• Title/Summary/Keyword: misdiagnosis

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A Case of Human Hepatic Alveolar Echinococcosis Accompanied by Lung and Brain Metastases

  • Liu, Chuanchuan;Fan, Haining;Ge, Ri-li
    • Parasites, Hosts and Diseases
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    • v.59 no.3
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    • pp.291-296
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    • 2021
  • Alveolar echinococcosis (AE) is considered as a fatal zoonosis caused by the larvae of Echinococcus multilocularis. The lungs and brain are the most common metastatic organs. We report a human case of hepatic alveolar echinococcosis accompanied by lung and brain metastasis. In particular, the patient had a history of tuberculosis and the lung lesions were easily misdiagnosed as lung abscesses. The lesions of liver and lung underwent radical resection and confirmed as alveolar echinococcosis by pathological examination. The patient had no surgical complications after operation and was discharged after symptomatic treatment. Unfortunately, the patient later developed multiple intracerebral AE metastases. We required the patient to take albendazole orally for life and follow up.

Sialolithiasis of minor salivary gland: a challenging diagnostic dilemma

  • Matiakis, Apostolos;Tzermpos, Fotios
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.2
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    • pp.145-148
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    • 2021
  • Minor salivary gland sialolithiasis (MSGS) is a not uncommon oral mucosal disease. Its clinical appearance may mimic a mucocyst or other benign submucosal overgrowth. Stasis of saliva, which accompanies MSGS, usually results in minor salivary gland inflammation, with a chronic sialadenitis appearance. MSGS typically is a painless lesion but can become painful when the salivary gland parenchyma or excretory duct becomes infected, with or without pus. However, misdiagnosis of this condition is rather common, as the clinical appearance is asymptomatic. The most common location is the upper lip, and MSGS affects males and females, with a slight predilection for males. The sialolith causing MSGS may be obvious during surgical excision, as in the case reported. In other cases, sialolith may be absent or fragmented. Differential diagnosis includes mucocele, swelling due to local irritation like fibroma and diapneusia, chronic abscess of the oral mucosa, and neoplasms either benign (lymphangioma, pleiomorphic adenoma) or malignant. Histopathological examination is needed to establish clinical diagnosis.

Glossopharyngeal Neuralgia

  • Jae Sung, Park;Young Hwan, Ahn
    • Journal of Korean Neurosurgical Society
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    • v.66 no.1
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    • pp.12-23
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    • 2023
  • Glossopharyngeal neuralgia (GPN) is a rare disease that must be differentiated from trigeminal neuralgia. The purpose of this article is to provide a comprehensive review of anatomy, pathophysiology, diagnostic criteria, and several options of treatment for GPN. Lessons learned through our experience of treating GPN are presented in detail, as well as cases of misdiagnosis and diagnostic pitfalls. Microvascular decompression (MVD) should be primarily considered for medically intractable GPN. Techniques employed in MVD for GPN are categorized and described. Especially, we underscore the advantages of the 'transposition' technique where insulating material is positioned 'off' the root entry zone (REZ), instead of 'on' it. We believe this 'off-the-REZ' technique can fundamentally prevent recurrence, if applicable. In addition, Gamma Knife radiosurgery can be an alternative option when a patient is ineligible for MVD, though it is categorized as a destructive procedure.

Sural nerve grafts in subacute facial nerve injuries: a report of two cases

  • Jiwon Jeong;Yongjoon Chang;Kuylhee Kim;Chul Hoon Chung;Soyeon Jung
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.99-103
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    • 2024
  • Because facial nerve injuries affect the quality of life, leaving them untreated can have devastating effects. The number of patients with traumatic and iatrogenic facial nerve paralysis is considerably high. Early detection and prompt treatment during the acute injury phase are crucial, and immediate surgical treatment should be considered when complete facial nerve injury is suspected. Symptom underestimation by patients and clinical misdiagnosis may delay surgical intervention, which may negatively affect outcomes and in some cases, impair the recovery of the injured facial nerve. Here, we report two cases of facial nerve injury that were treated with nerve grafts during the subacute phase. In both cases, subacute facial nerve grafting achieved significant improvements. These cases highlight surgical intervention in the subacute phase using nerve grafts as an appropriate treatment for facial nerve injuries.

Fenestrated popliteal vein pierced by a branch of the tibial nerve

  • Edward C. Muo;Joe Iwanaga;Juan J. Cardona;Lukasz Olewnik;Aaron S. Dumont;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • v.56 no.4
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    • pp.566-569
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    • 2023
  • Knowledge of anatomical variations is important so as to avoid potential iatrogenic injury or misdiagnosis on imaging. Here we report an unusual finding and relationship between the tibial nerve and popliteal vein. During the routine dissection of an adult cadaver, it was noted that a branch of the tibial nerve in the popliteal fossa pierced the most distal part of the popliteal vein. This unusual finding is described and relevant reports in the literature discussed. Our hopes are that such a report might help surgeons avoid injury to such a fenestrated popliteal vein and the tibial nerve branch traveling through it therefore decreasing patient morbidity.

A Case of Herpetic Whitlow of Toe Misdiagnosed as Bacterial Infection: A Case Report (세균성 감염으로 오인된 발가락의 헤르페스 손끝염: 증례 보고)

  • Ye Rang Jeong;Young Sik Yoon
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.68-70
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    • 2024
  • Finger infections are a common problem often caused by viruses, bacteria, or fungi. Similarly, toe infections can present with similar clinical symptoms. Prompt identification of the cause of an infection is crucial for preventing disease progression to a state necessitating immediate and appropriate medical or surgical intervention. Herpetic whitlow is characterized by erythema and painful, non-purulent vesicles and typically results from a herpes simplex virus type 1 or 2 finger infections. However, while herpes whitlow of a finger is common, cases involving a toe are rare. Consequently, a lack of experience of herpetic whitlow of the toe could lead to a misdiagnosis as a bacterial infection and potentially result in unnecessary surgical treatment. Herein, we present a case of herpetic whitlow affecting a great toe that was initially misdiagnosed as a bacterial infection and subsequently treated surgically.

Macroamylasemia in a 4-year-old girl with abdominal pain (복통을 주소로 내원한 4세 여아에서 진단된 마크로아밀라제혈증 1예)

  • Ko, Jeong Hee;Lee, Dae Hyoung
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1283-1285
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    • 2009
  • Macroamylasemia is a benign condition characterized by abnormally large-sized serum amylase; it has been reported to occur in 1-2% of the population. In macroamylasemia, a macromolecular complex consisting of amylase linked to immunoglobulins circulates in the plasma and usually causes hyperamylasemia with low or normal amylasuria. Macroamylasemia is extremely rare in children. We report a case of a 4-year-old girl with abdominal pain and macroamylasemia, who was initially misdiagnosed as having acute pancreatitis. Failure to immediately identify macroamylase as the cause of the unexplained but benign hyperamylasemia can lead to the misdiagnosis of the condition, necessitating costly analyses for ruling out pancreatic disease and unnecessary prescriptions such as fasting and intravenous replacement therapies, as was observed in our patient.

Occurrence and Analysis of Apple Blotch-like Symptoms on Apple Leaves

  • Back, Chang-Gi;Lee, Seung-Yeol;Kang, In-Kyu;Yoon, Tae-Myung;Jung, Hee-Young
    • Horticultural Science & Technology
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    • v.33 no.3
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    • pp.429-434
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    • 2015
  • Apple blotch-like symptoms (ABLS) were observed on 'Fuji' apple leaves in Cheongsong, Gunwi and Yeongcheon apple orchards located in Gyeongbuk Province during 2010-2014. Characteristics of ABLS were yellowing, brown spots on leaves, and defoliation, similar to apple blotch diseased (ABD) leaves, which are infected with Marssonina coronaria. It is difficult to differentiate by eye between ABLS and ABD, which has led to misdiagnosis and overuse of fungicides. The present study was conducted to investigate the cause of ABLS using stereomicroscopy, culture isolation, cross-sectional analysis of leaves, and PCR. No acervuli were found on the surface of ABLS leaves and no growth was observed on potato dextrose agar (PDA) plates in culture. Furthermore, cross-sectional analysis revealed similar results, and mycelia were absent in ABLS leaves. By contrast, all these characteristics were present in ABD leaves. Furthermore, no fungi or viruses were detected in ABLS leaves by PCR, suggesting that the disease is not caused by these agents. These findings suggest that ABLS might be a physiological disorder in plants that is distinct from ABD.

The Legal Consideration in Emergency Medical Service System (의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로-)

  • Kang, Byung Woo
    • The Korean Journal of Emergency Medical Services
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    • v.3 no.1
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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Triploidy that escaped diagnosis using chromosomal microarray testing in early pregnancy loss: Two cases and a literature review

  • Park, Ji Eun;Park, Ji Kwon;Kang, Min Young;Jo, Hyen Chul;Cho, In Ae;Baek, Jong Chul
    • Journal of Genetic Medicine
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    • v.16 no.2
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    • pp.76-80
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    • 2019
  • About 15% to 20% of all clinically recognized pregnancies result in spontaneous abortion or miscarriage, and chromosomal anomalies can be identified in up to 50% of first trimester miscarriages. Chromosomal microarray analysis (CMA) is currently considered first-tier testing for detecting fetal chromosomal abnormalities and is supported by the absence of cell culture failure or erroneous results due to cell contamination in pregnancy loss. Triploidy is a lethal chromosome number abnormality characterized by an extra haploid set of chromosomes. Triploidy is one of the most common chromosomal aberrations in first trimester spontaneous abortions. Here, we report two cases of triploidy abortion that were not detected using array comparative genomic hybridization-based CMA. The aim of this report was to remind clinicians of the limitations of chromosomal testing and the misdiagnosis that can result from biased test selection.