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https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#1
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28343155/more-than-just-muscle-spasms-a-rare-presentation-of-aortic-dissection
#2
Ebisa Bekele, Deepthi Chaitanya Kagolanu, Martin Kim, Kent Stephenson
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28343153/de-garengeot-s-hernia-an-unusual-case-on-call
#3
Madeline Moore, Bassem Amr
De Garengeot's hernia is defined as a femoral hernia that contains the appendix. Owing to the extreme rarity of de Garengeot's hernia, it could represent a diagnostic challenge; however, it should remain in the differential diagnosis, particularly in this patient demographic. A female patient aged 96 years, who presented as an emergency with acute right iliac fossa pain, was found to have de Garengeot's hernia. The diagnosis was made intraoperatively, where she was treated with an appendicectomy and repair of the hernia defect...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28342811/myeloid-sarcoma-presentation-diagnosis-and-treatment
#4
REVIEW
L Max Almond, Maria Charalampakis, Samuel J Ford, David Gourevitch, Anant Desai
Myeloid sarcoma is an extramedullary tumor of immature granulocytic cells. It is a rare condition, most often associated with acute myeloid leukemia (AML), although in some rare cases it may present in nonleukemic patients. It should therefore be considered as a differential diagnosis of any atypical cellular infiltrate. It may occur at any site, leading to very varied clinical presentations. Diagnosis is challenging and relies on a high index of suspicion as well as radiology, histology, immunophenotyping, and molecular analyses, which also are essential for risk stratification and treatment planning...
March 7, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28341505/secondary-aortoenteric-erosion-followed-by-recurrent-lower-extremity-abscesses
#5
Shigeshi Ono, Yoshitomo Samejima, Susumu Watada, Toshihiro Kakefuda
A secondary aortoenteric fistula (SAEF) is a relatively rare complication of aortoiliac reconstructive surgery, often involving relatively fixed duodenal 3(rd) portion and a vascular anastomosis. We observed a 52-year-old man with a recurrent right lower leg abscess following the erosion between ipsilateral bifurcated prosthetic graft limb and non-fixed jejunum. In situ graft-sparing surgical treatment with aggressive debridement was successfully performed. A SAEF may occur even at a non-vascular anastomosis site, or in non-fixed small bowel, and may become a source of a septic embolus...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28338457/transplant-renal-vein-thrombosis
#6
Khaled El Zorkany, Julie-Michelle Bridson, Ajay Sharma, Ahmed Halawa
Transplant renal vein thrombosis usually occurs early after surgery with a reported prevalence of 0.1% to 4.2%. It is a devastating event that ultimately leads to graft loss in almost all cases. There are many predisposing factors related to donor, recipient, surgery, and immunosuppression, with mechanical factors being considered the most common causes of transplant renal vein thrombosis. The clinical manifestations of acute renal vein thrombosis are nonspecific and are not dissimilar to the features of urine leak, urinary obstruction, or severe acute rejection...
April 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28333777/arteriovenous-lesions-of-the-internal-auditory-canal
#7
Charles L Anzalone, John I Lane, Michael J Link, Matthew L Carlson
OBJECTIVE: To describe a unique case of an asymptomatic arteriovenous lesion of the internal auditory canal (IAC) and present the associated imaging findings. METHODS: Retrospective case report and review of the literature. RESULTS: A 55-year-old man presented for further evaluation of a left-sided sudden sensorineural hearing loss that occurred 8 years earlier. Careful review of outside serial magnetic resonance (MR) imaging revealed a contralateral, ill-defined right-sided IAC mass with low T2 signal and subtle peripheral enhancement on postcontrast T1-weighted sequencing...
March 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28331645/propylene-glycol-toxicity-in-adolescent-with-refractory-myoclonic-status-epilepticus
#8
Kara A Bjur, Bryan C Cannon, Anthony L Fine, Matthew J Ritter, Kerry E Schueler, Michael E Nemergut
Propylene glycol (PG) is a solvent commonly used in medications that, while benign at low doses, may cause toxicity in adults and children at high doses. We describe a case and the physiologic sequelae of propylene glycol toxicity manifested in a critically ill adolescent male with refractory myoclonic status epilepticus aggressively treated with multiple PG-containing medications (lorazepam, phenobarbital, and pentobarbital)-all within accepted dosing guidelines and a total daily PG exposure previously recognized to be safe...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28327420/segmental-arterial-mediolysis-with-5-splenic-artery-aneurysms-a-rare-finding-of-a-rare-disease-case-report-and-literature-review
#9
Salah Termos, Ali Taqi, Hussein Hayati, Ameera J M S Alhasan, Mohammad Alali, Ayman Adi
INTRODUCTION: Splenic artery aneurysms (SAA) are uncommon findings. They are usually single and isolated; however they can be multiple; hence vasculopathy and segmental artery mediolysis may be considered. PRESENTATION OF CASE: In our manuscript we present a case of a 54year old multiparous lady who was discovered incidentally to have a diseased splenic artery containing five SSAs. The largest aneurysm was close to the takeoff of the vessel and the smallest was distal embedded in the splenic hilum...
March 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28327419/concomitant-unilateral-post-traumatic-leg-and-foot-compartment-syndrome-in-a-5-years-old-child-case-report
#10
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28325360/postradiation-associated-sclerosing-mediastinitis-diagnosed-in-fine-needle-aspiration-specimen-a-cytological-pathological-correlation
#11
Tamar Giorgadze, June H Koizumi, Shira Ronen, Michael Chaump, Cynthia M Magro
Sclerosing mediastinitis (SM) is an aggressive fibroproliferative process in the mediastinum that may lead to encasement of mediastinal structures within a dense fibrotic mass. This disease may cause significant clinical complications, morbidity, and even mortality. The etiology and pathogenesis of SM is unclear and in more than one third of cases remains idiopathic. Among the known causes of SM, granulomatous infection is the commonest. Association of SM with radiation therapy has been rarely reported. Herein, we are reporting a case of postradiation sclerosing mediastinitis diagnosed in fine needle aspiration (FNA) specimen...
April 2017: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/28325198/the-evaluation-and-management-of-suspicious-gastric-lesions-following-bariatric-surgery
#12
REVIEW
Guillermo Gomez
Obesity has reached epidemic proportions worldwide and is associated with a higher mortality from several diseases, including adenocarcinoma of the esophagus and of the gastric cardia. Increased body mass index is associated with an increased incidence of gastroesophageal reflux disease (GERD), Barrett metaplasia, and adenocarcinoma of the cardia. Bariatric surgery remains the most effective therapy for morbid obesity and has the potential to improve weight-related GERD. A high index of suspicion is paramount for early detection of foregut neoplasia after bariatric surgery...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28325193/management-of-non-neoplastic-gastric-lesions
#13
REVIEW
Ryan K Schmocker, Anne O Lidor
Benign gastric lesions represent various pathologic entities and management considerations. Upper endoscopy serves as the primary diagnostic modality for gastric lesions. Persistent or giant gastric ulcers represent unique subtypes of ulcers, requiring investigation of the underlying cause. Medical management remains the mainstay of treatment; however, indications for surgical intervention remain. Gastric polyps also represent diverse etiologies, and accurate diagnosis requires pertinent information and tissue samples...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28324118/early-onset-polymyalgia-rheumatica-two-rare-cases-under-age-of-50
#14
Jinyoung Park, Duk Hyun Sung
Polymyalgia rheumatica (PMR) is almost an exclusive disease of adults over the age of 50, and only a few cases have been reported. Two 46-year-old females visited our locomotor pain clinic with multiple joint pain with increased acute phase reactants. Rheumatologic markers, and HLA-B27 were checked. Serum protein electrophoresis and serum immunofixation electrophoresis, imaging studies including plane image, sonography, and magnetic resonance image was done. (18)F-Fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed characteristic findings of PMR, without evidences of sacroiliitis...
March 21, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28321841/histoid-leprosy-a-retrospective-clinicopathological-study-from-central-nepal
#15
Mahesh Mathur, Ayush Jha, Ruprerna Joshi, Roshani Wagle
BACKGROUND: Histoid leprosy is a rare variant of lepromatous leprosy characterized by varied morphological and histopathological appearance while having a high bacillary load. These factors contribute to an ominous threat to the elimination status of leprosy, whereby these patients may act as a reservoir of infection. OBJECTIVE: To identify the clinicopathological characteristics of histoid leprosy in Chitwan, Nepal. METHODS: A retrospective hospital-based study spanning a period of 6 years was carried out at our department...
March 21, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28320588/herpes-zoster-reactivation-in-patients-with-chronic-hepatitis-c-under-treatment-with-directly-acting-antiviral-agents-a-case-series
#16
Mohamed El Kassas, Mohamed Naguib Wifi, Reem Mahdy, Shimaa Afify, Enas Hafez, Yasmeen Abd El Latif, Marwa Ezzat, Adel El Tahan, Naglaa Youssef, Gamal Esmat
We report a series of cutaneous Herpes Zoster (HZ) reactivation cases in patients with hepatitis C virus (HCV) infection treated with directly acting antiviral (DAA) agents. Five cases were detected among 2133 treated patients with DAAs at one of the specialized viral hepatitis treatment centers in Egypt. A control group including 2300 age and sex matched HCV patients who were previously treated with pegylated interferon and ribavirin did not show any HZ reactivation reports while on treatment. None of cases had an evidence of immunosuppression or a risk factor for HZ reactivation...
March 17, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28318198/-subglottic-stenosis-as-the-initial-manifestation-of-wegener-s-granulomatosis-in-a-teenager-case-report
#17
Giselle Cuestas, Verónica Rodríguez, Flavia Doormann, Alejandra Pringe, Patricio Bellia Munzón, Gastón Bellia Munzón, Carlos Ortega, Rubén Álvarez
Wegener's granulomatosis is a necrotizing granulomatous vasculitis of autoimmune origin that primarily affects the upper and lower airways and kidneys. It is very rare in children and adolescents. When started at a young age it is often associated with subglottic stenosis. Subglottic stenosis is a potentially fatal manifestation of Wegener's granulomatosis. Its diagnosis requires a high index of suspicion since it might develop in the absence of other signs of activity. Occasionally, subglottic stenosis may present as the initial manifestation of the disease...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28318090/caecal-bascule-a-case-series-and-literature-review
#18
Jin-Soo Park, Kheng-Seong Ng, Christopher J Young
BACKGROUND: Caecal bascule is a rare condition characterized by the inferior pole of the caecum folding on a horizontal axis antero-superiorly towards the ascending colon, potentially causing obstruction. An unusual variant of volvulus, diagnosis is challenging due to its obscurity. We present the experience of an Australian tertiary-referral hospital with the diagnosis/management of caecal bascule, and review cases reported in the literature to raise awareness of this uncommon diagnosis...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28316938/accidental-non-masturbatory-non-intercourse-related-self-inflicted-penile-fracture-case-report-and-review-of-literature
#19
Christopher Bastianpillai, Aijing Wang, Jeevan Kumaradevan, Sudhanshu Chitale
Penile fracture is a relatively rare condition arising from a rupture of the corpus cavernosum. In the western world, it is most commonly associated with sexual intercourse. We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture. It was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting in a good long-term clinical outcome. Our case highlights the importance of maintaining a high index of suspicion to diagnose this rare condition, even in the absence of a typical mechanism of injury, in order to ensure that such an injury is not missed...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28314643/acute-ascending-aortic-dissection-after-mdma-ecstasy-use-a-case-report
#20
Satoko Kanahara, Mostafa El-Refai, Nasser Lakkis, Rashed Tabbaa
Acute aortic dissection is rare among young patients in the absence of connective tissue disorders. One of the risk factors associated with aortic dissection among young patients is amphetamine use. We report a case of a 37-year-old female with a past medical history of hypertension presenting with syncope and altered mental status who was found to have an acute DeBakey Type I aortic dissection after ingestion of 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy. This is the second case in the literature describing aortic dissection in relation to MDMA use...
November 15, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
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