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International Journal of Surgery Case... 2019Abdominal localization of cyst lymphangioma is rare. The splenic involvement is exceptional.
INTRODUCTION
Abdominal localization of cyst lymphangioma is rare. The splenic involvement is exceptional.
CASE PRESENTATION
A 63-year-old woman, who was followed for martial anemia evolving associated with abdominal pain in the past 12 months. On clinical examination, she had pallor conjunctival mucosa, with a normal abdominal and lymph node examination. The abdominal ultrasound showed multiple splenic cysts. The abdominal CT scan showed a normal-sized spleen with multiples hypodense cystic lesions. At the laparotomy exploration a multinodular spleen was found which measured 18 cm*15 cm*6 cm. The histological exam results showed concluded to a splenic cavernous lymphangioma without malignity signs. The follow-up after 12 months was normal.
CONCLUSION
splenic lymphangioma is rare and benign tumor. Total splenectomy under laparotomy or laparoscopy is the appropriate treatment.
PubMed: 31430605
DOI: 10.1016/j.ijscr.2019.07.078 -
Cureus Feb 2019Tick-borne diseases are frequently seen in tick-inhabited areas. Lyme disease is the most common tick-borne illness. However, patients with co-infections can present...
Tick-borne diseases are frequently seen in tick-inhabited areas. Lyme disease is the most common tick-borne illness. However, patients with co-infections can present with nonspecific symptoms, which can make the diagnosis far more challenging. We present a case of triple infection with babesiosis, Lyme disease, and anaplasmosis treated with antibiotics and red blood cell (RBC) exchange (erythrocytapheresis). A 74-year-old, avid female gardener presented with one week of progressive dyspnea, cough with mucoid expectoration, and fatigue. On presentation, she was afebrile, hypotensive, and tachycardic. General examination was significant for altered mental status, dyspnea, pallor, and peripheral edema. Lung examination was remarkable for bibasilar crackles. Pertinent laboratory findings were significant for hemolytic anemia and thrombocytopenia. A peripheral blood smear revealed the presence of intracytoplasmic parasites consistent with Babesia. The patient was started on azithromycin and atovaquone. Doxycycline was added empirically for Lyme disease, which was later confirmed by serology. In addition, Anaplasma titers were also positive. Further investigation revealed that the parasitic load was 9.04%, and RBC exchange (erythrocytapheresis) was performed for severe babesiosis. Repeat laboratory tests demonstrated an inadequate reduction in parasitic load (6.54%), requiring a second round of RBC exchange. Antimicrobials were changed to clindamycin, quinine, and doxycycline for a total of 14 days. There was an improvement in the patient's anemia and thrombocytopenia along with clinical improvement.
PubMed: 31016091
DOI: 10.7759/cureus.4064 -
Journal of Health, Population, and... Feb 2010A 12-year-old girl was brought to the Dhaka Hospital of ICDDR,B with diarrhoea. Incidentally, the parents provided a history of repeated episodes of pallor and jaundice...
A 12-year-old girl was brought to the Dhaka Hospital of ICDDR,B with diarrhoea. Incidentally, the parents provided a history of repeated episodes of pallor and jaundice since she was two and half years old. Three of her family members had similar problems. History, clinical examination, and laboratory findings of the girl and her family members suggested a case of hereditary spherocytosis. To our knowledge, this is the first report of such a case in Bangladesh.
Topics: Abdomen; Bangladesh; Child; Dehydration; Diagnosis, Differential; Diarrhea; Female; Folic Acid; Genetic Predisposition to Disease; Hematocrit; Hemoglobins; Hepatomegaly; Humans; Leukocyte Count; Oryza; Sodium Chloride; Spherocytosis, Hereditary; Splenomegaly; Ultrasonography; Vitamin B Complex; Vitamins
PubMed: 20214092
DOI: 10.3329/jhpn.v28i1.4529 -
Medicina Clinica May 2009Raynaud's phenomenon is a frequent reason for seeking of medical attention, since it affects 3-5% of the population. It is characterized by sudden, transient and... (Review)
Review
Raynaud's phenomenon is a frequent reason for seeking of medical attention, since it affects 3-5% of the population. It is characterized by sudden, transient and recurrent episodes of pallor and/or digital cyanosis, after exposure to cold or stressful situations. No known underlying illness is identified in over 80% of cases and consequently these cases are classified as primary Raynaud's phenomenon. Connective tissue diseases, particularly systemic sclerosis, are the main causes of the phenomenon. Once a complete clinical and physical evaluation rule out other causes, a nailfold capillaroscopy and antinuclear antibodies determination are the most useful adjunctive tests. Mild Raynaud's phenomenon can be managed almost exclusively with conservative non-pharmacological lifestyle modifications. However, if a patient develops a severe vascular condition a suitable vasodilator treatment is needed. When critical digital ischemia develops, intravenous treatment with prostaglandin analogues and surgery may be useful.
Topics: Humans; Raynaud Disease
PubMed: 19268319
DOI: 10.1016/j.medcli.2008.11.017 -
Current Opinion in Neurology Feb 2019The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient... (Review)
Review
PURPOSE OF REVIEW
The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient care.
RECENT FINDINGS
Medical practitioners are often first taught to examine the ocular fundus using a direct ophthalmoscope, however, this skill requires frequent practice. Nonmydriatic tabletop and portable fundus photography and even smartphone-based photography offer alternative and practical means for approaching examination of the ocular fundus. These alternative tools have been shown to be practical in a variety of settings including ambulatory clinics and emergency departments. Decreased retinal microvascular density detected with fundus photography has been linked to accelerated rates of cognitive decline. Research has also found optic disc pallor and retinopathy detected via fundus photography to be more prevalent in patients with recent stroke or transient ischemic attack.
SUMMARY
Alternative methods of funduscopic examination based on fundus photography have the potential to improve the ease of use, portability, and availability of funduscopy. Recognition of changes in retinal microvasculature has the potential to noninvasively identify patients at the highest risk for cognitive impairment and cerebrovascular disease. However, further research is needed to determine the specific utility of measurements of retinal microvascular changes in clinical care. Innovative funduscopy techniques offer neurologists new approaches to this essential facet of the neurological examination.
Topics: Eye Diseases; Fundus Oculi; Humans; Neurologic Examination; Ophthalmoscopy; Photography
PubMed: 30516640
DOI: 10.1097/WCO.0000000000000637 -
Archives of Disease in Childhood Nov 1980Two siblings developed a fulminant fatal myeloproliferative disease at 7 and 8 weeks of age. The illness presented with pallor, haemorrhagic symptoms, and...
Two siblings developed a fulminant fatal myeloproliferative disease at 7 and 8 weeks of age. The illness presented with pallor, haemorrhagic symptoms, and hepatosplenomegaly, and the blood picture was that of pancytopenia and leucoerythroblastosis. Bone marrow histology showed reduced haemopoiesis with generalised fibrosis. Histiocytes were present, but haemophagocytosis was not prominent. There was evidence of extramedullary haemopoiesis in the spleen, with a chronic inflammatory infiltrate of other organs. The condition closely resembles acute idiopathic myelofibrosis of infancy, but the early onset with severe pancytopenia and the histological appearances may arouse suspicion of the possible familial nature of the condition. Although clinically resembling familial haemophagocytic reticulosis, the uncharacteristic bone marrow, liver, and spleen histology serve to exclude this diagnosis.
Topics: Bone Marrow; Female; Humans; Infant; Male; Primary Myelofibrosis
PubMed: 7436463
DOI: 10.1136/adc.55.11.888 -
Dermatology Online Journal Jul 2007A 13-year-old girl presented with a history of red scaly plaques involving the chest, arms and legs beginning in infancy. Punch biopsy revealed psoriasiform hyperplasia...
A 13-year-old girl presented with a history of red scaly plaques involving the chest, arms and legs beginning in infancy. Punch biopsy revealed psoriasiform hyperplasia and pallor of the epidermis. The patient's serum zinc level was 36 mug/dl [nl. 66-144 mug/dl]. A diagnosis of acrodermatitis enteropathica was established and the patient responded well to zinc replacement therapy. Acrodermatitis enteropathica is a rare autosomal recessive disorder caused by mutations in SLC39A4, which encodes the tissue-specific zinc transporter ZIP4.
Topics: Acrodermatitis; Adolescent; Astringents; Biopsy; Cation Transport Proteins; Diagnosis, Differential; Female; Follow-Up Studies; Genetic Predisposition to Disease; Humans; Mutation; Skin; Zinc; Zinc Sulfate
PubMed: 18328205
DOI: No ID Found