Kantar, Yusuf

Foreign body impaction in the esophagus is a common emergency, particularly among children; however, unusual presentations in geriatric patients are rarely encountered. The clinical manifestation may vary depending on the type and location of the foreign body and the patient's underlying condition. We report the case of a 79-year-old bedridden male patient with Alzheimer's disease who presented to the emergency department with shortness of breath and audible wheezing. Initial evaluation and imaging studies revealed no acute pulmonary pathology. A lateral neck X-ray demonstrated an image consistent with a foreign body at the cervical level, which was later confirmed by computed tomography to extend along the esophagus. Under sedation with fentanyl and ketamine, the foreign body-a sock-was successfully removed using a laryngoscope and long forceps. The patient recovered uneventfully and was discharged after clinical stabilization. This case is remarkable due to the atypical presentation and the unusual nature of the ingested object. While most esophageal foreign bodies in adults are accidental or intentional, this case resulted from unconscious behavior related to Alzheimer's disease. Emergency physicians should maintain a high index of suspicion when evaluating elderly or cognitively impaired patients presenting with atypical respiratory symptoms, as early recognition and prompt intervention can be lifesaving.

Barkay, Orcun; Karakeçili, Faruk; Binay, Umut Devrim; Sümer, Betul

Brucellosis and Crimean-Congo Hemorrhagic Fever are diseases that can present with similar clinical and laboratory findings to those of COVID-19. This can delay diagnosis and increase the risk of nosocomial transmission in the case of Crimean-Congo Hemorrhagic Fever. Although misdiagnosis of Brucellosis and Crimean-Congo Hemorrhagic Fever, and even a case of coinfection have been reported in the literature, no case report mentioning Crimean-Congo Hemorrhagic Fever and Brucellosis coinfection hospitalized with the pre-diagnosis of COVID-19 was found. A 35-year-old female patient presented to the emergency service with complaints of fever and fatigue. The patient was evaluated in the emergency triage and was taken to the area where COVID-19 pre-diagnosed patients were being examined. A thorax computed tomography without intravenous contrast usage was reported as normal, and the patient was discharged after being informed about COVID-19 transmission routes. The patient re-applied to the emergency service with complaints of fever, fatigue, headache, and myalgia four days later. The laboratory findings showed a white-cell count of 1600/mm(3), haemoglobin of 12,8 g/liter, platelet of 146000/mm(3), urea of 21,5 mg/dl, creatinine of 0,81 mg/dl, alanine aminotransferase of 134 U/liter, aspartate aminotransferase of 303 U/liter, lactate dehydrogenase of 714 U/liter, creatine kinase of 1796 U/liter, C-reactive protein of 3 mg/liter, D-dimer of 2000 mu g/liter, and a thorax computed tomography showed minimal ground-glass opacity. The patient was hospitalized with a preliminary diagnosis of COVID-19 by the chest diseases clinic. This case highlights the importance of considering other diseases with similar clinical and laboratory findings in endemic regions of Brucellosis and Crimean-Congo Hemorrhagic

Peker, Kemal; Güllü, Huriye; Sahin, Murat; Issin, Ahmet

Pneumoscrotum is a rare pathology that has received little attention in the literature, although a few cases have been presented with different causes. Etiological factors that can cause pneumoscrotum include the lungs, retroperitoneal sources, surgical procedures or infections with microorganisms producing gas. A 57-year-old man was admitted to the emergency department following a motorcycle accident. He had chest excoriations and a painless crepitant scrotum. In conclusion, subcutaneous emphysema of the scrotum due to traumatic pneumothorax is not an urgent condition and assessment should be supportive with intervention directed at the etiology.