scholarly journals The Riddles of Mazeppa; or, More Questions than Answers: Watermarks and Cohabitations, April 1817–September 1818

Romanticism ◽  
2020 ◽  
Vol 26 (3) ◽  
pp. 267-279
Author(s):  
Richard Lansdown
Keyword(s):  
Unusual Case ◽  
Don Juan ◽  
Important Link ◽  
History Of ◽  
Literary Allusion

Byron's Mazeppa is an unusual case in his writing career. He was generally a quick writer, but this poem – an important link between his earlier melodramatic tales and his later comic ones – was started in April 1817 and completed only in September 1818, nearly eighteen months later. This essay uses various forms of evidence, in particular literary allusion and the various paper stocks on which the poem was drafted, to suggest when and where the poem was ‘broken off’ before being finally completed. It also considers in the poem in the light of other works written during the period ( The Lament of Tasso, Manfred, Childe Harold IV, Beppo, and Don Juan) before considering its overall theme in contrast to Voltaire's History of Charles XII.

A Case of Multiple Chemical Sensitivities: Cognitive Therapy for Somatization Disorder and Metaworry

2003 ◽  
Vol 17 (3) ◽  
pp. 267-277 ◽  
Author(s):  
Scott Temple
Keyword(s):  
Cognitive Therapy ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Somatization Disorder ◽  
Case Conceptualization ◽  
Marital Problems ◽  
Multiple Chemical Sensitivities ◽  
Common Clinical Presentation ◽  
History Of ◽  
Multiple Chemical

“Multiple chemical sensitivities” has become an increasingly common clinical presentation to physicians, though it is infrequently seen by psychotherapists. This case report describes a 61-year-old woman who presents with a long history of chemical sensitivities, that led to a somatization disorder with debilitating agoraphobia, depression, and marital problems. Features of a variety of anxiety disorders are present, as are metacognitions that required an unusual case conceptualization. A cognitive therapy case conceptualization and treatment are described, which address the highly idiosyncratic clinical presentation of this patient.

563 A Rare Case of Small Bowel Obstruction Secondary to Peritoneal Encapsulation, Congenital Adhesional Band and Gallstone Ileus

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Gungadin ◽  
A Taib ◽  
M Ahmed ◽  
A Sultana
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Unusual Case ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Case Presentation ◽  
Peritoneal Encapsulation ◽  
History Of ◽  
Gall Stone Ileus

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.

Cutibacterium acnes sternoclavicular joint osteomyelitis in an otherwise healthy 55-year-old man

2021 ◽  
Vol 14 (7) ◽  
pp. e241778
Author(s):  
Sean Yaphe ◽  
Kemal Bahcheli
Keyword(s):  
Unusual Case ◽  
Left Knee ◽  
Sternoclavicular Joint ◽  
Joint Injection ◽  
Cutibacterium Acnes ◽  
History Of ◽  
Haematogenous Spread ◽  
Body Joint ◽  
Full Body

Sternoclavicular joint osteomyelitis is extremely rare, with only 225 reported cases in the last 45 years. We present an unusual case in an otherwise healthy 55-year-old man with a history of well-controlled type 2 diabetes mellitus and hypertension. He presented to the emergency department after a week of left knee pain that worsened to full-body joint pain with left sternoclavicular swelling. He was started on antibiotics with multiple washouts of the left knee and treated for septic arthritis. By MRI and CT, he was found to have left sternoclavicular joint osteomyelitis and abscess and underwent debridement and resection. We believe that the initial joint injection resulted in haematogenous spread to the left sternoclavicular joint, stressing the importance of a sterile field for joint procedures.

scholarly journals Subglottic acute lymphoblastic leukaemia

2018 ◽  
Vol 11 (1) ◽  
pp. e226364
Author(s):  
Shilpa Ojha ◽  
Julian Gaskin ◽  
Michael Saunders
Keyword(s):  
Differential Diagnosis ◽  
Paediatric Patient ◽  
Acute Lymphoblastic Leukaemia ◽  
Airway Obstruction ◽  
Lymphoblastic Leukaemia ◽  
Unusual Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Low Threshold

Acute lymphoblastic leukaemia (ALL) is one of the the most common malignancies of childhood and can occasionally present as acute airway obstruction. We present the unusual case of a 1-year-old boy who was referred to our Paediatric Otolaryngology (ENT) clinic with a recurrent history of croup. This is the first reported case of localised ALL presenting as a subglottic mass in a paediatric patient. It highlights the need to have a broader differential diagnosis in children presenting with ‘recurrent croup’ including extramedullary presentation of leukaemia and to have a low threshold for performing endoscopy in such cases.

scholarly journals Unusual case of Giardia lamblia causing eosinophilic ascites along with Plesiomonasshigelloides gastroenteritis

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 321-323
Author(s):  
Ballal Mamatha ◽  
Shetty Vignesh ◽  
Agarwal Manali ◽  
Nayal Bhavna ◽  
Umakanth Shashikiran
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Giardia Lamblia ◽  
Complete Resolution ◽  
Unusual Case ◽  
Peripheral Eosinophilia ◽  
Short Trip ◽  
Eosinophilic Ascites ◽  
History Of

A case report of a healthy, immunocompetent male,an international traveller from Germany who had visited India for a short trip,presented at our OPD with a history of loose stools, fever and abdominal pain,for two months. After thorough investigations, he was diagnosed to have an infection withGiardia lambliaacute gastroenteritis (AGE) along witheosinophilic ascites with peripheral eosinophilia, withassociatedPlesiomonasshigelloidesdiarrhoea. He was then treated with metronidazole and cotrimoxazole, which resulted in complete resolution of the symptoms.

scholarly journals Pott’s disease with extensive bilateral psoas abscesses in a Nigerian woman: an unusual case

2020 ◽  
Vol 32 (3) ◽  
pp. 168-175
Author(s):  
Nneka Iloanusi
Keyword(s):  
Computed Tomography ◽  
Unusual Case ◽  
Surgical Drainage ◽  
Optimal Outcome ◽  
Ultrasound Guided ◽  
Pott’S Disease ◽  
Tb Treatment ◽  
Nigerian Woman ◽  
History Of ◽  
Abscess Wall

Bilateral psoas abscesses are uncommon in Pott’s disease. We describe a 28-year-old Nigerian woman with a 2-year history of constitutional symptoms and a 1-year history of bilateral paravertebral masses. She had received anti-tuberculosis (TB) treatment in an interrupted manner. A computed tomography (CT) scan revealed T10–T12 spondylitis, wedge collapse and extensive bilateral psoas abscesses. Histology of the abscess wall was definitively diagnosed as soft tissue TB, and special staining for acid-fast bacilli was positive. She was successfully treated with anti-TB therapy and ultrasound-guided surgical drainage of 6 L of abscess fluid. Complicated cases of Pott’s disease may require multi-disciplinary interventions for optimal outcome.

scholarly journals Ascending aorta graft pseudoaneurysm and aortobronchial fistula caused by a fractured sternal wire: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ahmad Ali Amirghofran ◽  
Elahe Nirooei ◽  
Mohammad Ali Ostovan
Keyword(s):  
Unusual Case ◽  
Preventive Measures ◽  
Prosthetic Graft ◽  
Ascending Aorta ◽  
Dacron Graft ◽  
Thoracoabdominal Aorta ◽  
Case Presentation ◽  
Pseudoaneurysm Formation ◽  
Aortobronchial Fistula ◽  
History Of

Abstract Background Pseudoaneurysm of ascending aorta is a rare but serious complication of cardiovascular surgeries and it infrequently occurs in the normal prosthetic graft materials. We share our experience with an unusual case of ascending aorta Dacron graft pseudoaneurysm caused by a fractured sternal wire. Case presentation A 34-year-old man, known case of Marfan syndrome, with history of two prior aortic surgeries for aneurysm of ascending aorta, arch and thoracoabdominal aorta, presented with hemoptysis. The hemoptysis originated from an aortobronchial fistula secondary to a huge ascending aorta Dacron graft pseudoaneurysm. The graft erosion and subsequent pseudoaneurysm was caused by a fractured sternal wire. Surgical repair of the pseudoaneurysm was performed successfully and a Gore-tex patch was placed behind the sternum over the graft to prevent further direct contact of the wire and the graft. Conclusion Sternal wires can damage the adjacent vascular grafts and lead to fatal complications such as pseudoaneurysm formation. Thus, preventive measures such as using sternal bands and placing a covering layer between the sternal wires and aortic grafts are recommended in patients with dilated or replaced ascending aorta.

scholarly journals Unusual presentations of a severe type 2 leprosy reaction mimicking sepsis induced by helminth infection

2021 ◽  
Vol 15 (7) ◽  
pp. e0009453
Author(s):  
Sri Linuwih Menaldi ◽  
Anastasia Asylia Dinakrisma ◽  
Hok Bing Thio ◽  
Iris Rengganis ◽  
Salma Oktaria
Keyword(s):  
Septic Shock ◽  
Unusual Case ◽  
Helminth Infection ◽  
Endoscopic Examination ◽  
Course Of Illness ◽  
Source Of Infection ◽  
Helminth Infections ◽  
History Of ◽  
Severe Type

We describe an unusual case of type 2 leprosy reaction (T2R) with septic shock–like features induced by helminth infection in a 31-year-old Moluccan male patient with a history of completed treatment of WHO multidrug therapy (MDT)–multibacillary (MB) regimen 2 years before admission. During the course of illness, the patient had numerous complications, including septic shock, anemia, and disseminated intravascular coagulation (DIC). Nevertheless, antibiotic therapies failed to give significant results, and the source of infection could not be identified. Helminth infection was subsequently revealed by endoscopic examination followed by parasitological culture. Resolution of symptoms and normal level of organ function–specific markers were resolved within 3 days following anthelmintic treatment. This report demonstrated the challenge in the diagnosis and treatment of severe T2R. Given that helminth infections may trigger severe T2R that mimics septic shock, health professionals need to be aware of this clinical presentation, especially in endemic regions of both diseases.

scholarly journals A Prolapsed Cecoureterocele in an Adult Treated Conservatively: Highly Rare, but Existent

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Löcherbach Florian ◽  
Preusser Stefan ◽  
Meier Mark
Keyword(s):  
Early Childhood ◽  
Case Report ◽  
Urinary Tract ◽  
Surgical Therapy ◽  
Surgical Procedure ◽  
Unusual Case ◽  
Ectopic Ureterocele ◽  
History Of ◽  
Urinary Tract Anomalies

Ectopic ureteroceles are one of the most common human urinary tract anomalies. They tend to be recognized and treated in early childhood, especially when they have prolapsed. In most cases surgical therapy is inevitable. In this case report, however, we present the unusual case of a 26-year-old woman suffering from a prolapsed cecoureterocele without any known history of an ectopic ureterocele so far. She was successfully treated without the need for a surgical procedure.

Silent sinus syndrome: an unusual case of facial numbness

2018 ◽  
Vol 18 (6) ◽  
pp. 494-496 ◽  
Author(s):  
Samuel Tribich ◽  
Colin J Mahoney ◽  
Nicholas W Davies
Keyword(s):  
Maxillary Sinus ◽  
Complete Resolution ◽  
Unusual Case ◽  
Clinical Context ◽  
Blurred Vision ◽  
Silent Sinus Syndrome ◽  
Osteomeatal Complex ◽  
Middle Meatal Antrostomy ◽  
Facial Numbness ◽  
History Of

A 49-year-old man presented with a 1-week history of right facial paraesthesia with blurred vision and diplopia. Examination was normal apart from reduced facial sensation. Following appropriate neuroimaging, we considered a diagnosis of silent sinus syndrome. He underwent a middle meatal antrostomy with complete resolution of symptoms. Silent sinus syndrome results from occlusion of the osteomeatal complex, preventing normal aeration of the maxillary sinus. Maxillary sinus hypoventilation typically causes inferior displacement of the globe in the orbit (unilateral hypoglobus). Neurologists will only infrequently see people with silent sinus syndrome but it can have devastating consequences if left untreated and so must be considered in the appropriate clinical context.

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