Tag Archives: necrosis
The patient also had hemorrhagic necrosis of the skin and soft tissue of the right thigh.

A Genetic Origin? Purpura Fulminans

Over days, a patient’s relatively small lesion evolved into widespread tissue damage. A previously healthy 49-year-old Arab woman was admitted for a 2-cm painful red lesion on her left breast. She had been well until a few days earlier, when she developed left flank pain and was treated with ofloxacin for a presumed urinary tract […]

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Complicated Necrotizing Otitis Externa Progressing to Coalescent Mastoiditis and Temporal Lobe Abscess

A 77-year-old man with a history of hypertension, chronic kidney disease, and poorly controlled type 2 diabetes mellitus presented to our intensive care unit from an outside hospital with complicated necrotizing otitis externa. One month prior, the patient developed purulent drainage from the right external auditory canal with associated hearing loss. One week prior, he […]

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(A and B) Large eschars on bilateral medial thighs with mild erythema; corresponding plain radiographs with vascular and soft tissue calcifications are shown in the inset. (C) 99mTc-sestamibi parathyroid scintigraphy demonstrating hypermetabolic activity posterior to the superior pole of the right thyroid lobe suggestive of parathyroid adenoma.

Classic Lesion, Not-So-Classic Cause

Calciphylaxis (also known as calcific uremic arteriolopathy) is a serious disorder characterized by skin necrosis secondary to reduction in the blood flow caused by calcification, fibrosis, and thrombus formation in the dermohypodermic arterioles. While calcific uremic arteriolopathy has been reported in nonuremic patients, it is primarily observed in patients with end-stage renal disease, especially those […]

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Acute Epigastric Pain as the Cause of Urgent Gastrectomy in a Healthy Patient

A 63-year-old man with no surgical history, taking no medication,was referred to the emergency department for epigastric pain and nausea that had started afew hours earlier. A sore throat had begun 24hours previously. Physical examination revealed normal temperature, hemodynamic stability, a distended abdomen with abdominal guarding that was very painful on palpation, and no mass […]

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Axial (A), coronal (C), and parasagittal (D) computed tomography chest maximal intensity projections revealed innumerable spiculated soft-tissue nodules throughout the lungs, varying in size from 1 to 20 mm. Although the majority are centrilobular, there are some based on the pleura and within fissures, highlighted in the parasagittal slice (D). They are well defined and not typical of hypersensitivity pneumonitis. The nodules were variably avid on positron emission tomography scan (B).

Necrotizing Sarcoid Granulomatosis: Clinico-Radio-Pathologic Diagnosis

A 30-year-old man was referred to the rheumatology outpatient department and seen urgently after developing diplopia over a 4- to 8-hour period and an isolated left fourth cranial nerve palsy associated with a bifrontal and left temporal headache and episodic vertigo. Magnetic resonance imaging of the brain at that time was unremarkable. The following week […]

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Abdominal CT scan showing a large pancreatic fluid collection with pancreatic necrosis (red arrows) and ascites in the pericolic gutters (blue arrows).

Chylous Ascites: An Unusual Complication of Necrotizing Pancreatitis

  A 59-year-old woman with hypertension presented to the emergency department with abdominal pain secondary to gallstone pancreatitis. She had no history of liver disease, tuberculosis, or cancer. She was febrile to 38.9°C (102°F), blood pressure 49/29 mm Hg, heart rate 124 beats per minute, respiratory rate 31 breaths per minute, and normal oxygenation. Abdominal […]

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