An unusual case of dysphagia

2018 ◽  
Vol 17 (3) ◽  
pp. 154-155
Author(s):  
Adam Williamson ◽  
◽  
Christopher Kelly ◽  
Keyword(s):  
Unusual Case ◽  
Previous History ◽  
Upper Respiratory Tract ◽  
Medical Unit ◽  
Solid Foods ◽  
Acute Medical Unit ◽  
History Of ◽  
Upper Respiratory ◽  
Ventriculo Peritoneal Shunt

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of neck or back pain and her pain was not controlled with simple analgesia. She also complained of new odynophagia and high dysphagia, particularly to solid foods. There was no history of upper respiratory tract infection.

scholarly journals Dissecting the Diagnosis – An Unusual Case of Pericarditis

2017 ◽  
Vol 16 (4) ◽  
pp. 200-203
Author(s):  
Louise Mundy ◽  
◽  
Purav Desai ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Unusual Case ◽  
Correct Diagnosis ◽  
Timely Manner ◽  
Medical Unit ◽  
Coronary Syndrome ◽  
Acute Medical Unit

Chest pain is an extremely common presenting complaint on the acute medical unit. It is important to distinguish between patients who have serious pathology and those without. Often, the focus is on ruling out an acute coronary syndrome and inadequate consideration is given to other possible causes. This case highlights the importance of performing relevant investigations in a timely manner, in order to ensure that a correct diagnosis is made.

scholarly journals An outbreak of SARS-CoV-2 with high mortality in mink (Neovison vison) on multiple Utah farms

2021 ◽  
Author(s):  
Chrissy Eckstrand ◽  
Tom Baldwin ◽  
Mia Kim Torchetti ◽  
Mary Lea Killian ◽  
Kerry A Rood ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Signs ◽  
Viral Transmission ◽  
Viral Rna ◽  
Upper Respiratory Tract ◽  
Tracheobronchial Lymph Node ◽  
Multiple Organs ◽  
Upper Respiratory ◽  
Polymerase Chain

The breadth of animal hosts that are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may serve as reservoirs for continued viral transmission are not known entirely. In August 2020, an outbreak of SARS-CoV-2 occurred in multiple mink farms in Utah and was associated with high mink mortality and rapid viral transmission between animals. The outbreak's epidemiology, pathology, molecular characterization, and tissue distribution of virus within infected mink is provided. Infection of mink was likely by reverse zoonosis. Once established, infection spread rapidly between independently housed animals and farms, and caused severe respiratory disease and death. Clinical signs were most notably sudden death, anorexia, and increased respiratory effort. Gross pathology examination revealed severe pulmonary congestion and edema. Microscopically there was pulmonary edema with moderate vasculitis, perivasculitis, and fibrinous interstitial pneumonia. Reverse transcriptase polymerase chain reaction (RT-PCR) of tissues collected at necropsy demonstrated the presence of SARS-CoV-2 viral RNA in multiple organs including nasal turbinates, lung, tracheobronchial lymph node, epithelial surfaces, and others. Whole genome sequencing from multiple mink was consistent with published SARS-CoV-2 genomes with few polymorphisms. The Utah mink SARS-CoV-2 strain fell into Clade GH, which is unique among mink and other animal strains sequenced to date and did not share other spike RBD mutations Y453F and F486L found in mink. Localization of viral RNA by in situ hybridization revealed a more localized infection, particularly of the upper respiratory tract. Mink in the outbreak reported herein had high levels of virus in the upper respiratory tract associated with mink-to-mink transmission in a confined housing environment and were particularly susceptible to disease and death due to SARS-CoV-2 infection.

scholarly journals Outbreak of 2009 pandemic influenza A(H1N1) in a Finnish garrison - a serological survey

2010 ◽  
Vol 15 (45) ◽  
Author(s):  
M Aho ◽  
O Lyytikaïnen ◽  
J E Nyholm ◽  
T Kuitunen ◽  
E Rönkkö ◽  
...  
Keyword(s):  
Pandemic Influenza ◽  
Military Service ◽  
Influenza A ◽  
Major Part ◽  
H1n1 Virus ◽  
Upper Respiratory Tract ◽  
Serological Survey ◽  
Influenza A H1n1 ◽  
History Of ◽  
Upper Respiratory

In September 2009, an outbreak of 2009 pandemic influenza A(H1N1) took place in a Finnish garrison. In November 2009, we performed a serological survey among 984 recruits undergoing their military service at the garrison and related the results to self-reported upper respiratory tract infection (URTI) with or without fever. Of 346 volunteers who donated a blood sample, 169 (49%) had pandemic influenza A(H1N1) virus-specific antibodies. Of those, 84 (50%) reported no recent history of URTI, suggesting that a major part of those infected with pandemic influenza A(H1N1) virus may be asymptomatic.

Comparison of Primary and Metastatic Malignant Melanoma of the Esophagus: Clinicopathologic Review of 10 Cases

2008 ◽  
Vol 132 (10) ◽  
pp. 1623-1629 ◽  
Author(s):  
Amy A. Sanchez ◽  
Tsung-Teh Wu ◽  
Victor G. Prieto ◽  
Asif Rashid ◽  
Stanley R. Hamilton ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Cell Morphology ◽  
Growth Phase ◽  
Cutaneous Melanoma ◽  
Radial Growth ◽  
Spindle Cell ◽  
Previous History ◽  
Depth Of Invasion ◽  
History Of

Abstract Context.—Primary esophageal melanoma (PEM) is a rare disease and is difficult to distinguish from other esophageal malignancies and from metastatic melanoma. Objective.—To develop diagnostic criteria for PEM, we compared the clinicopathologic features of 5 PEMs and 5 metastatic melanomas to esophagus. Design.—Ten cases of esophageal melanoma, including 4 surgically resected specimens, 2 autopsy cases, and 4 cases reported on mucosal biopsies, were reviewed. The histologic parameters used in this study were well-characterized features for cutaneous melanoma, including junctional component (in situ melanoma), radial growth phase, modified Breslow thickness, depth of invasion, lymphovascular invasion, satellitosis, predominant type of cytology, and regional lymph node metastasis. Clinical and follow-up information was obtained by reviewing patients' medical records. Results.—Previous history of cutaneous melanoma was present in all 5 cases of metastatic esophageal melanoma but was not present in the 5 patients with PEMs. In situ melanoma and/or radial growth phase were identified in all 5 PEMs but were not present in any of the metastatic cases. Among the 4 resected and 2 autopsy cases, melanocytosis and mixed epithelioid and spindle cell morphology was present in 2 (50%) of 4 PEMs but was not present in 2 (40%) of the metastatic melanomas. Melanin pigment was detectable in all cases. Patients with PEM had better survival than those who had metastatic melanoma to esophagus (P = .03). Conclusions.—The presence of in situ melanoma, radial growth phase, melanocytosis, and mixed epithelioid and spindle cell morphology, in the context of no history of melanoma, distinguishes PEM from metastatic melanoma.

scholarly journals The snoring 2-year-old boy: a case of primary nasopharyngeal Burkitt’s lymphoma

2020 ◽  
Vol 13 (1) ◽  
pp. e233536
Author(s):  
Gerd Xuereb ◽  
Justine Borg ◽  
Kurt Apap ◽  
Charles Borg
Keyword(s):  
Respiratory Tract Infections ◽  
Cervical Lymphadenopathy ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
Upper Respiratory Tract ◽  
Lymph Node Enlargement ◽  
History Of ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Nose And Throat

Sporadic Burkitt’s lymphoma affecting the nasopharyngeal region is an extremely rare disease, especially in infants. We describe the case of a 2-year-old boy who presented to the ear, nose and throat department with a history of snoring, blood-stained rhinorrhoea and symptoms consistent with upper respiratory tract infections. Physical examination revealed massive cervical lymphadenopathy. MRI of the head and neck showed a mass lesion in the nasopharynx with bilateral lymph node enlargement. Debulking of the mass was performed and biopsies were sent for histology, which confirmed Burkitt’s lymphoma. The patient was treated with complex chemotherapy and had a good clinical response. The patient remains in remission after 6 years.

Sudden hearing loss in intralabyrinthine haemorrhage in a child

2004 ◽  
Vol 118 (6) ◽  
pp. 450-452 ◽  
Author(s):  
Chul Ho Jang ◽  
Young Ho Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Unusual Case ◽  
Previous History ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Bleeding Disorders ◽  
Resonance Imaging ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

This paper reports an unusual case in which aseptic meningitis presented with sudden sensorineural hearing loss (SSNHL) associated with intralabyrinthine haemorrhage (ILH). A seven-year-old girl presented with sudden right-sided hearing loss with dizziness. She did not have a previous history of bleeding disorders. This child was assessed using audiograms and magnetic resonance imaging (MRI). The patient's hearing loss was irreversible. Steroid therapy was not effective. SSNHL associated with ILH can be one of the negative prognostic factors in children.

scholarly journals Development of Agranulocytosis after Discontinuation of Methimazole: An Unusual Case

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Rıfkı Üçler ◽  
Murat Atmaca ◽  
Ömer Candar ◽  
Murat Alay ◽  
Burhan Göy ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Clinical Improvement ◽  
Unusual Case ◽  
Antithyroid Drugs ◽  
Upper Respiratory Tract ◽  
Empirical Antibiotic Treatment ◽  
Upper Respiratory

Agranulocytosis is a rare and critical adverse effect of antithyroid drugs (ATD). The occurrence of agranulocytosis in continuous ATD treatment patients is well known; however, a case of ATD agranulocytosis occurring following the discontinuation of methimazole (MMI) treatment is not a usual situation. We herein describe a case of a 41-year-old woman who was previously administered methimazole (MMI) for ten days and developed ATD-induced agranulocytosis and symptoms of an upper respiratory tract infection after three weeks following discontinuation of MMI treatment. A thorough hematologic and serological evaluation did not disclose an alternative cause for the agranulocytosis. After receiving empirical antibiotic treatment, she responded successfully with clinical improvement of her symptoms and resolved neutropenia on the seventh day. This case is atypical because agranulocytosis developed after discontinuation of MMI, which strengthens the importance of remaining alert for signs of agranulocytosis even after discontinuation of ATD treatment.

scholarly journals The Incidence of Central Serous Chorioretinopathy after Photorefractive Keratectomy and Laser In Situ Keratomileusis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Majid Moshirfar ◽  
Maylon Hsu ◽  
Julia Schulman ◽  
Joseph Armenia ◽  
Shameema Sikder ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Refractive Surgery ◽  
Chart Review ◽  
Previous History ◽  
Laser In Situ Keratomileusis ◽  
Photorefractive Keratectomy ◽  
Causal Association ◽  
History Of ◽  
Low Incidence

Purpose. To assess the incidence of central serous chorioretinopathy (CSCR) following laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).Methods. A chart review was performed to identify all patients with CSCR and a previous history of LASIK or PRK.Results. Over the 6-year study period, 1 of 4,876 eyes which had LASIK or PRK at the Moran Eye Center was diagnosed with CSCR. One other patient was referred from an outside center, developed CSCR symptoms one month after PRK. Both patients were managed conservatively with a final visual acuity of 20/20 or better. All other patients presented 4 or more years after refractive surgery.Conclusions. We report the first 2 CSCR cases developing within one month after PRK. The low incidence argues against a causal association. Topical corticosteroids or anxiety may elevate cortisol levels presenting therapeutic challenges for the management of CSCR after PRK or LASIK.

Breath Alcohol Analysis and the Blood: Breath Ratio

1975 ◽  
Vol 15 (3) ◽  
pp. 205-210 ◽  
Author(s):  
B. M. Wright ◽  
T. P. Jones ◽  
A. W. Jones
Keyword(s):  
Liquid Chromatography ◽  
Blood Analysis ◽  
Gas Liquid Chromatography ◽  
Upper Respiratory Tract ◽  
Breath Sampling ◽  
Breath Alcohol ◽  
History Of ◽  
Upper Respiratory ◽  
Sampling Procedures

The history of breath alcohol analysis and of the concept of a blood: breath ratio is briefly reviewed and it is suggested that the ratio is always lower and more variable than predicted by accepted theory. Using gas liquid chromatography for both breath and blood it has been shown that the blood: breath ratio falls during expiration and only reaches its presently accepted value of 2100: 1, predicted from in vitro studies, after prolonged rebreathing. It is suggested that this is due to alcohol being absorbed from the breath during expiration by the mucosa of the upper respiratory tract, to replace that lost during inspiration. Proposals are made for further studies and for modifications in present breath sampling procedures which could make breath analysis an acceptable substitute for blood analysis in all except marginal cases.

Pleomorphic lobular carcinoma in situ: A distinct entity of controversial significance.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 177-177
Author(s):  
Marina De Brot ◽  
Shirin Muhsen ◽  
Victor P. Andrade ◽  
Starr Koslow Mautner ◽  
Melissa Murray ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Previous History ◽  
Prior History ◽  
Lobular Carcinoma In Situ ◽  
Pleomorphic Lobular Carcinoma ◽  
History Of

177 Background: Pleomorphic lobular carcinoma in situ (PLCIS) is an increasingly diagnosed variant of lobular carcinoma in situ. Histologically, it resembles ductal carcinoma in situ (DCIS), leading to controversy over proper management. Yet, the natural history of PLCIS is unknown. Here we describe our experience with PLCIS. Methods: Review of pathology reports (1995–2012) identified 233 cases of LCIS variants. Patients with synchronous ipsilateral DCIS or invasive cancer (IC) were excluded leaving 25 cases for review. Consensus review by 3 pathologists further excluded 7; leaving 18 cases, 12 of which were classified as PLCIS and 6 as LCIS with pleomorphic features (LCIS-PF). (Table) PLCIS was defined by cellular dyshesion, nuclear pleomorphism with a 2-3 fold size variation, conspicuous nucleoli, mitoses and abundant cytoplasm; lesions not meeting all parameters were classified as LCIS-PF. Loss of e-cadherin was confirmed; clinical data were obtained from medical records. Results: Mean patient age at diagnosis of PLCIS/LCIS-PF was 57 yrs (42-67 yrs). All cases presented with imaging abnormalities. A previous history of breast cancer was present in 7/18 (39%) pts (3/7, ipsilateral; 4/7, contralateral). Following PLCIS/LCIS-PF diagnosis, 6/18 (33%) pts underwent mastectomy and 12/18 had excision alone, with (n=3) or without chemoprevention (n=9). Margin status was negative in 4/12 pts; close in 3/12 pts and positive in 5/12 pts undergoing excision. At a median follow-up of 27 mos (2-148 mos), 2/12 pts treated with excision developed ipsilateral breast cancer (1 DCIS; 1 IC). Both had close margins at initial excision; median time to cancer, 54 mos. Conclusions: Pure PLCIS is an uncommon lesion. Synchronous malignancy or prior history of breast cancer are often present in patients with PLCIS, contributing to the difficulty in determining the actual risk conferred by this lesion and appropriate management. Efforts to systematically characterize LCIS variants and prospective documentation of outcomes are needed to clarify the significance of these lesions. [Table: see text]

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