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1.
J Med Case Rep ; 15(1): 15, 2021 Jan 15.
Article in English | MEDLINE | ID: mdl-33451352

ABSTRACT

BACKGROUND: Hyperreflective lesions at the level of ganglion cell (GCL) and inner plexiform retinal layers (IPL) by optical coherence tomography (OCT) and cotton wool spots in the examination of the eye fundus have recently been described as findings in patients with COVID-19 infection. CASE REPORT: We report the case of a 42-year-old healthy Caucasian male anesthetist who had treated COVID-19 patients during the previous 5 weeks and suddenly presented with a temporal relative scotoma in his left eye. Best-corrected visual acuity was 20/20 for the left eye, and no discromatopsy or afferent pupillary defect was present. Visual field test was performed, with no significant findings associated with the focal loss of sensitivity described by the patient. The anterior segment was unremarkable on slit lamp examination in both eyes. Fundus examination of the left eye showed no significant findings. A placoid, hyperreflective band at the level of the GCL and IPL was visible in OCT which spared the outer retina, at the time of diagnosis and 1 month later. An oropharyngeal swab test was performed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA), immunoglobulin G (IgG) and immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) determination. Real-time reverse-transcriptase polymerase chain reaction (RT-PCR) was negative. ELISA testing and a third rapid antibody detection test performed 7 days after the onset of symptoms were positive. CONCLUSIONS: Ocular signs and symptoms in COVID-19 cases are rarely reported, but may be underestimated, especially those that affect the retina and occur in asymptomatic or paucisymptomatic cases. We present a case of COVID-19 diagnosis based on retinal ophthalmic examination.


Subject(s)
COVID-19 , Fundus Oculi , Retina/diagnostic imaging , SARS-CoV-2/isolation & purification , Scotoma , Tomography, Optical Coherence/methods , Adult , Asymptomatic Infections , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19 Testing/methods , Diagnostic Errors/prevention & control , Diagnostic Techniques, Ophthalmological , Humans , Male , Scotoma/diagnosis , Scotoma/etiology , Visual Acuity
2.
Surg Radiol Anat ; 41(12): 1421-1423, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31482300

ABSTRACT

Most of the anatomic variations of the extensor hallucis longus (EHL) muscle are related to the tendon of insertion. We show a double origin of the EHL from the medial aspect of the fibula and the lateral aspect of the tibia. A 27-year-old male with a double closed fracture of tibia and fibula showed an involuntary extension of the big toe during foot plantar flexion after surgery. A tendon fibrosis by the fixation plates could be the cause of the foot functional alteration. Interestingly, the anatomic variation described could be related to the postsurgical foot dysfunction, since when the fibrotic tissue was removed the normal extension of big toe recovered. As illustrated in this case report, knowledge of anatomic variations is very useful, particularly in the context of foot surgery.


Subject(s)
Anatomic Variation , Muscle, Skeletal/abnormalities , Postoperative Complications/physiopathology , Tendons/abnormalities , Tibial Fractures/surgery , Adult , Ankle/abnormalities , Ankle/diagnostic imaging , Bone Plates , Fibrosis , Fibula/abnormalities , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/instrumentation , Hallux/physiopathology , Humans , Male , Muscle, Skeletal/pathology , Muscle, Skeletal/physiopathology , Postoperative Complications/etiology , Radiography , Tendons/pathology , Tibia/abnormalities , Tibia/surgery
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