Adult Still's disease is now a well recognised distinct clinical entity. Two cases of the disorder are presented to illustrate the protean nature of the syndrome. The literature is reviewed with regards to the diagnosis, management and complications of the condition. The need for the physician to be aware of ...

Xanthogranulomatous pyelonephritis (XGP) is a rare inflammatory process of the kidney that results in focal or diffuse renal enlargement and nonexcretion. In the past, XGP often has been misdiagnosed as renal carcinoma. Newer investigative modalities and an increased awareness of XGP should make preoperative diagnosis possible. Thirty-two cases of XGP ...

Two cases are presented to illustrate some of the issues that arise in the management of patients diagnosed as suffering from the dementia syndrome of depression (Pseudodementia). Case 1 illustrates the dilemma of relatively normal autopsy findings in the brain in a patient presenting with a history of depression and ...

Pericardial fat necrosis has a highly characteristic clinical picture that enables a preoperative diagnosis to be made on clinical grounds. Surgical therapy, which remains the treatment of choice for this curable entity, confirms the diagnosis. This report reviews the literature and adds a thirteenth documented case to the previously reported ...

Normal reference ranges and pertinent background information on equine hematology are presented and briefly discussed. Diagnostic interpretation of hematologic data is discussed and three diagnostic algorithms and two diagnostic tables are provided to facilitate the use of the presented information for diagnosis. Two cases are presented and the information presented ...

Twelve cases of traumatic tricuspid insufficiency (only three of which already have been published), collected in the same city, are reported. This figure strongly contrasts with the limited number of cases published to date in the literature. Emphasis is placed on the difficulty of diagnosis, the utility of echocardiography and ...

Twenty-eight cases of extreme lateral and foraminal disc herniation diagnosed by CT are reported. All cases have been surgically verified. In four cases (14%) CT diagnosis failed. The clinical pattern in these cases was not very different from that of typical disc herniation. The reliability of clinical diagnosis is 71%. ...

As a result of a traumatic delivery a newborn male child developed thoracic and intra-abdominal problems. Haemoperitoneum and chylous ascites were diagnosed; from a scrotal enlargement secondary to bilateral patent processus vaginalis and a chylothorax became apparent during investigation of the scrotal swellings. We discuss the presentation, diagnosis and management ...

The authors reviewed 20 cases of xanthogranulomatous pyelonephritis. An accurate preoperative diagnosis of this disease is difficult because of its clinical and radiologic similarities to various other renal lesions. A resistant urinary tract infection in a patient with a nonfunctioning kidney and a perinephric abscess should lead to the condition ...

Primary non-obstructive megaureter is rarely first diagnosed in adult life. The clinical and radiographic findings in 11 adults presenting with this condition are reviewed. The commonest complaint was pain. In all cases the diagnosis was suggested by intravenous urography, which was usually the initial diagnostic test. Confirmation was aided chiefly ...

A 54-year-old man presented with gangrenous myositis caused by Streptococcus pyogenes. A review of the literature disclosed 10 similar cases. Their presenting manifestations were spontaneously occurring, localized, excruciating pain; mottling suggestive of ischemic changes; and signs of sepsis. The duration of illness ranged from two to six days, and the ...

We report a case of choledochocele associated with choledocholithiasis. The patient became symptomatic when a gallstone was trapped within the choledochocele, causing intermittent biliary obstruction. Endoscopic retrograde cholangiography (ERC) provided the diagnosis and endoscopic sphincterotomy was performed for definite nonoperative treatment. The lesion could not be identified on ultrasound even ...

Following a review of central leukaemia registration data for Scottish children 1968-1981 a retrospective assessment of leukaemia type was made by inspection of bone marrow slides. Only 57% of slides were still available and in 72% of these the review panel confirmed the initial diagnosis of leukaemia and its type. ...

Peripartum cardiomyopathy is a myocardial disease of a dilatative (congestive) nature which typically presents in the last month of pregnancy or within the first 5 postpartum months. In the first case described, heart failure was noted prior to delivery, and complete recovery was achieved with early and aggressive management. Cardiomyopathy ...

A firm diagnosis of Huntington's Disease (HD) is based upon both clinical observation and a positive family history. 192 cases of HD occurred in South Wales over a 10 year period fitting both criteria but an additional 37 patients did not have affected relatives despite detailed enquiries. Twenty-two of these ...

An unusual case of mandibular paresthesia as the only presenting symptom of a cerebrovascular accident is presented. The differential diagnosis of inferior alveolar nerve paresthesia is discussed. Obtaining a definitive diagnosis depends on a thorough medical and dental history complemented by a complete clinical and radiographic examination. The etiology of ...

We report four patients with a congenital gallbladder septum whose symptoms resembled those of cholelithiasis, in one case giving rise to acute cholecystitis. Cholecystectomy relieved symptoms in all cases and examination of the operative specimen confirmed the clinical diagnosis and X-ray findings. Ultrasonography made a positive diagnosis in the last ...

A new indirect radiographic technique is described for the differential diagnosis of erectile impotence in the bull. Two cases of impotence have been investigated in this way. In the first, occlusion of the dorsal longitudinal canal of the corpus cavernosum penis in an 18-month-old Hereford bull was diagnosed. In the ...

Articular infections due to the fungus Sporothrix schenkii are rare. Only 46 cases of Sporotrichosis arthritis have been well-documented in the English literature to date. The presentation may be limited to a monoarticular synovitis, hence the diagnosis may be confused with other more common causes resulting in costly delays in ...

Necrotizing fasciitis must be considered in a diabetic with cutaneous ulceration. A case report of limb salvage in a 48-year-old diabetic female with progressive necrotizing fasciitis is presented. Methods of early diagnosis including clinical signs, radiographs, and soft tissue biopsy of the involved extremity are reviewed. The microbiology of the ...

A case of cryptococcal meningoencephalitis, as presented by a hypertensive hydrocephalus, is described. To our knowledge, this is the 24th case described in Italy since 1953. The diagnosis was made with ventricular fluid examination: the patient was successfully treated with amphotericin B and 5-fluorocytosine, thus avoiding the risks of surgical ...

Acromegaly is an insidious disorder of somatic growth and metabolic derangements that results from the chronic hypersecretion of growth hormone (GH) in the adult. While its precise incidence in this country remains undocumented, a recent epidemiologic study of a stable population of 3.1 million in England suggested an annual incidence ...

A patient with wide QRS tachycardia is described. His initial electrocardiogram revealed P waves in lead V1 that led to a diagnosis of supraventricular tachycardia. Subsequently, during an electrophysiology study, the tachycardia was reproduced and documented to be ventricular in origin. The P waves seen were actually part of the ...

A case of hypogammaglobulinemia in a 4.5-year-old boy is presented. The radiologist was the first physician to suggest this diagnosis by noting the absence of adenoidal and tonsillar lymphoid tissue on computed tomography in a patient with sinusitis. A review of the radiographic features of the primary immunodeficiency states is ...

A 36-year old laborer presented with bilocular swelling, bulging above and below the floor retinaculum of the right hand with transmitted fluid impulse. A clinical diagnosis of compound palmar ganglion of tuberculous nature was made at the time of surgery, and confirmed later by pathological examination. Complete excision of the ...

The authors review the literature and present 8 cases of extradural haematoma of the posterior fossa operated from 1979 to 1985 at the Neurosurgical Clinic of the University of Pavia. Emphasis is placed on the importance of an early diagnosis of the symptoms which are often ignored due to the ...

From the clinical signs and symptoms of 145 cases of streptococcal pharyngitis and 126 cases of non-streptococcal pharyngitis, a new scoring system for diagnosis of streptococcal pharyngitis was devised. Efficacy of diagnosis for streptopharyngits by this method was 54% if a case had 5 items, 75% if he had 6 ...

The authors present a case of right parietal pleomorphic xanthoastrocytoma that occurred in a 24-year-old man. The patient was originally operated on in 1966, and at that time the diagnosis of monstrocellular sarcoma was made. The patient is still alive and totally symptom-free. A careful reevaluation of the microscopic findings, ...

Three children who had suffered prolonged hypotension or severe asphyxia and who subsequently developed cystic subcortical leucomalacia are reported. This condition fits into the spectrum of perinatal ischaemic brain disease but the diagnosis in life has not previously been reported. Aetiological factors and neurodevelopmental outcome, which was poor in all ...

A case of gravida presenting with upper abdominal pain, an elevated serum glutamic oxaloacetic transaminase level, and thrombocytopenia, all of which resolved promptly after delivery, and with none of the standard signs and symptoms needed for the diagnosis of preeclampsia is presented. The issues of how this case relates to ...

Spontaneous cerebrospinal fluid (CSF) otorrhea implies the observation of CSF draining from the ear or nose without any previous history of traumatic or infectious etiology. The term does not exclude embryologic or developmental abnormalities. The condition may be life-threatening. Thus far it has been reported about twenty times. Because it ...

Tularemia is an uncommon, highly communicable disease occurring with seasonal regularity in endemic parts of the United States. The varied signs and symptoms may confound the unwary physician. Two cases are reported illustrating the ulceroglandular and ingestion forms of the disease. Septic (typhoidal), oculoglandular, pleuropulmonary, glandular, and oropharyngeal forms also ...

The spectrum of cytomorphologic changes of pulmonary granulomas diagnosed by fine needle aspiration (FNA) biopsy is reported, with a review of the pertinent literature concerning the cytologic diagnosis of granulomatous disease. In our cases, organisms were not seen in the Papanicolaou-stained smears. Recognition of the granulomatous cellular pattern, however, resulted ...

For the purpose of clinical management, any woman with an acute rise in blood pressure in the latter half of pregnancy must be regarded as having preeclampsia with the possibility of progression to eclampsia. Unfortunately, such diagnoses have been accepted uncritically in the selection of cases for clinical and laboratory ...

A case of herpes zoster encephalitis which responded very rapidly to acyclovir is presented. The differential serum: cerebrospinal fluid antibody response was followed and its value in making the diagnosis is discussed. The penetration of acyclovir into the cerebrospinal fluid was measured, and found to be in agreement with predicted ...

2 further cases of malakoplakia of the prostate are reported, so that a total of 23 cases have now been described. The histological picture, as well as the methods of staining for the demonstration of the pathognomonic Michealis-Gutmann bodies are reviewed. The presence of Escherichia coli as a possible factor ...

The following document includes an account of the visits to Oranim (and some related materials) of two of the subjects of this investigation. A. (No. 19) is a kibbutz-index case whose father was diagnosed as schizophrenic; H. (No. 81) was a town-index case whose mother had that diagnosis. Each of ...

The syndrome called proctalgia fugax may be a repository of various conditions, because there are no distinctive signs or supporting tests. Usually, the pain of this condition is described as cramping, gnawing or tight, and lasts about ten to 15 minutes. It occurs most frequently at night and is localized ...

The Budd-Chiari syndrome is an uncommon clinical entity, in which invasive investigations are necessary to make a definitive diagnosis. Liver scintigraphy is a simple, safe, non-invasive screening test that can be performed when this diagnosis is suspected. If the appearance on the liver scan supports the diagnosis, further, more definitive, ...

Gestational choriocarcinoma frequently presents diagnostic difficulties as the first symptoms are often due to distant metastases, particularly to the lung. A case of choriocarcinoma is described; the main features were thyrotoxicosis and a solitary metastasis in the lung arising from a clinically normal uterus. It is emphasized that clinical evaluation ...

A case of cystadenoma of the common bile duct is described. An erroneous diagnosis made in a young woman caused secondary biliary cirrhosis with fatal outcome. The diagnosis of cirrhosis should never be established without thorough visualization of the entire biliary tract in patients with biochemical or clinical jaundice of ...

A rare case of septic puerperal pelvic thrombophlebitis is presented. This condition is an uncommon but potentially serious complication of pyogenic pelvic infection. The purpose of this report is to describe a particular form of septic pelvic thrombophlebitis (SPT) that frequently eludes diagnosis because of the absence of positive abdominal ...

The medical management of neutropenic enterocolitis has been associated with a 100% mortality rate according to recent reports. This report describes two cases which were successfully managed without colonic resection. In one case, 67Ga radionuclide scanning was utilized as an aid in the diagnosis. The incidence, pathogenesis, diagnosis, and previously ...

Six cases of human paragonimiasis (Paragonimus uterobilateralis) are documented from Liberia and Guinea. These are the first cases reported from these countries. Paragonimiasis should be considered in the differential diagnosis of any West African patient who presents with hemoptysis. Praziquantel was used successfully to treat these patients, and may be ...

Twelve cases of purulent pericarditis (P.P.) are presented. In each case diagnosis was confirmed by aspiration of pus from the pericardial sac. Clinical presentation of this condition is discussed, and therapeutic alternatives are compared. A review of the literature dealing with this condition in a tropical environment is made. It ...

The Authors report a case of hydatiform mole coexistent with a 12 week old foetus. They suggest that a diagnosis of hydatiform mole cannot always be based on the results of ultrasound examination and that combined ultrasound/hormone assay investigation is a valid obstetric tool for formulating the diagnosis and prognosis ...

A case of portacaval shunt associated with nervous signs secondary to hepatic encephalopathy in a 18 month old Doberman bitch is reported. The dog was presented because of a noticeable weight loss over a two week period and for occasional tremor.A portacaval shunt was suspected upon the clinical observations and ...

Rhabdomyosarcoma is an uncommon neoplasm that is seen in the head and neck area. Since the symptoms of rhabdomyosarcoma, such as aural discharge and nasal obstruction, mimic common disease states, the clinical diagnosis is often delayed. Case reports and a literature review are presented to emphasize the clinical and roentgenological ...

A study of 281 patients evaluated for a meniscus pathologic condition was performed to assess the accuracy of the clinical diagnosis and arthrogram and delineate the role of arthroscopy. Following the clinical examination, the surgeon stated his level of confidence in his diagnosis, as did the radiologist in his interpretation ...

Wound botulism, a potentially fatal disease, presents with signs and symptoms of food-borne botulism without the gastrointestinal manifestations. All cases have been associated with extremity wounds. The diagnosis is clinical, and aggressive ventilatory support is the cornerstone of successful therapy. A case is reported and the pathophysiology, diagnosis, and treatment ...