Death of a 3 Month-Old Infected Infant with Dilated Cardiomyopathy after COVID-19 Infection: A Case Report

2021 ◽  
Author(s):  
Fatemeh Baghalsafa ◽  
Hossein Neamatzadeh ◽  
Sedigheh Ekraminasab
Keyword(s):  
Case Report ◽  
Dilated Cardiomyopathy ◽  
Cardiac Injury ◽  
Viral Myocarditis ◽  
Rare Condition ◽  
Underlying Disease ◽  
Pediatric Emergency ◽  
Sufficient Evidence ◽  
Infected Infant ◽  
Severe Underlying Disease

Background: Several numbers of studies have reported that coronavirus disease-2019 (COVID-19) in infants and children have shown milder symptoms and a better prognosis than in adult patients. However, there is no sufficient evidence on the effect of cardiovascular involvement in COVID-19 in the infant. Case Report: Here, we report an infant infected with COVID-19 with the manifestations of dilated myocarditis. The patient was referred to Pediatric Emergency with lethargy and tachypnea. On physical examination, she had holosystolic murmur with grade 3/6. The laboratory examinations showed anemia as well as increased alkaline phosphatase (ALP) levels. Due to respiratory distress, she was intubated and put under mechanical ventilation. The diagnosis of COVID-19 infection was confirmed by real-time polymerase chain reaction (RT-PCR) using a pharyngeal specimen. Finally, dilated cardiomyopathy (DCM) was diagnosed and one day after hospitalization the infant was died due to complications of DCM. Conclusion: It seems that in the infant with severe underlying disease, even a mild COVID-19 infection, may be lethal. Focal viral myocarditis is a very rare condition described by localized disturbance of the myocardium occurring in ventricular dysfunction with significant morbidity and mortality. Thus, due to the possibility of cardiac injury in infected neonates with COVID-19 disease and the manifestation of myocarditis, effective measurement is recommended.

scholarly journals Early Experiences with Management of Extra Hepatic Portal Vein Obstruction

2013 ◽  
Vol 11 (2) ◽  
pp. 4-6
Author(s):  
Sushil Bahadur Rawal ◽  
Srijan Malla ◽  
Naresh Kumar Giri ◽  
Jyoti Rayamajhi ◽  
Kunda Shah
Keyword(s):  
Portal Vein ◽  
Demographic Data ◽  
Rare Condition ◽  
Underlying Disease ◽  
Diagnostic Tools ◽  
Early Experiences ◽  
Difficult Condition ◽  
Portal Vein Obstruction ◽  
Severe Underlying Disease ◽  
Hepatic Portal

Introduction: Extrahepatic portal vein obstruction (EHPVO), a rare condition, is increasingly being diagnosed due to easier availability of proper diagnostic tools and early referrals. Here we report our series of 16 cases of EHPVO who were treated at our hospital. The aim of this paper is to share our early experiences of managing this rare and difficult condition. Methods: A retrospective analysis of patients’ records admitted with the diagnosis of EHPVO for a period of 18 months from Jan 2008 to June 2010 was performed. Patients were followed up for at least 9 months, their demographic data and outcome of surgery was analysed. Results: Of the 10 cases fulfilling the inclusion criteria, 9 underwent surgical therapy. Distal lienorenal shunt was performed in 4 patients, proximal lienorenal shunt in 2 patients and devascularisation procedure in 3 patients. Rebleeding was seen in 2 patients. The prognosis of EHPVO was good in patients without a severe underlying disease at a median follow up of  9 months. Conclusion: Conventional surgical therapies have a good outcome in management of EHPVO in our context. Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/4-6 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7898

scholarly journals Point-of-care Ultrasound in Early Diagnosis of Cardiomyopathy in a Child with Viral Myocarditis: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 186-189
Author(s):  
Ayush Gupta ◽  
Trevor Eckenswiller
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Cardiogenic Shock ◽  
Point Of Care ◽  
Viral Myocarditis ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
High Morbidity ◽  
Threatening Condition ◽  
High Index Of Suspicion

Introduction: Pediatric myocarditis is a commonly missed diagnosis in the pediatric emergency department (ED) with high morbidity and mortality. The presentation of cardiogenic shock secondary to myocarditis and septic shock can be difficult to differentiate during initial resuscitation, and incorrect treatment can lead to poor prognosis. Early diagnosis may provide a better prognosis for this life-threatening condition. Case Report: We report a case of a five-year-old female who presented to the ED with non-specific symptoms of myocarditis. Rapid point-of-care ultrasound led to early diagnosis, correct management, and great prognosis for the patient. Conclusion: Providers must maintain a high index of suspicion for cardiogenic shock in patients with nonspecific symptoms and fluid unresponsiveness. Point-of-care ultrasound can help in the identification of cardiac disorders and guide practitioners in their management plans.

Fournier's gangrene as Amyand's hernia complication

2019 ◽  
Vol 98 (7) ◽  
pp. 291-296
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Rare Condition ◽  
Sporadic Case ◽  
Fournier’S Gangrene ◽  
Amyand’S Hernia ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Based Medicine ◽  
Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

MARKED FIRST-DEGREE ATRIOVENTRICULAR BLOCK ASSOCIATED WITH PSEUDO-PACEMAKER SYNDROME: A CASE REPORT

2019 ◽  
pp. 199-206
Author(s):  
О. З. Скакун ◽  
С. В. Федоров ◽  
О. С. Вербовська ◽  
І. З. Твердохліб
Keyword(s):  
Case Report ◽  
Atrioventricular Block ◽  
Heart Block ◽  
Pacemaker Implantation ◽  
Rare Condition ◽  
Permanent Pacemaker ◽  
Type I ◽  
Atrial Contraction ◽  
General Weakness ◽  
Pacemaker Syndrome

Distinctive atrioventricular type I heart block is diagnosed when the PQ interval is 0.30 s. or more. Prolongation of the PQ interval more than 0.50 s. is a very rare condition. Usually it is associated with a pseudo-pacemaker syndrome. The last one manifests itself with dizziness, syncope, general weakness, shortness of breath upon physical exertion, cough, seizures, cold sweat, a feeling of pulsation in the head, neck and abdomen, a headache, paroxysmal nocturnal dyspnea, swelling of the lower extremities, tachypnea and jugular venous pulsation. The P wave appears immediately after the previous QRS complex. Atrial contraction occurs at the moment when the ventricles don’t relax after the previous contraction; due to the fact that pressure in the ventricles at this moment is higher than in the atria, the tricuspid and mitral valves remains closed. During the atrial contraction, most of the blood is ejected not into the ventricles, but backward into the pulmonary veins from the left atrium and into the venae cavae from the right atrium. Also, an atrial kick is absent which results in a less ventricular filling. There is increased pressure in the atria leading to their distension and excessive secretion of the atrial natriuretic peptide. A case report of the distinctive atrioventricular type I heart block associated with the pseudo-pacemaker syndrome is described. The patient suffered from a pre-syncope, short-term dizziness during the previous two days, tinnitus, general weakness, feeling of pulsation in the abdomen, neck, head, which interfered with his sleep. He developed these complaints after an infectious disease, which manifested as a runny nose and sore throat. In this patient, an extremely prolonged PQ interval up to 0.70 s. was observed. Also, episodes of Mobitz I and Mobitz type II atrioventricular block were detected. During the monitoring of patient state, the interval PQ was gradually shortening, and in 1 month it reached the normаl duration. It can be assumed that in the case of distinctive atrioventricular type I heart block, a significant prolongation of the refractory period in the rapid pathways of the AV-node plays a key role in the pathogenesis of this condition. According to the recommendations of the ACC/AHA (1998), for patients with distinctive atrioventricular type I heart block accompanied by the pseudo-pacemaker syndrome and documented alleviation of symptoms with temporary AV pacing, the pacemaker implantation should be considered (IIaB). The implantation of dual chamber pacemaker may reduce symptoms and lead to an improvement in the functional state of patients, in whom shortening of the interval between atrial and ventricular contractions improves hemodynamics. For asymptomatic patients with the PQ interval of ≥ 0.30 s, pacemaker is not recommended. The distinctive atrioventricular type I heart block in patients with pseudo-pacemaker syndrome is a rare condition and often remains undiagnosed. But it may have a benign course with a gradual normalization of the PQ interval. Indications for permanent pacemaker implantation should be reviewed as this block may be completely reversible. A permanent pacemaker may be used in the case of absence of positive dynamics in a shortening of the PQ interval.    

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

scholarly journals Long-term survival with multiple metastasectomies for pulmonary osteosarcoma: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Satoshi Takamori ◽  
Hiroyuki Oizumi ◽  
Jun Suzuki ◽  
Katsuyuki Suzuki
Keyword(s):  
Case Report ◽  
Pulmonary Metastases ◽  
Multidisciplinary Treatment ◽  
Underlying Disease ◽  
Pulmonary Metastasectomy ◽  
Extensive Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Primary Surgery

Abstract Background Repeat pulmonary metastasectomy (PM) considerably improves the prognosis of patients with pulmonary metastases of osteosarcoma. Reports have demonstrated a significantly improved prognosis in patients who have undergone repeat metastasectomy for osteosarcoma; however, there have been no reports with more than six metastasectomies. Herein, we describe the long-term survival of a patient following resection of multiple tumors and other treatments for metastatic osteosarcoma. Case presentation A 28-year-old woman underwent extensive resection and postoperative adjuvant chemotherapy for right tibial sarcoma. Over the years, she developed repeated pulmonary metastases. First, 116 metastases were removed from the bilateral lungs. After that, multiple PMs of approximately 250 tumors and other treatments for deep metastatic lesions were performed. The patient died of the underlying disease 24 years after the primary surgery. Conclusions This case report demonstrates the long-term survival benefit of a multidisciplinary treatment centered on multiple metastasectomies.

scholarly journals Erythromelanosis Follicularis Faciei et Colli: A Case Report in a Caucasian Male and Brief Review of the Literature

2020 ◽  
Vol 12 (3) ◽  
pp. 231-235
Author(s):  
Carl Maximilian Thielmann ◽  
Wiebke Sondermann
Keyword(s):  
Case Report ◽  
Family History ◽  
Clinical Presentation ◽  
Rare Condition ◽  
Unknown Etiology ◽  
Review Of The Literature ◽  
Caucasian Male

Erythromelanosis follicularis faciei et colli, a rare condition of unknown etiology, was first described by Kitamura et al. from Japan in 1960. It is characterized by a triad consisting of well-demarcated erythema, hyperpigmentation, and follicular papules. We report the case of a 50-year-old Caucasian male, who had asymptomatic symmetrical facial lesions since the age of 42. His family history was unremarkable. Published erythromelanosis follicularis faciei et colli cases of the last 10 years are summarized in this report to demonstrate the variability and differences in the clinical presentation of this uncommon diagnosis.

scholarly journals Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199223
Author(s):  
Xiaolin Zhang ◽  
Hongmei Jiao ◽  
Xinmin Liu
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Respiratory Infections ◽  
Relevant Literature ◽  
Rare Condition ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Esophageal Diverticulum ◽  
Bronchoesophageal Fistula ◽  
Fatal Complications

Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

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