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1.
Ann Med Surg (Lond) ; 85(6): 3022-3025, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37363561

RESUMO

Linear IgA bullous dermatosis (LABD) is a rare acquired skin blistering autoimmune disease. It can be diagnosed by confirming the presence of a linear band of IgA at the dermoepidermal junction on direct immunofluorescence microscopy. LABD can be characterized by vesicular lesions, diffuse blisters, or even as a mimicker of Steven-Johnson syndrome. LABD may be caused by tumours, infections, or drugs (amiodarone, furosemide, phenytoin, however, vancomycin is the potential inciting drug in most reports). Case presentation: The authors present here a case of a 61-year-old woman with a history of HTN. The patient had a discectomy 15 years ago, and also underwent a lumbar fusion surgery that resulted in complications with her discitis. Due to the complications from the surgery, intravenous treatment with vancomycin and meropenem was initiated. After a few days of treatment, the patient developed clear, tense, fluid-filled bullae over the upper extremities. Immunofluorescence microscopy is not available in our hospital. Therefore a diagnosis of vancomycin-induced LABD was proposed based on the clinical manifestation of the lesions and the coincidence with vancomycin administration. After 2 days of discontinuing the administration of vancomycin and applying local diprosone, the lesions started to regress and a full recovery was achieved on day 10. Discussion and conclusion: Even though drug-induced LABD is uncommon, its incidence has been steadily increasing in the last few years. LABD is a simple condition with a good prognosis and full recovery after the discontinuation of vancomycin.

2.
Ann Med Surg (Lond) ; 85(5): 1915-1918, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37229039

RESUMO

Pott's disease is a form of extrapulmonary tuberculosis (TB) and has a global increase in incidence. The diagnosis should be made early to avoid neurological deficiency or deformity of the spine. Case presentation: A 2-year-old and 6-month-old boy was admitted with fever and unspecific generalized pain, the examination revealed mild hyperreflexia in the lower extremities, isotope scan showed increased uptake in the T8 vertebra. MRI demonstrated destruction in the T8 vertebra with kyphotic deformity and abscess anterior to T7, T8, and T9 levels with an epidural abscess at the T8 level extending to the spinal canal and compressing the spinal cord. The patient underwent a surgical procedure with a transthoracic approach, the decompression of the spinal canal was performed through T8 corpectomy, the reduction of kyphosis was performed and the internal fixation with a dynamic cylinder and lateral titanium plate was carried out. Microbiologic examination suggests Mycobacterium tuberculosis. Clinical discussion: Pott's disease (spinal TB) is extremely rare in the young children population, and surgical treatment is reported only in a few reports, and it is considered a technical challenge. There are several surgical approaches during childhood, for upper thoracic spinal TB, the posterior approach is easy, minimally invasive, safe, reliable, and effective. But it had the worst outcomes. In contrast, the anterior approach provides direct access to the lesions. Conclusion: More research are needed to detect the best choice in the management of thoracic spinal TB in children.

3.
Ann Med Surg (Lond) ; 78: 103755, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35592824

RESUMO

Introduction: Choroid Plexus Carcinomas (CPC) are rare malignant brain neoplasms of choroid plexus epithelium, with a tendency to occur in infants and children, especially those who are under two years of age. The Main symptoms of CPC include nausea, vomiting, headache, irritability, blurred vision, and seizures. Few studies discuss the therapeutic methods to treat this tumor. However, most of these studies confirmed the poor prognosis of it. Case presentation: A two-year-old girl presented with a headache due to head trauma, normal consciousness, GCS 15/15, and without intracranial hypertension symptoms. Computed Tomography (CT) has shown a large heterogeneous lesion in the region of the right lateral ventricle. Magnetic resonance imaging (MRI) showed a large poorly-defined mass in the right lateral ventricle with mild dilatation of the ipsilateral lateral ventricle, and midline shift and marked edema surrounding it. In this case, the mass has been discovered by accident. The histological diagnosis was choroid plexus carcinoma (WHO grade 3), curettage of the right lateral ventricle was performed. Discussion and conclusion: CPC is a serious condition with a poor prognosis. Early diagnosis and appropriate approaches are required in order to reduce mortality and morbidity rates.

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