small intestine are lost. The diagnosis is suspected on the basis of symptoms and signs, enhanced by laboratory and x-ray studies, and confirmed by biopsy revealing flat mucosa and subsequent clinical and histologic improvement on a gluten-free diet. Gluten must be excluded from diet. Supplementary vitamins, minerals and hematinics may be given depending on deficiency. Case report This is a case report of a 23-year old female patient with a mineralization defect (osteomalacia and secondary osteoporosis caused by long-time unrecognized celiac disease. The patient had many symptoms: short stature, steatorrhea, anemia, weight loss and chronic bone pain. Laboratory and x-ray studies and jejunal biopsy revealed a chronic intestinal malabsorption disorder caused by gluten intolerance. Gluten-free diet and supplementary vitamins, minerals and hematinics were included with apparent clinical remission. Discussion and Conclusion Some people with celiac disease may not have symptoms. The undamaged part of their small intestine is able to absorb enough nutrients to prevent symptoms. However, people without symptoms are still at risk for complications of celiac disease. Biopsy of the small intestine is the best way to diagnose celiac disease. Decreased bone density (osteoporosis and osteomalacia is a serious problem for celiacs. If calcium

  10. Gold Enamel Choumps – A Case report

    Directory of Open Access Journals (Sweden)

    Sargam D. Kotecha

    2016-09-01

    Full Text Available Tooth jewellery has been practiced since time immemorial and has become an increasingly popular trend. This case report provides a brief insight into a kind of tooth adornment/a tooth tattoo on the enamel prevalent in parts of western Uttar Pradesh, India locally known as a ‘Choump’. A tooth tattooed with ‘Choumps’ has extremely low incidence and could be used as an identification trait. Tooth adornment with ‘Choumps’ has been reported in adults however, this is the first reported case of ‘Choumps’ in children.

  11. Adult cerebellar medulloblastoma: CT and MRI findings in eight cases

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho Neto, Arnolfo de; Bertoldi, Guilherme A. [Parana Univ., Curitiba, PR (Brazil). Radiologia Diagnostica]. E-mail: arnolfo.carvalho@avalon.sul.com.br; Gasparetto, Emerson L. [Parana Univ., Curitiba, PR (Brazil). Hospital das Clinicas. Secao de Radiologia Diagnostica; Ono, Sergio E. [Parana Univ., Curitiba, PR (Brazil). Faculdade de Medicina; Gomes, Andre F. [Diagnostico Avancado Por Imagem (DAPI), Curitiba, PR (Brazil)

    2003-06-01

    Medulloblastoma is a brain tumor of neuro epithelial origin, which represents 15 to 30% of all pediatric brain tumors, and less than 1% of CNS adult neoplasms. We report the imaging findings of 8 adult patients with medulloblastoma. The mean age was 35 years, ranging from 20 to 65 years, and the male:female rate was 3:5. The tumors were predominantly lateral (63%), hyperdense on CT scans (83%), and on the MRI, hypointense on T1 (100%) and hyperintense on T2 (80%) weighted images. It was seen intratumoral necrosis and cysts in six cases and calcifications in three. Hydrocephalus was observed in 5 cases and brain stem invasion in four. The imaging findings of medulloblastomas in adults are different of those in child, and also nonspecific. Although these tumors are uncommon in adults, they must be considered in the differential diagnosis of cerebellar masses in the posterior fossa of this age group. (author)

  12. NECROTIZING SIALOMETAPLASIA. CASE REPORT

    Directory of Open Access Journals (Sweden)

    A.I. Navazo Eguía

    2010-01-01

    Full Text Available Introduction: Necrotizing sialometaplasia (NSM is a benign lesion affecting the salivary glands mainly in the hard palate. It presents as an ulcer with irregular borders, slightly elevated and necrotic The differential diagnosis should include malignant neoplasms. Case Report: A 26-year-old woman sought medical advice for a painful 2 cm ulceration of the hard palate. She is carrying pierced tongue. The patient had a history of cigarette smoking, chronic anxiety disorder and bulimia,. Analytical normal (including HIV and syphilis serology. Histopathology: accessory gland with squamous metaplasia, pseudoepitheliomatous hyperplasia and conservation lobulararchitecture. She had an important improvement with total resolution of the lesion in 4 months Discussion: The NSM is a necrotizing inflammatory process. It presents as an ulcer located in the posterior hard palate or the junction between the hard and soft palate. This situation has been associated with local ischemia as surgical trauma, thromboangiitis obliterans, dentures, alcohol, snuff, cocaine, and certain malignancies such as lymphomas, rhabdomyosarcoma or Warthin tumor. Currently associated withbulimia, it being necessary suspected in young women. It is important to rule out neoplasms and infectious processes (tuberculosis or syphilis. Also consider subacute necrotizing sialadenitis, nonspecific acute inflammatory process of unknown cause, with focal necrosis without hyperplasia or ductal metaplasia pseudoepitheliomatous. Treatment is symptomatic and usually resolves in 2-3 months. Conclusion: The NSM is a benign lesion which may mimic neoplasia. The trend is toward resolution. It must be recognized to avoid unnecessary surgery.

  13. Patellar osteochondroma: case report,

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2014-04-01

    Full Text Available The aim was to report on a rare case of patellar osteochondroma. A 60-year-old man presented a tumor on his left patella that had developed over a 10-year period, which is a rare occurrence, considering the patient's age and the site at which the tumor appeared. The clinical condition comprised mild pain and the presence of a mass, without limitation of flexion-extension or any neurovascular deficit. The tumor dimensions were 8 cm longitudinally × 6 cm transversally × 3 cm anteroposteriorly. It was hardened and was adhering to the patellar bone plane. On radiographs and tomographic scans, we observed areas of greater density corresponding to bone and other less dense areas that could correspond to slow-growing cartilage, with irregularities on the patellofemoral joint surface. Simple resection of the tumor was performed, and the anatomopathological examination confirmed that it was a patellar osteochondroma. Osteochondroma, or osteocartilaginous exostosis, includes a large proportion of the benign bone tumors. It results from cell alterations that trigger unregulated production of spongy bone. It is basically treated by means of surgical removal of the tumor mass. This is not essential, but is recommended in order to avoid lesions caused by contiguity and the risk of malignant transformation.

  14. Ileocecocolic Intussusception Induced by Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Bang Sil; Kim, Min Jeong; Jang, Kyung Mi; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2009-09-15

    Intussusception is a rare disease in adults. Moreover, appendiceal disease is very rarely the leading cause of adult intussusception. We report a case in which ileocecocolic intussusception is secondary to an acute appendicitis in an adult, and describe the radiologic, clinical, and pathologic findings.

  15. Myopericarditis during a primary Epstein-Barr virus infection in an otherwise healthy young adult. An unusual and insidious complication. Case report and a 60-year literature review.

    Science.gov (United States)

    Sabbatani, Sergio; Manfredi, Roberto; Ortolani, Paolo; Trapani, Fabio Filippo; Viale, Pierluigi

    2012-06-01

    An otherwise healthy young man had infectious mononucleosis detected after an atypical clinical onset, including myocarditis and pericarditis. Our patient slowly but completely recovered from his cardiac complications after the course of his primary Epstein-Barr infection, as shown by periodical electrocardiographic and ultrasonographic studies, and a simple treatment with aspirin alone. Our case report is briefly reported, and discussed with regard to the existing literature, which has recorded such complications since the mid 1940s.

  16. Xp11 translocation renal cell carcinoma morphologically mimicking clear cell-papillary renal cell carcinoma in an adult patient: report of a case expanding the morphologic spectrum of Xp11 translocation renal cell carcinomas.

    Science.gov (United States)

    Parihar, Asmita; Tickoo, Satish K; Kumar, Sunil; Arora, Vinod Kumar

    2015-05-01

    Xp11 translocation renal cell carcinoma (RCC) is a relatively rare tumor mainly affecting children and adolescents. It shows significant morphological overlap with the 2 most common adult renal tumors, which are the clear cell (conventional) RCC and papillary RCC. We describe case of a young adult female who presented with right flank pain and abdominal mass. Radiological investigations showed features suggestive of renal cell carcinoma in the right kidney. Histopathological findings while suggestive of Xp11 carcinoma, showed significant overlap with the recently described entity clear cell papillary RCC. TFE3 immunohistochemistry confirmed the tumor to be Xp11 translocation RCC. The patient had an aggressive course with lymph node metastasis. In this report, we discuss differential diagnosis and the diagnostic challenges of Xp11 translocation RCC in adults.

  17. Adult T-cell leukemia/lymphoma: report of two cases Leucemia/linfoma de células T do adulto: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Ricardo Aparecido Olivo

    2008-06-01

    Full Text Available Adult T-cell leukemia/lymphoma is a lymphoproliferative disorder of mature T lymphocytes associated with infection with human T-cell lymphotrophic virus type I (HTLV-I. Adult T-cell leukemia/lymphoma is characterized by clinical and laboratory polymorphism that allows it to be classified into four distinct subgroups: smoldering, chronic, acute and lymphomatous types. We present here two cases of adult T-cell leukemia/lymphoma, respectively in the acute and lymphomatous forms of the disease. Case 1 was a 35-year-old woman who presented abdominal distension accompanied by hepatosplenomegaly, adenomegaly, skin lesions, positivity for anti-HTLV-I antibodies and leukocytosis with the presence of flower cells. Case 2 was a 38-year-old man who was admitted with generalized lymphadenomegaly, positivity for anti-HTLV-I antibodies, hypercalcemia and osteolytic lesions. In this paper, we correlate the clinical-laboratory findings of these two cases with data in the literature.A leucemia/linfoma de células T do adulto é um distúrbio linfoproliferativo de linfócitos T maduros associado à infecção pelo vírus linfotrópico de células T humanas tipo I (HTLV-I. A leucemia/linfoma de células T do adulto tem polimorfismo clínico e laboratorial, que a classifica em quatro subgrupos distintos entre si: smoldering, crônica, aguda e linfomatosa. Apresentamos neste artigo, dois casos de leucemia/linfoma de células T do adulto, respectivamente, nas formas aguda e linfomatosa da doença. O caso 1: uma paciente de 35 anos apresentava distensão abdominal com hepato-esplenomegalia, adenomegalia, lesões cutâneas, anticorpos anti-HTLV-I positivo e leucocitose com presença de flower cell. O caso 2: homem de 38 anos, internado com linfadenomegalia generalizada, anticorpos anti-HTLV-I positivo, hipercalcemia e lesões osteolíticas. Neste artigo correlacionamos os achados clínicos e laboratoriais destes dois casos com dados da literatura.

  18. Adult Degenerative Scoliosis with Spinal Stenosis Treated with Stand-Alone Cage via an Extreme Lateral Transpsoas Approach; a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Arvind von Keudell

    2015-04-01

    Full Text Available We report the case of a 73-year-old female with severe degenerative scoliosis and back and leg pain that wassuccessfully treated with stand- alone cages via an extreme lateral transpsoas approach. This patient had declinedopen surgery and instrumentation due to her advanced age concerns about potential side effects.

  19. Esthesioneuroblastoma: a case report.

    Science.gov (United States)

    Shukla, R C; Singh, P K; Senthil, S; Pathak, R

    2010-06-01

    Esthesioneuroblastoma (olfactory neuroblastoma) is an uncommon neuroectodermal tumor. Its biological activity ranges from indolent growth to local recurrence and rapid widespread metastasis. Treatment options consist of surgical resection followed by radiation therapy for primary lesions and the addition of chemotherapy for advanced, recurrent, or metastatic lesions. Patients often present with nasal obstruction, rhinorrhea, recurrent epistaxis, hyposmia, or anosmia. We report a case of esthesioneuroblastoma involving bilateral nasal cavity leading to bilateral nasal obstruction, epistaxis and proptosis of the right eye associated with decreased visual acquity on that eye and loss of smell. A diffuse nontender, 6x6 cms swelling with illdefined margins was seen over the nasal bridge, extending superiorly to glabella and laterally to right maxillary region. X-ray PNS showed soft tissue mass in the nasal cavity with destruction of nasal septum, intense periosteal reaction with destruction of right maxillary wall and extension to right orbit. CT scan of paranasal sinuses showed 8.5 x 4.9 x 7.8 cms irregularly marginated heterogeneous iso- to hyper dense soft tissue mass lesion with extensive adjacent bony destruction and spiculated periosteal reaction involving bilateral nasal cavity and anterior cranial fossa. Biopsy from right nasal mass showed neuroblastoma. The patient received radiotherapy and chemotherapy. The modified Kadish staging system, lymph node status, treatment modality, and age are useful predictors of survival in patients who present with esthesioneuroblastoma. Excellent outcomes for esthesioneuroblastoma are achievable. Long-term follow-up is necessary because of the extended interval for recurrent disease; unlike most sinonasal malignancies, surgical salvage is possible.

  20. Secretory breast cancer. Case report.

    Science.gov (United States)

    Lombardi, A; Maggi, S; Bersigotti, L; Lazzarin, G; Nuccetelli, E; Amanti, C

    2013-04-01

    Secretory carcinoma of the breast is a rare tumor initially described in children but occurring equally in adult population. This unusual breast cancer subtype has a generally favorable prognosis, although several cases have been described in adults with increased aggressiveness and a risk of metastases. However, surgery is still considered the most appropriate treatment for this pathology. We describe the case of a 50 -year-old woman who has undergone a breast conservative surgery for a little tumor, preoperatively diagnosticated by a fine needle aspiration biopsy (FNAB) as a well differentiated infiltrating carcinoma.

  1. Dioctophymiasis: A Rare Case Report.

    Science.gov (United States)

    Chauhan, Sapna; Kaval, Sunil; Tewari, Swati

    2016-02-01

    Dioctophyma renale commonly known as "giant kidney worm' is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India.

  2. Parathyroid carcinoma: case report

    Science.gov (United States)

    STURNIOLO, G.; GAGLIANO, E.; TONANTE, A.; TARANTO, F.; PAPALIA, E.; CASCIO, R.; DAMIANO, C.; VERMIGLIO, F.; STURNIOLO, G.

    2013-01-01

    Summary: The authors present a case of parathyroid carcinoma in a patient with primary hyperparathyroidism. Following a literature review, the clinical and diagnostic profile, treatment and prognosis of this rare disease are discussed. PMID:23837957

  3. Má rotação intestinal em adulto, relato de caso e revisão da literatura Adult intestinal malrotation, case report and literature review

    Directory of Open Access Journals (Sweden)

    Ubirajara Rutilio Mendes e Ferreira de Araújo

    2009-12-01

    symptoms develop in adolescents and adults. CASE REPORT: A woman presented to the hospital with intense abdominal pain of three days' duration and progressive worsening over the preceding 24 hours. The pain increased markedly after meals, accompanied by nausea and vomiting. On physical examination, the patient was in good general health, her abdomen was flat, flaccid, with normal bowel sounds, and tender to palpation of the epigastrium, yet with no signs of peritoneal irritation. Laboratory test results were within the limits of normal, as was ultrasonography. No clinical improvement was achieved despite the treatment instituted; surgical exploration was chosen as tomography was suggestive of intestinal malrotation. Intraoperatively, all the small intestine was found to be positioned to the right side of the abdomen and the colon, to the left side. In addition, the proximal jejunum was ischemic and forming a volvulus of 720º over the axis of the superior mesenteric vessels. In order to correct the anomaly, enterotomy of the proximal jejunum was performed at approximately 10 cm from the ligament of Treitz, and the volvulus was corrected. This promoted a progressive improvement of the intestinal ischemia, which made enteroanastomosis possible. The middle colic artery pedicle was ligated at its root and a right colectomy was performed, followed by a side-to-side ileo-transverse anastomosis. The patient is doing well. CONCLUSION: Intestinal malrotation in adults is a condition of difficult primary diagnosis, since it is not among the initial diagnostic hypotheses of the general surgeon.

  4. A Case Report

    African Journals Online (AJOL)

    anorexia, lower abdominal pains and fever, progressing ... injury to visceral organs are known to be associated ... In this report, we present a mechanical intestinal obstruction caused by a band of adhesion from ... out via the nasogastric tube.

  5. 成人双眼复视117例临床分析%Clinical analysis of adult binocular diplopia: a 117 cases report

    Institute of Scientific and Technical Information of China (English)

    乔彤; 陈偕穗

    2014-01-01

    Objective To analyze the types of strabismus and the path of the genetic features in binocular diplopia in adults in order to improve the therapeutic effect of treatment.Methods A Hess screen,red glass test and motility examination were used to evaluate ocular alignment,ocular ductions and versions and diplopic image analysis in 117 cases of binocular diplopia.Biochemical examination of blood,image analysis (MRI and/or MRA) and an edrophonium test were used.Results The main types of strabismus among the 117 cases were paralytic strabismus that included sixth cranial nerve palsy (35 cases,29.9%),third cranial nerve palsy (28 cases,23.93%),superior oblique palsy (19 cases,16.2%),and multiple cranial nerve palsy (8 cases,6.8%).Restricted strabismus included restricted hypotropia (18 cases,15.4%) and restricted exotropia (2 cases,1.7%).Concommitent strabismus included early onset intermittent exotropia (4 cases,3.4%)and acute esotropia (4 cases,3.4%).The main causes were diabetes (32 cases,27.4%),vascular disease (20 cases,17.1%),trauma (15 cases,12.8%),brain tumor (11 cases,9.4%),virus infection (10 cases,8.6%),Graves disease (9 cases,7.7%),myasthenia gravis(5 cases,4.3%),chemotherapy (2 cases,1.7%) and unknown reasons (4 cases,3.4%).Conclusion Binocular diplopia is a complicated syndrome.Multiple methods should be combined to identify the latent causes and find better treatments.%目的 探讨引起双眼复视的斜视的类型以及病因学的诊断.方法 回顾性病例研究.117例双眼复视患者,年龄20~82岁,年龄中位数为47岁.采用三棱镜、红球片、Hess屏及同视机等方法分析复像;辅以血液生化检查、新斯的明试验和头颅影像学)和磁共振血管造影,必要时进行胸腺MRI检查来辅助诊断.结果 117例复视中非共同性斜视包括麻痹性斜视、限制性斜视.麻痹性斜视包括展神经麻痹(35例,29.9%)、单纯动眼神经麻痹(28例,23.9

  6. Iatrogenic psoas abscess. Case report

    DEFF Research Database (Denmark)

    Bernstein, Inge Thomsen; Hansen, B J

    1991-01-01

    A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago.......A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago....

  7. Hemimegalencephaly without epilepsy: case report.

    Science.gov (United States)

    James, Greg; Shanmuganathan, Mano; Harkness, William

    2014-09-01

    Hemimegalencephaly is a rare sporadic brain malformation characterized by enlargement of one cerebral hemisphere. The classical clinical triad consists of intractable epilepsy, severe psychomotor delay and hemiparesis. In this report, we describe a case of a 3-year-old girl, with all the radiological features of severe hemimegalencephaly but with a comparatively benign clinical course. She had no hemiparesis, mild delay and no seizures. An extensive literature review reveals only one previously reported case of hemimegalencephaly with the absence of seizures, as part of case series. This is the first dedicated case report, with clinical description and radiological images, of this entity.

  8. Perioral gustatory sweating: case report.

    NARCIS (Netherlands)

    Kayser, S.C.; Ingels, K.J.A.O.; Hoogen, F.J.A. van den

    2012-01-01

    OBJECTIVE: Presentation of a case of perioral Frey syndrome. DESIGN: Case report. SUBJECT: A 72-year-old woman with hyperhidrosis around the mouth and chin. RESULTS: This patient suffered from bilateral perioral gustatory sweating following a mandibular osteotomy; such a case has not previously been

  9. Outcome of intensive outpatient rehabilitation and bracing in an adult patient with Scheuermann’s disease evaluated by radiologic imaging—a case report

    Directory of Open Access Journals (Sweden)

    Hagit Berdishevsky

    2016-10-01

    Full Text Available Abstract Background No studies examine the efficacy of intensive specific physical therapy (PT exercises along with brace for the adult with Scheuermann’s kyphosis (SK. The aim of this study was to examine the effects of intensive PT based on the Barcelona Scoliosis Physical Therapy School (BSPTS and SpinoMed brace on a 76-year-old female with SK. Case Description A 76-year-old female, diagnosed with SK as an adolescent, presented in October 2014 with thoracic hyperkyphosis T1 to T12 Cobb angle of 85° and lumbar hyper lordosis L1 to L5 Cobb angle of 70°. Lumbar scoliosis T12-L5 with 21° Cobb and vertebral rotation 2. Trunk translation in the sagittal plan was 4.5 cm. Intermittent low back pain 6/10 at worst. Quality-of-life score was 3.8 (SRS 22 questionnaire. Method The PT regimen included one-hour Schroth exercise sessions three times per week for 6 months. In addition, a home exercise program (HEP was recommended. Patient also wore a SpinoMed brace for 2 h per day. All tests and measurements were recorded before and after treatment. Results After a six-month treatment period the kyphosis Cobb angle was reduced to 70° and the lordosis Cobb angle improved to 57°. A recent x-ray (October 2015 showed another improvement in the sagittal plane with thoracic kyphosis measuring 64° and lumbar lordosis 55°. Lumbar curvature decreased to 12° and vertebral rotation to 1. The quality-of-life score showed improvement with a score of 4.5 on the SRS 22. Pain score diminished to 2. Trunk deviation improved by 2.2 cm. Conclusion These findings suggest that intensive and specific PT and bracing were successful for the treatment of this adult patient with SK.

  10. Pyoderma gangrenosum in a newborn - case report

    OpenAIRE

    2013-01-01

    Pyoderma gangrenosum is a rare, inflammatory, chronic and recurrent disease of unknown etiology, characterized by noninfectious, necrotizing and painful cutaneous ulcers. Usually it affects adults aged between 25 and 54 years old and rarely children (less than 4%), in which it mainly affects the head, face, buttocks, genital and perianal region. The disease presents a quick response to systemic corticosteroids. We report a case of a newborn with hemorrhagic and necrotic ulcers, distributed in...

  11. Neurolisteriosis en adultos: a propósito de seis casos clínicos Neurolisteriosis in adults: report of six clinical cases

    Directory of Open Access Journals (Sweden)

    Ronald Salamano

    2005-12-01

    Full Text Available INTRODUCCION: Listeria monocytogenes tiene una especial predilección por infectar el sistema nervioso central y sus cubiertas meningeas. Afecta a pacientes que se encuentran en edades extremas de la vida, pacientes con deficiencia en su inmunidad celular y adultos sanos. La forma mas común de manifestarse es la meningitis aguda, aunque puede expresarse como cerebritis, encefalitis de tronco (romboencefalitis, y excepcionalmente mielitis. CASUISTICA: Se presentan y comentan seis casos clinicos de neurolisteriosis, cinco en adultos sanos, con sus hallazgos imagenológicos y licuorales. RESULTADOS: Tres de los pacientes se presentaron como meningitis aguda, uno como meningoencefalitis, otro como cerebritis y el restante como romboencefalitis. Se destaca el carácter turbio o ligeramente turbio del líquido cefalo-raquideo (LCR, la glucorraquia normal detectada en tres de los casos y el diagnostico realizado en cinco de los casos por cultivo del LCR. Se comenta la resonancia magnética singular del caso de la romboencefalitis con microabscesos en tronco. Todos los pacientes tuvieron evolución satisfactoria con tratamiento antibiotico. CONCLUSIÓN: La neurolisteriosis debe ser un diagnostico a tener en cuenta no solo en pacientes inmunocomprometidos o en edades extremas de la vida. Debe también tenerse en cuenta en pacientes adultos jóvenes sanos procedentes de regiones donde las condiciones sanitarias son precarias y no existe un adecuado control en la elaboración de alimentos.INTROCTION: Listeria monocytogenes shows a special attraction to infect the central nervous system and its meningeals coats. It affects newborn as well as elderly people, patients with deficiencies in their cellular inmune systems, and healthy adults. It presents most commonly as an acute meningitis, although it can present itself as cerebritis, brain stem encephalitis (rhomboencephalitis, and exceptionally as myelitis. PATIENTS: We describe six clinical cases of

  12. Odontoameloblastoma: A case report.

    Science.gov (United States)

    Negi, Amita; Puri, Abhiney; Nangia, Rajat; Sachdeva, Alisha

    2015-01-01

    Odontoameloblastoma (OA) is an extremely rare odontogenic tumor that contains an ameloblastomatous component together with odontoma-like elements. Till date, very few cases have fulfilled the criteria of the current World Health Organization classification of odontogenic tumors. It is characterized by slow, progressively growing lesion with growth pattern similar to solid multi-cystic ameloblastoma. The majority of the tumors are associated with unerupted teeth and commonly seen in males. It is usually asymptomatic and may occur in either maxilla or mandible, but shows a slight predilection for mandible. As this tumor is extremely rare, there exists controversy regarding its treatment. Here, we present a case of OA in 17-year-old female patient resembling a fibro-osseous lesion and a brief review of the related literature.

  13. Odontoameloblastoma: A case report

    Directory of Open Access Journals (Sweden)

    Amita Negi

    2015-01-01

    Full Text Available Odontoameloblastoma (OA is an extremely rare odontogenic tumor that contains an ameloblastomatous component together with odontoma-like elements. Till date, very few cases have fulfilled the criteria of the current World Health Organization classification of odontogenic tumors. It is characterized by slow, progressively growing lesion with growth pattern similar to solid multi-cystic ameloblastoma. The majority of the tumors are associated with unerupted teeth and commonly seen in males. It is usually asymptomatic and may occur in either maxilla or mandible, but shows a slight predilection for mandible. As this tumor is extremely rare, there exists controversy regarding its treatment. Here, we present a case of OA in 17-year-old female patient resembling a fibro-osseous lesion and a brief review of the related literature.

  14. Odontoameloblastoma: A case report

    Science.gov (United States)

    Negi, Amita; Puri, Abhiney; Nangia, Rajat; Sachdeva, Alisha

    2015-01-01

    Odontoameloblastoma (OA) is an extremely rare odontogenic tumor that contains an ameloblastomatous component together with odontoma-like elements. Till date, very few cases have fulfilled the criteria of the current World Health Organization classification of odontogenic tumors. It is characterized by slow, progressively growing lesion with growth pattern similar to solid multi-cystic ameloblastoma. The majority of the tumors are associated with unerupted teeth and commonly seen in males. It is usually asymptomatic and may occur in either maxilla or mandible, but shows a slight predilection for mandible. As this tumor is extremely rare, there exists controversy regarding its treatment. Here, we present a case of OA in 17-year-old female patient resembling a fibro-osseous lesion and a brief review of the related literature. PMID:26604505

  15. Multiple pregnancy. Case report.

    Directory of Open Access Journals (Sweden)

    Práxedes Regla Rojas Quintana

    2009-11-01

    Full Text Available We present a case of a 34-year-old white female patient, of rural origins, with a history of 3rd degree bronchial asthma and respiratory arrests for that cause, who has required several admissions in the ICU. Gestation history 1, no deliveries, 1 abortion and secondary infertility, for which she was treated, along with her spouse, in the infertility consultation, in which ovulation disorders were diagnosed, consisting of bilateral tubaric obstruction on her and severe oligospermia on her spouse, for which they underwent combined surgical treatment. Tubaric permeability with hydrotubation was first accomplished, then ovulation and spermatogenesis with clomiphene citrate and then low-technology fertilization was performed, resulting in a quadruple pregnancy, which satisfactorily arrived to full term at 34 weeks of gestation. Due to the mother’s medical history, the risks involved in this type of pregnancy and its happy outcome, we decided to publish the case.

  16. Malignant histiocytosis. Case report

    OpenAIRE

    RUIZ, OSCAR; Instituto de Investigaciones Clínicas, UNMSM; Servicio Hematologia Clínica, Hospital Dos de Mayo; QUIÑONES, WILLY; Servicio Hematologia Clínica, Hospital Dos de Mayo; MISAD, OSCAR; Laboratorio de Anatomia Patológica “Oscar Misad; Delgado, Carlos; Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú.; Ronceros, Sergio; Instituto de Investigaciones Clínicas, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú. médico patólogo.; MARANGONI, MANUELA; Departamento de Enfermería, Hospital Dos de Mayo; BARDALES, LUZ; Servicio Hematologia Clínica, Hospital Dos de Mayo; REYES, RAFAEL; Servicio Hematologia Clínica, Hospital Dos de Mayo; CASTILLO, ALFREDO; Servicio Hematologia Clínica, Hospital Dos de Mayo; URRUTIA, KATIA; Servicio Hematologia Clínica, Hospital Dos de Mayo

    2013-01-01

    Fourteen year-old male patient referred from Huancayo who presented one month gastric intolerance, jaundice, fever and a lymph proliferative syndrome. Laboratory tests revealed severe pancytopenia due to phagocytosis. Haematologic and anatomy-pathology diagnosis was human malignant histiocytosis. We present this case due to its low frequency and the emergency character of the disease. Paciente varón de 14 años, procedente de Huancayo, que presenta un mes antes de su hospitalización intoler...

  17. IPEX syndrome: Case report

    OpenAIRE

    Radlović Nedeljko; Janić Dragana; Sajić Silvija; Janković Srđa; Ješić Maja; Leković Zoran; Petrović Rada

    2008-01-01

    INTRODUCTION IPEX syndrome, namely, a hereditary (X-linked) immunodysregulation with autoimmune polyendocrinopathy and enteropathy, as the basic manifestations, presents a rare and exceptionally severe disease. It develops due to gene mutation responsible for the synthesis of a specific protein (FOXP3), which, by differentiation and activation of regular T-lymphocytic CD4+CD25+, has the key role in the induction and maintenance of the peripheral tolerance of one's own tissue. CASE OUTLINE We ...

  18. [Chilaidity syndrome. Case report].

    Science.gov (United States)

    Candela, Stefano; Candela, Giancarlo; Di Libero, Lorenzo; Argano, Francesco; Romano, Ornella; Iannella, Iolanda

    2012-01-01

    Chilaidity syndrome is a mal position by bowel mal rotation o malfissation. It is more common in right side expecially in obese people. If asyimptomatic, the syndrome is an occasional comparison by radiology, surgical exploration by laparoscopy or autopsy, otherwise, if symptomatic, there are obstructive symptoms,abdominal pain, nausea, vomiting, abdominal distension, flatulence, breath, constipation and anorexia. Diagnosis is radiological. We present a rare case of this syndrome in a man with serious obstructive symptoms.

  19. Case report: pelvic actinomycosis.

    Science.gov (United States)

    Maxová, K; Menzlová, E; Kolařík, D; Dundr, P; Halaška, M

    2012-01-01

    A case of pelvic actinomycosis is presented. The patient is 42-year-old female with a 5 weeks history of pelvic pain. An intrauterine device (IUD) was taken out 3 weeks ago. There is a lump length 9 cm between rectus muscles. Ultrasound, magnetic resonance imaging (MRI) and histology are used to make the diagnosis. Actinomycosis can mimic the tumour disease. The definitive diagnosis requires positive anaerobic culture or histological identification of actinomyces granulas. A long lasting antibiotic therapy is performed.

  20. Dieulafoy's lesion of duodenum: a case report

    Directory of Open Access Journals (Sweden)

    Wagholikar Gajanan D

    2003-01-01

    Full Text Available Abstract Background Dieulafoy's lesion is an uncommon but important cause of recurrent upper gastrointestinal bleeding. Extragastric location of Dieulafoy's lesion is rare. We report two cases of Dieulafoy's lesion of the duodenum and discuss the management of this extremely uncommon entity. Case presentation Two cases of massive upper gastro-intestinal bleeding in young adults due to Dieulafoy's lesion of the duodenum are reported. Endoscopic diagnosis was possible in both cases. Hemostasis was achieved successfully by endoscopic adrenaline injection. The endoscopic appearance, pitfalls in the diagnosis and management of this rare lesion are discussed. Conclusions Endoscopic diagnosis of extragastric Dieulafoy's lesion can be difficult because of the small size and obscure location of the lesion. Increased awareness and careful and early endoscopic evaluation following the bleeding episode are the key to accurate diagnosis. Adrenaline injection is one of the important endoscopic modalities for control of bleeding.

  1. Adult type 3 Gaucher disease as manifestation of R463C/Rec Nci I mutation: first reported case in the world literature.

    Science.gov (United States)

    Chauhan, V; Kumar, R V; Mahesh, D M; Kashyap, R; Thakur, S

    2013-05-01

    Gaucher disease is the most common lysosomal storage disorder. It is autosomal recessive in nature and results from mutations in the GBA gene coding for acid beta glucosidase. It is classified into three types based on CNS involvement and its severity. Type 3, or chronic neuronopathic Gaucher disease, generally has an onset in childhood and by definition, includes all patients with any form of neurologic involvement who have survived the first few years of life. Here we present a 36 year old male patient presenting with hip pain showing bilateral avascular necrosis of femoral head with massive splenomegaly and on evaluation, showed mental retardation, seizures, bilateral vertical and horizontal gaze palsies and eventually turned out to be type 3b Gaucher disease. This is the first case of Type 3 Gaucher disease being reported from India with mutation analysis and only case of Type 3 Gaucher disease in world literature showing R463C/Rec Nci I mutation.

  2. Extensive ameloblastic fibroma of the mandibula in a female adult patient: A case report with a follow-up of 3 years.

    Science.gov (United States)

    Tozoglu, Sinan; Hatipoglu, Mukerrem; Aytekin, Zeliha; Gurer, Elif Inanc

    2016-01-01

    Ameloblastic fibroma (AF) is rare benign odontogenic tumour which usually occurs in the first two decades of life. It can occur either the mandible or maxilla but it is most frequently found in the posterior region of the mandible. Treatment of AF in usual is a conservative approach, such as enucleation and curettage but the aggressive lesions require a radical approach. A more radical approach should be considered in older patients who have likely high recurrence tendency. This report describes a case of AF in a 38-year-old female patient identified during a routine radiographic exam. Tomographic examination through three-dimensional reconstruction indicated vestibular fenestration of the cortical bone, with involvement of lingual cortical bone as the lession extended to the posterior region. We removed the tumor under local anesthesia. In this case patient has continued to be followed frequently and has been disease-free for 3 years.

  3. Neurocysticercosis. Case report.

    Directory of Open Access Journals (Sweden)

    Gilberto Serrano Ocaña

    2009-05-01

    Full Text Available A female patient (15 years, from Eastern Cape, South Africa, was admitted in the hospital on July 13th, 2007 with general tonic-clonic convulsions. There was not history of epilepsy or fever convulsions and the patient denied alcohol, cigar or drugs consumption. The physical examination showed postictal confusion, without neurological deficit, neck rigidity or peripheral edema. Computer axial tomography was definitive for neurocysticercosis disgnosis. Since it is a serious health problem for the area the patient lives in, we decided to publish the case.

  4. Interrupted inferior vena cava with hemiazygos continuation in an adult with a persistent left superior vena cava and left single coronary artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Jin; Kwon, Se Hwan; Ahn, Sung Eun; Kim, Soo Joong; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2016-06-15

    A 50-year-old woman was referred to our institution for medical screening due to an incidental finding on abdominal ultrasonography. She underwent chest, abdomen and cardiac multi-detector computed tomography (MDCT). Her MDCT revealed absence of the hepatic segment of the inferior vena cava (IVC), with hemiazygos continuation and a left single coronary artery. The dilated hemiazygos vein drained directly into the persistent left superior vena cava (SVC). Herein, we reported a very rare case combining an incidentally found interrupted IVC with hemiazygos vein continuation, persistent left SVC and a left single coronary artery diagnosed by MDCT.

  5. Humeral lengthening: Case report

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2013-01-01

    Full Text Available Introduction. Difference in length of upper extremities has mainly esthetic significance and is therefore not so often a subject of operative treatment, compared to lower extremities. Case Outline. We are presenting a case of a 16­year­old patient in whom a shortening of 9 cm of the right humerus was determined at the end of growth. This shortening was the result of surgical treatment of solitary bone cyst at the proximal end of the humerus done at the age of 10 years. In order to correct the length of the humerus we applied distraction osteogenesis with a compressive­distracting device according to Mitkovic (Traffix, and we achieved the lengthening of 7.5 cm. During the period of distraction we encountered the following complications: minimal suppuration at the site of the wedges that was successfully resolved with intensive local treatment, while pain and paresthesias along the N. radialis were resolved with a temporarily slowing of the distraction process. Fixation with a plate, i.e. bone grafting was not necessary, and final functional and esthetic result was excellent. Conclusion. Successful lengthening of the shortened humerus can be achieved with a unilateral compressive­distracting device according to Mitkovic as its application up to a complete bone reconstruction does not require additional plate fixation or bone grafting. The patient was capable of performing usual daily activities during application of the device.

  6. Cervical synovial cyst: case report.

    Science.gov (United States)

    Found, Ernest; Bewyer, Dennis

    2011-01-01

    A 47-year-old female school teacher with a six-week history of left-sided scapular and arm pain is presented. We report her evaluation and treatment Although lumbar degenerative synovial cysts have been reported over 200 times in the literature,6 cervical synovial cysts are much more rare. This case reports a cervicothoracic junction degenerative synovial cyst presenting as radiculopathy.

  7. [Omental torsion. Case Report].

    Science.gov (United States)

    Zaleta-Cruz, Janny Lizbeth; Rojas-Méndez, Javier; Garza-Serna, Ulises; González-Ruvalcaba, Román; Ortiz de Elguea-Lizarraga, José; Flores-Villalba, Eduardo

    Omental torsion is an infrequent cause of acute abdomen and its symptoms are non-specific, often presenting with pain at the right iliac fossa as the only symptom. Its aetiology remains unknown, but different risk factors have been associated with the disease, including obesity, congenital malformations, and tumours. These risk factors have been classified as predisposing or triggering, primary or secondary, and external or internal. The is a case of a 24-year-old male who complained about pain in the right iliac fossa without any other symptoms. The diagnosis was acute appendicitis, but during the laparoscopic approach, omental torsion was found. The diagnosis of omental torsion is is complex. However, computed tomography and ultrasound have been used successfully. The treatment for omental torsion is the resection of necrotised tissue by a laparoscopic approach. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  8. Iniencephaly: Case Report

    Directory of Open Access Journals (Sweden)

    Hernando R Alvis-Miranda

    2015-01-01

    Full Text Available The iniencephaly involves a variable defect in the occipital bone, resulting in a large foramen magnum, partial or total absence of the cervical and thoracic vertebrae, accompanied by incomplete closure of arcs and/or vertebral bodies, significant shortening of the spinal column and hyperextension of the malformed cervicothoracic spine; the individual′s face is deviated upward, the mandibular skin is directly continuous with anterior thorax due to the absence of neck. Its incidence is about 1:1000-1:2000 births, so this is a pretty rare neural tube defect. We present a case of iniencephaly in association with cardiovascular, spinal cord, and intracranial malformations that ended demonstrating the low survival of patients affected with this condition.

  9. Mucormycosis: 2 Case Report

    Directory of Open Access Journals (Sweden)

    M. Faruk Oktay

    2007-01-01

    Full Text Available Mucormycosis is a rare, saprophytic, invasive and fulminant fungal disease. It is infective to patients with underlying immunocompromised conditions. We presented two cases of mucormycosis, one of which occured in the nose and the other on the auricle. A two-year-old female patient with diabetic ketoacidosis revealed necrosis and surrounding hyperemia in the nasal vestibule, nasal septum and dorsum of nose. A 17-year-old female diabetic patient had been suffering from black-colored lesion on the auricle. Physical examination presented necrosis on the auricle. Facial paralysis occured in the patient with auricular mucormycosis. Systemic amphotericin B was empirically administered after the sample was obtained for microbiologic and histopathologic examination in both patients. Necrotic tissues was also debrided in the second patient. The first patient died on the second day of treatment, and the second patient on the seventh day. We discussed the bacteriologic characteristics, histological peculiarities, and alternative treatments.

  10. Hemihydranencephaly; a Case Report

    Directory of Open Access Journals (Sweden)

    Amit Agrawal

    2009-04-01

    Full Text Available Background:Hemihydranencephaly is a rare disorder of the brain characterized by complete or almost complete unilateral absence of cerebral cortex with preservation of meninges, basal ganglia, pons, medulla, cerebellum, and falx. Case Presentation:Thirteen year-old male child presented with left sided upper and lower limb weakness with facial asymmetry since the age of six months. His magnetic resonance imaging (MRI scans demonstrated a nearly complete absence of the right cerebral hemisphere including basal ganglion, which was replaced by cerebrospinal fluid with a small residual rim of the occipital cortex. The imaging features were suggestive of right-sided hemihydranencephaly. Conclusion:Patients with hemihydranencephaly provide an experiment of nature with potential implications for normal cognitive development and illustrate how much there is still to be learned about human development.

  11. TETANUS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sreelatha

    2014-09-01

    Full Text Available Clostridium tetani is the causative agent of Tetanus. The aim was to detect the presence of Clostridium tetani in a case of suspected Tetanus in a 40 year old male who had history of handling a a thorn injury in the agricultural field 15 days ago. The patient presented with spasm of all the limb muscles and Lockjaw of 2 days duration together with history of convulsions for the last 3 days. Bits of tissue were collected from the necrotic depth of the wound abscess and were analyzed. Clostridium tetani was isolated. A diagnosis of Tetanus was made and the concerned authority was immediately notified. The patient was successfully treated with complete recovery. An early diagnosis of TETANUS is significant because it can help the clinician in early management and prevention of development of terminal respiratory failure and death

  12. Urachal endometrioma: a case report.

    LENUS (Irish Health Repository)

    Browne, Katherine M

    2009-01-01

    INTRODUCTION: We discuss a rare presentation of an unusual case of endometrioma. CASE PRESENTATION: A 40-year-old Caucasian woman presented with subacute abdominal pain and a suprapubic mass. A final diagnosis was made after the mass was resected and histopathology confirmed an endometrioma originating from an urachal remnant. Select imaging studies and histopathology are presented in this case report. CONCLUSION: While endometriomata are well known to arise from abdominal scars, the condition described in this case report is a rare example of an endometrioma arising from the urachus. A review of the pathological complications of the urachus is also included.

  13. Prosthetic repair of umbilical hernias in adults with local anesthesia in a day-case setting: a comprehensive report from a specialized hernia center.

    Science.gov (United States)

    Kulacoglu, H; Yazicioglu, D; Ozyaylali, I

    2012-04-01

    Umbilical hernia is a common surgical problem. However, there seems to be a certain discrepancy between its importance and the attention it has received in the literature to date. This prospective study aimed to report a detailed analysis of prosthetic umbilical hernia repairs with local anesthesia in a day-case setting. It was planned to enroll 100 consecutive patients who underwent an elective umbilical hernia repair with local anesthesia. Patients who required general anesthesia and simultaneous hernia repairs were excluded. The procedure including local anesthesia and intravenous sedation was explained to the patients in detail by the operating surgeons and the anesthesiologist. The following parameters were strictly recorded: gender, age, body mass index (BMI), concomitant diseases, history of hernia (primary/recurrent), size of fascial defect, duration of operation, level of intravenous sedation (light/moderate), discharge time, and complications. There were 54 male and 46 female patients. The mean age was 48.6 years (24-78 years). Four patients were older than 70 years of age. Forty-one patients had 84 concomitant diseases. Eleven patients had a recurrent hernia. Female patients more frequently presented with a recurrent hernia than male patients (19.6 vs. 3.7%, P = 0.009). A standard polypropylene mesh was used in the onlay position in 91 cases. In nine cases, a light mesh was placed in the preperitoneal space. A closed vacuum drain was left in situ in 37 cases. Light sedation was set in 86 cases, whereas 12 patients received a moderate sedation. Monitored anesthesia care was used in two cases. When moderate sedation was needed, a concurrent increase in lidocaine dose and total volume was recorded. There was a positive correlation between increased lidocaine use and high midazolam dose and additional propofol requirement. The mean total local anesthetic volume was 33 ml (10-63 ml). Lidocaine doses displayed a large range between the cases (70-600 mg). The

  14. Interparietal (Inca bone: a case report

    Directory of Open Access Journals (Sweden)

    Udupi S

    2011-05-01

    Full Text Available The squamous part of occipital bone consists of two parts, supraoccipital and interparietal. The interparietal portion ossifies intramembranously and in rare cases may be separated from the supraoccipital part by a suture. It is then called as the interparietal or Inca bone. The occurrence of Inca variable is rare in humans. The authors here report a case of true interparietal or Inca bone in adult human skull. Knowledge of Inca ossicles in human skulls may be useful to neurosurgeons orthopedic surgeons, anthropologists, radiologists and forensic experts.

  15. IPEX syndrome: Case report

    Directory of Open Access Journals (Sweden)

    Radlović Nedeljko

    2008-01-01

    Full Text Available INTRODUCTION IPEX syndrome, namely, a hereditary (X-linked immunodysregulation with autoimmune polyendocrinopathy and enteropathy, as the basic manifestations, presents a rare and exceptionally severe disease. It develops due to gene mutation responsible for the synthesis of a specific protein (FOXP3, which, by differentiation and activation of regular T-lymphocytic CD4+CD25+, has the key role in the induction and maintenance of the peripheral tolerance of one's own tissue. CASE OUTLINE We present a male infant with classic clinical features of IPEX syndrome, which manifested by the end of the first month after birth, first with type 1 diabetes mellitus and chronic diarrhoea followed by dehydration and disordered development, and then with facial eczema and laboratory signs of thyroiditis without thyroid dysfunction (antithyreoglobulin antibodies 1:5500, antimicrosomal antibodies 1:40. In addition, plasma IgE level was high (517 IU/l, while antibodies to tissue transglutaminase were mildly increased (IgA 7.5 U/ml, and anti-smooth muscle and anti-DNA antibodies were absent. Based on the typical clinical features, as well as the laboratory findings, IPEX syndrome was diagnosed, which was further confirmed by proved IVS7+5G>A mutations in the FOXP3 gene. Therapy with insulin and Pronison, combined with parenteral and semielementary nutrition resulted in the patient's clinical improvement. At the age of 9 months, despite Pronison and hypoallergenic nutrition, the child had a relapse of severe and persistent diarrhoeal disorder followed by dehydration, weight loss and deterioration of general condition. Beside the complete parenteral nutrition, as well as other measures, azathioprine was introduced into the treatment, but without the desired effect. At the age of 12.5 months, due to bacteraemia and disseminated intravascular coagulation as complications, the patient ended lethally. CONCLUSION IPEX syndrome should be kept in mind in all the cases of

  16. Severe Tetanus in Adults:Report of Four Cases and Review of Literature%成人重症破伤风4例诊治体会

    Institute of Scientific and Technical Information of China (English)

    张滋凤; 余明主; 曾小明

    2011-01-01

    目的 探讨成人重症破伤风的治疗方法.方法 回顾性研究自2008年1月至2011年3月应用改进后的破伤风治疗方法治疗成人重症破伤风4例,分析治疗方法及疗效.结果 4例患者均予以注射人破伤风免疫球蛋白或破伤风抗毒素、抗感染、营养支持、肌松镇静解痉等综合治疗.4例均行气管切开、呼吸机辅助呼吸.4例患者中1例并发肺部感染,1例合并肺部感染,1例有吸毒史.4例患者均治愈出院.结论 应用改进后的破伤风治疗方法,可明显提高所研究病例的治愈率,改善重症破伤风患者的预后.%Objective To investigate the treatment of adults with severe tetanus. Methods A retrospective analysis of treatment methods and efficacy was conducted on adults with severe tetanus who received the improved treatment of tetanus between Jan. 2008 and Mar. 2011. Results Patients were treated with human tetanus immune globulin or tetanus antitoxin,antibiotics,nutritional support, antispasmodic and sedative muscle relaxants, and other comprehensive treatment approaches. All patients underwent tracheotomy and mechanical ventilation. Among the 4 cases, 1 was complicated by pulmonary infection, 1 was associated with pulmonary infection,and 1 had a history of drug abuse. All the 4 patients were cured and discharged from hospital. Conclusion The improved treatment of tetanus can significantly increase the cure rate and improve the prognosis in patients with severe tetanus.

  17. Arthrogryposis - case report

    Directory of Open Access Journals (Sweden)

    Mariana CEVEI

    2008-05-01

    Full Text Available Arthrogryposis is a congenital disorder characterized by multiple joint contractures found throughout the body at birth. We present the case of a 3.5 year-old girl with multiple congenital defects: arthrogryposis involving bilateral hip, knee and ankle joints, together with sacral agenesis and with lumbar dysmorphism, anorectal agenesis, hydronephrosis of the left kidney as the result from reflux, right kidney hypoplasia, renal fusion and heart anomalies: tetralogy of Fallot. Immediately after birth, in several steps, colostomy, left ureterocystoneostomy and suprapubic cystostomy were performed. Later in infancy corrective surgery for the heart defect was required. At the age of 2 years, surgery for the equinovarus deformities and for left genu flexum was performed. Medical rehabilitation tries to maximize independent function. The main goals were increasing the muscle tonus of upper-limbs, increase the rate of motion of the joints, establishment of stability for ambulation, learning different schemes of movement according to her needs, obtaining of a functional independency. The therapies were successful, after 10 weeks an improvement of the moving capacity and of the transfer in orthostatism with minimal external assistance, with the obvious increasing of the patient's satisfaction, were noticed.

  18. Perilunar Luxation. Case Report

    Directory of Open Access Journals (Sweden)

    Yaniel Truffín Rodríguez

    2015-06-01

    Full Text Available Within the specter of injuries found in dorsal perilunar luxation or injuries of the bigger arch, the one belonging to bigger frequency reciprocates with the fracture luxation trasescafo dorsal perilunar. Much less frequent are the luxations that associate the big bone's fractures and those with displaced fractures of the pyramidal. Throughout the above, the case of a 19 year old patient is presented, that came to the emergency room of Gustavo Aldereguía Lima, Cienfuegos Hospital, after suffering a fall on his left hand with background of previous health. Great increase of volume in the left-handed wrist, acute pain in spite of immobilization and absolute functional impotence were verified. Manual reduction under general anesthesia of the perilunar luxation of the carpus was accomplished. By means of X-ray pictures of control, anteroposterior and lateral of the wrist, escafoides's fracture and its characteristics were verified. For the marked angulation and conminution of the fracture surgical open-cast treatment was decided, using the technique of Ruse, that was postpone to the tenth day from the initial lesion, when the wrist was less inflamed and the risks of complications were less. The patient was discharged of the consultation of orthopedics to the six months of operated showing functional acceptable results.

  19. Pseudoachondroplasia: A case report

    Directory of Open Access Journals (Sweden)

    Radlović Vladimir

    2013-01-01

    Full Text Available Introduction. Pseudoachondroplasia (PSACH is an autosomal dominant osteochondrodysplasia due to mutations in the gene encoding cartilage oligomeric matrix protein. It is characterized by rhizomelic dwarfism, limb and vertebral deformity, joint laxity and early onset osteoarthrosis. We present the girl with the early expressed and severe PSACH born to clinically and radiographically unaffected parents. Case Outline. A 6.5-year-old girl presented with short-limbed dwarfism (body height 79.5 cm,

  20. Atypical teratoid/rhabdoid tumor (AT/RT) arising from the acoustic nerve in a young adult: a case report and a review of literature.

    Science.gov (United States)

    Wang, Xingfu; Liu, Xueyong; Lin, Zhixiong; Chen, Yupeng; Wang, Pengcheng; Zhang, Sheng

    2015-01-01

    Atypical teratoid/rhabdoid tumors (AT/RTs) are rare, highly malignant central nervous system tumors that predominantly occur in young children. A 22-year-old woman presented with a 4-year history of relapsing tinnitus and gradual hearing loss. Neuroimaging revealed an enhanced intrinsic left internal auditory canal mass. The patient underwent radiotherapy treatment. Three years later, the tumor size continued to increase, as observed by imaging, and ultimately evolved into the left cerebellopontine angle. As a consequence, a total tumor resection was performed, and a pathological diagnosis of AT/RT was made. Aggressive radiotherapy and chemotherapy treatment continued; however, the tumor recurred within 11 months after the total tumor resection. The patient died within 4 months of the second operation. Histopathologically, the tumor contained characteristic rhabdoid cells with areas that resembled a classical primitive neuroectodermal tumor. Immunostaining showed loss of INI1 protein expression in tumor cells, and fluorescence in situ hybridization showed a hemizygous deletion of the hSNF5/INI1 gene region on 22q11.2. This is the first report of an AT/RT that arised from the acoustic nerve in a young adult. Despite manifold diagnostic and therapeutic advances, the prognosis of patients with AT/RT remains poor.

  1. Disulfiram neuropathy: two case reports

    OpenAIRE

    2016-01-01

    Background Neuropathy is a rare adverse side effect of disulfiram therapy and is under-recognized. There have been few case reports documenting this side effect. Case presentation Two cases of disulfiram peripheral neuropathy are discussed. The first case is that of a 25-year-old Caucasian woman who was exposed to disulfiram therapy for a total of 8 months and developed pain and stiffness that prevented her from walking. The second case is that of a 46-year-old Caucasian woman who developed s...

  2. [Synovial sarcoma. Case report].

    Science.gov (United States)

    Deme, Dániel; Abdulfatah, Bishr; Telekes, András

    2016-02-07

    In 2013 there were 94,770 new cancer patients reported in Hungary. Synovial sarcoma accounts for 0.05-0.1% of all cancers and, therefore its incidence is predicted to be 47-94 patients/year in Hungary. The authors report the history of a 18-year-old man who was operated on a right upper abdominal wall tumor with R1 resection. During the next 5 months the tumor grew up to 8 cm in largest diameter. Histology revealed monophasic synovial sarcoma. Immunohistochemistry showed bcl2, focal CD99 and high molecular weight cytokeratin positivity, while smooth muscle actin, S100 and CD34 immunostainings were negative. Becose of this reoperation was not possible, curative six cycles of doxorubicine and ifosfamide with granulocyte colony stimulating factor support and 60 Gy radiotherapy was given to the tumor bed. After these treatments computed tomography scan was negative and the patient attended regular imaging every 3 months. At the age of 20 years the patient developed two neoplastic lesions in the surgical scar measuring 10 mm and 45 × 10 mm in size. R0 resection, partial rib resection and abdominal wall reconstruction were performed. Histology confirmed residual monophasic synovial sarcoma. Radiotherapy was not given because of a risk of intestinal wall perforation. Staging positron emission tomography-computed tomography proved to be negative. At the age of 22 years magnetic resonance imaging scans indicated no tumor recurrence, but after one month a rapidly growing tumorous lesion was found on ultrasound in the surgical scar measuring 20 × 20 × 12 mm in size. Cytology confirmed local recurrence and fluorescence in situ hibridization indicated t(x;18). R0 exstirpation and partial mesh resection were performed and histology showed the same monophasic synovial sarcoma. Because of the presence of vascular invasion and a close resection margin (1 mm) the patient underwent 3 cycles of adjuvant chemotherapy (doxorubicine and ifosfamide) with granulocyte colony stimulating

  3. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  4. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  5. Typhoid spine - A case report

    Directory of Open Access Journals (Sweden)

    Rajesh P

    2004-01-01

    Full Text Available A case of Salmonella typhi isolated from L4-L5 spine is reported here. The causative organism was not suspected preoperatively. The patient responded favourably to surgical drainage and appropriate antibiotic therapy.

  6. Paragonimiasis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Kyung Hyeo; Park, Mi Jung; Bae, Kyung Soo; Choi, Hae Young; Choi, Ho Cheol; Na, Jae Boem; Choi, Dae Seob; Kim, Ho Cheol; Jang, In Seok; Kim, Dong Chul [Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

    2013-11-15

    Pleuropulmonary paragonimiasis is a parasitic infection caused by lung flukes including Paragonimus westermani. Paragonimiasis usually occurs from ingestion of raw or improperly cooked freshwater crabs or crayfish. Pleural or lung parenchymal lesions are commonly found on CT or chest radiographs, and radiologic manifestations of pleuropulmonary paragonimiasis vary with the stage of the disease. Early findings include pneumothorax or hydrothorax, focal air-space consolidation, and linear opacities. Later findings include thin-walled cysts, mass-like consolidation, nodules, or bronchiectasis. Pulmonary paragonimiasis often can be mistaken for pulmonary tuberculosis in tuberculosis-endemic areas or lung cancer when it presents as a solitary pulmonary nodule. Intraperitoneal or ectopic lesions such as those in the retroperitoneum can form during migration of a juvenile worm from the small intestine to the lungs. Although the symptoms and signs of pulmonary paragonimiasis are nonspecific, an early diagnosis can be made if radiologists understand the pathogenesis and typical imaging findings of the disease. The purpose of this report was to demonstrate the various imaging findings of pleuropulmonary paragonimiasis and to review articles to help radiologists make a proper diagnosis.

  7. [Ischemic hepatitis. Case report].

    Science.gov (United States)

    Squella, Freddy; Zapata, Rodrigo

    2003-06-01

    Ischemic hepatitis or shock liver is defined as an extensive hepatocellular necrosis associated with a decrease in hepatic perfusion due to systemic hypotension. Serum aminotransferase levels (ALAT and ASAT) increase rapidly after the ischemic episode and peak within 1 to 3 days to at least 20 times the upper normal limit. After recovery, aminotransferases return to near normal levels in 7-10 days of the initial insult. Histological it is characterized by centrolobular necrosis without inflammation. We report a 47 years old woman with a rheumatic mitral valve disease, atrial fibrillation on anticoagulation and congestive heart failure. She was admitted due to a rapid auricular arrhythmia and secondary severe hypotension. She developed rapidly progressive jaundice (bilirubin up to 8.9 mg/dl) and her aminotransferases (ALAT and ASAT) increased rapidly to levels near 100 times the upper normal limit. Other causes of liver disease were excluded. With hemodynamic support and after heart rate control she improved rapidly within the following 10 days with normalization of liver function tests and complete clinical recovery.

  8. Secondary middle turbinate: case report

    Energy Technology Data Exchange (ETDEWEB)

    Aburjeli, Bruna de Oliveira Melim; Avila, Ana Flavia Assis de; Diniz, Renata Lopes Furletti Caldeira; Motta, Emilia Guerra Pinto Coelho; Ribeiro, Marcelo Almeida; Moreira, Wanderval, E-mail: bruninha86@hotmail.com [Radiology and Imaging Diagnosis, Hospital Mater Dei, Belo Horizonte, MG (Brazil)

    2012-11-15

    Secondary middle turbinate is an anatomical variant rarely observed in the nasal cavity, firstly described by Khanobthamchai et al. as a bone structure originating from the lateral nasal wall and covered by soft tissue. In most cases reported in the literature, this variant is bilateral, occurring without associated complications. In the present report, the authors describe the case of patient of their institution with such anatomical variation. (author)

  9. Paroxysmal upgaze deviation: case report

    OpenAIRE

    Echeverría-Palacio CM; Benavidez-Fierro MA

    2012-01-01

    The paroxysmal upgaze deviation is a syndrome that described in infants for first time in 1988; there are just about 50 case reports worldwide ever since. Its etiology is unclear and though it prognosis is variable; most case reports indicate that during growth the episodes tend to decrease in frequency and duration until they disappear. It describes a 16-months old male child who since 11-months old presented many episodes of variable conjugate upward deviation of the eyes, compensatory neck...

  10. Pediatric Idiopathic Intracranial Hypertension: A Case Report

    Directory of Open Access Journals (Sweden)

    Divya Nandwani, OD

    2015-08-01

    Full Text Available Background: Idiopathic intracranial hypertension (IIH presents differently in prepubertal children as compared to postpubertal children and adults. In adults, IIH is most common in obese women of child-bearing age. However, when occurring in prepubertal children, IIH has been shown to have no predilection for gender and does not correlate with obesity. This case report exemplifies the rare occurrence of IIH in a pediatric patient. Case Report: A five-year-old Hispanic female patient was seen at the University Eye Center for a longstanding hypotropia secondary to a likely congenital fourth nerve palsy with an exotropia component. After a strabismus surgery and a series of follow-up visits, bilateral swollen optic nerves were observed, and a prompt referral to the emergency room was made. Consequently, she was diagnosed with IIH. A treatment regimen of acetazolamide was initiated with subsequent improvement of the clinical presentation of increased intracranial pressure, confirmed by the reduction of swelling of her optic nerves. Conclusions: Bilateral swelling of the optic nerves can be an emergency, especially in children. It is important urgently to rule out causes for increased intracranial pressure. If treatment is significantly delayed, or if no treatment is given to a patient with this condition, loss of visual function may occur. In addition to reporting a rare circumstance of pediatric idiopathic intracranial hypertension, this case report serves to remind eye care practitioners of the importance of monitoring the ocular health of patients closely, even in young, healthy children.

  11. [Splenic hamartoma. Case report].

    Science.gov (United States)

    Soto-Medina, Carlos Alberto; Mier-Escurra, Erik Antonio; Treviño-Garza, Francisco; Ripa-Galván, Paola

    2014-01-01

    Antecedentes: los hamartomas son tumores benignos mixtos muy raros, de crecimiento lento, que generalmente no provocan síntomas, por lo que es más frecuente encontrarlos como un incidentaloma en autopsias o laparotomías. La incidencia de los hamartomas del bazo es sólo de 0.001% entre la población general. Caso clínico: hombre de 39 años de edad, sin antecedentes relevantes, inició dos meses previos con pirosis y dolor ocasional en el hemiabdomen superior. En un ultrasonido de abdomen se observó una tumoración pseudoquística dependiente del bazo. La resonancia magnética reveló cuatro lesiones en el bazo, una de ellas de gran tamaño en el polo inferior, bilobulada, de 12 × 10 × 9 cm. Se realizó una esplenectomía. El paciente no sufrió complicaciones y fue dado de alta al tercer día. El reporte de patología indicó un hamartoma esplénico. Conclusiones: los hamartomas del bazo y otras localizaciones son lesiones benignas que se encuentran como incidelantomas. El diagnóstico se confirma por medio de estudio histopatólogico y su tratamiento es la esplenectomía, siendo la técnica preferida la transabdominal completa por vía laparoscópica. A pesar de que su baja incidencia en México, es de vital importancia que el médico lo considere como diagnóstico diferencial al evaluar una tumoración.

  12. Intracortical chondrosarcoma: a case report.

    Directory of Open Access Journals (Sweden)

    Khodamorad Jamshidi

    2014-02-01

    Full Text Available Chondrosarcoma is the second most common primary mesenchymal malignant tumor of the bone. The most common form is central chondrosarcoma and the rarest is intracortical chondrosarcoma. Here, we describe the clinical, pathological, and imaging features of a case of intracortical chondrosarcoma as well as the outcome of surgical treatment. This is the third case reported in the literature.

  13. Dermatomyositis panniculitis: a case report.

    Science.gov (United States)

    Carroll, Melissa; Mellick, Nick; Wagner, Godfrey

    2015-08-01

    Dermatomyositis-related panniculitis is a rare cutaneous manifestation of dermatomyositis. There are few reported cases in the medical literature. We present the case of a 60-year-old woman with a 2-year history of dermatomyositis and recent biopsy-confirmed panniculitis treated with prednisone, cyclophosphamide and i.v. immunoglobulin.

  14. Proliferative periostitis: a case report.

    Science.gov (United States)

    Zand, Vahid; Lotfi, Mehrdad; Vosoughhosseini, Sepideh

    2008-04-01

    Proliferative periostitis of Garré represents a periosteal reaction to the presence of infection or other irritants. This can be odontogenic or nonodontogenic. This is a case report of an odontogenic periostitis resulting from endodontic origin. It was successfully treated by nonsurgical root canal therapy without using antibiotic therapy during the treatment of this case.

  15. Malformación congénita de la vía aérea pulmonar: Reporte de un caso adulto Congenital pulmonary airway malformation: An adult case report

    Directory of Open Access Journals (Sweden)

    CARLOS ÁLVAREZ Z

    2009-01-01

    Full Text Available La malformación congénita de la vía aérea pulmonar (MCVAP, llamada también malformación congénita adenomatoidea quística que compromete al pulmón es una anomalía embrionaria. La MCVAP es de rara presentación en la infancia y es excepcional en los adultos. En este artículo comunicamos el caso de un hombre adulto con MCVAP y presentamos una breve revisión sobre esta condición. Caso clínico: Hombre de 23 años de edad con varios episodios de neumonía y de síndrome bronquial obstructivo en su niñez. El paciente se quejaba de dolor torácico pleurítico, malestar general y fiebre. En el examen físico se encontró disminución del murmullo pulmonar en la parte inferior del hemitórax derecho, abundantes crepitaciones y matidez. La radiografía y la tomografia computada de tórax (TC revelaron múltiples imágenes hidro-aéreas complejas en el pulmón derecho. Debido a la falta de respuesta al tratamiento médico, se practicó una lobectomía inferior derecha. La histopatología demostró una MCVAP tipo 1. Después de ser dado de alta el paciente presentó una fístula broncopleural, la cual fue tratada exitosamente con una segunda intervención quirúrgica. Tres años después de la cirugía el paciente está asintomático. Discusión: La MCVAP es una malformación congénita hamartomatosa muy poco frecuente. En adultos es excepcional. La técnica diagnóstica de elección es la TC de tórax. Considerando el alto potencial neoplásico de esta malformación, su tratamiento debe ser la resección quirúrgica, incluso si el paciente está asintomático.Congenital pulmonary airway malformation or CPAM (congenital cystic adenomatoid malformation that involve the lung is an embryonic anomaly. CPAM is a rare condition in chilhood, and even more so in adulthood. In this article we report the case of a young adult man with CPAM and present a brief review about this condition. Case study: 23 years old man with several episodes of pneumonia

  16. Eagle's syndrome: a case report

    OpenAIRE

    Moon, Chang-Sig; Lee, Baek-Soo; Kwon, Yong-Dae; Choi, Byung-Jun; Lee, Jung-Woo; Lee, Hyun-Woo; Yun, Sun-Ung; Ohe, Joo-Young

    2014-01-01

    Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually charac...

  17. Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

    Directory of Open Access Journals (Sweden)

    Skand Sinha

    2013-10-01

    Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.

  18. Renal myxoma: a case report

    Directory of Open Access Journals (Sweden)

    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  19. Dirofilariasis: A rare case report

    Directory of Open Access Journals (Sweden)

    Singh R

    2010-01-01

    Full Text Available Human dirofilariasis is a zoonotic infection most commonly caused by Dirofilaria repens. It has not been widely recognized in India. There is probably a focus of human infection with D. repens in Kerala. We report the first case of dirofilariasis, from the Eastern-part of India, to the best of our knowledge. Among the documented cases of human dirofilariasis caused by D. repens, recorded in India, most of them had ocular infections and few had subcutaneous involvement of the face. This is the first case report of human dirofilariasis from India involving the lower part of human body.

  20. [Pheochromocytoma. Report of 10 cases].

    Science.gov (United States)

    Rabii, R; Joual, A; Rais, H; Bennani, S; el Mrini, M; Benjelloun, S

    1999-01-01

    We report 10 cases of adrenal pheochromocytoma seen over a period 15-years. A female predominance was noted (8 women/2 men). Patients were aged between 16-46 years with a mean of 34 years. Clinical manifestations consisted of hypertension observed in all cases, with vasomotor symptoms (90%). Time to consultation was prolonged (mean: 23 months). CT scan performed in 7 cases showed pheochromocytoma in all cases, located on the right side in 6 cases, while one pheochromocytoma was located in Zukerkandal organ. All patients were operated via anterior approach and adrenalectomy was performed. A favourable course was observed in 90% of cases with normalisation blood pressure. One death was noted. Histological examination showed no malignancy in all cases.

  1. 儿童活体肝移植42例临床报告%Adult-to-children living donor liver transplantation: a report of 42 cases

    Institute of Scientific and Technical Information of China (English)

    唐丹; 邓玉华; 张明满; 严律南; 李英存; 戴小科; 蒲从伦; 康权; 郭春宝; 任志美

    2010-01-01

    目的 总结成人活体部分供肝儿童肝移植的临床疗效和经验.方法 42例儿童患者,年龄80 d至14岁.小于1岁者28例;体重3.08~45 kg,小于10kg者27例.移植前有不同程度的黄疸、腹水、营养不良和肝功能严重损害.其中父母供肝36例,祖母供肝4例.舅父和表兄供肝各1例.供肝类型包括:左外叶31例.Ⅱ段肝组织1例,左半肝8例.右半肝2例.对供肝的肝静脉、肝动脉和受者的肝动脉、肝静脉、门静脉进行成形.以便吻合;供肝动脉较短者,以供者大隐静脉搭桥.免疫抑制方案:采用环孢素A(CsA)+糖皮质激素21例,CsA+吗替麦考酚酯(MMF)+糖皮质激素8例,他克莫司(Tac)+糖皮质激素7例,Tac+MMF+糖皮质激素6例.术后随访时问2~43个月.结果 移植物与受者质量比为0.91%~5.71%,移植物与受者标准肝体积比为40.7%~137.1%.术后早期32例(76.2%,32/42)出现并发症,死亡5例,其中4例死于血管并发症;随访期9例出现并发症,死亡4例,其中3例死于血管并发症;意外死亡2例.其余31例(73.8%,31/42)健康存活.结论 成人活体部分供肝儿童肝移植是治疗儿童终末期肝病的有效方法,术后血管并发症是主要的死亡原因.预防和治疗血管并发症能明显提高手术成功率.%Objective To present our clinical outcomes of adult-to-children living donor liver transplantation(A-CLDLT) and summarize our experience. Methods The clinical data, preoperative assessment, surgical strategies and complications of 42 adult donors and children recipients who underwent A-CLDLT from April 2006 to December 2009 in Children's Hospital of Chongqing Medical University were retrospectively analyzed. These 42 recipients (21 boys and 21 girls) aged from 80 days to 14 years whose body weight at the time of operation was 3. 08 to 45. 00 kg. In all the children recipients, 28 cases suffered biliary atresia, 6 Wilson' s diseases, 4 glycogen storage diseases, 3 cavernous transformation of the

  2. Neuroradiology and histopathology in two cases of adult medulloblastoma.

    Science.gov (United States)

    Romero-Rojas, Alfredo E; Diaz-Perez, Julio A; Raju, Sharat; Lozano-Castillo, Alfonso

    2014-04-01

    Medulloblastoma (MB) is the most common central nervous system neoplasm in children and only rarely presents in the adult population. Recent molecular biology findings have characterized MB as a heterogeneous neoplasm distinguished by well-defined tumour subsets each with specific histologic and molecular features. Available immunohistochemical stains can now be used to differentiate the distinct molecular types of MB. This report analyzed the histopathologic and neuroradiologic features of two new cases of adult MB. Imaging studies in these patients revealed the morphological appearance of high-grade, well-circumscribed heterogeneous tumours with necrosis, located laterally within the posterior cranial fossa. Histopathology of resected samples demonstrated high-grade tumours (WHO grade IV) containing sheets of undifferentiated neural cells with high mitotic activity and evidence of necrosis. The histopathologic and molecular characteristics of these cases of MB are reviewed for potential applications in new molecular methods of imaging.

  3. Pulmonary artery sling: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gil Hyun; Lee, Sun Wha; Cha, Sung Ho [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly,which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case were identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.

  4. Nonspecific Hyperamylasemia: A Case Report

    Directory of Open Access Journals (Sweden)

    Julio Cesar Wiederkehr

    2013-01-01

    Full Text Available Context The elevation of serum amylase and lipase are generally associated with pancreatic diseases. However they can be associated with different pathologies unrelated with amylase and lipase. Case report This paper aims to report a case of a patient diagnosed with nonspecific hyperamylasemia and warn of this possibility in the differentiation of hyperamylasemia. Conclusion The correct diagnosis of silent hyperamylasemia is important in order to determine whether there is the risk of pancreatic disease or if we are just ahead of a benign hyperenzymemia.

  5. Cardiac leiomyosarcoma, a case report

    DEFF Research Database (Denmark)

    Andersen, Rikke; Kristensen, Bjarne W; Gill, Sabine

    2013-01-01

    In this case report we present the history of a patient admitted with recurrent pulmonary edema. Transesophageal chocardiography showed a tumour in the left atrium, occluding the ostium of the mitral valve and mimicking intermittent mitral stenosis. Cardiac surgery followed by pathological...... examination revealed that the tumour was a leiomyosarcoma. Images from the echocardiography as well as the pathological findings are shown and discussed. The present case report illustrates that atrial tumors comprise also sarcomas, suggesting the use of careful, rapid diagnostic procedures and treatment...

  6. Infantile Scurvy: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Leila Ghedira Besbes

    2010-01-01

    Full Text Available Background. Ascorbic acid (vitamin C is necessary for the formation of collagen, reducing free radicals, and aiding in iron absorption. SCURVY, a disease of dietary ascorbic acid deficiency, is uncommon today. It still exists in high risk groups including economically disadvantaged populations with poor nutrition. The incidence of SCURVY in the pediatric population is very low. Cases Report. Here we report two cases of SCURVY revealed by subperiosteal hematoma in children with cerebral palsy and developmental delay. Conclusion. SCURVY is extremely rare in children. Musculoskeletal manifestations are prominent in pediatric SCURVY. Multiple subperiosteal hematomas are an important indicator for diagnosis.

  7. Cephalic Tetanus: A Case Report

    Directory of Open Access Journals (Sweden)

    M. A. Alhaji

    2011-01-01

    Full Text Available A case report of cephalic tetanus in a 2-year-old girl who was not immunized against tetanus following suppurative otitis media (SOM is presented. This case is reported because of the rarity of cephalic tetanus associated with high mortality, to highlight the risk of cephalic tetanus as sequelae of SOM and the need for proper aural care and prompt treatment of SOM. Primary immunization of all eligible children as well as booster vaccination at appropriate time as an effective management strategy for tetanus is emphasized.

  8. Neonatal acute apendicitis, case report

    OpenAIRE

    Romero Rojas, Nery; Instituto de Patología, UNMSM; Sánchez García, Luis; Hospital Nacional Docente de Cajamarca

    2016-01-01

    Introduction. Acute appendicitis is a rare disease in newborns with a high mortality because of unspecific clinical features. We report a case of non-perforated acute appendicitis in a newborn at the San Bartolome Hospital in Lima. Case report. A female newborn weighing 3 170 g in the first day repelled maternal lactation; at the third day, she presented 39°C fever, and later, abdominal distention, constipation, and abundant vomiting. The X-ray films showed a distended gastric camera and para...

  9. A Case Report on Parvovirus B19 Associated Myositis

    Directory of Open Access Journals (Sweden)

    Nathan D. Oliver

    2012-01-01

    Full Text Available Introduction. Whilst there are reports of viral myopathies affecting children and the immunocompromised, infective myositis is a relatively rare inflammatory myopathy in adults. The clinical spectrum can range from benign myalgias to more serious complications in certain risk groups. Case Presentation. We present two cases of myositis as a result of parvovirus B19 infection. Conclusion. Viral myositis and parvovirus B19 associated myositis should be considered in adults presenting with significant myalgia.

  10. Kikuchi-Fujimoto disease: pediatric case report.

    Science.gov (United States)

    Ojeda Lewis, Eduardo; Vásquez Paz, Héctor

    2015-09-28

    The Kikuchi-Fujimoto disease is a rare disease that occurs mostly in young adults, although some cases have been reported in children. It is usually characterized by fever and cervical lymphadenopathy. The etiology of the disease remains unknown. Its course is usually benign and self-limited. It has special histopathological features that allow the differential diagnosis with other entities, which from a clinical point of view can be very complicated. We report a 9 years 11 months old girl with lymphadenopathy and fever with five months evolution, which is the longest evolution among the cases reviewed by the authors in world literature. Given that the presentation of this disease in children is very rare, we estimate that the knowledge of this disease is relevant and pediatricians must consider it in the differential diagnosis of fever of unknown origin in children.

  11. Ainhum - A Rare Case Report

    Science.gov (United States)

    Prabhu, Ravi; Vinoth, Sundaresan; Praveen, Chinnappan Balasubramanian

    2016-01-01

    The term ‘AINHUM’ is derived from the African word meaning ‘to saw or cut’. True ainhum otherwise called dactylolysis spontanea is a condition involving soft tissue or digits with constricting rings commonly presenting in fifth toes, usually bilateral. It is to be differentiated from Pseudo-ainhum that occurs secondary to some hereditary and nonhereditary diseases that lead to annular constriction of digits. We report a rare case of true ainhum involving the left fourth toe only. It is a very rare case and a very few were reported worldwide. The highest incidence of ainhum has been reported in South Africa and South America. It is rarely reported in India. Ainhum when diagnosed and treated in early stages can be prevented from progressing to mutilating deformities. PMID:27190888

  12. Intraspinal endometriosis: a case report

    Institute of Scientific and Technical Information of China (English)

    孙正义; 汪玉良; 赵琳; 马璐琪

    2002-01-01

    @@ Endometriosis (EM) is defined by the presence of tissue histologically and functionally similar to the endometrium outside the uterus. EM has been mostly reported in the pelvis. Intraspinal endometriosis (IEM) is so rare that only four cases have been reported in the literature, to our knowledge.1-4 Two years ago, a patient was admitted to the Second Affiliated Hospital of Lanzhou Medical College and was treated successfully (with 2 years of follow-up).

  13. Marjolin ulcer: a case report

    Directory of Open Access Journals (Sweden)

    Beatriz Di Martino Ortiz

    2014-01-01

    Full Text Available Marjolin’s ulcer is part of a group of neoplasms arising in chronic skin lesions, whether inflammatory or traumatic. Squamous cell carcinoma is the most frequently reported in the literature, it appears most frequently in burn scars, although also described in other types of lesions. We report a case of Marjolin ulcer in a male, native, 65 years old, from the Paraguayan Chaco, with antecedents of scar post trauma in youth.

  14. Penile Epidermal Cyst: A Case Report

    Science.gov (United States)

    Kumaraguru, Veerapandian; Prabhu, Ravi

    2016-01-01

    Epidermal cysts also known as epidermoid cysts, is one of the common benign tumours presenting anywhere in the body. However, epidermal cyst in the penis is very rare. This condition in children is usually congenital due to abnormal embryologic closure of the median raphe; hence, it is termed as median raphe cysts (MRCs). Penile epidermal cysts may occur in adults following trauma or surgery due to epidermal elements being trapped within closed space. During wound healing, trapped squamous epithelium, undergoing keratinisation leads to cyst formation. Here, we report a rare case of patient with a penile epidermoid cyst whose main complaints was discomfort during coitus. PMID:27437298

  15. Familial Mediterranean fever: the first adult case in Korea.

    Science.gov (United States)

    Lim, Ah Leum; Jang, Hyun Joo; Han, Jung Wan; Song, Yong Keun; Song, Won Jun; Woo, Heung Jung; Jung, Young Ok; Kae, Sea Hyub; Lee, Jin

    2012-11-01

    Familial Mediterranean fever (FMF) is known to be a genetic disorder that prevalent among populations surrounding the Mediterranean Sea. Since Mediterranean fever gene (MEFV) was discovered at 1997, some cases have been reported in countries not related or close to this area like Japan. In addition it has been generally accepted that the clinical onset of FMF begins before 20 yr of age in most patients. Onset of the disease at an older age may occur but is rare. Adult-onset FMF may be a form of disease with distinct clinical, demographic and molecular characteristics. We describe a case of adult-onset FMF confirmed by DNA analysis of the MEFV gene in a Korean patient. A 32-yr-old man, who has no family history of FMF, presented with periodic fever, abdominal pain and vomiting. Though several various tests were thoroughly performed to evaluate the cause of his symptoms, there was no evidence of infectious, autoimmune or neoplastic diseases. Several gene analysis of periodic fever syndrome was finally performed and two point mutations (p.Leu110Pro, p.Glu148Gln) were identified. We confirmed the first adult case of FMF through detection of MEFV gene mutations in Korea and describe his clinical characteristics.

  16. Workplace Inhalant Abuse in Adult Female: Brief Report

    Directory of Open Access Journals (Sweden)

    Rohit Verma

    2011-01-01

    Full Text Available Inhalant abuse is the purposeful inhalation of intoxicating gases and vapors for the purpose of achieving an altered mental state. With its propensity for being yet an under-recognized form of substance use, being gateway to hard substances, cross-cultural penetration crossing socioeconomic boundaries, and causing significant morbidity and mortality in early ages, the prevention of inhalant misuse is a highly pertinent issue. This clinical report identifies a newer perspective in the emergence of inhalant abuse initiation. We report a case of an adult female with late onset of inhalant dependence developing at workplace and recommend for greater awareness, prevention, and management of this expanding substance abuse problem.

  17. Hemifacial Microsomia - A Case Report

    Directory of Open Access Journals (Sweden)

    Sushma Rao

    2005-01-01

    Clinically one sees facial asymmetry, macrostomia, micrognathia, and microtia to anotia of the external ear, preauricular skin tags, and Epibulbar tumors in the eyes. One such case of Hemifacial Microsomia seen in a boyaged 9 years, who complained of facial asymmetry on the right side of the face since birth and an extra auricle on the same side, is reported here.

  18. [Emphysematous pyelonephritis: a case report].

    Science.gov (United States)

    Rabii, R; Fekak, H; Mezzour, H; Joual, A; Moufid, K; el Mrini, M; Benjelloun, S; Cherkab, R; Bensaid, A; el Kettani, C; Barrou, L

    2003-04-01

    Diabetic patients with urinary tract infections had a certain risk of developping emphysematous pyelonephritis with gas producting bacteria. This disease was accompagned with high mortalité. We will report one case who was treated successfully by high dose antibiotic regim and emergency nephrectomy.

  19. Gestational diabetes insipidus. Case Report.

    Science.gov (United States)

    Ejmocka-Ambroziak, Anna; Grzechocińska, Barbara; Jastrzebska, Helena; Kochman, Magdalena; Cyganek, Anna; Wielgoś, Mirosław; Zgliczyński, Wojciech

    2015-01-01

    Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor.

  20. Lithium nephropathy: a case report

    OpenAIRE

    Raphael Reis Pereira-Silva; Debora Esperancini-Tebar

    2014-01-01

    Although widely used in the management of bipolar disorder, lithium may cause adverse kidney effects. The importance of the present study is to report the case of a 59-year-old woman who was under regular treatment with lithium for bipolar disorder and whose imaging studies demonstrated the presence of multiple renal microcysts, suggesting lithium nephropathy as main diagnostic hypothesis.

  1. Lithium nephropathy: a case report

    Directory of Open Access Journals (Sweden)

    Raphael Reis Pereira-Silva

    2014-01-01

    Full Text Available Although widely used in the management of bipolar disorder, lithium may cause adverse kidney effects. The importance of the present study is to report the case of a 59-year-old woman who was under regular treatment with lithium for bipolar disorder and whose imaging studies demonstrated the presence of multiple renal microcysts, suggesting lithium nephropathy as main diagnostic hypothesis.

  2. Neonatal brucellosis: A case report.

    Science.gov (United States)

    Alnemri, Abdul Rahman M; Hadid, Adnan; Hussain, Shaik Asfaq; Somily, Ali M; Sobaih, Badr H; Alrabiaah, Abdulkarim; Alanazi, Awad; Shakoor, Zahid; AlSubaie, Sarah; Meriki, Naema; Kambal, Abdelmageed M

    2017-02-28

    Although brucellosis is not uncommon in Saudi Arabia, neonatal brucellosis has been infrequently reported. In this case of neonatal brucellosis, Brucella abortus was isolated by blood culture from both the mother and the neonate. Serology was positive only in the mother.

  3. Beer potomania: a case report

    OpenAIRE

    Bhattarai, Nimesh; Kafle, Poonam; Panda, Mukta

    2010-01-01

    A syndrome of hyponatraemia associated with excessive beer drinking was first recognised in 1971. This syndrome has been referred to as beer potomania. Dilutional hyponatraemia occurs due to excessive consumption of an exclusive beer diet which is poor in salt and protein. We report a case of beer potomania who improved dramatically with introduction of solute load, with no subsequent neurological sequelae.

  4. Beer potomania: a case report.

    Science.gov (United States)

    Bhattarai, Nimesh; Kafle, Poonam; Panda, Mukta

    2010-04-29

    A syndrome of hyponatraemia associated with excessive beer drinking was first recognised in 1971. This syndrome has been referred to as beer potomania. Dilutional hyponatraemia occurs due to excessive consumption of an exclusive beer diet which is poor in salt and protein. We report a case of beer potomania who improved dramatically with introduction of solute load, with no subsequent neurological sequelae.

  5. Gorlin syndrome: A case report

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    Abbas Darjani

    2016-01-01

    Full Text Available Gorlin syndrome is a rare autosomal dominant disorder which characterize by multi-organ abnormities such as odontogenic keratocysts in the jaw, skeletal abnormities and multiple basal cell carcinoma etc. We report a case of this syndrome in a young man with palmar pits, multiple facial BCC, clacifications of the falx cerebri and bifid rib.

  6. Necrotizing faciitis: report of case.

    Science.gov (United States)

    Mruthyunjaya, B

    1981-01-01

    A case of necrotizing fasciitis following infection of a mandibular third molar is reported. Necrotizing fasciitis is a relatively rare but fulminating clinical entity characterized by necrosis of fascia with widespread undermining of the superficial tissue and extreme systemic toxicity. Prompt recognition and proper management can reduce the morbidity and mortality in this severe soft tissue infection.

  7. Beer potomania: a case report

    Science.gov (United States)

    Bhattarai, Nimesh; Kafle, Poonam; Panda, Mukta

    2010-01-01

    A syndrome of hyponatraemia associated with excessive beer drinking was first recognised in 1971. This syndrome has been referred to as beer potomania. Dilutional hyponatraemia occurs due to excessive consumption of an exclusive beer diet which is poor in salt and protein. We report a case of beer potomania who improved dramatically with introduction of solute load, with no subsequent neurological sequelae. PMID:22736559

  8. Emphysematous Cystitis: A Case Report

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    Suleyman Tagci

    2014-12-01

    Full Text Available Emphysematous cystitis is an infectious disease, which is characterized by accumulation of air within the lumen and wall of the bladder. Diabetes mellitus, neurogenic bladder and advanced age are important risk factors for the development of the disease. In this case report, we present a young diabetic male patient with neurogenic bladder, who was treated with the diagnosis of emphysematous cystitis.

  9. Parietal intraparenchymal Schwannoma: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Hwan; Chung, Tae Woong; Yoon, Woong; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National University Hospital, Kwangju (Korea, Republic of)

    2008-10-15

    We report a case of an intraparenchymal schwannoma of the left parietal lobe. A 51-year-old woman was admitted to our hospital with complaints of intermittent headaches. Computed tomography and magnetic resonance images revealed a 1.3 cm sized intra-axial homogeneous enhancing mass in the left parietal lobe. The lesion was pathologically confirmed to be a schwannoma.

  10. Intravitreal dexamethasone implants for the treatment of refractory scleritis combined with uveitis in adult-onset Still's disease: a case report.

    Science.gov (United States)

    Ahn, Seong Joon; Hwang, Sun Jin; Lee, Byung Ro

    2016-11-08

    Adult-onset Still's disease is a systemic inflammatory disease which presents with uveitis and scleritis in the eye. Intravitreal dexamethasone implants are used for the treatment of refractory uveitis. A 19-year-old woman diagnosed to have adult-onset Still's disease for fevers, joint pain, and a salmon-colored bumpy rash presented with scleritis and uveitis in the left eye. Topical and systemic steroids with oral methotrexate failed to control the inflammation. We performed intravitreal injections of dexamethasone implants for side effects of steroid and refractory ocular inflammation. The therapy resulted in improvements in the patient's uveitis with reductions in scleral vessel engorgement and redness. There was no recurrence of uveitis or scleritis during 4 months following treatment. Intravitreal injections of dexamethasone implants may result in clinical improvements of refractory scleritis combined with uveitis.

  11. Menstruation angina: a case report

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    Choo Wai Kah

    2009-03-01

    Full Text Available Abstract Introduction Menstruation is commonly associated with migraine and irritable bowel but is rarely correlated with angina or myocardial ischaemia. Only a small number of cases have been reported suggesting a link between menstruation and myocardial ischaemic events. Case presentation A case of menstruation angina is reported in order to raise awareness of this association. A 47-year-old South Asian woman presented with recurrent chest pains in a monthly fashion coinciding with her menstruations. Each presentation was associated with troponin elevation. Angioplasty failed to resolve her symptoms but she eventually responded to hormonal therapy. Conclusions The possibility of menstruation angina should always be taken into account in any female patients from puberty to menopause presenting with recurrent chest pains. This can allow an earlier introduction of hormonal therapy to arrest further myocardial damage.

  12. Adult-onset Still's disease: Clinical cases

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    G. R. Imametdinova

    2014-01-01

    Full Text Available The annual incidence of adult-onset Still's disease (AOSD worldwide is 0.16 cases per 100,000 persons. Its leading symptoms are joint involvement, fever, skin rash, and neutrophilic leukocytosis in the absence of rheumatoid factor and anticyclic citrullinated peptide antibodies in serum and synovial fluid. In its initial stage, there may be monoarthritis more commonly of the wrist, hip, or knee. Then the lesion assumes the pattern of oligo- or polyarthritis. Musculoskeletal involvement appearing as arthralgia, arthritis, and myalgia is noted in all patients. In the majority of patients, articular involvement progresses and destructive polyarthritis develops. Symmetric involvement of the carpophalangeal and distal interphalangeal joints is frequently detected. Skin lesion manifests itself as maculopapular or roseolous rashes on the chest, back, shoulders, occasionally on the legs, or in the areas of mechanical irritation. A sore throat with the signs of pharyngitis is a characteristic early symptom of the disease. There may be involvements of the liver, cardiovascular system, lung, as well as lymphadenopathy, or splenomegaly. The chronic course of the disease is more frequently noted.The paper describes two cases of AOSD. One case demonstrates that the physician has no experience in diagnosing and managing patients with AOSD, resulting in the misinterpretation of the increase in disease activity when the subclinical doses of methotrexate (MT are used, which has been regarded as a therapeutic complication. The use of the adequate dose of MT could achieve a clinical and laboratory remission and discontinue glucocorticoids (GC.In the other case of recurrent AOSD and mild clinical symptoms, the unreasonable use of high GC doses gave rise to adverse reactions.

  13. Adult-onset Still's disease: Clinical cases

    Directory of Open Access Journals (Sweden)

    G. R. Imametdinova

    2014-12-01

    Full Text Available The annual incidence of adult-onset Still's disease (AOSD worldwide is 0.16 cases per 100,000 persons. Its leading symptoms are joint involvement, fever, skin rash, and neutrophilic leukocytosis in the absence of rheumatoid factor and anticyclic citrullinated peptide antibodies in serum and synovial fluid. In its initial stage, there may be monoarthritis more commonly of the wrist, hip, or knee. Then the lesion assumes the pattern of oligo- or polyarthritis. Musculoskeletal involvement appearing as arthralgia, arthritis, and myalgia is noted in all patients. In the majority of patients, articular involvement progresses and destructive polyarthritis develops. Symmetric involvement of the carpophalangeal and distal interphalangeal joints is frequently detected. Skin lesion manifests itself as maculopapular or roseolous rashes on the chest, back, shoulders, occasionally on the legs, or in the areas of mechanical irritation. A sore throat with the signs of pharyngitis is a characteristic early symptom of the disease. There may be involvements of the liver, cardiovascular system, lung, as well as lymphadenopathy, or splenomegaly. The chronic course of the disease is more frequently noted.The paper describes two cases of AOSD. One case demonstrates that the physician has no experience in diagnosing and managing patients with AOSD, resulting in the misinterpretation of the increase in disease activity when the subclinical doses of methotrexate (MT are used, which has been regarded as a therapeutic complication. The use of the adequate dose of MT could achieve a clinical and laboratory remission and discontinue glucocorticoids (GC.In the other case of recurrent AOSD and mild clinical symptoms, the unreasonable use of high GC doses gave rise to adverse reactions.

  14. Choledochal cyst as a diagnostic pitfall: a case report

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    Waidner Uta

    2008-01-01

    Full Text Available Abstract Introduction Choledochal cysts are rare congenital anomalies. Their diagnosis is difficult, particulary in adults. Case presentation This case report demonstrates the diagnostic and therapeutic pitfalls. Conclusion To prevent cost-intensive and potentially life-threating complications, a choledochal cyst must be considered in the differential diagnosis whenever the rather common diagnosis of a hepatic cyst is considered.

  15. Regional Odontodysplasia: Report of a case

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    Rashidian A.

    2013-12-01

    Full Text Available Regional odontodysplasia is a rare dental anomaly affecting both primary and adult dentitions in the maxilla or mandible or both jaws, whilst involvement of the maxilla is more common [1-2]. In most cases, one quadrant is affected. One of the characteristics of this anomaly is discolored and soft teeth that can be accompanied by swelling or abscess. In this anomaly, enamel and dentin are thin and hypoplastic, therefore, the teeth give the impression of “ghost teeth” [2, 8]. In radiography, the delineation between enamel and dentin is not clear and pulp chamber is wide. Histologically, areas of hypocalcified enamel are observed and the enamel prisms appear to be irregular in direction [2]. There is a distur-bance in dentin formation and dentinal tubules are reduced in number. The etiology of regional odontodysplasia is still unknown [8]. Managements of these cases should be based on the esthetics and functional needs as well as the degree of involvement.This report describes a case of regional odontodysplasia in a 3.5 year old Iranian girl whose chief complaint was the abscess formation in the left maxillary primary molar re-gion. This case study aims to report the clinical and radiological findings of the current case.

  16. Regional Odontodysplasia: Report of a case.

    Science.gov (United States)

    Rashidian, A; Afsharian Zadeh, M; Azarshab, M; Zarrabian, T

    2013-12-01

    Regional odontodysplasia is a rare dental anomaly affecting both primary and adult dentitions in the maxilla or mandible or both jaws, whilst involvement of the maxilla is more common [1-2]. In most cases, one quadrant is affected. One of the characteristics of this anomaly is discolored and soft teeth that can be accompanied by swelling or abscess. In this anomaly, enamel and dentin are thin and hypoplastic, therefore, the teeth give the impression of "ghost teeth" [2, 8]. In radiography, the delineation between enamel and dentin is not clear and pulp chamber is wide. Histologically, areas of hypocalcified enamel are observed and the enamel prisms appear to be irregular in direction [2]. There is a disturbance in dentin formation and dentinal tubules are reduced in number. The etiology of regional odontodysplasia is still unknown [8]. Managements of these cases should be based on the esthetics and functional needs as well as the degree of involvement. This report describes a case of regional odontodysplasia in a 3.5 year old Iranian girl whose chief complaint was the abscess formation in the left maxillary primary molar region. This case study aims to report the clinical and radiological findings of the current case.

  17. CASE REPORT: Chorangiophagus Parasiticus: A Rare Case Report

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    Ranjit Kangle

    2012-07-01

    Full Text Available Malformations are common in twin pregency compared to singleton pregnancy. One such rare anomaly is Chorangiophagus parasiticus also known as twin to twin transfusion which is an asymmetric abnormality of monozygotic twins, where asymmetric twin survive by parasitisizing normal twin. It’s a rare condition with an incidence of 1 in 35.000 deliveries. We report such a case with complete autopsy findings.

  18. [Ectopic breast fibroadenoma. Case report].

    Science.gov (United States)

    Senatore, G; Zanotti, S; Cambrini, P; Montroni, I; Pellegrini, A; Montanari, E; Santini, D; Taffurelli, M

    2010-03-01

    Among the rare anomalies of the breast development, polythelia is the most common, between 1% and 5% of women and men present supernumerary nipples. Polymastia, usually presenting as ectopic breast tissue without areola-nipple complex, is seen mostly along the milk line, extending from the axilla to the pubic region. Ectopic breast tissue is functionally analogous to mammary gland and it is subjected to the same alterations and diseases, whether benign or malignant, that affect normal breast tissue. We report the case of a 21 years-old female evaluated by the medical staff after founding a solid nodular mass by suspect axillary lymphadenopathy. Differential diagnosis with lymphoma is the major problem in these cases. The mass was removed and the intraoperative histological examination showed fibroadenoma in axillary supernumerary breast. Presence of ectopic breast tissue is a rare condition; development of benign mass or malignant degeneration is possible, but it is very unusual. In case of polymastia diagnosis is simple; in case of isolated nodule, without local inflammation or infection, there are greater difficulties. Ultrasonography is diagnostic in case of breast fibroadenoma, but it might be inadequate in ectopic localizations owing to the shortage of mammary tissue around the mass. Preoperative diagnosis is important to plan an adequate surgical treatment; lumpectomy is indicated in case of benign tissue; in case of malignancy, therapy is based on the standard treatment used for breast cancer (surgery, chemotherapy and radiation therapy).

  19. Giant sacral meningeal diverticulum containing a thickened filum with lipoma in an adult with spinal cord tethering. Case report and review of the literature.

    Science.gov (United States)

    Feigenbaum, Frank

    2008-09-01

    An unusual case of a patient with a giant intrasacral meningeal diverticulum and spinal cord tethering with a thickened filum is presented. Instead of being empty as is typical, the meningeal diverticulum in this case contained a segment of the thickened tethering filum, which entered from the thecal sac through an ostium. A search of the literature revealed no prior description of a meningeal diverticulum containing a portion of tethered filum or any other structure. Only 2 previous cases of intrasacral meningeal cyst and spinal cord tethering with a thickened filum were found, both in the non-English literature.

  20. Case report on anorexia nervosa

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    Preeti Srinivasa

    2015-01-01

    Full Text Available Anorexia nervosa is an eating disorder characterized by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception. It is clinically diagnosed more frequently in females, with type and severity varying with each case. The current report is a case of a 25-year-old female, married for 5 years, educated up to 10 th standard, a homemaker, hailing from an upper social class Hindu (Marvadi family, living with husband′s family in Urban Bangalore; presented to our tertiary care centre with complaints of gradual loss of weight, recurrent episodes of vomiting, from a period of two years, menstrual irregularities from 1 year and amenorrhea since 6 months, with a probable precipitating factor being husband′s critical comment on her weight. Diagnosis of atypical anorexia nervosa was made, with the body mass index (BMI being 15.6. A multidisciplinary therapeutic approach was employed to facilitate remission. Through this case report the authors call for the attention of general practitioners and other medical practitioners to be aware of the symptomatology of eating disorders as most patients would overtly express somatic conditions similar to the reported case so as to facilitate early psychiatric intervention.