scholarly journals Septic Bursitis in an 8-Year-Old Boy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Panagiotis Kratimenos ◽  
Ioannis Koutroulis ◽  
Dante Marconi ◽  
Jennifer Ding ◽  
Christos Plakas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Differential Diagnosis ◽  
Streptococcus Pyogenes ◽  
High Index ◽  
Puncture Wound ◽  
Septic Bursitis ◽  
High Index Of Suspicion ◽  
Prepatellar Bursitis

Background.The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children.Methods.We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis.Results.Wound cultures grewStreptococcus pyogenes, with the infection resolving with amoxicillin.Conclusions.A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

scholarly journals Bilateral Charcot hip Arthropathy Due to Tabes Dorsalis: A Case Report

2018 ◽  
Vol 25 (1) ◽  
pp. 21-23
Author(s):  
Ip Hoi Yeung ◽  
Yeung Yip Kan ◽  
Luk Kristine Shik ◽  
Lam Polly Wy ◽  
Wong Kwok Ho
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Clinical Course ◽  
High Index ◽  
Tabes Dorsalis ◽  
High Index Of Suspicion

This article illustrates the clinical course of a patient diagnosed to have bilateral Charcot hip arthropathy secondary to tabes dorsalis from delayed untreated syphilitic infection. This differential diagnosis of rapid bilateral hip destruction was a near-extinct entity, and a high index of suspicion is needed to prevent untoward sequelae.

scholarly journals Pediatric Infectious Prepatellar Bursitis with Kingella kingae

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Charles C. Pitts ◽  
Walter R. Smith ◽  
Michael J. Conklin
Keyword(s):  
Pediatric Population ◽  
Kingella Kingae ◽  
Laboratory Methods ◽  
Fluid Analysis ◽  
Irrigation And Debridement ◽  
Prior Literature ◽  
Septic Bursitis ◽  
Polymerase Chain ◽  
High Index Of Suspicion ◽  
Prepatellar Bursitis

We present the first reported case of septic prepatellar bursitis with Kingella kingae in a 2-year-old female. Although it is a well-established cause of osteoarticular infections in the pediatric population, K. kingae has never been reported as the etiology for septic bursitis. A high index of suspicion is required for the diagnosis given that this organism is difficult to culture and isolate using standard laboratory methods. Our diagnosis was established through bursal fluid analysis, though oropharyngeal polymerase chain reaction (PCR) may be also be considered. Our case also builds upon prior literature suggesting that the pathophysiology of septic bursitis in children differs from that of the adult and may be more comparable to that of pediatric osteomyelitis. As an organism of increasing prevalence, K. kingae should remain high on the differential for osteoarticular or periarticular infections when cultures fail to isolate a distinct pathogen. Early diagnosis and a formal irrigation and debridement, if warranted, are crucial in preventing devastating complications of untreated septic bursitis.

scholarly journals Unexpected Etiology in a Case of Bilateral Maculopathy

2021 ◽  
pp. 622-628
Author(s):  
Prem Patel ◽  
Kaylie Jones ◽  
Deborah I. Friedman ◽  
David G. Birch ◽  
Rafael L. Ufret-Vincenty
Keyword(s):  
Rheumatoid Arthritis ◽  
Genetic Testing ◽  
Retinal Degeneration ◽  
High Index ◽  
Autoimmune Retinopathy ◽  
Negative Results ◽  
History Of ◽  
High Index Of Suspicion

A 74-year-old woman with a history of rheumatoid arthritis using hydroxychloroquine presented with gradually progressive decreased vision in both eyes and was found to have a bilateral maculopathy. Initial genetic testing was negative, and after discussing the low likelihood of her severe findings being secondary to her relatively low hydroxychloroquine exposure, the possibility of an autoimmune retinopathy was entertained. Updated data on the genetic testing reclassified one of her mutations in HGSNAT as pathogenic. This case highlights the value of genetic testing and the need to keep a high index of suspicion even after initial negative results, given the fact that our knowledge of mutations leading to retinal degeneration is constantly evolving.

scholarly journals Silent uterine rupture in second trimester: a differential diagnosis to remember

2020 ◽  
Vol 9 (7) ◽  
pp. 3081
Author(s):  
Rajlaxmi Mundhra ◽  
Anupama Bahadur ◽  
Kiran Kunwar ◽  
Juhi Mishra ◽  
Ankita Yadav ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Maternal Mortality ◽  
Uterine Rupture ◽  
Emergency Situation ◽  
High Index ◽  
Second Trimester ◽  
Life Threatening ◽  
High Index Of Suspicion

Spontaneous silent uterine rupture is a life-threatening emergency situation requiring immediate laparotomy. High index of suspicion is key to prevent maternal mortality as at times the presentation can be nonspecific. Authors herein present a case of spontaneous silent uterine rupture during second trimester of pregnancy wherein the diagnosis was initially missed. To the best of authors knowledge, only a few cases with spontaneous fundal second trimester uterine rupture have been recorded so far.

Rubber Foreign Bodies in Puncture Wounds of the Foot in Patients Wearing Rubber-Soled Shoes

2001 ◽  
Vol 22 (5) ◽  
pp. 409-414 ◽  
Author(s):  
Chang Haw Chong ◽  
William Verhoeven ◽  
Chay Wai Mun
Keyword(s):  
Foreign Bodies ◽  
Correct Diagnosis ◽  
High Index ◽  
Puncture Wound ◽  
History Of ◽  
High Index Of Suspicion ◽  
Infective Complications

We report 8 cases of puncture wound of the foot associated with rubber foreign bodies in patients who were wearing rubber-soled shoes. The difficulty in making the correct diagnosis and the complications arising from these injuries are reviewed. The morbidity associated with these seemingly innocuous puncture wounds can be serious. Infective complications resolved only with removal of all imbedded rubber foreign bodies. A history of wearing rubber-soled shoes during the injury and a high index of suspicion may prevent complications.

scholarly journals Wandering Spleen - A Rare Entity

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdomen ◽  
High Index ◽  
Wandering Spleen ◽  
Rare Entity ◽  
Rare Differential Diagnosis ◽  
High Index Of Suspicion ◽  
Very High

Wandering spleen is a rare differential diagnosis of an acute abdomen and must be suspected if a patient presents with abdominal pain along with a palpable lump and displacement of bowel to left upper quadrant and should be confirmed by CT scan. As the condition is very rarely diagnosed pre-operatively, it requires a very high index of suspicion.

Neurobrucellosis associated with feral swine hunting in the southern United States

2020 ◽  
Vol 13 (12) ◽  
pp. e238216
Author(s):  
Harry Ross Powers ◽  
Jared R Nelson ◽  
Salvador Alvarez ◽  
Julio C Mendez
Keyword(s):  
United States ◽  
At Risk ◽  
High Index ◽  
Southern United States ◽  
Endemic Country ◽  
Feral Swine ◽  
Neurological Sequelae ◽  
Initial Symptoms ◽  
The Usa ◽  
High Index Of Suspicion

Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.

Mycobacterium Fortuitum Infections of the Hand

1992 ◽  
Vol 17 (6) ◽  
pp. 675-677 ◽  
Author(s):  
F. K. IP ◽  
S. P. CHOW
Keyword(s):  
Correct Diagnosis ◽  
High Index ◽  
Mycobacterium Fortuitum ◽  
High Index Of Suspicion

Five cases are reported of infection due to Mycobactenum fortuitum involving the hand following contaminated injection or traumatic wounds. Synovectomy, debridement, or amputation together with prolonged chemotherapy using kanamycin or amikacin were required. Doxycycline and sulphamethoxasole also seemed to be the effective antibiotics for this organism. A high index of suspicion is important in order to obtain the correct diagnosis.

scholarly journals Acute permethrin neurotoxicity: Variable presentations, high index of suspicion

2014 ◽  
Vol 1 ◽  
pp. 1026-1028 ◽  
Author(s):  
Bonny Drago ◽  
Namrata S. Shah ◽  
Samir H. Shah
Keyword(s):  
High Index ◽  
High Index Of Suspicion

Benign ano-rectal disorders

2017 ◽  
Vol 10 (5) ◽  
pp. 253-261
Author(s):  
James Kynaston
Keyword(s):  
Primary Care ◽  
High Index ◽  
Diagnosis And Management ◽  
High Index Of Suspicion ◽  
Adult Presentation ◽  
Surgical Referral

Benign ano-rectal disorders are a common adult presentation to primary care; they also generate a significant number of secondary referrals. The exact prevalence of these conditions is difficult to determine, due to under-reporting of symptoms, which patients can find embarrassing and difficult to disclose. It can be challenging to distinguish between different ano-rectal disorders which present with similar symptoms. A high index of suspicion is required to detect serious malignant pathology. The aim of this article is to outline the epidemiology, pathophysiology, diagnosis and management of common benign ano-rectal disorders in primary care. The indications for surgical referral and important cancer referral guidelines are included.

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