Subject(s)
Megacolon, Toxic/diagnostic imaging , Pulmonary Embolism/etiology , Tomography, X-Ray Computed/methods , Adult , Colectomy/methods , Colitis, Ulcerative/diagnosis , Diagnosis, Differential , Female , Humans , Ileostomy/methods , Megacolon, Toxic/complications , Megacolon, Toxic/pathology , Megacolon, Toxic/surgery , Treatment OutcomeSubject(s)
Abscess/diagnosis , Lymphadenitis/diagnosis , Skin Diseases/diagnosis , Child , Diagnosis, Differential , Humans , Lymph Nodes/pathology , Male , UlnaABSTRACT
Internal jugular vein (IJV) aneurysm is a rare entity, and a thrombosed aneurysm poses diagnostic and management challenges. We came across a 53-year-old woman who presented with fever, vomiting and right neck swelling for a week. Laboratory investigations showed neutrophilic leucocytosis, raised acute phase reactant and blood culture yielded Klebsiella pneumoniae Ultrasound and contrast-enhanced CT neck revealed a large fusiform aneurysm of the right IJV with filling defect extending from the aneurysm into the right transverse sinus. There was a cavity at the right lower third molar tooth. MRI confirmed the findings with additional enhancing focus at right lower periodontal region. The swelling reduced after 2 weeks of medical therapy, and follow-up imaging 4 months later showed complete resolution of the aneurysm with residual thrombosis. After extensive workup, dental infection remains the only identifiable primary source leading to thrombophlebitis of the right IJV and subsequent sequelae.
Subject(s)
Aneurysm/diagnosis , Jugular Veins/pathology , Lemierre Syndrome/diagnosis , Aneurysm/drug therapy , Anti-Bacterial Agents , Anticoagulants/administration & dosage , Ceftriaxone/administration & dosage , Enoxaparin/administration & dosage , Female , Humans , Jugular Veins/diagnostic imaging , Klebsiella pneumoniae/isolation & purification , Lemierre Syndrome/drug therapy , Lemierre Syndrome/etiology , Metronidazole , Middle Aged , Neck/diagnostic imaging , Tomography, X-Ray Computed , Tooth Diseases/complications , Tooth Diseases/microbiologySubject(s)
Angiography , Chest Pain/diagnostic imaging , Embolism, Fat/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Accidents, Traffic , Chest Pain/etiology , Critical Care , Embolism, Fat/therapy , Femoral Fractures/diagnostic imaging , Humans , Male , Pulmonary Embolism/therapy , Syndrome , Tachycardia , Treatment Outcome , Young AdultSubject(s)
Azygos Vein/diagnostic imaging , Chest Pain/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Choledocholithiasis/diagnostic imaging , Computed Tomography Angiography , Venous Thrombosis/diagnostic imaging , Azygos Vein/pathology , Chest Pain/etiology , Choledocholithiasis/surgery , Humans , Intraoperative Complications , Male , Middle Aged , Venous Thrombosis/pathology , Watchful WaitingABSTRACT
Melioidosis is endemic in Southeast Asia and tropical Australia with varying clinical features from benign skin lesions to fatal septicaemia. Imaging plays an important role in evaluation of the melioid liver abscesses. A 45-year-old man with underlying diabetes presented with fever and lethargy for 2 weeks and abdominal pain for 2 days. His liver was enlarged on examination. Blood investigations revealed mild leucocytosis and raised liver enzymes. Ultrasound showed multiple multiloculated hypoechoic lesions throughout the liver and spleen. CT of abdomen confirmed that some liver lesions were made up of asymmetric locules of varying sizes (honeycomb sign), while others had hypodense centre with small symmetric peripheral locules in radial fashion (necklace sign). Blood culture was positive for Burkholderia pseudomallei He was subsequently treated with ceftazidime for a month followed by oral trimethoprim-sulfamethoxazole for 3 months. Follow-up CT of abdomen a month after diagnosis and treatment showed resolving hepatic and splenic lesions.
