scholarly journals Nodular vasculitis or erythema induratum without cutaneous tuberculosis: An unusual presentation in an uncommon site

2021 ◽  
Vol 12 (2) ◽  
pp. 145-147
Author(s):  
Ramin Mofarrah ◽  
Nafiseh Jallab ◽  
Ramina Mofarrah ◽  
Kousar Jahani Amiri ◽  
Naghmeh Jallab

Erythema induratum (EI) is a rare chronic disease, which occurs with cutaneous tuberculosis (TB). Nodular vasculitis, much rarer than erythema induratum, describes the same condition but without cutaneous TB, with lesions usually in the lower legs and rarely on the breasts. We report the case of a 46-year-old female with a history of crusted skin and necrotic lesions two years before, which, once self-limited, multiplied one month before and transferred to uncommon sites of the body, such as the breast. There was no evidence of other clinical presentations, and a chest X-ray gave no pathological findings. A biopsy was taken from the lesions, and the patient was diagnosed with erythema induratum without cutaneous tuberculosis, that is, nodular vasculitis. After treatment with calcineurin-inhibiting tacrolimus ointment, topical corticosteroids, and immunosuppressive oral azathioprine, the lesions improved.

2018 ◽  
Vol 47 (2) ◽  
pp. 164
Author(s):  
Puspa Zuleika ◽  
Abla Ghanie

Latar belakang: Aspirasi benda asing ialah masuknya benda yang berasal dari luar atau dalam tubuh, ke saluran trakeobronkial. Aspirasi benda asing saluran trakeobronkial merupakan keadaan darurat yang memerlukan tindakan bronkoskopi segera untuk mencegah komplikasi yang lebih serius. Tujuan: Mengidentifikasi karakteristik klinis pasien aspirasi benda asing saluran trakeobronkial di bagian Telinga Hidung Tenggorok – Bedah Kepala Leher (T.H.T.K.L) Fakultas Kedokteran Universitas Sriwijaya/ Rumah Sakit Dr. Mohammad Hoesin Palembang. Metode: Penelitian ini merupakan penelitian observasional deskriptif. Sampel penelitian ini diambil dari data rekam medis pasien aspirasi benda asing pada saluran trakeobronkial di Rumah Sakit Dr. Mohammad Hoesin Palembang periode Januari 2012 - Desember 2016. Hasil: Didapatkan 20 pasien dengan riwayat teraspirasi benda asing di saluran trakeobronkial. Dijumpai 9 orang laki-laki dan 11 orang perempuan dengan perbandingan 1:1,2, di mana usia 0-15 tahun merupakan penderita terbanyak aspirasi benda asing ini. Benda asing yang paling banyak ditemukan adalah mainan dan benda plastik sebanyak 9 kasus, serta jarum pentul sebanyak 6 kasus. Sebanyak 19 pasien diketahui terdapat riwayat tersedak benda asing. Pemeriksaan foto toraks menunjukkan gambaran normal pada 12 pasien. Lokasi benda asing terbanyak ditemukan di trakea sebanyak 8 kasus. Kesimpulan: Aspirasi benda asing di saluran trakeobronkial sering terjadi pada anak-anak yang berusia kurang dari 15 tahun. Benda asing terbanyak adalah anorganik berupa mainan dan benda plastik. Pemeriksaan radiologi paru dalam 24 jam pertama setelah kejadian aspirasi pada umumnya menunjukkan gambaran normal. Lokasi benda asing di saluran trakeobronkial terbanyak pada penelitian ini adalah di trakea. Kata kunci: Aspirasi, bronkoskopi, foto toraks, benda asing, traktus trakeobronkial ABSTRACT Background: Foreign body aspiration is the entrance of foreign objects from outside or inside of the body into the tracheobronchial tract. Aspiration of foreign body in tracheobronchial tract is an emergency condition that needs immediate bronchoscopy procedure to prevent serious complications. Objectives: To identify clinical characteristics of foreign body aspiration patients in ENT Department Sriwijaya Medical Faculty / Dr. Mohammad Hoesin Hospital, Palembang. Method: This study was a descriptive observational study. The sample of this study was taken from the medical record of tracheobronchial foreign body aspiration patients at Dr. Mohammad Hoesin Hospital from January 2012 until December 2016. Result: There were twenty patients with the history of foreign body aspiration in tracheobronchial tract, consisted of 9 male and 11 female, with the ratio 1:1,2, in which 0–15 year-old children were the majority of the patients. The most common foreign bodies were toys and plastic objects in 9 cases and head veil pin in 6 cases. Nineteen cases of the patients had the history of choking as presenting symptom. Chest X-Ray showed normal imaging on twelve patients. The most common site in tracheobronchial tract where foreign bodies found was the trachea, in eight cases. Conclusions: Foreign body aspirations in tracheobronchial tract were most frequently happened in children less than 15 year-old. The most common foreign bodies were anorganic material, such as toys and plastic objects. Lung X-Rays on the first 24 hours commonly showed normal imaging. Foreign bodies in tracheobronchial tracts most frequently were found in the trachea. Keywords: Aspirations, bronchoscopy, chest X-Ray, foreign body, tracheobronchial tree


1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)


2016 ◽  
Vol 15 (1) ◽  
pp. 30-32
Author(s):  
Legate Philip ◽  
◽  
Neil Andrews ◽  

Acute mitral regurgitation (acute MR) is a rare cause of acute respiratory distress, which can present diagnostic challenges. We present the case of a 57 year old man who developed acute shortness of breath subsequently associated with fever, raised white cells and elevated CRP. Chest x-ray revealed unilateral shadowing and he was treated for pneumonia, despite the finding of severe mitral regurgitation on echo. Failure to respond to antibiotic treatment following 3 weeks on ITU led to the consideration of acute MR as the cause of his symptoms and he responded well to diuretics. He subsequently underwent mitral valve repair. The causes and clinical presentations of this condition are discussed.


2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Waiel Abusnina ◽  
Hazim Bukamur ◽  
Zeynep Koc ◽  
Fauzi Najar ◽  
Nancy Munn ◽  
...  

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.


2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.


2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.


Author(s):  
Yulia V. Chumakova ◽  
Sofia E. Dubrova ◽  
Natalia S. Muranova ◽  
Olga M. Popova ◽  
Vladimir A. Klevno

Introduction: The article deals with the criteria, forensic and radiological "life tests", difficulties in assessing the results of live birth and stillbirth of the fetus. An excursion into the history of the development of X-ray, including pre-sectional, examination of the corpses of newborns is made. Cases from the practice of two corpses of newborns which underwent pre-section computed tomography are presented. Case presentation: Case № 1: examination of the corpse of a baby found in a cardboard box on the unheated terrace of a private house after a secret self-birth. Case № 2: examination of the corpse of an infant with massive injuries and the division of the body into two fragments, found on a sorting tape in the premises of the waste sorting shop. Conclusion: Postmortem CT of newborn corpses was an evidence-based and visual addition to the traditional forensic medical study, which allowed even at the pre-dissection stage to speak about the maturity of fetuses, to identify injuries and anatomical variants of the structure, to refute the presence of congenital deformities; to establish and record evidence-based CT signs of live birth and stillbirth.


2015 ◽  
Vol 79 (3-4) ◽  
Author(s):  
Gabriella Guarnieri

The case of a 72-year-old man with a long history of chronic obstructive pulmonary disease (COPD, patient D according to Guidelines GOLD 2013) in a subject professionally exposed to welding fumes is presented. Diagnosis was based on symptoms and spirometry and confirmed by chest X-ray examination. Since 1997 the patient has been under different therapies, including high-dose inhaled corticosteroids and bronchodilators, with poor clinical control and frequent exacerbations. Roflumilast 500 μg once daily was started in January 2012 and patient’s respiratory symptoms, number of exacerbations and spirometry values have gradually improved since then. Roflumilast was an effective treatment in this case of difficult to treat severe COPD.


2015 ◽  
Vol 19 (2) ◽  
pp. 159-162 ◽  
Author(s):  
Rachel Asiniwasis ◽  
Maha T. Dutil ◽  
Scott Walsh

Background/Objectives The clinical and histopathologic findings of a rare simultaneous occurrence of papulonecrotic tuberculid and nodular tuberclid in a patient with active but asymptomatic pulmonary tuberculosis are presented. Papulonecrotic tuberculid was observed at a very early stage, presenting as molluscum-like lesions. This has been described once in the literature. This was observed in conjunction with lesions compatible with the rare clinicopathologic variant of nodular tuberculid. Critical to the diagnosis of active pulmonary tuberculosis was the use of induced sputum testing, which confirmed the diagnosis despite the lack of a cough and a chest x-ray negative for active tuberculosis. Methods/Results A 40-year-old male presented with a 2-week history of fever and a skin eruption consisting of molluscum-like papules on the ears, arms, and abdomen and nodules on his legs. Biopsies from both lesions were consistent with papulonecrotic and nodular tuberculid, respectively. Despite the lack of any respiratory symptoms, induced sputum grew Mycobacterium tuberculosis, and the lesions resolved on antituberculous therapy. Conclusions and Relevance Tuberculids are rare in Western countries but must be considered in the differential diagnosis of eruptions in patients from endemic countries. An active tuberculous focus must be sought out.


2019 ◽  
Vol 12 (5) ◽  
pp. e229225
Author(s):  
Michelle N Lee ◽  
Luke T Surry ◽  
David M Ferraro

A Caucasian woman aged 58 years with history of asthma and surgically repaired congenital diaphragmatic hernia presented to the emergency department (ED) with persistent cough, pleuritic chest pain, shortness of breath, in spite of recent treatment for influenza A virus. On physical examination, a large bulge was protruding from her left posterior thorax. She was found to have a large abnormal radiographic lucency on lateral chest X-ray posterior to the thoracic cavity, confirmed with chest CT to represent a large lung herniation in between the left seventh and eighth ribs. The patient was evaluated by a thoracic surgeon and offered surgical repair but ultimately decided on conservative management which to date has been ineffective.


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