1/10. bacteroides pericardial effusion and cardiac tamponade in a patient with chronic renal failure.A 31-year-old woman with chronic renal insufficiency and recurrent pericarditis developed an enlarging cardiac silhouette and physical signs of cardiac tamponade. cardiac catheterization demonstrated pericardial effusion with hemodynamic evidence of cardiac compression. At pericardial exploration, 1.5 L. of foul-smelling purulent material was removed from a distended pericardial sac. Cultures of both the exudate and pericardium revealed pure growth of bacteroides fragiles. The patient was subsequently treated with intravenous chloramphenicol and has had an uncomplicated clinical course since that time. This represents the first reported case of cardiac tamponade secondary to culturally proved bacteroides pericarditis in the setting of chronic renal insufficiency.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. Anterior tibial compartment syndrome due to the pyomyositis in a patient with rheumatoid arthritis. A case report.Anterior tibial compartment syndrome was developed due to pyomyositis in a 33-year-old male patient with rheumatoid arthritis while receiving steroid therapy during the follow-up period. The preoperative physical examination, laboratory findings, MRI images, intraoperative observation and postoperative histopathological examinations confirmed the association with pyomyositis. The surgical drainage and antibiotic treatment were effective, and in the follow-up period, neuromuscular dysfunctions disappeared completely within 6 months. The patient has been asymptomatic for 4 years of follow-up. To date, anterior tibial compartment syndrome due to pyomyositis in a case with rheumatoid arthritis has not been reported.- - - - - - - - - - ranking = 4.6110383260175keywords = physical examination, physical (Clic here for more details about this article) |
3/10. Surgical management of severe mammary hidradenitis suppurativa.hidradenitis suppurativa is a devastating disease of the apocrine sweat glands. The chronic form is characterized by a malodorous discharge from multiple draining sinuses embedded in dense fibrous tissue, and physical discomfort. The disease commonly affects the axillary, perineal, and perianal regions. A case of hidradenitis suppurativa of the mammary gland necessitating mastectomy is presented here to illustrate the severity of the disease at an uncommon site. As in other regions of the body, aggressive surgical intervention provides a chance for rapid recovery. The surgical treatment should be tailored to the severity of the disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/10. mediastinitis occurring as a complication of odontogenic infections.mediastinitis occurring from a descending odontogenic infection occurs rarely. The diagnosis is sometimes difficult to make and is often delayed until the patient is in extremis. The physical examination is often nondiagnostic, but may include brawny edema of the neck and chest. CT scanning provides the most accurate diagnostic information. The treatment is always surgical, in combination with appropriate antibiotics. Five patients with mediastinitis secondary to odontogenic infections are presented, and the technique of transcervical drainage of the anterior and posterior mediastinum is reviewed.- - - - - - - - - - ranking = 4.6110383260175keywords = physical examination, physical (Clic here for more details about this article) |
5/10. Transient neonatal pustular melanosis.A Mexican-American boy presented at birth with an extensive eruption consisting of 0.5 to 1.0 cm hyperpigmented macules with a distinct peripheral scale involving primarily the forearms, abdomen and lower back (Fig. 1). Rare intact vesicopustules were also identified. There was an unremarkable prenatal history, and the infant was a product of a normal vaginal delivery. With the exception of the skin lesions and moderate hepatosplenomegaly, the physical examination was normal. Gram stains of the pustules showed numerous neutrophils but no bacteria. Bacterial cultures, of the skin and blood, TORCH screen (toxoplasmosis, rubella, cytomegalic virus, and herpes virus) and a VDRL were negative. On the second day of life, the patient developed several pustules with surrounding erythema consistent with erythema toxicum neonatorum. Wright-stained smears of these lesions showed abundant eosinophils. Hepatosplenomegaly resolved by the third day of life and at the time of discharge only hyperpigmented macules persisted. Follow-up visit six weeks later showed no evidence of skin lesions.- - - - - - - - - - ranking = 4.6110383260175keywords = physical examination, physical (Clic here for more details about this article) |
6/10. Therapeutic utilization of laparoscopy in liver abscess cases.Recently, the authors encountered a case of a bacterial pyogenic abscess of the liver in which the localization of a solitary abscess in the right hepatic lobe could be delineated on the basis of the findings of a physical examination, sonography, scintigraphy, computer tomography and selective angiography. The popularization of endoscopic surgery and chemotherapy encouraged us to attempt drainage of the pus out of the pyogenic abscess under laparoscopic observation. The patient has been progressing favorably thereafter and now about ten months have passed since he returned home. He is in good health. Clinical utilization of laparoscopy is possible from a therapeutic standpoint in solitary abscess of the liver.- - - - - - - - - - ranking = 4.6110383260175keywords = physical examination, physical (Clic here for more details about this article) |
7/10. Pyogenic sacroiliitis. An absolute indication for computerized tomographic scanning.Pyogenic sacroiliitis (PSI) resulted from direct injection of a foreign substance, pumice, in a 32-year-old woman and was complicated by iliopsoas abscess. The symptoms of PSI are unspecific, and similar complaints may accompany such conditions as herniated disc and arthritis. Results of physical examination may be misleading, especially if movements that stress the sacroiliac joint are omitted. Early roentgenograms are normal and rarely aid in the diagnosis. Scintiscanning with gallium and technetium may indicate an inflammatory pelvic focus. These methods lack specificity, however, and may underestimate the extent of disease. The computerized tomographic (CT) scan was effective in detecting interosseous gas with an associated soft tissue abscess. It also proved invaluable in precisely delineating the location and extent of the lesion in and around the sacroiliac joint, facilitating use of the most expeditious surgical approach. Through follow-up CT studies the course and end results of therapy can be objectively determined.- - - - - - - - - - ranking = 4.6110383260175keywords = physical examination, physical (Clic here for more details about this article) |
8/10. Pseudohypopyon in acute myelogeneous leukemia.An 11-month-old boy presented with uniocular hypopyon, elevated intraocular pressure, and iris nodules. A differential diagnosis of physical abuse, infection, retinoblastoma, juvenile xanthogranuloma, and histiocytosis X were considered but initial physical and laboratory investigations all had normal results. Three weeks following initial presentation, the child developed fulminant acute myelogenous leukemia. The clinical course, investigations, and outcome are reviewed.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
9/10. pyomyositis in an adolescent female athlete.A case of pyomyositis in a healthy 13-year-old female volleyball player is presented and discussed. This case is unusual because, historically, pyomyositis has been more common in males, especially those who participate in strenuous physical activity. However, competitive sports and vigorous exercise programs are becoming more widely available to young females. Therefore, a relative increase in the number of adolescent women with pyomyositis can be expected.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/10. Geriatric acute perforated appendicitis: atypical symptoms lead to a difficult diagnosis.A geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain and the interval development of epigastric and left upper quadrant abdominal pain. He was admitted to the hospital for evaluation and serial examinations. Mild diffuse abdominal tenderness developed overnight, and computed tomography of the abdomen revealed a perforated appendix with suppuration. An appendectomy was done immediately. The diagnosis of appendicitis in the geriatric patient is occasionally difficult because of atypical and sometimes misleading physical findings.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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