Cases reported "Diabetes Mellitus, Type 2"

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1/41. Emphysematous pyelonephritis: case report and review of the literature.

    Emphysematous pyelonephritis (EP), a rare necrotizing infection of the upper urinary tract, is a life-threatening complication of patients with diabetes mellitus. A case of EP is described where the diagnosis was delayed for 36 h and the patient died notwithstanding aggressive medical and surgical intervention. The demonstration of gas in the renal structures is pathognomonic of EP. Because early diagnosis and aggressive medical and surgical management is imperative for recovery, we recommend plain abdominal radiographs as a minimal screening tool for all diabetic patients who present to hospital with a presumptive pyelonephritis. The diagnosis should also be considered in patients who failed appropriate medical therapy.
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keywords = pyelonephritis, necrotizing
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2/41. Necrotizing fasciitis after cosmetic blepharoplasty.

    PURPOSE: To report a case of necrotizing fasciitis after cosmetic blepharoplasty. METHOD: Case report. A 74-year-old woman with history of type II diabetes mellitus underwent bilateral upper eyelid blepharoplasty. Postoperatively she developed fever, grayish discoloration of the skin, violaceous bullae, and a right facial nerve palsy. Necrotizing fasciitis was diagnosed and treated with intravenous antibiotics, debridement of necrotic tissue, and hyperbaric oxygen therapy. RESULTS: The infection resolved, but the patient required reconstruction for correction of cicatricial ectropion. CONCLUSION: Necrotizing fasciitis is a potentially fatal infection that typically occurs in the setting of trauma. Early recognition of its pathognomonic signs and aggressive management are paramount.
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ranking = 0.0061529548766288
keywords = necrotizing
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3/41. A diabetic patient with scrotal subcutaneous abscess.

    A 51-year-old type 2 diabetic patient with a scrotal subcutaneous abscess is reported. He was diagnosed as having diabetes mellitus five years earlier. He had left scrotal swelling and pain with granulocytosis, elevated c-reactive protein and hyperglycemia. He was successfully treated with incision and drainage (streptococcus agalactiae was identified in the pus), debridement, antibiotics, immunoglobulin and insulin. This case resembled Fournier's gangrene, an infective necrotizing fasciitis of the perineal, genital or perianal regions. diabetes mellitus is a basic disorder often associated with Fournier's gangrene. Scrotal subcutaneous abscess should be prevented from progressing to Fournier's gangrene with early and appropriate treatment.
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ranking = 0.0061529548766288
keywords = necrotizing
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4/41. Successful medical treatment of acute bilateral emphysematous pyelonephritis.

    Emphysematous pyelonephritis most often presents as an acute medical emergency, typically in a septic diabetic patient with acute renal failure. The management of this condition has traditionally been surgical, with nephrectomy. However, some recent reports have described successful medical interventions. We describe a case of acute bilateral emphysematous pyelonephritis in a frail patient not suitable for bilateral nephrectomy and long-term dialysis. This condition was managed medically, not surgically, with intensive antibiotic and circulatory support. The outcome was complete recovery after months of hospital-based treatment. We discuss the management of this rare but important condition in detail.
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ranking = 0.99384704512337
keywords = pyelonephritis
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5/41. Fatal emphysematous pyelonephritis with gas in the spinal extradural space in a patient with diabetes.

    BACKGROUND: Emphysematous pyelonephritis (EP) is a rare but life-threatening condition of the upper urinary tract, characterized by the presence of gas in the renal parenchyma and perirenal space. The vast majority of patients with EP (90%) are known to have diabetes, with escherichia coli being the most common causative pathogen. CASE REPORT: We present a case of fatal bilateral EP in a patient with diabetes, with an unusual radiological finding of gas around the spinal cord and in the psoas muscle, with renal parenchymal sparing. Our case serves as an important reminder of this life threatening entity in diabetic patients, which is not well recognized by clinicians because of its rarity.
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ranking = 0.82820587093614
keywords = pyelonephritis
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6/41. Midfacial granuloma syndrome or an inflammatory non-specific disease? A case report.

    We report a case of idiopathic midline destructive disease in a 57-year-old man. The patient had a non-specific histological pattern in biopsies obtained from the nose and upper lip, characterized by a granulomatous reaction with progressive destruction of the tissues. The patient's general medical history was non-contributory. Clinical and laboratory data did not support any feasible etiology for this destructive process. The patient was treated with prednisone until the discovery of type II diabetes mellitus (never diagnosed before) and was then in turn treated only with oral antidiabetic therapy. Follow-up controls revealed progressive reduction of the symptoms and of the nasal and lip lesions and total remission of symptoms up to 2 years after the onset of the disease. We discuss the diagnostic and subsequent therapeutic problems in the management of the midline necrotizing lesions.
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ranking = 0.0061529548766288
keywords = necrotizing
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7/41. Necrotizing fasciitis as complication of injection into greater trochanteric bursa.

    Necrotizing fasciitis is a limb- and life-threatening soft-tissue infection that frequently involves the extremities. This article describes the first case of necrotizing fasciitis developing from a single steroid injection of the greater trochanteric bursa. Despite early resuscitation and aggressive surgical management that included a hip disarticulation, the patient expired. Potential contributing factors are reviewed.
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ranking = 0.0061529548766288
keywords = necrotizing
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8/41. Fatal enteritis necroticans (pigbel) in a diabetic adult.

    enteritis necroticans is a segmental necrotizing infection of the jejunum and ileum caused by clostridium perfringens, Type C. The disease occurs sporadically in parts of asia, africa, and the South Pacific, where it primarily affects children with severe protein malnutrition. The disease is extremely rare in developed countries, where it has been seen primarily in diabetics. Two cases have previously been reported in the united states, one in a child with poorly controlled Type 1 diabetes. A 66-year-old woman with a 12-year history of Type 2 diabetes mellitus developed severe abdominal pain and bloody diarrhea after eating a meal of turkey sausage. She died unattended at home. An autopsy showed peritonitis and segmental necrosis of the jejunum and ileum. Microscopic examination showed Gram-positive club-shaped bacilli consistent with Clostridia coating a necrotic mucosa. Products of cpa and cpb genes of C. perfringens, Type C were identified in the necrotic jejunum by polymerase chain reaction amplification.
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ranking = 0.0061529548766288
keywords = necrotizing
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9/41. Acute bilateral emphysematous pyelonephritis successfully managed by medical therapy alone: a case report and review of the literature.

    BACKGROUND: Bilateral emphysematous pyelonephritis is a life threatening condition usually occurring in diabetics. Management of this condition has traditionally been aggressive and surgery is considered mandatory. However, this is itself a hazardous intervention in a septic, unstable patient with circulatory or liver failure. When bilateral disease is present, the need for long-term dialysis is obviously unavoidable. CASE PRESENTATION: We herein report one of the few cases of bilateral emphysematous pyelonephritis successfully managed by non-surgical treatment.
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ranking = 0.99384704512337
keywords = pyelonephritis
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10/41. Necrotizing cellulitis caused by Apophysomyces elegans at a patch test site.

    Plant material occasionally is used in patch testing to diagnose contact dermatitis. Serious adverse reactions to this practice are extremely uncommon. The authors report on a 68-year-old non-insulin-dependent diabetic gentleman with hand dermatitis in whom severe necrotizing cellulitis developed caused by Apophysomyces elegans, a subtype of mucormycosis, at the site of a patch test to a snapdragon plant from his garden.
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ranking = 0.0061529548766288
keywords = necrotizing
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