Purpose： The purpose of this clinical case study is to attract attention to the fact that behind a diagnosis of hypertension a young patient was really diagnosed with a rare systemic vasculitis - polyarteristis nodos...Purpose： The purpose of this clinical case study is to attract attention to the fact that behind a diagnosis of hypertension a young patient was really diagnosed with a rare systemic vasculitis - polyarteristis nodosa. Topic： Polyarteritis nodosa is a disease more frequent in young men with a preceding acute viral hepatitis B which is AgHbs positive. The characteristic of this disease is the presence of many aneurysms at different sites of the small and medium size artery. It is possible for a palpable purpuric rash to appear at any time in the evolution of the disease. The histopathological examination represents the goal of the diagnosis. Method： The principals methods was to attain the desired result, a cerebral MRI was initially performed in order to view any brain malformations and also for excluded an ischemic or hemorrhagic stroke attack , this was followed via a cerebral vascular angiography, an abdominal ultrasound and CT scan, the results of which led to a renal artery angiography being performed, this led to the need to perform a cerebral artery angiography and finally a histopathological examination of the skin of the legs （biopsy）. Achievement： Through the above listed paramedical examinations I was able to prove the existence of multiple aneurysms in the cerebral arteries, renal arteries and small growth of the left kidney, this being a direct result of the aneurysms, this also meant disruption in kidney blood flow meaning, an increase in systemic blood pressure which was the manifest primary symptom the this young patient such as transitory stroke attack. The skin biopsy finally gave a certain diagnosis of Polyarteritis Nodosa.展开更多
Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-ol...Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.展开更多
文摘Purpose： The purpose of this clinical case study is to attract attention to the fact that behind a diagnosis of hypertension a young patient was really diagnosed with a rare systemic vasculitis - polyarteristis nodosa. Topic： Polyarteritis nodosa is a disease more frequent in young men with a preceding acute viral hepatitis B which is AgHbs positive. The characteristic of this disease is the presence of many aneurysms at different sites of the small and medium size artery. It is possible for a palpable purpuric rash to appear at any time in the evolution of the disease. The histopathological examination represents the goal of the diagnosis. Method： The principals methods was to attain the desired result, a cerebral MRI was initially performed in order to view any brain malformations and also for excluded an ischemic or hemorrhagic stroke attack , this was followed via a cerebral vascular angiography, an abdominal ultrasound and CT scan, the results of which led to a renal artery angiography being performed, this led to the need to perform a cerebral artery angiography and finally a histopathological examination of the skin of the legs （biopsy）. Achievement： Through the above listed paramedical examinations I was able to prove the existence of multiple aneurysms in the cerebral arteries, renal arteries and small growth of the left kidney, this being a direct result of the aneurysms, this also meant disruption in kidney blood flow meaning, an increase in systemic blood pressure which was the manifest primary symptom the this young patient such as transitory stroke attack. The skin biopsy finally gave a certain diagnosis of Polyarteritis Nodosa.
文摘Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.
