AN ABDOMINAL INFECTION SIMULATING MALIGNANCY : A CASE REPORT

2021 ◽  
pp. 29-30
Author(s):  
Varsha Konyala ◽  
Poornima M

Tuberculosis is notorious for its afiction to the lungs.However, one mustn't forget the case burden that extra pulmonary TB imposes.Here we present a case of a middle aged woman who came with non specic complaints per abdomen.Her abdominal pain, discomfort, loss of weight and appetite along with clinical examination and investigations pointed towards malignancy. On surgical exploration and histopathological examination, the case was conrmed as that of abdominal TB.Tuberculosis of the abdomen is one of the extra pulmonary sites where tubercular bacilli can reside. In such cases, apart from treating tuberculosis medically with anti tubercular therapy, one must also order a chest X-ray to identify any pulmonary foci of tuberculosis. This is to curb any potential spread of infection. Further, one must look acutely at cases with non specic ndings and consider TB in the differential diagnosis, particularly if the patient hails from a TB endemic region.With a keen eye for tuberculosis along with corroborative and relevant investigations, one can diagnose this chronic illness and put patients well on the road to recovery.

2010 ◽  
Vol 92 (5) ◽  
pp. e53-e54 ◽  
Author(s):  
Somprakas Basu ◽  
Shilpi Bhadani ◽  
Vijay K Shukla

Bilothorax is a rare complication of biliary peritonitis and, if not treated promptly, can be life-threatening. We report a case of a middle-aged woman who had undergone a bilio-enteric bypass and subsequently a biliary leak developed, which finally led to intra-abdominal biliary collection and spontaneous bilothorax. The clinical course was rapid and mimicked venous thromboembolism, myocardial infarction and pulmonary oedema, which led to a delay in diagnosis and management and finally death. We high-light the fact that bilothorax, although a rare complication of biliary surgery, should always be considered as a probable cause of massive effusion and sudden-onset respiratory and cardiovascular collapse in the postoperative period. A chest X-ray and a diagnostic pleural tap can confirm the diagnosis. Once detected, an aggressive management should be instituted to prevent organ failure and death.


Author(s):  
Toh Leong Tan ◽  
Chuan Hun Ding

Hypertensive crises can be life-threatening if undiagnosed due to the risk of acute target organ damage. This is a case of a middle-aged woman with poorly controlled hypertension who presented with a 3-day history of dyspnea, orthopnea, and cough productive of frothy sputum. Repeated attempts to measure her blood pressure (BP) using both a mercury and an electronic sphygmomanometer were unsuccessful. However, when an arterial catheterization of the right radial artery was performed, her mean BP was 358/151 mm Hg. A chest X-ray revealed cardiomegaly with plethoric lung fields. Following a diagnosis of hypertensive emergency with acute pulmonary edema, a glyceryl trinitrate infusion at a dose of 20 mg/min was commenced and titrated in an escalating manner. She was also given a single dose of intravenous frusemide 40 mg. Her BP was successfully reduced by 25% within 3 h of presentation.


2018 ◽  
Vol 5 (1) ◽  
pp. 4
Author(s):  
Bart Vrugt ◽  
Thomas Frauenfelder ◽  
Holger Dressel ◽  
Fabio Barresi ◽  
Christian Clarenbach ◽  
...  

Pleuroparenchymal fibro-elastosis (PPFE) is a rare idiopathic interstitial pneumonia. Secondary forms of PPFE may occur in patients following lung- or bone marrow transplantation. Here we report a middle-aged woman who presented with dyspnea and cough. She had been working as a cleaning woman in an agriculture company and logistic firm. Chest HRCT was highly suggestive for PPFE. Histopathological examination of a surgical biopsy showed a pattern of PPFE with airway-centered fibro-elastosis, constrictive bronchiolitis and birefringent particles in the pathological areas only. Using transmission electron microscopy with X-ray diffraction (TEM/EDX) these particles were identified as quartz and silicates, both components generally found in soil. The present case illustrates that secondary PPFE may result from agricultural dust exposure and stresses the need for a careful workup of the occupational history.


2021 ◽  
Vol 14 (8) ◽  
pp. e240687
Author(s):  
Vivek Srivastava ◽  
Pratik K Jha ◽  
Awgesh Kumar Verma ◽  
Mumtaz Ahmad Ansari

Aggressive angiomyxoma is a rare and locally aggressive mesenchymal tumour, predominantly occurring in women of reproductive age group. The term aggressive is attributed to the infiltrative nature and frequent local recurrences. They arise commonly from the vulvovaginal region, perineum or pelvis and are usually misdiagnosed as other common entities in these regions. Radiological investigations aid in the diagnosis and planning of surgery. However, the final diagnosis in most of the cases is established by histopathological examination. We herein report a case of a middle-aged woman presenting with recurrent large right vulvar mass highlighting the surgical challenges posed by its intrapelvic extension.


1970 ◽  
Vol 21 (1) ◽  
pp. 73-76
Author(s):  
MAK Pramanik ◽  
M Manjurul Haque ◽  
AM Rashid ◽  
SMK Nahar Begum ◽  
MN Hasan ◽  
...  

A middle aged woman presented with a lump and discharging sinus in her breast. On first look, the lesion seemed to be a carcinoma of breast. The patient got enlarged axillary lymph nodes with fever in the evening, night sweating and loss of weight, indicating the lesion to be of tuberculous in origin. FNAC indicated the lesion to be tuberculous but open biopsy was advised by the pathologist for confirmation. Excision biopsy of the lesion confirmed the lesion as tuberculous. Treatment with anti-tuberculous drugs cured the disease. A lump in the breast with skin involvemennt and axillary lymph node enlargement may be considered a malignant tumour on first sight, but tuberculosis cannot be ruled out, especially if a sinus is present along with systemic manifestations of the disease. doi: 10.3329/taj.v21i1.3224 TAJ 2008; 21(1): 73-76  


2019 ◽  
Vol 27 (5) ◽  
pp. 313-315
Author(s):  
Kelvin Shenq Woei Siew ◽  
Huynh Quoc Hieu ◽  
Alexander Loch

A middle-aged woman had a central venous catheter insertion for fluid resuscitation presented with tachypnea and oxygen desaturation 6 h later. Diagnosis was made based on the chest X-ray performed 6 h after the catheter placement. Thereafter, the patient received appropriate treatment.


2021 ◽  
Vol 14 (4) ◽  
pp. e241663
Author(s):  
Shweta Mallikarjun Revannavar ◽  
Supriya P S ◽  
Laxminarayana Samaga ◽  
Vineeth V K

A middle-aged woman with diabetes presented with left-sided facial pain, complete ptosis and fever of short duration. On presentation, she had hyperglycaemia without ketosis. There was total ophthalmoplegia of the left eye with a visual acuity of 6/36. She incidentally tested positive for COVID-19. CT paranasal sinus and MRI brain revealed left-sided pansinusitis with acute infarct in the left parieto-occipital region without angioinvasion. An emergency functional endoscopic sinus procedure was done, which confirmed mucormycosis on histopathological examination. After 1 week of conventional amphotericin B and antibiotics, repeat CT brain showed improvement in mucosal thickening and sinusitis. This case is a rare presentation of mucormycosis associated with rapid progression to orbital apex syndrome with brain infarction in a patient with non-ketotic diabetes and COVID-19. Early diagnosis and treatment are essential to prevent further end-organ damage. It is also interesting that there was no angioinvasion and transient periarterial inflammation was attributed to brain infarction.


Parasitology ◽  
1909 ◽  
Vol 2 (1-2) ◽  
pp. 156-191 ◽  
Author(s):  
George H. F. Nuttall ◽  
S. Hadwen

1. We have discovered that Trypanblau and Trypanrot are highly efficient remedies in the treatment of canine piroplasmosis, no drug or mode of treatment having hitherto been found to exert any appreciable effect upon this very fatal disease.2. The drugs exert a direct and observable effect upon the parasites (a) by causing the pyriform parasites to quickly disappear, and (b) in most cases, by causing the total disappearance of the parasites from microscopic observation in the peripheral blood.3. The disappearance of the parasites from the blood is usually temporary, the parasites reappearing in small numbers after an interval of 9 to 12 days, but the dogs, as a rule, show no symptoms and gradually progress toward recovery. In our experience there is but slight loss of weight in treated animals, this being in marked contrast to what is usually observed in dogs which recover naturally. In the two dogs which died of a relapse the parasites reappeared after an interval of 4 to 5 days.4. The experiments were conducted upon 21 dogs of all ages and of a variety of breeds. Many of the dogs were highly susceptible puppies. Twelve dogs were subjected to curative treatment, one dog received preventive treatment, and eight dogs served as controls.5. Twelve dogs received treatment as follows:(a) Two dogs were treated with Trypanrot and survived 111 days and 20 days respectively. In the latter case the dog was treated in an advanced stage of the disease, the parasites disappeared, and death appeared to be due to the after-effects of the malady.Two control dogs died respectively on the 9th and 7th day after they were inoculated.(b) Ten dogs were treated with Trypanblau and seven made a good recovery. Three of these dogs are still alive, having been respectively under observation for periods of 90, 83 and 65 days. Four of the recovered dogs died respectively of distemper on the 42nd and 43rd day, of severe mange on the 52nd day and of distemper and mange on the 69th day. We failed to cure the disease in 3 out of 10 cases treated: two small wormy ill-nourished puppies died from a relapse (on the 13th and 15th day) after they appeared to be on the road to recovery; one dog, treated only 3 hours prior to death, and when 50% of its corpuscles were infected, succumbed to the disease, but even in this case a visible effect was exerted upon the parasites by the drug.Of the 7 control dogs, 6 died of piroplasmosis within 7–13 days after inoculation with virulent blood, and the remaining dog died of piroplasmosis on the 36th day after inoculation.6. After the parasites disappear under the influence of the drug, the temperature usually falls to normal, but slight rises of temperature may at times occur, together with the subsequent reappearance of the parasites.7. When the parasites reappear after treatment they occur in small numbers and can usually be detected only at the edge of the film. In such cases the parasites tend to occur in higher multiples [(PPPP) or more] within the individual corpuscles. The same appearance has been observed in one of the control dogs, which died of chronic piroplasmosis on the 36th day.8. In the two puppies 10 and 11, in which death followed upon a relapse, the parasites reappeared after a shorter interval (4 to 5 days) than in any of the other dogs. The blood counts made during the fatal relapse are remarkable as showing a high percentage of dividing forms (D); that rapid invasion of fresh corpuscles was proceeding is also shown by the high percentage of single pyriform parasites (P) which occurred in the corpuscles.9. One experiment is reported (Dog 13) in which Trypanblau was injected 24 hours after the animal was inoculated, with the result that no parasites appeared in the dog's blood up to the 65th day, and the dog remained perfectly well. The control dog died of piroplasmosis on the 7th day. (This experiment has since been successfully repeated.)Further experiments of this character will be shortly reported upon.10. Arsacetin and Soamin exert no curative effect upon canine piroplasmosis.


Author(s):  
Toh Leong Tan ◽  
Chuan Hun Ding

Hypertensive crises can be life-threatening if undiagnosed due to the risk of acute target organ damage. This is a case of a middle-aged woman with poorly controlled hypertension who presented with a 3-day history of dyspnea, orthopnea, and cough productive of frothy sputum. Repeated attempts to measure her blood pressure (BP) using both a mercury and an electronic sphygmomanometer were unsuccessful. However, when an arterial catheterization of the right radial artery was performed, her mean BP was 358/151 mm Hg. A chest X-ray revealed cardiomegaly with plethoric lung fields. Following a diagnosis of hypertensive emergency with acute pulmonary edema, a glyceryl trinitrate infusion at a dose of 20 mg/min was commenced and titrated in an escalating manner. She was also given a single dose of intravenous frusemide 40 mg. Her BP was successfully reduced by 25% within 3 h of presentation.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Ekaterini Amaniti ◽  
Chrysoula Provitsaki ◽  
Panagiota Papakonstantinou ◽  
George Tagarakis ◽  
Konstantinos Sapalidis ◽  
...  

Tension pneumothorax during general anaesthesia is a rare but possibly deleterious event, especially where predisposing factors are absent or unknown, making diagnosis even challenging. We describe a case of a healthy middle-aged woman, who was planned to receive general anaesthesia for total thyroidectomy. After intubation, the patient experienced marked hypoxemia (SpO2=75%), hypotension, and tachycardia. Manual positive pressure ventilation seemed to worsen hypoxemia and tachycardia, while apnoeic oxygenation through circle system with valve open slightly improved cardiorespiratory collapse. The effect of positive ventilation, along with the absence of breath sounds in the right hemithorax and cardiorespiratory collapse, established the diagnosis of tension pneumothorax, managed immediately with emergency thoracentesis and placement of a thoracostomy tube. The patient was improved and pneumothorax was confirmed with chest X-ray and CT. The latter also confirmed the presence of bilateral multiple bullae. The operation was postponed and the patient was extubated a few hours later, in good condition. After thorough evaluation for any systemic disease, which was negative, the patient underwent two-stage thoracotomy for bullectomy.


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