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5.
Cureus ; 14(1): e21373, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35198285

RESUMO

Tumors of the salivary gland constitute a heterogeneous group of variable histological and biological behaviors. Patients with salivary gland tumors typically present with painless swelling. However, several neoplastic and non-neoplastic pathologies can result in salivary gland enlargement. We report the case of a 35-year-old woman complaining of a left neck swelling for 3 months duration. She had no relevant past medical or surgical history. On examination, there was a left submandibular swelling that was firm in consistency, non-tender, non-pulsatile, relatively mobile, and was not tethered to the underlying structures. Otherwise, examination of the head and neck was unremarkable. A CT scan of the neck revealed a well-defined hypodense lesion in the left submandibular region with foci of calcification along with multiple enlarged lymph nodes. After surgical exploration, the submandibular gland region, a mass lesion was found arising from the submandibular gland. Histopathological examination revealed the diagnosis of schwannoma. Salivary gland schwannoma is a very rare form of neurogenic tumor. Surgical resection is the treatment of choice; however, neural deficits are important and common postoperative complications.

6.
Cureus ; 13(12): e20201, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35004022

RESUMO

Urinary tract infections are very prevalent among women. The majority of urinary tract infections are uncomplicated and can be managed empirically with no further investigations. However, imaging studies may be indicated in patients with severe or persistent symptoms. Complicated urinary tract infections typically develop in the setting of diabetes mellitus. We report a case of a 52-year-old woman who presented to the emergency department with severe lower abdominal pain for two days that was associated with nausea, vomiting, and fever. There was no history of change in urine or bowel habits. Besides the history of well-controlled asthma, the patient was not known to have any comorbid medical condition. Upon examination, the patient had tachycardia, low-grade fever, and a localized suprapubic tenderness with guarding. Laboratory investigation revealed leukocytosis, elevated erythrocyte sedimentation rate and C-reactive protein, and deranged renal functions. Further, urinalysis revealed numerous white blood cells, red blood cells, positive nitrite, and leukocyte esterase. A computed tomography scan demonstrated the presence of small locules of gas within the lumen and the wall of the bladder representing emphysematous cystitis. The patient was admitted to the intensive care unit. She received aggressive hydration therapy and a short course of opioid therapy for pain control. Broad-spectrum antibiotic therapy in the form of piperacillin-tazobactam was initiated. Over the following few days, the patient exhibited significant improvement in his symptoms and resolution of the laboratory parameters. Emphysematous cystitis is a rare infection of the lower urinary tract with gas formation. The case highlighted that such a condition may develop in the absence of diabetes mellitus or other risk factors. Prompt treatment is crucial as emphysematous cystitis can be life-threatening if the diagnosis is missed or delayed.

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