scholarly journals Asymptomatic Late Migration of an Atrial Pacemaker Lead into the Right Lung

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Nicolas De Schryver ◽  
Sebastien Marchandise ◽  
Geoffrey C. Colin ◽  
Benoît Ghaye ◽  
Jean-Benoît le Polain de Waroux
Keyword(s):  
Unusual Case ◽  
Pacemaker Lead ◽  
Cardiac Perforation ◽  
The Right ◽  
Manual Traction

This report illustrates an unusual case of asymptomatic late cardiac perforation by an atrial pacemaker lead into the right lung. In the present case, the lead was explanted by simple manual traction through the device pocket without any complications.

Positional syncope occurring just at the right time in a patient with a permanent pacemaker: a case report

2021 ◽  
Vol 71 (10) ◽  
pp. 2461-2463
Author(s):  
Syed Haseeb Raza Naqvi ◽  
Madiha Fatima ◽  
Pir Sheeraz Ali ◽  
Maqsood Alam ◽  
Muhammad Taha Khan ◽  
...  
Keyword(s):  
Case Report ◽  
Hospital Admission ◽  
Unusual Case ◽  
Pacemaker Implantation ◽  
Integrated Approach ◽  
Permanent Pacemaker ◽  
Pacemaker Lead ◽  
History Taking ◽  
Lead Fracture ◽  
The Right

We present an unusual case of positional syncope occurring years after pacemaker implantation due to pacemaker lead fracture resulting from subclavian-crush syndrome. The syncope occurred incidentally during hospital admission and was timely diagnosed using an integrated approach of history taking, examination findings, device interrogation and radiographic parameters. The patient subsequently underwent lead and device revision which led to resolution of her symptoms. Continuous...

scholarly journals P040 An unusual case of giant cell arteritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Jessica Ellis ◽  
Keziah Austin ◽  
Sarah Emerson
Keyword(s):  
Inflammatory Markers ◽  
Illicit Drugs ◽  
Unusual Case ◽  
Temporal Arteritis ◽  
White Cell Count ◽  
Healthcare Providers ◽  
Temporal Artery ◽  
Low Grade ◽  
Temporal Artery Biopsy ◽  
The Right

Abstract Background/Aims  A 49-year-old female of Nepalese heritage was referred with right-sided headache, scalp tenderness, and a painful swelling overlying the right temple. She denied any visual or claudicant symptoms but felt systemically unwell with a fever. There were no symptoms suggestive of an inflammatory arthritis, underlying connective tissue disease or vasculitis. She was normally fit and well with no past medical history. She did not take any regular medications and denied using over the counter or illicit drugs or recent travel. On review she had a low grade fever. There was a large tender, erythematous swelling overlying the right temple. Bilaterally the temporal arteries were palpable and pulsatile. Peripheral pulses were normal with no bruits. There was no evidence of shingles (HSV) or local infection. Full systemic examination revealed no other abnormalities. Laboratory tests showed: PV 2.56, CRP 101, total white cell count 14.38 (eosinophils 0.4), albumin 33, Hb 115. Urine dip was normal. Renal function, liver function and immunoglobulins were normal. ANCA was negative. Hypoechogenicity surrounding the right frontal branch of the right temporal artery was seen on ultrasound. There were no discrete masses suggestive of cysts, abscess or tumours. Temporal artery biopsy confirmed the presence of vasculitis; histology demonstrated transmural lymphohistiocytic inflammation, disruption of the elastic lamina and intimal proliferation. Prednisolone was started at 40mg daily. Four weeks after initially presenting she was asymptomatic and her inflammatory markers had normalised. Methods  The case is discussed below. Results  Temporal arteritis, or GCA, is primarily a disease of older adults; with age 50 often used as an inclusion criteria, and is more common in Caucasian populations. Limited reports exist of GCA in younger cohorts, but these are rare. An important differential in younger patients, such as ours, is juvenile temporal arteritis. This rare localised vasculitis affects almost exclusively the temporal artery. It is typically a disease of young males, who present with non-tender temporal swelling. Systemic symptoms are unusual and inflammatory markers are normal. Clinical or laboratory evidence of organ involvement, peripheral eosinophilia or fibrinoid necrosis on histology should prompt consideration of an AAV or PAN. Incidence of GCA increases in correlation with Northern latitude, with highest rates reported in Scandinavian and North American populations. GCA is rare in Asian populations. Higher diagnostic rates in countries where physicians have increased awareness of GCA proposed as an explanation for this difference; however differences in incidence are still observed between Asian and Caucasian populations presenting to the same healthcare providers. Conclusion  GCA is an uncommon diagnosis in younger and non-Caucasian patients. Thorough investigation through ultrasound and biopsy helped increase our diagnostic confidence in this unusual case. Rheumatologists must be alert to atypical presentations in order to deliver prompt and potentially sight-saving treatment. Disclosure  J. Ellis: None. K. Austin: None. S. Emerson: None.

scholarly journals Sweet Syndrome and Secondary Syphilis in a Person with Acute Necrotizing Tonsillitis

2021 ◽  
Vol 13 (1) ◽  
pp. 216-221
Author(s):  
Joseph Mishal ◽  
Igor Viner ◽  
Alexandro Livoff ◽  
Shlomo Maayan ◽  
Eli Magen
Keyword(s):  
Unusual Case ◽  
Treponema Pallidum ◽  
Cervical Lymphadenopathy ◽  
Secondary Syphilis ◽  
Neutrophilic Dermatosis ◽  
Sweet Syndrome ◽  
Acute Febrile Neutrophilic Dermatosis ◽  
Acute Necrotizing ◽  
The Right ◽  
Syphilis Serology

Syphilis has received its classical designation as one of “the great imitators,” reflecting a wide variety of symptoms and presentations, which can cause difficulties in diagnosis. Here we report an unusual case of secondary syphilis in a person with acute necrotizing tonsillitis and Sweet syndrome. A 33-year-old female presented with fever, bilateral cervical lymphadenopathy, tonsillar enlargements with ulcerated pus-filled lesions on the right tonsil, and multiple pseudovesicular, mammillated, edematous plaques on her neck, face, and extremities. Syphilis serology was positive and a skin biopsy demonstrated a neutrophil-rich dermatitis characteristic of Sweet syndrome. The association of <i>Treponema pallidum</i> infection with Sweet syndrome may be a coincidence; nevertheless, our case serves as a reminder that secondary syphilis should remain in the differential diagnosis of the acute febrile neutrophilic dermatosis.

Unusual Transoral Penetrating Injury of the Foramen Magnum: Case Report

Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 989-991 ◽  
Author(s):  
Bradley J. Bartholomew ◽  
Charla Poole ◽  
Emilio C. Tayag
Keyword(s):  
Cerebrospinal Fluid ◽  
Unusual Case ◽  
Spinal Injury ◽  
Foramen Magnum ◽  
Penetrating Injuries ◽  
Computed Tomographic ◽  
Foreign Objects ◽  
Computed Tomographic Scan ◽  
Posterior Pharynx ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE Penetrating injuries of the cranium and spine are frequent to the civilian neurosurgical practice. Although a variety of unusual objects have been reported, to our knowledge, there has never been a craniocerebral or spinal injury caused by a fish. An unusual case of transoral penetration of the foramen magnum by a billed fish is described. The history, radiographic studies, and treatment are presented. CLINICAL PRESENTATION A fisherman struck by a jumping fish initially presented with severe neck pain and stiffness, bleeding from the mouth, and a laceration in the right posterior pharynx. A computed tomographic scan of the cervical spine revealed a wedge-shaped, hyperdense object extending from the posterior pharynx into the spinal canal between the atlas and the occiput. Because of the time factor involved, the fisherman was brought directly to surgery for transoral removal of the object. INTERVENTION The patient was placed under general anesthesia, and with a tonsillar retractor, a kipner, and hand-held retractors, the object was visualized and identified as a fish bill. Further dissection above the anterior aspect of the atlas permitted removal of the object by means of a grabber from an arthroscopic set. No expression of cerebrospinal fluid was noted, and a Penrose drain was placed. CONCLUSION The patient was treated under the assumption that penetrating foreign objects in continuity with the cerebrospinal fluid space and the outside environment should be removed as soon as possible. The patient was provided appropriate antibiotics to treat potential infection of normal pharyngeal flora and organisms unique to the marine environment. The patient recovered and did not experience any residual neurological deficit.

scholarly journals Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Lizette Vila Duckworth ◽  
William E. Winter ◽  
Mikhail Vaysberg ◽  
César A. Moran ◽  
Samer Z. Al-Quran
Keyword(s):  
Thyroid Gland ◽  
Parathyroid Carcinoma ◽  
Unusual Case ◽  
Thyroid Tissue ◽  
Parathyroid Tissue ◽  
African American Female ◽  
Thyroid Lobe ◽  
Local Infiltration ◽  
Sestamibi Scan ◽  
The Right

Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.

scholarly journals Patient with Acute Coronary Syndrome in the Setting of an Extremely Rare form of Complex Congenital Anomalous Coronaries

Aorta ◽  
2021 ◽  
Author(s):  
Mahmoud Abdelnabi ◽  
Fady Gerges ◽  
Yehia Saleh ◽  
Eman Elsharkawy ◽  
Mohamed Sanhoury ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Young Patient ◽  
Right Coronary Artery ◽  
Unusual Case ◽  
Single Coronary Artery ◽  
Sinus Of Valsalva ◽  
Rare Form ◽  
Coronary Syndrome ◽  
The Right

AbstractA single coronary artery is an exceedingly rare anomaly. Hereby, we present an unusual case of a young patient with an acute coronary syndrome who was found to have a single coronary artery originating from a single ostium in the right sinus of Valsalva with dual left anterior descending (LAD) arteries arising from the right coronary artery with two different anatomical courses, and additionally one of those LADs running a malignant intra-arterial course.

scholarly journals CMV Colitis in Immunocompetent Patients: 2 Cases of a Diagnostic Challenge

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Maria Paparoupa ◽  
Viola Schmidt ◽  
Helgard Weckauf ◽  
Huy Ho ◽  
Frank Schuppert
Keyword(s):  
Crohn’S Disease ◽  
Unusual Case ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Diagnostic Challenge ◽  
Unsuccessful Treatment ◽  
Benign Stenosis ◽  
The Right ◽  
Cmv Colitis ◽  
Immunocompetent Patients

CMV infections are generally thought to be opportunistic by immunosuppression. Many literature cases though indicate that CMV infections can be also observed in immunocompetent patients. We present an unusual case of an extensive concentric benign stenosis due to CMV colitis and a case of coexistence with Crohn’s Disease, both observed in nonimmunosuppressed individuals. The right diagnosis was set after implementation of multiple unsuccessful treatment strategies. Our purpose is therefore to familiarize clinicians involved with the diagnosis and treatment of gastroenterological diseases with this entity.

Chronic Fistulas of Thigh Presenting Unusually in an Operated Patient of Carcinoma Rectum. More Than What Meets the Eye!

2021 ◽  
pp. 153473462110655
Author(s):  
Zulqarnain Masoodi ◽  
Johannes Steinbacher ◽  
Peter Wimberger ◽  
Peter Tadeusz Panhofer ◽  
Chieh-Han John Tzou
Keyword(s):  
Unusual Case ◽  
Surgical Intervention ◽  
Skin Lesions ◽  
Late Presentation ◽  
Primary Objective ◽  
Time Span ◽  
End Colostomy ◽  
Chronic Skin ◽  
Carcinoma Rectum ◽  
The Right

Chronic skin lesions of the thigh (wounds, fistulas etc) are relatively uncommon, vis-à-vis, their notorious cousins over the distal limb. Even when present, the cause is usually obvious, mostly as trauma or a systemic affliction. We present an unusual case of chronic fistulas over the right thigh in a patient of carcinoma rectum for which anterior resection and an end colostomy was done 4 years earlier. Postsurgical pelvic abscesses finding their way into the thigh are a known entity, but they are usually accompanied by systemic/local features and their presentation is within a shorter time span. The novelty of our case lies in its manifestation (as a cluster of chronic fistulas and not a frank abscess), its late presentation as well as in the absence of any systemic/local inflammatory signs. Our primary objective is to educate wound physicians about the origin of such fistulas whenever they deal with patients who have had a preceding surgical intervention of the abdomen. In our humble opinion, this will ease out many diagnostic and management dilemmas, that such patients can potentially pose.

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