Carotid-cavernous fistulas are uncommon anomalous communications between the venous cavernous sinus and the carotid arterial system. We present two cases studied at our center. We show the characteristic CT, MRI, and orbital ultrasound findings and review the relevant literature.
Carotid-Cavernous Sinus Fistula/diagnosis , Vascular Fistula/diagnosis , Aged , Carotid-Cavernous Sinus Fistula/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Ultrasonography , Vascular Fistula/diagnostic imaging
Acute lobar nephronia is a focal form of acute bacterial renal infection. The prevalence of this disease is low. We report four cases of acute lobar nephronia. Three patients were diagnosed among 77 patients admitted to hospital for acute pyelonephritis. The fourth case was atypical and associated with epidermolysis bullosa. All cases were diagnosed by renal ultrasonography and the diagnosis was confirmed by computed tomographic examination in two patients with poor clinical course. A small abscess was detected in one patient. Urine cultures were positive in three of the four patients. Acute lobar nephronia is a radiological diagnosis and requires aggressive treatment and strict follow-up due to the risk of renal abscesses. Because the clinical manifestations are insidious and laboratory findings can be contradictory, this entity should be suspected in patients with poor clinical course or alterations on renal ultrasonography. Medical treatment is usually sufficient and prognosis is generally good.
Bacterial Infections , Kidney Diseases/microbiology , Acute Disease , Bacterial Infections/diagnosis , Bacterial Infections/therapy , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Kidney Diseases/diagnosis , Kidney Diseases/therapy , Male , Prognosis
La nefronía focal aguda (NA) es una infección bacteriana aguda localizada en el riñón. La prevalencia de esta enfermedad es escasa. Presentamos 4 casos de nefronía bacteriana aguda. De ellos, 3 pacientes fueron diagnosticados entre 77 pacientes ingresados por pielonefritis aguda y hubo un caso atípico, asociado con una epidermólisis bullosa. El diagnóstico se realizó por ecografía renal y se confirmó con tomografía computarizada ante la mala evolución de dos de los casos, detectando un pequeño absceso en uno de ellos. El urocultivo fue positivo en 3 de los 4 pacientes. La NA es un diagnóstico radiológico que precisa tratamiento más agresivo y seguimiento más estrecho por el riesgo de evolucionar a absceso renal. Dado que la clínica es insidiosa y las pruebas de laboratorio dispares, es preciso sospecharla ante una evolución tórpida de una pielonefritis o alteraciones en la ecoestructura renal. El tratamiento médico es suficiente y el pronóstico, en general, bueno
Acute lobar nephronia is a focal form of acute bacterial renal infection. The prevalence of this disease is low. We report four cases of acute lobar nephronia. Three patients were diagnosed among 77 patients admitted to hospital for acute pyelonephritis. The fourth case was atypical and associated with epidermolysis bullosa. All cases were diagnosed by renal ultrasonography and the diagnosis was confirmed by computed tomographic examination in two patients with poor clinical course. A small abscess was detected in one patient. Urine cultures were positive in three of the four patients. Acute lobar nephronia is a radiological diagnosis and requires aggressive treatment and strict follow-up due to the risk of renal abscesses. Because the clinical manifestations are insidious and laboratory findings can be contradictory, this entity should be suspected in patients with poor clinical course or alterations on renal ultrasonography. Medical treatment is usually sufficient and prognosis is generally good
Male , Female , Child , Humans , Kidney Diseases/diagnosis , Kidney Diseases/therapy , Pyelonephritis/complications , Pyelonephritis/diagnosis , Pyelonephritis/therapy , Erythromycin/therapeutic use , Tomography, Emission-Computed/methods , Abscess/complications , Abdominal Pain/diagnosis , Abdominal Pain/therapy , Cefotaxime/therapeutic use , Ampicillin/therapeutic use , Kidney
Although newborn screening of congenital hearing loss through otoacustic emissions allow prompt recognition, imaging techniques, such as CT and MRI are needed to get a morphological diagnosis. Furthermore they can be very useful in unilateral cases, whose clinical presentation is belated and more insidious. Our aim is to show the utility of MRI in the study of inner ear congenital anomalies, whose presentation is belated. Thus from a series of 88 consecutive patients in which a MRI was performed as screening of assymetric sensorineural hearing loss, we selected 6 cases aged between 6 and 20. Four of them showed an inner ear anomaly on MRI. We present these anomalies commenting the findings on CT and MRI. Imaging techniques are required to start hearing rehabilitation programs early on patients with bilateral inner ear anomalies. But also they are very useful in the evaluation of unilateral assymetric sensorineural hearing loss, in young patients, even if only some frequencies are damned, to determine the nature of hearing loss.
Cerebellopontine Angle/pathology , Hearing Loss, Sensorineural/diagnosis , Magnetic Resonance Imaging , Adolescent , Child , Cochlea/abnormalities , Cochlea/physiopathology , Cochlear Diseases/classification , Cochlear Diseases/congenital , Cochlear Diseases/diagnosis , Cochlear Diseases/physiopathology , Female , Hearing Loss, Sensorineural/physiopathology , Humans , Male , Severity of Illness Index
Pharyngeal perforations due to foreign bodies are severe when retropharyngeal space infection develops into an abscess. Although the common clinical presentation is sore throat and fever, when the perforation remains occult, torticollis can be a significant symptom. Palatopharyngeal lesions, caused by rigid objects' impactation through the mouth, are common in childhood. Most are not important, but all have the potential hazard of pharyngeal perforation with development of a retropharyngeal abscess. It must be suspected specially when air is shown in the retropharyngeal space on a lateral radiography of the neck, which should always be done. We report a 9-years old boy who had cervical stiffness and torticollis and elevation of the right shoulder, without previous known trauma. Air was shown in the retropharyngeal space on a lateral radiography of the neck in relation to a possible pharyngeal perforation which was later confirmed by a CT scan. We review the literature about diagnosis and treatment of retropharyngeal abscess in childhood.
Pharynx/injuries , Retropharyngeal Abscess/diagnosis , Torticollis/etiology , Child , Humans , Male , Retropharyngeal Abscess/complications
