Introduction and importance Coronavirus disease 2019 (COVID-19) is a pandemic disease that spread rapidly throughout the world and became a major public health concern. Approximately 5–12% of COVID-19 patients require admission to the intensive-care unit (ICU), where they often require oxygen therapy and prolonged intubation. Post-intubation laryngotracheal stenosis (PILS) is a complication that occurs in 10–22% of non-COVID-19 patients after prolonged intubation, while the rate of COVID-19 related PILS remains unknown. Additionally, there is still no consensus in the literature regarding the management modalities for PILS following COVID-19. Case presentation Here we report two cases of tracheal stenosis after prolonged intubation due to severe COVID-19 infection. The first patient was admitted to the ICU and intubated for 21 days; 3 months after discharge, he developed a 3 cm long tracheal stenosis that narrowed 70% of the lumen. The second patient was intubated for 2 months and, 4 months after discharge, developed a 2.5 cm long tracheal stenosis that narrowed 80% of the lumen. Clinical discussion In both cases, the diagnosis was confirmed by CT scan and Rigid bronchoscopy; then, they were managed successfully with tracheal resection and reconstruction by end-to-end anastomosis. Conclusion In conclusion, we would like to highlight the importance of suspecting PILS in recovered COVID-19 patients re-presenting with breathing difficulties following weaning from mechanical ventilation; therefore, careful follow-up in such patients is required. Moreover, we would like to point out that the management of tracheal stenosis after COVID-19 appears to be similar to that of tracheal stenosis in general.
Introduction and importance: Aicardi syndrome (AS) is a rare genetic syndrome characterized by a triad of features: agenesis or hypogenesis of corpus callosum, chorioretinal lacunae, and infantile spasms, along with other neurodevelopmental, ocular, craniofacial, gastrointestinal, and musculoskeletal disorders. The precise etiology of AS is unknown, and establishing a diagnosis is challenging since it is an extremely rare syndrome and may mimic other congenital neurological defects. Case presentation A 2-month-old girl was brought to our hospital, she developed multiple episodes of generalized spasticity with hyperflexion of upper and lower extremities on trunk (tonic seizure), with fast jerking movements of the eye, with signs of Psychomotor Development delay. Clinical discussion Ophthalmic examination showed bilateral medial strabismus without nystagmus, Retinal examination showed bilateral small peripapillary well-circumscribed chorioretinal lacunae with hyperpigmented borders, thoracic spine x-ray (AP view) showed hemivertebrae and loss of height in the 7th and 8th thoracic vertebral body. Magnetic Resonance Imaging (MRI) revealed grey matter heterotopia, underdevelopment of the left operculum, hypogenesis of the corpus callosum, hypogenesis of inferior vermis, and multiple cysts with peripheral enhancing. Eventually, the diagnosis of AS is confirmed by the results of radiological imaging and ophthalmology exam. Conclusion In this paper, we report a case of Aicardi syndrome diagnosed in a 7-month-old girl with frequent tonic seizures. We report this case to highlight that Aicardi syndrome should be considered in the differential diagnosis in cases of frequent tonic seizures with abnormal findings on retinal examination and characteristic findings on MRI.
Introduction and importance: The Echinococcus Granulosus, an endemic parasite in several parts of the world which causes hydatid disease. Human acts as an intermediate host and gets infected by eating parasitic eggs. As it is well known, lungs and liver are the most commonly involved organs in this disease. When the pleura is involved, it is almost always secondary to a ruptured primary lung cyst. Case presentation The purpose of this paper is to present a case of 16-year-old male with complaints of dyspnoea and dry cough for 6 months. His vital signs, CBC, and laboratory tests were all within normal. Chest X-ray showed a complete opacification of hemithorax. Clinical discussion CT revealed multiple cysts filling up the whole pleural cavity with collapsed lung and to-left mediastinal shift. The patient was diagnosed with primary pleural hydatidosis. The treatment was surgical, followed by parasitic medications. During the surgery, surgeons were able to simply extract many cysts by hand and eventually the collapsed lung returns to its normal volume and normal functional state. The patient was indicated to continue with Albendazole for 1 year after surgery. Three days after the surgery, chest X-ray was within normal. Conclusion Primary pleural hydatidosis is such a rare case to present as full filled up pleural cavity and a complete opacification of hemithorax on CXR. Using the developed technical methods helped to confirm such case and in choosing the best surgical intervention. The result was satisfactory with fully expanded and functional lung.
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