scholarly journals Oral Phenytoin Toxicity Causing Sinus Arrest: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ravi K. Thimmisetty ◽  
Janardhana Rao Gorthi ◽  
Mahmoud Abu Hazeem
Keyword(s):  
Case Report ◽  
Cardiac Toxicity ◽  
Case Reports ◽  
Sinus Node ◽  
Seizure Disorder ◽  
Sinus Arrest ◽  
Rare Presentation ◽  
Phenytoin Toxicity

We present a case of sinus node arrest leading to symptomatic junctional bradycardia from oral phenytoin toxicity, which is a rare presentation. Our patient had no prior cardiac history and was on phenytoin therapy for seizure disorder. Although bradycardia is more commonly associated with intravenous phenytoin and there were few case reports of bradycardia with oral phenytoin reported, the literature is limited. In this case report, we also reviewed the pathophysiology of phenytoin-induced cardiac toxicity.

scholarly journals Pericardial effusion and cardiac tamponade requiring pericardial window in an otherwise healthy 30-year-old patient with COVID-19: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Christina Walker ◽  
Vincent Peyko ◽  
Charles Farrell ◽  
Jeanine Awad-Spirtos ◽  
Matthew Adamo ◽  
...  
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Case Reports ◽  
Healthy Woman ◽  
Signs And Symptoms ◽  
Rare Presentation ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Novel Coronavirus

Abstract Background This case report demonstrates pericardial effusion, acute pericarditis, and cardiac tamponade in an otherwise healthy woman who had a positive test result for coronavirus disease 2019. Few case reports have been documented on patients with this presentation, and it is important to share novel presentations of the disease as they are discovered. Case presentation A Caucasian patient with coronavirus disease 2019 returned to the emergency department of our hospital 2 days after her initial visit with worsening chest pain and shortness of breath. Imaging revealed new pericardial effusion since the previous visit. The patient became hypotensive, was taken for pericardial window for cardiac tamponade with a drain placed, and was treated for acute pericarditis. Conclusion Much is still unknown about the implications of coronavirus disease 2019. With the novel coronavirus disease 2019 pandemic, research is still in process, and we are slowly learning about new signs and symptoms of the disease. This case report documents a lesser-known presentation of a patient with coronavirus disease 2019 and will help to further understanding of a rare presentation.

scholarly journals Fungus ball in concha bullosa, an unusual site: a case report from hilly region

2017 ◽  
Vol 4 (1) ◽  
pp. 301
Author(s):  
Shaweta . ◽  
R. S. Minhas ◽  
Vineeta Sharma ◽  
Santwana Verma ◽  
Trilok C. Guleria
Keyword(s):  
Case Report ◽  
Sphenoid Sinus ◽  
Case Reports ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Concha Bullosa ◽  
Rare Presentation ◽  
Unusual Site ◽  
Hilly Region

<p class="abstract"><span lang="EN-IN">Fungus is a rare cause of rhinosinusitis in children. Its incidence has been reported as ranging between 13.5 and 28%. Fungus balls are extramucosal tangled masses of fungal hyphae. It commonly involves just one paranasal sinus. Most commonly maxillary sinus is involved and occasionally sphenoid sinus. Concha bullosa is one of the most common anatomical variations in the nasal cavity, with a frequency of reporting ranging from 14-53.6%. There are very few case reports in which Concha bullosa was affected with fungus ball. In this case report 13 years female child presented with complaints of swelling right cheek. The patient underwent endoscopic sinus surgery and there was involvement of concha bullosa and sphenoid sinus with fungus ball. Fungus was confirmed on microscopic examination and culture. Fungus ball is a rare presentation of fungal rhinosinusitis. It should be considered in enlarged middle turbinate with heterogenous opacity on CT. The diagnosis should be confirmed by microscopy or culture.</span></p>

scholarly journals Subacute Thyroiditis After SARS-CoV-2 Infection Presenting With Pyrexia of Unknown Origin

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A957-A957
Author(s):  
Santosh Singh
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Unknown Origin ◽  
Subacute Thyroiditis ◽  
Pathophysiological Mechanism ◽  
Rare Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Upper Limit ◽  
First Case ◽  
Heart Rhythm Disorders

Abstract Subacute thyroiditis(SAT) is associated with viral(destructive) or post-viral(inflammatory) origin.[1]The most common clinical characteristics of SAT are female sex preponderance, anterior neck pain and fever.[2,3] Heart rhythm disorders and silent cervical forms have been described in SAT associated with SARS-CoV-2 infection,which occurs 16 to 36 days after resolution of COVID-19.[1,3] Symptomatic improvement occurs in a few days after initiation of therapy with sterods or NSAID.[3] Pyrexia of Unknown Origin (PUO) is a very rare presentation of SAT.[2] Hereby, a case of SAT, presenting with painful neck swelling and persistent fever (5weeks duration), two weeks after resolution of COVID-19, is being discussed. The index patient was a 50-year old obese,normotensive, diabetic (10 years duration, HbA1c-6.6% on SU, metformin, sitagliptin and dapagliflozin) male. TSH was suppressed (0.02 mIU/L), FT4 (3.06 ng/dl, upper limit of normal-1.48ng/dl) and FT3 (3.9 pg/ml, upper limit of normal-3.71 pg/ml) were elevated. Total T4 and T3 were normal. HS-CRP was markedly elevated. IL-6 and TBG were not estimated. Cervical USG revealed diffuse hypoechogenecity of thyroid gland and thyromegaly. There was reduced uptake in thyroid scan (technetium). The patient became afebrile after 4 days of initiation of 30 mg prednisolone (tapered by 10 mg every 5 days). The initial tachycardia reverted to sinus rhythm with marked reduction of neck tenderness. This case highlights certain considerations for SAT associated with SARS-CoV-2 infection. Firstly, it can present with PUO (first case report). Secondly, it may be associated with normal total T4 and T3 which can happen due to reduced TBG consequent upon increased IL-6.[4] References: 1. Caron Philippe: Thyroid disorders and SARS-CoV-2 infection: From pathophysiological mechanism to patient management. Ann Endocrinol (Paris), 2020, Sept. 2. Fever of Unknown Origin as a Sole Presentation of Subacute Throiditis in an Elderly Patient. A Case Report with Literature Review. Raj R, Yada S, Jacob A et al: Hindawi Case Reports in Endocrinology, 2018, Article ID 5041724 3. Brancatella A, Ricci D, Latrofa F et al: Is subacute thyroidits an underestimated manifestation of SARS-CoV-2 infection? Insights from a case serie. J Clin Endocrinol Metab, 2020, Aug 11, dgaa537. 4. Bartaleno L, Brogioni S, Grasso L and Martino E: Increased serum interleukin-6 concentration in patients with subacute thyroiditis:relationship with concomitant changes in serum T4-binding globulin concentration. Journal of Endocrinological Investigation, 1993, 16, 213-218.

scholarly journals Eosinophilic Gastrointestinal Disorder in Coeliac Disease: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Dennis N. F. Lim ◽  
Annelise Wilkins ◽  
Laura Elizabeth Horton ◽  
Ishfaq Ahmad ◽  
Catherine lo Polito ◽  
...  
Keyword(s):  
Case Report ◽  
Coeliac Disease ◽  
Case Reports ◽  
Gastrointestinal Disorder ◽  
Peripheral Eosinophilia ◽  
Rare Presentation ◽  
Gastrointestinal Manifestations ◽  
Eosinophilic Ascites ◽  
History Of ◽  
High Index Of Suspicion

Eosinophilic gastrointestinal disorder is a rare disorder characterised by eosinophilic infiltration of the gastrointestinal tract. There are various gastrointestinal manifestations with eosinophilic ascites being the most unusual and rare presentation. Diagnosis requires high index of suspicion and exclusion of various disorders associated with peripheral eosinophilia. There are no previous case reports to suggest an association between eosinophilic gastrointestinal disorder and coeliac disease in adults. We report a case of eosinophilic ascites and gastroenteritis in a 30-year-old woman with a known history of coeliac disease who responded dramatically to a course of steroids.

scholarly journals Phenytoin toxicity as a forgoer of schizophrenia like psychosis: a case report

2019 ◽  
Vol 7 (7) ◽  
pp. 2853
Author(s):  
Prasanta Dihingia ◽  
Anshu Kumar Jha
Keyword(s):  
Case Report ◽  
Epileptic Patient ◽  
Case Reports ◽  
Once Daily ◽  
Time Period ◽  
Anti Epileptic Drug ◽  
Drug History ◽  
Triggering Factor ◽  
To Come ◽  
Phenytoin Toxicity

This is a case report describing the toxicity of phenytoin overdose. It is very uncommon to find an anti-epileptic drug causing psychosis and till date only a few studies have found such a co-relation. A psychiatric patient was admitted in our department of medicine with the complain of ingestion of 30 tablets of phenytoin. On examination he was found to have auditory and visual hallucinations. He was restless and had an ill sustained concentration. First and foremost, thing was to stop the prescribed phenytoin tablets and sedate the patient with haloperidol and promethazine. Then, he was switched over to Levetiracetam 500 mg i.v. thrice daily, Clobazam 10 mg once daily and Resperidone 3 mg twice daily. On investigation we found serum phenytoin level >40 mg/dl. This was sufficient to support our diagnosis as after stopping the drug his symptoms improved. There have been case reports of epileptic patient presenting with psychosis but usually after 10-15 years, unlike our case. In our case this time period was reduced to 12 hours as there was a triggering factor present. So, if a known epilepsy patient develops psychosis, the drug history should be given a big importance and if required serum phenytoin level should be assessed to come to the diagnosis of “phenytoin induced schizophrenia like psychosis.

scholarly journals A Rare Presentation of Liesegang Rings in Adrenal Cavernous Hemangioma

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Wejdan Almotairi ◽  
Abdullah Alhamam ◽  
Aali Alotaibi ◽  
Tarek El Sharkawy ◽  
Hind S. Alsaif ◽  
...  
Keyword(s):  
Case Report ◽  
Single Case ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Vascular Tumors ◽  
Morbidly Obese ◽  
Rare Presentation ◽  
Liesegang Rings ◽  
Liesegang Ring ◽  
Single Case Report

Background. Adrenal cavernous hemangiomas (AH) are benign nonfunctional vascular tumors rarely discovered as incidental findings on imaging studies or autopsies. This study presents a single case report of AH with another rare finding of the Liesegang ring. Also, we reviewed 73 case reports of cavernous adrenal hemangioma to provide an overview of AH’s clinical characteristics. Case Report. A nonfunctional AH was incidentally discovered in a 59-year-old morbidly obese female patient with a 10-year history of hypertension and thyroidectomy. An abdominal computed tomography (CT) scan showed a left suprarenal mass of ∼16 cm in diameter. While the patient had no clinical manifestations from the hemangioma, all laboratory tests were within the normal values with no indication of a functional adrenal tumor. The mass was removed by open left adrenalectomy. The microscopic histological examination revealed a laminated structure with wide blood-filled spaces with a central core of necrotic and hemorrhagic changes, characteristic of a cavernous AH with the presence of a rare Liesegang ring. Conclusion. Although rare, AH should be considered as a differential diagnosis for adrenal masses. This is the first reported case of a cavernous AH with rare microscopic findings of the Liesegang ring.

Fournier's gangrene as Amyand's hernia complication

2019 ◽  
Vol 98 (7) ◽  
pp. 291-296
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Rare Condition ◽  
Sporadic Case ◽  
Fournier’S Gangrene ◽  
Amyand’S Hernia ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Based Medicine ◽  
Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

Hemangiomatosis of the greater omentum – a case report

2019 ◽  
Vol 98 (4) ◽  
pp. 178-180
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Histological Examination ◽  
Case Reports ◽  
Greater Omentum ◽  
Surgical Removal ◽  
Consumption Coagulopathy ◽  
Cavernous Hemangiomas ◽  
Mesodermal Origin ◽  
Benign Tumours

Cavernous hemangiomas are benign tumours of mesodermal origin. Even though various localizations of hemangioma have been described in the literature, its occurrence in the greater omentum is very rare. Only symptomatic hemangiomas are indicated for surgical treatment. There are case reports presenting resection or surgical removal of the greater omentum with hemangioma because of mechanical syndrome, consumption coagulopathy, bleeding, infection or suspicion of a malignancy. This article presents a case report of a patient operated on for a suspicion of carcinomatosis of the greater omentum. Histological examination found hemangiomatosis in the resected greater omentum.

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