ABSTRACT
Madura foot is a chronic infection caused by fungus and/or bacteria. Traditionally, treatment has been surgical debridement or amputation. Non-invasive management with long-term antimicrobials alone has been reported as successful. We report a case of Madura foot in a Somali refugee successfully managed with oral posaconazole and ciprofloxacin.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use , Ciprofloxacin/therapeutic use , Mycetoma/drug therapy , Triazoles/therapeutic use , Administration, Oral , Adult , Anti-Bacterial Agents/administration & dosage , Antifungal Agents/administration & dosage , Ciprofloxacin/administration & dosage , Drug Therapy, Combination , Humans , Magnetic Resonance Imaging , Male , Mycetoma/pathology , Triazoles/administration & dosage , Young AdultSubject(s)
Bronchial Fistula/diagnostic imaging , Embolism, Air/etiology , Heart Diseases/diagnostic imaging , Heart Ventricles/diagnostic imaging , Adult , Bronchial Fistula/complications , Embolism, Air/diagnostic imaging , Fatal Outcome , Heart Diseases/complications , Humans , Male , RadiographySubject(s)
Narcotics/adverse effects , Oxymorphone/adverse effects , Purpura, Thrombotic Thrombocytopenic/chemically induced , Substance Abuse, Intravenous/complications , Adult , Emergency Service, Hospital , Female , Humans , Plasmapheresis , Purpura, Thrombotic Thrombocytopenic/diagnosis , Purpura, Thrombotic Thrombocytopenic/therapyABSTRACT
A 60-year-old man was treated in the hospital for mesenteric vein thrombosis and discharged home on anticoagulation. On warfarin the patient started to bleed profusely from the nose and tongue. He was evaluated by ENT (ears, nose and throat); a nasal endoscopy revealed several vascular ectasias. Subsequent detailed history and general physical examination established the diagnosis of hereditary haemorrhagic telangiectasia also known as Osler-Weber-Rendu syndrome. On further evaluation, pulmonary arteriovenous malformations were diagnosed on imaging and treated by intervention radiology. In hindsight, the diagnosis could have been made in the general practitioner's office with just a routine thorough history and a physical examination at a new patient visit. We report this case to stress upon the importance of vigilant clinical, medical and family history and a thorough examination to establish an early diagnosis of this not-so-rare entity.
