CLINICAL HISTORY 3

A 2-year-old boy Jacob Witch was brought to the local General Practitioner by his mother. After the medical examination he was immediately referred to the city hospital. Five days before the admission he began to vomit and became irritable. He had a bad weakness, sweating and malaise.

On the admission a brain Computed Tomography was performed which revealed a large midline mass; the lesion was heterogeneous, cystic, partly solid with calcifications. Magnetic resonance imaging demonstrated a 5x4.9x4.7cm mass, extending into the left angle. The patient was operated upon and a total resection of the mass was performed.

CLINICAL HISTORY 4

A 34-year old school teacher of Geography Julia Mettew came to one of the clinics complaining of bad headaches and generalized malaise which lasted out. The temperature was 38,4º, the pulse rate 120, and the respiration 27 per minute. The throat was acutely inflamed and edematous and both tonsils were covered with an exudate. The patient was hospitalized and on the tenth day when the throat appeared normal and her ward doctor thought that the temperature should decrease too, it continued to be elevated and the woman complained that she could not swallow at all. A few hours later she refused to take the food. Local examination at this time revealed a swelling on the anterior surface of the neck above and in the region of the thyroid gland. The patient’s complaint that she could not swallow was confirmed by having her drink water under the observation: each time that she attempted to swallow it, the water came through her nose. A diagnosis of abscess of the prevertebral fascial space was made and the operation was performed. An incision, three and a half inches in length, was made. An aspirating needle was inserted into the mass and thick creamy pus was evacuated. The recovery was uneventful and the patient was discharged ten days later.

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