Delayed postpartum uterine dehiscence. A case report

BACKGROUND: Delayed postpartum uterine dehiscence with hemorrhagic shock may be caused by inadequate treatment of postpartum endomyometritis. CASE: A woman developed a delayed uterine dehiscence six weeks postpartum. Inadequate antibiotic treatment for postpartum endomyometritis was thought to be the etiology. The patient required a hysterectomy for definitive treatment because of associated hemorrhagic shock. CONCLUSION: Only one other case of uterine dehiscence that resulted from endomyometritis has been reported. Broad-spectrum antibiotic therapy is indicated in postpartum endomyometritis to avoid uterine dehiscence with hemorrhagic shock.     

Isodense subdural hematoma presenting with paraparesis: case report

Computerized tomography (CT) has replaced cerebral angiography in many institutions as the diagnostic test of choice in cranial trauma. However, isodense subdural hematomas can be a source of false-negative results on CT scans, resulting in omissions in therapy. The authors report a patient with bilateral isodense subdural hematomas who presented with paraparesis but was otherwise alert and fully oriented. The CT findings caused an initial diagnostic dilemma before being resolved.     

Osteogenesis imperfecta and coronary artery surgery. A case report

A new case of Osteogenesis Imperfecta (OI) suffering ischemic heart disease is reported. The patient was successfully operated on in our Institution and the bibliographic search showed only another case of such an association of diseases successfully treated by surgery. This patient proves that coronary artery surgery procedures are possible when OI complicates the cardiac ischemic syndrome.     

Delayed onset chloroquine retinopathy: case report

A patient presented with decreased visual acuity and retinal findings compatible with chloroquine retinopathy 5 years after discontinuing regular usage of chloroquine for rheumatoid arthritis. A review of the literature on chloroquine retinopathy is outlined. In addition, the characteristic findings including fluorescein angiography, retinal physiologic studies, and symptoms are reviewed. Chloroquine retinopathy is dose related and essentially irreversible and often progressive once typical findings are noted. To our knowledge very delayed onset of chloroquine retinopathy is a relatively rare phenomenon but the medical and ophthalmic communities must be alerted to the possibly severe complications of this iatrogenic disease entity.     

Delayed postpartum hemorrhage in adenomyosis: a case report

BACKGROUND: The mucocutaneous form of New World cutaneous leishmaniasis is caused, theoretically, by Leishmania (viannia) braziliensis. Pentad valency antimonic compounds are widely used for treatment of New World cutaneous leishmaniasis. The rate of recurrence is often high when these drugs are used for mucocutaneous forms. Pentamidine has been considered as a second line treatment although little data is available. PATIENTS AND METHODS: Seventeen patients with mucocutaneous leishmaniasis were treated with pentamidine isothionate, 4 mg/kg every 48 hours. A complete oto-rhino-laryngological examination was performed once a week to determine the course of the lesions. Treatment was discontinued when the lesions healed. A follow-up oto-rhinolaryngological examination was also performed after treatment withdrawal and every three months thereafter for an undetermined period. RESULTS: Lesions healed with pentamidine isothionate in 16 patients (94%). Mean dosage required was 2872 mg (2025-4320 mg) for a mean treatment duration of 22 days (12-32 days). Mean follow-up was 13.3 months (3-37 months). Leishmaniasis relapsed in one patient 4 months after treatment withdrawal. DISCUSSION: Pentamidine isothionate is an effective treatment for mucocutaneous leishmaniasis, providing cure with a low rate of recurrence.     

Delayed cardiotoxicity following quinine overdose: a case report

Quinine poisoning typically results in a constellation of non-life threatening symptoms which include tinnitus, deafness, nausea, vomiting, vision changes, headache, and hypotension. Cardiac conduction defects, dysrhythmias, and cardiovascular collapse have all been reported after overdose and generally occur within 8 hours of ingestion. We report a unique case of delayed cardiotoxicity following quinine ingestion. Toxicity included marked ventricular conduction abnormalities for which serum alkalinization appeared to be therapeutically beneficial, and torsades de pointes requiring overdrive pacing for termination.     

Spondylitis in infancy. A case report

The authors report on a case of a spondylodiskitis in three year old child. Diskitis is an inflammatory process of the intervertebral disk space, not often described in pediatric age. The etiology is infective and generally presents with lumbar spine localization. Clinically it is characterized by lumbar pain at times radiating to a lower extremity. Symptoms are aspecific and radiological signs do not appear for several weeks after the onset of symptoms. Interest in this pathology derives from the fact that it may be more common than previously recognized. This case offered us the opportunity to review principal symptoms of diskitis and to describe the main diagnostic technics used.     

Unilateral compartment syndrome after prolonged gynecologic surgery in the dorsal lithotomy position. A case report

We describe the onset of the compartment syndrome after gynecologic surgery in the dorsal lithotomy position for neovaginal reconstruction with a fasciocutaneous flap.     

Castleman's disease. A case report

Angiofollicular lymph node hyperplasia or Castleman's Disease (CD) is a rare lymphoproliferative disorder that manifests itself as a local or generalized tumor-like condition affecting both lymph nodes and non-nodal tissues, usually in the chest and abdomen. Hyaline vascular and plasma cell types have been identified histologically. A new clinical form of CD with multisystemic involvement has been defined as multicentric Castleman's disease. It is very rare in childhood. In this paper we present an eight-year-old boy with multicentric Castleman's disease.     

Fatal exorcism. A case report

A five-year-old girl was killed by her mother when she tried to pull the devil out of the girl's mouth by means of her hands. In that way the enlarged tonsils were pushed back and caused together with the woman's fingers a temporary closure of the hypopharynx and at least the suffocation of the child. About two years ago the woman began to show paranoic ideas exacerbating up to the fatal event.     

Stomach diverticulum. A case report

The author reports a case of gastric symptomatic diverticulum, not connected to other gastric-biliary-duodenal pathology. The author points out the rarity of diverticulum of the alimentary canal, and points out the symptomatic picture that, in association with a radiologically ascertained diverticulum staunching, represent indications for surgery.     

Morgagni-Larrey hernia. A case report

The authors report a case of Morgagni-Larrey hernia. It is anuncommon diaphragmatic hernia, often asymtomatic and occasionally found. The authors point out the disease's clinical, diagnostic and therapeutic aspects. The hernia's repair can be done both abdominal and thoracic via. The operation is always advisable as well as in asymptomatic pazients.     

Reno-colo-cutaneous fistula. A case report

Reno-colo-cutaneous fistula due to genito-urinary tuberculosis is extremely rare. We describe one such case which was successfully managed by single stage surgery (nephroureterectomy, fistulectomy and primary repair of colon) and anti-tubercular treatment.