Rickettsia conorii infection with fatal complication

Rickettsial diseases (RD) are a group of endotheliotropic infectious diseases caused by different species of genera Rickettsia. RD are not an uncommon disease and may be misdiagnosed during the evaluation of acute febrile illness due to a lack of reliable serological marker and diagnostic culture methods. Clinical manifestation of RD varies from febrile illness with rashes and myalgia to fatal complications such as shock and respiratory failure. We describe a case of a young male who presented initially with acute febrile illness, followed by shock and respiratory failure, and unfortunately succumbed to death. A post-mortem examination showed histological features of endotheliotropic infection, such as interstitial / perivascular edema in various organs and noncardiogenic pulmonary edema (suggesting increased vascular permeability) and evidence of vasculitis in the lung, liver, and intestines. Molecular studies performed from lung, liver, and kidney tissue confirm the diagnosis of spotted fever group rickettsial disease due to Rickettsia conorii

Medical Selfies: Emotional Impacts and Practical Challenges

Medical images taken with mobile phones by patients, i.e. medical selfies, allow screening, monitoring and diagnosis of skin lesions. While mobile teledermatology can provide good diagnostic accuracy for skin tumours, there is little research about emotional and physical aspects when taking medical selfies of body parts. We conducted a survey with 100 participants and a qualitative study with twelve participants, in which they took images of eight body parts including intimate areas. Participants had difficulties taking medical selfies of their shoulder blades and buttocks. For the genitals, they prefer to visit a doctor rather than sending images. Taking the images triggered privacy concerns, memories of past experiences with body parts and raised awareness of the bodily medical state. We present recommendations for the design of mobile apps to address the usability and emotional impacts of taking medical selfies

Ineffective Esophageal Motility is Associated with Impaired Bolus Clearance but does not Correlate with Severity of Dysphagia

BACKGROUND: Ineffective esophageal motility (IEM) is defined as a distal contractile integral 0.01). There was a moderate inverse correlation between dysphagia and percent bolus clearance (R = - 0.37) in group A, but none in group B (R = 0.09). CONCLUSION: The classification of IEM did not discriminate from normal studies for symptom severity in our cohort. However, patients with IEM did have an inverse correlation between dysphagia score and bolus clearance, but those without IEM did not. Adding impedance information to the motor pattern classification should be considered in the symptom assessment in minor motility disorders

A rare case report of aneurysmal bone cyst involving the roof of the orbit

Aneurysmal bone cyst (ABC) is a benign, tumor like, multi-cystic vascular lesion that causes destruction of the cortical bone. It usually involves the metaphysis of long bones and spine (posterior elements). ABC arising in the orbit constitutes less than 0.25% of all reported cases. We report a 5-year-old girl who presented with painless right sided proptosis without any visual disturbance, which was gradual in onset. Contrast enhanced computed tomography and magnetic resonance imaging scans of the orbit were suggestive of an expansile bony lytic lesion in the roof of the right orbit. Frontal craniotomy followed by the supra-orbital osteotomy was carried out. The entire tumor-like mass was removed piece-meal. Histopathological diagnosis was "a solid variant of ABC of the orbital roof." Post-operative course was satisfactory and the patients eye symptoms improved

Periampullary Variceal Bleeding: An Atypical Complication of Portal Hypertension

Variceal bleeding remains a fatal complication of portal hypertension. Periampullary varices are rare and, due to their location, are difficult to diagnose and treat. Similar to esophagogastric varices, they are the result of high portosystemic pressures secondary to intrahepatic causes such as cirrhosis and extrahepatic causes such as portal or splenic vein thrombosis. We report a case of a periampullary varix resulting in hemobilia during endoscopic retrograde cholangiopancreatography (ERCP)