scholarly journals Recurrent Pneumonia due to Fibrosing Mediastinitis in a Teenage Girl: A Case Report with Long-Term Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Avigdor Hevroni ◽  
Chaim Springer ◽  
Oren Wasser ◽  
Avraham Avital ◽  
Benjamin Z. Koplewitz
Keyword(s):  
Fibrous Tissue ◽  
Rare Condition ◽  
High Morbidity ◽  
Healthy Children ◽  
Teenage Girl ◽  
Positive Serology ◽  
Recurrent Pneumonia ◽  
Fibrosing Mediastinitis ◽  
The Right

A teenage girl was evaluated for recurrent right pneumonia. The evaluation revealed a calcified mediastinal mass that compressed the right intermediate and middle lobar bronchi, as well as the right pulmonary artery and veins. The clinical picture together with imaging studies and borderline positive serology testing suggested a diagnosis of fibrosing mediastinitis associated with histoplasmosis. This rare condition is characterized by the local proliferation of invasive fibrous tissue within the mediastinum due to a hyperimmune reaction to Histoplasma capsulatum. Antifungal and anti-inflammatory therapies are usually ineffective, and surgical intervention contains a high morbidity risk. Palliative surgery and stenting of the compressed airway have been suggested. In the past, the prognosis was thought to be poor, but recent studies demonstrate a more positive outcome. Our patient had been radiologically and functionally stable under follow-up for over thirteen years and has married and delivered two healthy children, both following an uneventful pregnancy.

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

Physiological Pacing: A New Road to Future

2021 ◽  
pp. 263246362097804
Author(s):  
Vanita Arora ◽  
Pawan Suri
Keyword(s):  
Side Effects ◽  
Fibrous Tissue ◽  
Cardiac Pacing ◽  
His Bundle ◽  
Anatomy And Physiology ◽  
Long Term Follow Up ◽  
Pacing Lead ◽  
The Right

Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than an anatomical one. For more than 50 years, a standard approach to permanent cardiac pacing has been an anatomical placement of transvenous pacing lead at the right ventricular apex with a proven benefit of restoring the rhythm. However, the resultant ventricular dyssynchrony on the long-term follow-up in patients requiring more than 40% ventricular pacing led to untoward side effects in the form of heart failure and arrhythmias. To counter such adverse side effects, a need for physiological cardiac pacing wherein the electrical impulse be transmitted directly through the normal conduction system was sought. His bundle pacing (HBP) with an intriguing alternative of left bundle branch pacing (LBBP) is aimed at restoring such physiological activation of ventricles. HBP is safe, efficacious, and feasible; however, localization and placement of a pacing lead at the His bundle is challenging with existing transvenous systems due to its small anatomic size, surrounding fibrous tissue, long-learning curve, and the concern remains about lead dislodgement and progressive electrical block distal to the HBP lead. In this article, we aim to take the reader through the challenging journey of HBP with focus upon the hardware and technique, selective versus nonselective HBP, indications and potential disadvantages, and finally the future prospects.

scholarly journals A Case of Congenital Bronchial Pulmonary Arterial Malformation Successfully Treated by Embolization

2018 ◽  
Vol 02 (03) ◽  
pp. 201-204
Author(s):  
Ferdinand Chu ◽  
Ko Sit ◽  
King Kwok
Keyword(s):  
Bronchial Artery ◽  
Effective Means ◽  
Rare Condition ◽  
Embolic Material ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right ◽  
Arterial Malformation ◽  
Right Bronchial Artery

AbstractIdiopathic bronchial pulmonary arterial malformation (BPAM) is a very rare condition. The authors present a case of BPAM in which a right bronchial artery communicates with a main upper lobe branch of the right pulmonary artery. It was successfully treated by embolization in one setting. The patient remained asymptomatic and well during the follow-up period. The authors therefore conclude that if the embolic material/device is carefully chosen, it is a safe and effective means of treating BPAM.

scholarly journals Oral Rehabilitation with Zygomatic Implants in a Patient with Cleft Palate

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Guilherme José Pimentel Lopes de Oliveira ◽  
Mariana Schaffer Brackmann ◽  
Larissa Carvalho Trojan ◽  
Paulo Domingos Ribeiro Júnior ◽  
Luis Eduardo Marques Padovan
Keyword(s):  
Cleft Palate ◽  
Fibrous Tissue ◽  
Oral Rehabilitation ◽  
Atrophic Maxilla ◽  
Zygomatic Implants ◽  
Fixed Prosthesis ◽  
Edentulous Patients ◽  
The Right ◽  
Zygomatic Implant

Edentulous patients with an atrophic maxilla associated with lip-palate fissures have unpredictable results after undergoing grafting procedures. In situations where the atrophic maxilla does not adequately allow reconstruction, the use of zygomatic implants has been indicated, and probably these implants can be indicated for the rehabilitation of patients with lip-palate fissures. This case report describes the oral rehabilitation treatment of a patient with a lip-palate cleft treated with zygomatic implants and implant-supported fixed prosthesis with two years of follow-up. A 65-year-old female patient had a lip-palate cleft and previously underwent surgery to close the cleft. The patient had a severely atrophic maxilla and had difficulty adapting to a removable total prosthesis. Due to the small amount of bone remaining and extensive fibrous tissue in the palate region, a rehabilitation with conventional implants associated with zygomatic implants was chosen. Two zygomatic implants and a conventional implant were placed on the right side, and a zygomatic implant and conventional implant were placed on the left side; these implants were later activated by a protocol-type prosthesis. The zygomatic implants provided an adequate aesthetic and functional outcome of the prosthesis in a patient with cleft palate.

Primary Localized Laryngeal Amyloidosis (LA)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4596-4596
Author(s):  
Matthew Richards ◽  
Kim Le ◽  
Mercedes Lorenzo-Medina ◽  
Langsjoen Dane ◽  
Carmen Arango ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Conflicts Of Interest ◽  
Polarized Light ◽  
Rare Condition ◽  
B Cell Lymphoma ◽  
Laryngeal Amyloidosis ◽  
The Right ◽  
False Vocal ◽  
Localized Laryngeal Amyloidosis

Abstract Abstract 4596 Background: Localized Laryngeal Amyloidosis (LA) is a rare condition. There is limited understanding of its natural history. Our aim is to report the clinical evolution of a patient diagnosed with localized LA. Methods: Case report. Results: In May 2002, a 43-year-old gentleman presented with hoarseness and a CT scan of the neck showed a thickening of the right vocal cord with a mass that measured 2.9 × 1.2 cm in widest diameter. The patient had this mass removed surgically and the pathology showed a positive Congo red staining and a positive birefringence under polarized light, diagnostic of amyloidosis. No evidence of systemic amyloidosis or an overt B-cell lymphoma was found in this patient. Patient lost follow-up until October 2008 when he was found to have soft tissue induration around the left false vocal cord area. The biopsy showed again amyloidosis. Conclusions: LA recurrences can manifest several years after initial diagnosis. Long-term follow-up is essential. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Fatal congenital lobar emphysema in a puerpera: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanyi Gan ◽  
Liang Xia ◽  
Yushang Yang ◽  
Qiang Pu ◽  
Lunxu Liu
Keyword(s):  
Left Lung ◽  
Middle Lobe ◽  
Left Hemithorax ◽  
Recurrent Pneumonia ◽  
Mediastinal Shift ◽  
Life Threatening ◽  
Right Middle Lobe ◽  
Lobar Emphysema ◽  
The Right

Abstract Background Congenital lobal emphysema (CLE) is a developmental lung abnormality usually diagnosed in the neonatal period and is rarely observed in adults. Adults with CLE are usually asymptomatic and only a small fraction may present with coughing, recurrent pneumonia and respiratory distress. In imaging studies, the most frequently affected lobe of CLE is the left upper lobe, followed by the right middle lobe. However, multilobar involvement with severe mediastinal shift is extremely rare. Case presentation We report a case of fatal CLE in a 28-year-old puerpera with postpartum respiratory failure. Chest computed tomography (CT) revealed emphysema of the right upper, middle and lower lobes resulting in adjacent atelectasis. Hyperinflation of the right upper lobe crossed the midline, leading to a deviation of the mediastinal structure to the left hemithorax and severe compression of the left lung. Conclusions Early and timely diagnosis of CLE with routine follow-up is necessary for patients. CLE, especially with multilobar involvement or mediastinal shift, could be life-threatening and should be promptly and aggressively treated to prevent severe complications.

scholarly journals Spontaneous Hyphema from Iris Microhemangiomatosis in an Elderly Patient with Hypertensive Crisis

2020 ◽  
Vol 11 (1) ◽  
pp. 68-72
Author(s):  
Pedro J.  Nuova ◽  
Dinah Zur ◽  
Anat Loewenstein ◽  
Matias Iglicki
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Hypertensive Crisis ◽  
Anterior Segment ◽  
Rare Condition ◽  
Vascular Tumors ◽  
Recurrent Bleeding ◽  
Iris Neovascularization ◽  
The Right

Background: Iris microhemangiomatosis is a rare vascular iris tumor, with potential severe complications such as increased intraocular pressure (IOP). We aim to describe a case report of a patient presenting with hyphema secondary to iris microhemangiomatosis triggered by excessive high blood pressure. Case Presentation: A 74-year-old woman was treated for hypertensive crisis. After her high blood pressure had been controlled and stabilized, she was discharged home. However, the same day, she complained about an acute decrease in vision in her left eye. Best corrected visual acuity was 20/20 on the right eye and 20/200 on the left eye. On biomicroscopy, a hyphema was seen. Iris neovascularization was absent, IOP and fundus examination were normal. After spontaneous resolution of the hyphema, a fluorescein angiography of the anterior segment was performed, which revealed bilateral subtle early hyperfluorescence with late staining scattered at the pupillary margin. The patient was diagnosed with iris microhemangiomatosis. During the follow-up of 24 months, the blood pressure was stable and well controlled. The patient did not experience any recurrent hemorrhage. Discussion and Conclusion: Spontaneous hyphema is the most common complication of iris vascular tumors. We report the occurrence of a spontaneous hyphema triggered by uncontrolled blood pressure in a patient with a very rare condition, i.e., iris microhemangiomatosis. In order to avoid complications of microhemangiomatosis such as uncontrolled glaucoma or recurrent bleeding requiring surgery, blood pressure should be monitored closely and controlled.

scholarly journals Celiac disease with acute cerebellar stroke as first presentation: A case report

2021 ◽  
Vol 26 (3) ◽  
pp. 591-594
Author(s):  
Maria Maddalena Sirufo ◽  
Enrica Maria Bassino ◽  
Francesca De Pietro ◽  
Lia Ginaldi ◽  
Massimo De Martinis
Keyword(s):  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Cerebellar Hemisphere ◽  
Neurological Involvement ◽  
Positive Serology ◽  
Immune Disorder ◽  
Brain Ct Scan ◽  
Serology Test ◽  
The Right

Celiac disease is an immune disorder occurring in response to ingestion of gluten in genetically predisposed individuals. It is a complex multiorgan disease with possible neurological involvement. Thrombotic events can occur but rarely as presenting symptom. We describe the case of a young man admitted to the Stroke Unit for worsening headache, nausea, vomiting, unsteadiness, dysarthria, and dysmetria. Brain CT scan showed an ischemic hypodense lesion of the right cerebellar hemisphere with compression of the adjacent IV ventricle. Studies to determine the etiology of stroke showed positive serology for celiac disease. On follow up he has completely recovered clinically. He is on gluten-free diet and the serology is now negative. Our case demonstrated that in young stroke, even without gastrointestinal symptoms, celiac disease should be considered a possible differential diagnosis and the appropriate serology test performed.

scholarly journals How Multiple the Submandibular Gland Sialoliths Can Be?

2019 ◽  
Vol 3 (7) ◽  
pp. 174-175
Keyword(s):  
Submandibular Gland ◽  
Maxillofacial Surgery ◽  
Fibrous Tissue ◽  
Duct System ◽  
Glandular Tissue ◽  
Longitudinal Size ◽  
History Of ◽  
The Right ◽  
Surgery Department

A 52-year-old man presented to the Maxillofacial Surgery Department of Kyiv Regional Clinical Hospital with a several-year history of swelling in the right submandibular area and salivary colic during exacerbation. A physical examination showed significantly enlarged and firm right submandibular gland (Panel A, arrow). The gland was permanently increased in size during last months. Ultrasound (Panel B – Video) shows dilated intragandular ducts and multiple sialoliths (arrowheads), which visualized as hyperechoic bodies with artifact of acoustic shadowing). Replacement of glandular tissue with fibrous one was also noted. The patient underwent a complete gland removal and 8 different sized salivary stones have been found in the intraglandular duct system of the specimen (Panel C, arrows indicate sialoliths, and a fibrous tissue is indicated by asterisks). Two stones reached 8 and 10 mm in longitudinal size, and six another sialoliths measured no more than 3 mm. The two microsialoliths, with less than 1 mm in size, were also found. At follow up 6 months after the surgery no complaints were noted.

scholarly journals Upper extremity deep vein thrombosis in an informal porter

2020 ◽  
Vol 39 (3) ◽  
pp. 207
Author(s):  
Dewi S. Soemarko ◽  
Herlinah Herlinah
Keyword(s):  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Rare Condition ◽  
Predisposing Factor ◽  
Manual Lifting ◽  
Vein Thrombosis ◽  
Medicine Physician ◽  
The Right ◽  
Deep Vein

Background<br />Upper extremity deep vein thrombosis (UEDVT) is a rare condition, in which job-related arm movements and repetitive, forceful or overhead arm activities have been recognized as the predisposing factor for this condition. UEDVT can occur among informal porters. This report describes a case of UEDVT in an informal porter due to manual lifting of heavy goods and reviews the literature for occupational reports of this condition.<br /><br />Case description<br />A 35-year-old male informal porter presented with marked swelling, pain, and numbness of his right arm 3 days after a prolonged episode of lifting heavy goods. A Doppler ultrasound showed thrombosis in the right subclavian and axillary veins and laboratory tests found elevated D-dimer. Patient was diagnosed as having axillo-subclavian thrombosis and treated with low molecular-weight heparin. One month after the last follow-up, patient returned to work with modified capacity and after 3 months of return to work, patient was able to resume his regular duties without impairment or disability.<br /><br />Conclusion<br />The occupation of informal porter should be considered a risk factor for upper extremity deep vein thrombosis (UEDVT), thus the occupational medicine physician should be aware of this condition in the context of manual workers. Detailed occupational history to aid the diagnosis and future risk assessment are needed, and education for preventing UEDVT should be provided to porters.

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