scholarly journals Case Report: Pediatric POCUS: 4 month old infant with a timely diagnosis

POCUS Journal ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 13-14
Author(s):  
Victor Istasy MD, FRCPC ◽  
Tim Lynch MD, FRCPC ◽  
Rodrick Lim, MD, FRCPC
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Female Infant ◽  
Telephone Consultation ◽  
Timely Diagnosis ◽  
Bilious Vomiting ◽  
History Of ◽  
Local Emergency Department

A healthy, four month-old female infant presented to a local emergency department with a 12-hour history of decreased activity, non-bilious vomiting and one episode of dark red blood in the stools. There was no history of fever. Telephone consultation was completed and the patient was transferred to a tertiary, pediatric centre for further evaluation. On arrival, the infant appeared pale and was lethargic during the exam.

scholarly journals Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 239-241
Author(s):  
Mary Starrs ◽  
Onur Yenigun
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Use Case ◽  
Resonance Imaging ◽  
Cerebellar Dysfunction ◽  
History Of ◽  
The Central Nervous System ◽  
Local Emergency Department

Introduction: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use. Case Report: We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two. Conclusion: Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints.

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

scholarly journals Non-painful severe variant form of eruptive lingual papillitis: A case report and literature review

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Manal Ahmed Halwani
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Oral Hygiene ◽  
Rare Case ◽  
Dorsal Surface ◽  
Variant Form ◽  
Girl Child ◽  
Rare Case Report ◽  
History Of

Eruptive lingual papillitis is a common benign disorder manifested by inflammation of fungiform papillae on the dorsolateral surface of the tongue. Several variants of lingual papillitis have been reported since 1997, most or all of them with painful erythematous papules. Here we report a case of 6 years old girl child with non-painful severe variant form of eruptive lingual papillitis presented to the emergency department. The entire dorsal surface of the tongue was surfaced by 2-3mm by multiple erythematous papules and some with a white or yellowish colour. The papules were excessively inflamed, pigmented, aggregated, and crusted. The cause was idiopathic which resolved within ten days. The parent and patient were reassured with advice to practice oral hygiene. This is a rare case report describing non-painful lingual papillitis without a history of any prior episodes.

scholarly journals Case report: MRI findings of acute uremic encephalopathy in a 1-year-old boy

2021 ◽  
pp. 20210057
Author(s):  
Amar Ajay Chotai ◽  
Dipayan Mitra
Keyword(s):  
Emergency Department ◽  
Renal Function ◽  
Case Report ◽  
Extracellular Potassium ◽  
Neurological Abnormality ◽  
Normal Range ◽  
Mri Findings ◽  
Intracellular Space ◽  
History Of ◽  
Function Profile

We present a 1-year-old boy who presented to the emergency department with a 7-day history of diarrhoea and vomiting. The initial renal function profile demonstrated a urea of 55 mmol l−1 (normal range between 5 and 20 mmol l−1), creatinine 695 micromol/L (normal range between 62–106 micromol/L) and potassium 9.1 mmol l−1 (normal range between 3.5–5.0 mmol l−1), with a profound metabolic acidosis. Upon examination, there were no significant findings, specifically no neurological abnormality. He was prescribed back-to-back Salbutamol nebulisers, to increase the shift of extracellular potassium into the intracellular space, followed by i.v. calcium gluconate, with some improvement in potassium levels. A further 5 mmol of sodium bicarbonate was given, as well as a stat dose of 1 mg/kg furosemide, and per rectal calcium resonium. He was then commenced on an infusion with 10% dextrose with insulin. He was subsequently found to be in urinary retention and a catheter was inserted, which drained 1700 ml. A subsequent renal function profile, 24 hours after admission, demonstrated improvement with urea 39 mmol l−1, creatinine 300 micromol/L and potassium 3.0 mEq/L.

Wound Management of a Pediatric Spina Bifida Patient Secondary to a Canine-Inflicted Fifth-Digit Amputation: A Case Report

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Brittany A. Lovett ◽  
Cristóbal S. Berry-Cabán ◽  
Deanna E. Duran ◽  
Sharon P. McKiernan
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Spina Bifida ◽  
Human Infection ◽  
Further Education ◽  
Wound Management ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
The Family ◽  
History Of

We present a case of a pediatric patient with a history of spina bifida who presented to the emergency department of a large Army medical treatment facility with a partially amputated right fifth digit she sustained while sleeping with the family canine. There are several reports in the popular press that suggest that an animal, particularly a dog, can detect human infection, and it is hypothesized that the toe chewing was triggered by a wound infection. This case provides an opportunity to provide further education in caring for foot wounds in patients with spina bifida.

scholarly journals Futile Sexual Homicide in Nepal: A Case Report

2021 ◽  
Vol 59 (243) ◽  
pp. 1174-1176
Author(s):  
Alok Atreya ◽  
Shiva Pandit ◽  
Samata Nepal ◽  
Jun Bajracharya ◽  
Deepak Shrestha
Keyword(s):  
Emergency Department ◽  
Sexual Abuse ◽  
Case Report ◽  
Sexual Intercourse ◽  
Sexual Homicide ◽  
Sexual Offenses ◽  
History Of ◽  
Uncommon Case

Although cases of sexual offenses are not uncommon in children, they present to the Emergency Department seeking treatment for a medical cause. Sometimes the history of abuse is missed by the treating clinicians who are only focused upon the presenting complaint and not upon the underlying cause. Furthermore, the lack of reporting of sexual abuse in medical literatures makes them a rarity in the Nepalese scenario. We present an uncommon case of a child where the perpetrator who tried to silence her during the sexual intercourse made a futile attempt to kill her cutting her throat with a sickle.

Hypovolemic Shock in a Child as a Consequence of Corporal Punishment

PEDIATRICS ◽  
1991 ◽  
Vol 87 (4) ◽  
pp. 570-571
Author(s):  
SCOTT P. EICHELBERGER ◽  
DOUGLAS W. BEAL ◽  
RONALD B. MAY
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Corporal Punishment ◽  
Hypovolemic Shock ◽  
Health Problems ◽  
Black Girl ◽  
Local Emergency Department ◽  
Home And School ◽  
Progressive Weakness ◽  
Accepted Form

Corporal punishment is an accepted form of discipline in the American home and school despite numerous publications in various fields reporting concerns.1-7 We describe a case of paddling associated with hypovolemic shock. CASE REPORT The patient, a 5-year-old black girl with no known underlying health problems, was seen at a local emergency department for complaints of progressive weakness. The previous day she had been paddled by her mother for disciplinary reasons. Her mother had used a wooden paddle, spanking her on the buttocks and upper thighs. Neither mother nor daughter could recall the number of blows administered. Shortly after being spanked, the child complained of generalized soreness over the area of injury.

scholarly journals Gemcitabine-induced pseudocellulitis: a case report and review of the literature

2019 ◽  
Vol 26 (5) ◽  
Author(s):  
H. Bami ◽  
C. Goodman ◽  
G. Boldt ◽  
M. Vincent
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Side Effects ◽  
Chemotherapeutic Agent ◽  
Whipple Procedure ◽  
Venous Stasis ◽  
Past Medical History ◽  
Review Of The Literature ◽  
Peripheral Vascular ◽  
History Of

Gemcitabine is a chemotherapeutic agent used in a wide variety of solid tumours. Known side effects include a dose-limiting myelosuppressive toxicity, mild rash, and radiation-dependent dermatitis. Rarely, localized inflammation in the form of pseudocellulitis has also been observed. We present the case of a 77-year-old woman with a history of a Whipple procedure for pancreatic adenocarcinoma who presented to the emergency department after the start of gemcitabine therapy with increased erythema, swelling, and tenderness in her lower legs. Relevant past medical history included peripheral vascular disease, dyslipidemia, and hypertension. A diagnosis of gemcitabine-induced pseudocellulitis aggravated by venous stasis was confirmed after an extensive workup. This case report and the literature review describe this rare reaction, highlighting the need for increased recognition to avoid unnecessary therapeutic intervention.

scholarly journals Aspirin misuse: a case report

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
David Goldrich ◽  
Anita Sreedhar ◽  
Rehan Aziz ◽  
Kenneth R. Kaufman ◽  
Anthony Tobia ◽  
...  
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Case Report ◽  
Signs And Symptoms ◽  
Over The Counter ◽  
Medication Misuse ◽  
Counter Medication ◽  
History Of ◽  
Salicylate Intoxication ◽  
At Risk Populations

Aspirin-use disorder is an underreported condition. Identification of the signs and symptoms of aspirin misuse are important in light of prevalent non-prescribed medicine/over-the-counter medication (NPM/OTC) misuse. We discuss here the case of a patient with a history of chronic aspirin misuse who presented to the emergency department with salicylate intoxication and described elation secondary to deliberate aspirin consumption. This case highlights the importance of screening for NPM/OTC medication misuse in at-risk populations.

scholarly journals Successful Management of Spondylodescitis in a Three Years Old Girl: A Case Report

2020 ◽  
pp. 5-7
Author(s):  
Khadija Saleh ◽  
AL Zahraa Hamed ◽  
Ali AL Sharqi ◽  
Hilal Al Hashami
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Case Report ◽  
Early Intervention ◽  
Rare Diseases ◽  
Lower Extremities ◽  
Complete Recovery ◽  
Successful Management ◽  
Lumbar Back Pain ◽  
History Of

Spondylodescitisis considered one of the rare diseases that cause back pain. The disease pathology is not yet been clearly known, however, in most patients the disease thought to be spreading hematogenously from a previously existing site of infection. We report two years and 11 months old child, previously healthy girl, presented to the emergency department with two weeks’ history of weakness of the lower extremities and lumbar back pain with slightly arched back. She had a complete recovery with early intervention and complete course of antibiotics.

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