Open Access DOI:10.23937/2474-3682/1510194
Primary Cutibacterium Acnes Leptomeningeal Abscess Causing Focal Seizures
Waller S, Browning S, Pepper EM and Loewenthal MR
Article Type: Case Report | First Published: December 13, 2021
A previously well 71-year-old male presented with recurrent stereotyped episodes of right hemisensory disturbance, weakness, and expressive dysphasia lasting 10-20 minutes. Cognitive decline had been noted over the preceding 6-months. He was otherwise in good health with no history of infective symptoms or prior neurosurgical procedures. Interictal neurological examination was unremarkable. EEG was abnormal with asymmetrical slowing over the left hemisphere and he was commenced on sodium valproa...
Open Access DOI:10.23937/2474-3682/1510193
Teleconsultation in COVID Era can be Unwholesome at Times
Bhushan Bhalgat, Suresh Singh, Pravin Kumar, Phanindra Kumar Swain, Kamal Kishore Lakhera and Raj Govind Sharma
Article Type: Images in Surgery | First Published: December 13, 2021
COVID-19 pandemic has led to a vast increase in the number of teleconsultations. These images alongside are a perfect example of misinterpreted diagnosis due to unwanted importance to radiological investigations without performing a proper clinical examination. The X-ray chest PA view (see Figure 1) was advised by family physician of the patient on a well-known multiplatform messaging app when the patient complained of 'chhati mai gaath hai' (translated to English: 'swelling in the chest'). Afte...
Open Access DOI:10.23937/2474-3682/1510192
Candida Albicans Brain Microabscesses in a Preterm Neonate
António Bento Guerra, M Inês Nunes Marques, Sónia Antunes and Ana Serrano
Article Type: Clinical Image | First Published: November 20, 2021
We report the case of a male preterm at 27 weeks of gestational age, born by emergency cesarean section with 1195 g, of an untreated HIV-infected mother, with an unsupervised pregnancy. After immediate resuscitation, he was admitted to the neonatal intensive care unit (NICU). He was started on standard neonatal antiretroviral HIV prophylaxis and completed seven days of ampicillin and gentamicin. Due to Staphylococcus epidermidis late sepsis, he completed 21 days of cefotaxime and vancomycin, but...
Open Access DOI:10.23937/2474-3682/1510191
Intraoperative Fluoroscopy for Central Venous Catheter Tip Position- “Use It When U Have It Modality”
Nishant Patel, Abhishek Singh, Saranlal AM and Naveen Bokinala
Article Type: Clinical Image | First Published: November 20, 2021
Central venous catheters (CVC) are a vital part of an anaesthetist’s armamentarium for resuscitation during intraoperative emergencies and they carry an inherent risk associated with tip malposition. Various sources recommend catheter tip position at the distant one-third of superior venecava (SVC) as ideal. Our principle concern is to place the tip above the pericardial reflection of SVC to avoid vascular erosion and consequent pericardial tamponade. There are multiple ways of ensuring that t...
Open Access DOI:10.23937/2474-3682/1510190
COVID-19 Associated Cerebral Mucormycosis
Abhishek Singh, Kapildev Soni, Satish Kumar Verma and Anjan Trikha
Article Type: Clinical Image | First Published: October 30, 2021
A 33-year-old female was admitted to COVID ICU after testing positive for the disease with 7 days history of fever, cough, inability to open as well as pain in the left eye, and inability to speak with right sided hemiparesis. She was known diabetic and hypertensive. Clinical examination showed presence of multiple pus points in left infratemopral region. Its microscopic examination showed wide area of necrosis along with cluster of mucormycosis. Due to sudden deterioration of patients GCS, CECT...
Open Access DOI:10.23937/2474-3682/1510189
Infected Multilocular Renal Cyst and its Challenging Approach
Carla Pereira Fontes, Andreia M Teixeira and Samuel Fonseca
Article Type: Medical Image | First Published: October 23, 2021
An 80-year-old woman with a history of metabolic syndrome, ischemic heart and cerebrovascular disease was admitted at the emergency department with asthenia and left abdominal and flank pain. She was on day 5th of empiric cefuroxime for urinary tract infection. On physical examination, the patient was febrile, but hemodynamically stable; an abdominal mass in the left flank was evident and painful on deep palpation; ipsilateral Murphy’s sign was present. Laboratory studies showed a marked eleva...
Open Access DOI:10.23937/2474-3682/1510188
Incidental Acute Appendicitis due to Enterobius vermicularis
Mohammed Najih and Mohamed Fahsi
Article Type: Image Article | First Published: October 03, 2021
Simultaneous Enterobius vermicularis infection and appendicitis is rare. Nocturnal anal pruritus remains the most important clinical symptom of E. vermicularis infestation, a result of female pinworms laying eggs within the anal verge at night. Laparoscopic appendectomy is the definitive treatment for appendicitis, followed by either mebendazole or albendazole for complete pinworm eradication. A 20-year-old man presented to the emergency department with a 4-day history of pain in the right iliac...
Open Access DOI:10.23937/2474-3682/1510187
A Rare Differential of a Large Abdominal Swelling!
Alhad Mulkalwar, Sujay Jaju and Jignesh Gandhi
Article Type: Image Article | First Published: October 03, 2021
A 42-year-old male presented with a gradually increasing round abdominal swelling following a blunt trauma to the abdomen 2 weeks back. The swelling was about 5 cm in size when first noticed, which gradually increased to its present size of around 20 cm (Figure 1). The swelling was accompanied with mild pain and discomfort, which increased with increase in size of the swelling. Clinical examination and radiological investigations revealed a large abdominal seroma. Owing to the size of the seroma...
Open Access DOI:10.23937/2474-3682/1510177
Association Pyoderma Gangrenosum and Systemic Lupus Erythematosus
A Rkiouak, PhD, I El Kassimi, MD, N Sahel, MD, M Zaizae, MD and Y Sekkach, PhD
Article Type: Image Article | First Published: April 26, 2021
19-year-old patient, follow-up for 8 years for SLE treated with hydroxychloroquine 400 mg/day and who had been in remission for a year. SLE diagnosis was based on the association of a malar rash, photosensitivity, lymphopenia, autoimmune hemolytic anemia, antinuclear antibodies positivity, anti-DNA antibodies identified and lupus nephritis. On December 2019, patient noticed a well-defined irregular popular lesion on left leg (Figure 1) associated with ulcerations appeared 1 month later. Treatmen...
Open Access DOI:10.23937/2474-3682/1510176
Dyshidrotic Eczema: Difficulty of Etiological Diagnosis and Therapeutic Management
S. Belmourida, M. Meziane, N. Ismaili, L. Benzekri and K. Senouci
Article Type: Image Article | First Published: April 07, 2021
Dyshidrotic eczema or acute palmoplantar eczema is a common cause of hand and foot dermatitis in adults. It is a recurrent vesicular eruption affecting the soles, palms, or both. It is very pruriginous and generally appears suddenly. It creates vesicles that, on physical examination, can look similar to “tapioca pudding”, which is the characteristic clinical feature of this disorder. It is more common in young adults and affects men and women equally. In this report, we present the case of a...
