Mixed Clinical Pictures of Endogenous Endophthalmitis in a Relapse Leukemic Patient.

Endogenous endophthalmitis is rare but sight-threatening in leukemic patients, which can have devastating sequelae. We report a case of a 15-year-old teenager with acute myeloid leukemia on relapse, presented with a mixed picture of endogenous endophthalmitis. The diagnosis dilemma in this patient proved difficult as Investigations and management can be challenging as young teenagers are usually less cooperative than adults. Endogenous endophthalmitis is not uncommon in this group of patients; however, mixed clinical pictures are almost unheard of, and the final diagnosis can be misleading if not treated accordingly. Viral infections such as cytomegalovirus (CMV), bacterial, and fungal are all considered potential opportunistic infections. Diagnosis of endogenous endophthalmitis is complex and relies heavily on the clinical characteristics of each organism supported by intravitreal tapping and culture samples. However, data from endogenous endophthalmitis in leukemic patients is scarce nowadays across the board. In this case report, we highlight the challenges of managing endogenous endophthalmitis in a young leukemic patient due for bone marrow transplantation. Future studies are needed to investigate the current microorganism trends and treatments available. An algorithm for managing endophthalmitis in immunosuppressed patients should be done to provide a better approach from the get-go.

Ultrasound in the diagnosis of palpable abdominal masses in children.

Ultrasound examinations were done to evaluate clinically palpable abdominal masses in 125 children. The examinations were normal in 21 patients. In 15 patients, the clinically palpable masses were actually anterior abdominal wall abscesses or hematomas. Final diagnosis was available in 87 of 89 patients with intraabdominal masses detected on ultrasound. The majority (71%) were retroperitoneal masses where two-thirds were of renal origin. Ultrasound diagnosis was correct in 68 patients (78%). All cases of hydronephrosis were correctly diagnosed based on characteristic ultrasound appearances. Correct diagnoses of all cases of adrenal hematoma, psoas abscess, liver hematoma, liver abscess and one case of liver metastases were achieved with correlation of relevant clinical information.

Retrieval of detached fragment of central venous pressure catheter (CVP) lodged in the right ventricle and pulmonary artery: a case report.

A successful retrieval of a detached segment of a CVP catheter by percutaneous right transfemoral venous route, using a Dotter intravascular retriever basket, is reported. The procedure was monitored under fluoroscopy. Only local anaesthesia, which was infiltrated around the puncture site, was given to the patient. No significant complication was encountered. Successful retrieval of the detached catheter fragment by percutaneous means obviates the need for thoracotomy.