Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsA Rare Presentation of Extramedullary Hematopoiesis: Perirenal Masses.
Extramedullary hematopoiesis (EMH) is a physiological compensatory mechanism that develops in response to ineffective or insufficient hematopoiesis. Although the liver and spleen are the most common sites, EMH may occur anywhere in the body. Peri-renal involvement in EMH is quite rare and mimics tumoral lesions. ⋯ For the definitive diagnosis, an ultrasound-guided core needle biopsy was performed. The histopathological examination was consistent with EMH. This case aims to highlight the peri-renal involvement of EMH, which mimics renal and peri-renal malignancies.
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J Coll Physicians Surg Pak · Apr 2022
Informed Consent in Stage IV Cancer Patients: Are We Doing it Right?
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsFrom Gut to Heart: Extensively Drug-resistant Salmonella typhi with Multi System Involvement.
Extensively drug-resistant (XDR) salmonella typhi is a gram-negative bacillus, transmitted by feco-oral route. Its systemic manifestations are protean. Untreated enteric fever carries high morbidity and mortality. ⋯ Multi-drug-resistant (MDR) salmonella typhi was isolated from blood cultures. Her symptoms resolved after intravenous antibiotics and she completely recovered. Key Words: Myocarditis, Salmonella typhi, Coagulopathy.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsFishbone-induced Pericardial Hemorrhage Resulting in a Misdiagnosis of Acute Myocardial Infarction.
Fishbone intake is a common clinical event; but serious complications resulting from the ingestion of fishbones, such as perforations in the stomach, diaphragm, and pericardium and heart lacerations, are rare. Here, we present a case of fishbone-induced pericardial hemorrhage that led to a misdiagnosis of acute myocardial infarction (AMI) since the emergency coronary angiogram showed normal coronaries. However, the patient's circulatory status was not good and an echocardiogram revealed pericardial effusion. ⋯ The fishbone was removed, damaged vessels were repaired, and the pericardium was closed with a drain. The patient was discharged in good clinical condition. In order to avoid unnecessary damage and suffering, the possibility of a foreign body in the esophagus or heart must be considered when patients have chest pain, and careful reporting of histories and corresponding examinations are necessary. Key Words: Acute myocardial infarction, Fishbone, Pericardial effusion.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsChryseobacterium indologenes Bacteraemia: A Potential Cause of Early-onset Neonatal Sepsis in a Full-term Baby.
Chryseobacterium indologenes is considered as an emerging pathogen known to cause pneumonia, bacteremia, and meningitis in children. It has been reported previously, mainly from the Indian subcontinent, as a rare cause of early-onset neonatal infection, mostly affecting preterm infants. ⋯ A positive neonatal blood culture of C. indologenes should not automatically be considered as a contaminant; and a joint discussion between neonatologists and microbiologists should determine the appropriate management and antibiotic regimen. Key Words: Early-onset neonatal sepsis, Bacteremia, Chryseobacterium indologenes, Contaminant, Antibiotics.