Case Report

SUPPURATIVE PULMONARY SEQUELAE OF INVASIVE GROUP A STREPTOCOCCUS IN 5-YEAR OLD CHILD

KUNLE SAMSON OYEDOKUN, SUDHAKAR KANDASAMY, FEMI ADENIYI

Journal of Case Reports in Medical Science, Page 24-27

Background: The incidence of invasive group A streptococcal infection (iGAS) is on the rise. Necrotizing pneumonia as suppurative sequelae is rare but potentially fatal complication of the disease in children. Successful treatment and cure depend on supportive management and early administration of intravenous antibiotics.

Case Presentation: A case was reported of previously healthy 5-year old boy who developed severe rapidly progressing lung disease secondary to iGAS sepsis. He was diagnosed with necrotizing pneumonia after failure of antimicrobial therapy.

Result: He made rapid complete recovery following surgical lobectomy.

Conclusion: Necrotizing pneumonia is a serious complication of iGAS and clinicians need to consider this diagnosis in a child with rapidly progressing pneumonia not improving with adequate antibiotics.

Case Report

BILATERAL PARATUBAL SEROUS CYSTADENOMAS IN AN INFERTILE WOMAN – CASE REPORT OF A RARE ENTITY

B. SUPRAJA, PONNUSWAMY KARKUZHALI

Journal of Case Reports in Medical Science, Page 28-33

Serous tumors occur most commonly in the ovaries and rarely in the para tubal region. Simple serous cysts / fimbrial cysts are the most common cystic lesions found in the para ovarian region. Cystic neoplasms are rare in this site, and bilateral serous neoplasms in this site have not yet been reported. Hence we report an unusual case of bilateral serous cystadenoma of a para tubal region.

Case Report: A 43-year-old nulligravid woman presented for evaluation of her primary infertility with lower abdominal pain.Intra-operatively bilateral cysts, independent of the ovaries were found. Histopathology revealed a bilateral para tubalserous cystadenoma.

Conclusion: This case is presented for its rarity and to emphasise the need to explore the possibility of its etiologic association for infertility.

Case Report

A LARGE RIGHT ATRIAL APPENDAGE ANEURYSM RESECTION AND INTRAOPERATIVE ACCESSORY PATHWAY ABLATION (HYBRID PROCEDURE)

AZZA EL-FIKY, WALEED ISMAIL, KHALED A. SHAMS, R. AHMED YEHIA, MOHAMED S. HAFEZ, ALIAA M. ZAAZOU

Journal of Case Reports in Medical Science, Page 34-39

A 32-year-old male, who was diagnosed with supraventricular tachycardia (SVT) and was kept on medical treatment, developed recurrent SVT and was scheduled for percutaneous electrophysiological study (EPS) and ablation, pre-procedural investigation revealed a large thin-walled cystic mass anterior to right ventricle (RV) which was confirmed to be a large right atrial appendage aneurysm (RAAA) by transesophageal echocardiography (TEE) and cardiac magnetic resonance imaging (CMRI), Catheter ablation failed in spite of many times of radiofrequency energy delivery which was attributed to the complexity of the anatomy due to the RAAA, so combined RAAA resection and intraoperative ablation of the accessory pathway were performed successfully. 

Learning objective: Catheter ablation of accessory pathway in patients with supraventricular tachycardia is one of the main stay of treatment, RAAAs are rarely encountered, they are most often congenital, they can present at any age usually in the third decade of life, they can present with palpitation, dyspnea or accidentally discovered, TEE and CMRI are crucial in the diagnoses and management, and combined surgical resection of RAAA and intraoperative ablation of accessory pathway can be performed successfully.

Case Report

PRETIBIAL MYXEDEMA IN GRAVES’ DISEASE PRESENTING AS A LOCALIZED THYROID DERMOPATHY

RAVIKUMAR RAVINDRAN, KOFI OBUOBIE

Journal of Case Reports in Medical Science, Page 40-42

A 53-year old man, on drug treatment for Graves’ disease and ophthalmopathy presented with an enlarged right big toe (Fig. 1). Examination revealed a slightly erythematous diffuse, nontender swelling and non-pitting of the right big toe. An X-ray of the foot demonstrated only soft tissue involvement with no subperiosteal bone formation. The features and clinical context were suggestive of Pretibial myxoedema (thyroid      dermopathy) localised to the right big toe nearly 30 years after the presentation of initial Graves’ disease. Biopsy of the lesion was not done as it was aymptomatic and the patient was not willing for one. Pretibial myxoedema is a well-recognised benign complication of Graves’ disease, which may not be restricted to the pretibial area.

Case Study

SUBDURAL EMPYEMA IN CHILDREN PRESENTING WITH HEADACHE, VOMITING, LIMB WEAKNESS: CASE REPORT AND LITERATURE REVIEW

RIZALDY PINZON, DEVIE KRISTIANTI, HANDOYO PRAMUSINTO

Journal of Case Reports in Medical Science, Page 43-46

Subdural empyema is an uncommon emerging case. We report case of subdural empyema in a12 years-old boy. The symptoms are right temporal headache, vomiting, and left limb weakness. Headache, vomiting and left limb weakness are acute. In CT-scan of the head, there is hypodense with HFU 30 on fronto temporo occipital dextra, edema cerebri, midline shift to the left and lateral ventricels constriction. Empyema evacuation was performed. The combination of cefotaxime and metronidazole are given. The condition is getting better. Patients discharged on day ten with a minor disability.  A craniotomy is performed in this patient. Although craniotomy has been performed in patients, it does not rule out the possibility of recurrence.