MyMedR

Pseudocyst and cystic lesions of the pancreas--a diagnostic dilemma

Ponnudurai R

Med J Malaysia, 2005 Jul;60 Suppl B:101-3.

PMID: 16108187

Matched MeSH terms: Diagnosis, Differential

A four-point clinical criteria distinguishes immune thrombocytopenia from acute lymphoblastic leukaemia

Lum SH, How SJ, Ariffin H, Krishnan S

Med J Malaysia, 2016 02;71(1):28-9.

PMID: 27130741

Immune thrombocytopenia is the most common diagnosis of isolated thrombocytopenia. The dilemma encountered by paediatricians is missing diagnosis of acute leukaemia in children with isolated thrombocytopenia. We demonstrated childhood ITP could be diagnosed using a four point clinical criteria without missing a diagnosis of acute leukaemia. Hence, bone marrow examination is not necessary in children with typical features compatible with ITP prior to steroid therapy. This can encourage paediatricians to choose steroid therapy, which is cheaper and non-blood product, as first line platelet elevating therapy in children with significant haemorrhage.

Matched MeSH terms: Diagnosis, Differential

Fulltext Appendicular mass complicating acute appendicitis in a patient with dengue fever

Low YN, Cheong BM

Med J Malaysia, 2016 04;71(2):83-4.

PMID: 27326951 MyJurnal

Abdominal pain with dengue fever can be a diagnostic challenge. Typically, pain is localised to the epigastric region or associated with hepatomegaly. Patients can also present with acute abdomen. We report a case of a girl with dengue fever and right iliac fossa pain. The diagnosis of acute appendicitis was made only after four days of admission. An appendicular mass and a perforated appendix was noted during appendectomy. The patient recovered subsequently. Features suggestive of acute appendicitis are persistent right iliac fossa pain, localised peritonism, persistent fever and leucocytosis. Repeated clinical assessment is important to avoid missing a concurrent diagnosis like acute appendicitis.

Matched MeSH terms: Diagnosis, Differential

Fulltext Dens invaginatus in a geminated maxillary lateral incisor

Pallivathukal RG, Misra A, Nagraj SK, Donald PM

BMJ Case Rep, 2015 May 22;2015.

PMID: 26002668 DOI: 10.1136/bcr-2015-209672

Dens invaginatus (DI) and gemination are two developmental abnormalities that are well reported in the dental literature, but their coexistence in a single tooth is rare. Such situations worsen the risk factors associated with these anomalies, and the treatment plan should be customised as they possess altered morphology and anatomy. A 19-year-old girl came for evaluation of a cracked tooth in the front region of the upper jaw. The tooth showed clinical features of gemination and radiographic features of DI, and was diagnosed as DI in geminated maxillary lateral incisor. The differential diagnoses based on clinical appearance without radiographic investigation may warrant the treatment approach if these two abnormalities coexist in a single tooth. The report also highlights the importance of three-dimensional imaging in diagnosis and treatment planning of teeth with altered pulp canal anatomy. There are few reported cases in the literature detailing the treatment options for these two anomalies occurring in the same tooth.

Matched MeSH terms: Diagnosis, Differential

Unmistakable Morphology? Infantile Malignant Osteopetrosis Resembling Juvenile Myelomonocytic Leukemia in Infants

Strauss A, Furlan I, Steinmann S, Buchholz B, Kremens B, Rossig C, et al.

J Pediatr, 2015 Aug;167(2):486-8.

PMID: 25982139 DOI: 10.1016/j.jpeds.2015.04.064

The initial clinical and hematologic presentation of infantile malignant osteopetrosis may be indistinguishable from that of juvenile myelomonocytic leukemia in infants. Timely radiographic imaging, however, allows straightforward delineation of these 2 severe diseases and facilitates immediate initiation of appropriate therapy.

Matched MeSH terms: Diagnosis, Differential

Basaloid Squamous Cell Carcinoma: An Unusual Ball-Valve Laryngeal Obstruction

Tan SH, Hindi KW, Chandran PA, Chong AW

Iran J Otorhinolaryngol, 2015 May;27(80):243-6.

PMID: 26082908

INTRODUCTION: A rare case of basaloid squamous cell carcinoma (BSCC) of the larynx, which has not been previously reported, is described.

CASE REPORT: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords.

CONCLUSION: Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

Matched MeSH terms: Diagnosis, Differential

Asia Pacific Consensus Statements on Crohn's disease. Part 1: Definition, diagnosis, and epidemiology: (Asia Pacific Crohn's Disease Consensus--Part 1)

Ooi CJ, Makharia GK, Hilmi I, Gibson PR, Fock KM, Ahuja V, et al.

J Gastroenterol Hepatol, 2016 Jan;31(1):45-55.

PMID: 25819140 DOI: 10.1111/jgh.12956

Inflammatory bowel disease (IBD) was previously thought to be rare in Asia, but emerging data indicate rising incidence and prevalence of IBD in the region. The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology with the goal of developing best management practices, coordinating research, and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis, and management of Crohn's disease. The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses, and treatment availability. It does not intend to be all comprehensive and future revisions are likely to be required in this ever-changing field.

Matched MeSH terms: Diagnosis, Differential

Letter: prompt endoscopy in Asians with uninvestigated dyspepsia

Mahadeva S, Goh KL

Aliment Pharmacol Ther, 2015 Apr;41(8):792.

PMID: 25781046 DOI: 10.1111/apt.13120

Matched MeSH terms: Diagnosis, Differential

Cervical osteoarthropathy: an unusual cause of dysphagia

Srinivas P, George J

Age Ageing, 1999 May;28(3):321-2.

PMID: 10475873

PRESENTATION: A 72-year-old man complained of progressive dysphagia for solids associated with a sensation of foreign body in his throat for 2 years. A barium swallow showed a bridging osteophyte between C4 and C5 vertebrae indenting the oesophagus posteriorly and displacing it anteriorly.

OUTCOME: He refused surgical intervention and was given dietary advice. After 6 months, his weight was steady and he was able to swallow semi-solid food without difficulty.

Matched MeSH terms: Diagnosis, Differential

The value of cytology in granulomatous mastitis: a report of 16 cases from Malaysia

Yip CH, Jayaram G, Swain M

Aust N Z J Surg, 2000 Feb;70(2):103-5.

PMID: 10711470

BACKGROUND: Granulomatous mastitis is a rare condition of the breast that can mimic a carcinoma. There are characteristic histological features, the most important of which is a predominantly lobular inflammatory process. It must be differentiated from known causes of granulomatous inflammation, such as tuberculosis.

METHODS: In the present paper, the clinical and pathological features of 16 patients with granulomatous mastitis seen over a 3-year period in the University Hospital, Kuala Lumpur, are described.

RESULTS: A clinical suspicion of malignancy was present in 10 cases. One of the patients was nulliparous. One had an associated hyperprolactinaemia, while two had systemic lupus erythromatosis. One of the patients was pregnant at the time of presentation. Four patients had localized lumps excised, five were treated conservatively because the lesion was too extensive to resect, and seven patients required drainage procedures for abscess formation.

CONCLUSION: Awareness of this condition is important because it mimics a carcinoma, and surgery may not be the best treatment for recurrent disease.

Matched MeSH terms: Diagnosis, Differential

Kimura's disease: a report of three cases with a brief review of literature

Madhavan M, Othman NH, Singh MS, Indudharan R, Sharma HS, Shamsuddin AR

Acta Otorhinolaryngol Ital, 2000 Aug;20(4):284-9.

PMID: 11234448

Kimura's disease (KD) is an uncommon chronic inflammatory condition of unknown aetiology involving subcutaneous tissue, presenting as a tumor like lesion with a predilection for the head and neck region. Clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnose before tissue biopsy. Fine needle aspiration cytology has only limited value. Unless the pathologists are aware of this entity, it might be misdiagnosed. Surgery, radiotherapy and steroid therapy have been tried but none is proved best and recurrence is common. Three cases of KD seen in our hospital and the problems encountered in them are presented.

Matched MeSH terms: Diagnosis, Differential

Fulltext Trauma induced testicular torsion: a reminder for the unwary

Yeap JS, Moissinac K

J Accid Emerg Med, 2000 Sep;17(5):381-2.

PMID: 11005420

Trauma induced testicular torsion is a well recognised entity, the incidence being 4-8% in most studies reporting on testicular torsion. The signs and symptoms of testicular torsion may easily be mistakenly attributed to preceding testicular trauma if there was such an event. A patient is described with trauma induced testicular torsion who presented on three occasions before a decision was made to perform scrotal exploration. Unfortunately, an orchidectomy was the outcome. The message that trauma can and not infrequently does precipitate torsion, needs to be reiterated. Awareness of the entity and constant vigilance is required of clinicians to avoid a delay in definitive treatment.

Matched MeSH terms: Diagnosis, Differential

Fulltext Pneumonia presenting as acute abdomen in children: a report of three cases

Vendargon S, Wong PS, Tan KK

Med J Malaysia, 2000 Dec;55(4):520-3.

PMID: 11221169

From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with lung collapse secondary to pneumonia. The dominant initial clinical presentation in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two cases post-operatively after surgical contributory causes were excluded intra-operatively. Thoracotomy, evacuation of infected debris and decortication of the collapsed lung was done in all three cases. In children presenting with acute abdominal pain, basal pneumonia should be considered as a possible contributory cause.

Matched MeSH terms: Diagnosis, Differential

Fulltext Ectopic pregnancy: uncommon presentations and difficulty in diagnosis

Wong CM, Ganesh R, Ng KY

Med J Malaysia, 1999 Mar;54(1):117-9.

PMID: 10972015

Diagnosis of ectopic pregnancy prior to rupture is an arduous task even with the availability of many new investigative methods and imaging modalities. Above all, a high index of suspicion is necessary when dealing with women who present in early pregnancy with abdominal pain and vaginal bleeding. With the increased use of ovulation induction agents, the probability of heterotropic pregnancy should be kept in mind. The use of transvaginal ultrasonography (TVS) will help in earlier diagnosis because of its advantages over transabdominal ultrasonography (TAS).

Matched MeSH terms: Diagnosis, Differential

A fever from the tropics

Gherardin T

Aust Fam Physician, 2000 Mar;29(3):259.

PMID: 10785992

Shirley is a 42 year old woman who has rung you 5 days after returning from a 3 week resort holiday in Malaysia and Thailand. You saw her before her trip and administered a hepatitis A vaccine and advised her that she did not require anti malarial drugs as she was only going to large cities and beach resorts. She says she has had a high fever, headache and body aches for several days and that she feels exhausted, but is well enough to come to the surgery. When you see her later that morning, she looks fairly well, although she is moving rather gingerly. She says she has been resting, is drinking lots of fluids, has some anorexia, but no other significant symptoms. Examination reveals a temperature of 38 degrees C and she has a fine morbilliform rash on her body, limbs and neck. There are no other abnormal findings.

Matched MeSH terms: Diagnosis, Differential

Dens evaginatus on a wisdom tooth: a diagnostic dilemma. Case report

Ngeow WC, Chai WL

Aust Dent J, 1998 Oct;43(5):328-30.

PMID: 9848984

Pericoronitis is the most common odontogenic problem associated with the wisdom tooth in young men and women. Patients may present with problems associated with infection, swelling and pain. However, other associated pathology such as caries, periodontal disease and referred pain from the temporomandibular joint must be investigated when treating pain from the wisdom tooth. The authors wish to present a case in which the pain from a wisdom tooth was due to a fractured dens evaginatus. The importance of this dental anomaly should not be overlooked.

Matched MeSH terms: Diagnosis, Differential

Extramammary Paget's disease presenting as condylomata lata

Mohammed KN

Int J STD AIDS, 1993 Jul-Aug;4(4):242-3.

PMID: 8399509

Matched MeSH terms: Diagnosis, Differential

Fulltext Dopa responsive dystonia with diurnal fluctuation (Segawa's syndrome)

Ong LC, Tang SF, Lal TR

Med J Malaysia, 1994 Jun;49(2):176-8.

PMID: 8090100

A 10-year-old girl presented with progressive dystonia with diurnal fluctuation. Response to low dose L-Dopa was dramatic and sustained with no complications. Recurrence of symptoms was observed on attempted withdrawal. Because of the dramatic response to therapy, dopa-responsive dystonia must be considered in the differential diagnosis of disorders presenting as gait disorders in childhood.

Matched MeSH terms: Diagnosis, Differential

Calcifying fibroblastic granuloma. A case report

Taiyeb Ali TB, Siar CH

J N Z Soc Periodontol, 1997.

PMID: 9522721

Matched MeSH terms: Diagnosis, Differential

Fulltext Bladder outflow obstruction masquerading as pelviureteric junction (PUJ) obstruction

Teh CL, Lei CC, Khairullah A

Med J Malaysia, 1996 Mar;51(1):156-8.

PMID: 10968001

We report a case of bladder outflow obstruction presenting with upper tract dilatation mistaken initially as pelviureteric junction (PUJ) obstruction. The lower tract obstruction ought to be dealt with first before upper tract obstruction is assessed because the renal pelvic pressure is significantly affected by vesical filling and high bladder pressure.

Matched MeSH terms: Diagnosis, Differential

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