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Journal of Medical Case Reports

Vinay Kapur, Sanjay D'Cruz, Ravinder Kaur
INTRODUCTION: Cerebral venous thrombosis is relatively rare and characterized by a wide spectrum of clinical features. It is more common in young adults with women affected more than men. The diagnosis of cerebral venous thrombosis is easier nowadays due to easy access to advanced neuroimaging techniques. Abnormalities in thrombophilic profile are associated with enhanced risk of cerebral venous thrombosis. It has varied etiologies such as hypercoagulable states, infection, dehydration, pregnancy, and substance abuse...
February 18, 2019: Journal of Medical Case Reports
Mukesh Dube, Raunak Dani, Ayush Dubey, Dinesh Chouksey
BACKGROUND: In the list of named numerical neuro-ophthalmological syndromes, such as one-and-a-half syndrome and others, we report for the first time twenty-and-a-half syndrome, which is characterized by one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy (1.5 + 7 + 7 + 5 = 20.5) in a patient with ischemic stroke. CASE PRESENTATION: A 45-year-old Asian Hindu woman presented with vomiting and imbalance of 1 day's duration. She had left-sided ataxic hemiparesis with one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy...
February 15, 2019: Journal of Medical Case Reports
M Ghalleb, M A Ayadi, S Slim, I Zemni, R Doghri, J Ben Hassouna, K Rahal
INTRODUCTION: Cutaneous metastatic disease arising from urinary tract carcinoma is rare and associated with a poor prognosis. We report a case of metastatic disease occurring in a patient treated for synchronous urothelial tumor of the bladder and left renal pelvis. CASE PRESENTATION: A 61-year-old Caucasian man was treated for a synchronous urothelial tumor of the bladder and left renal pelvis. He had an en bloc radical cystectomy and left ureteronehprectomy associated with a cutaneous transileal urinary diversion and lymph node dissection...
February 14, 2019: Journal of Medical Case Reports
Nobuhiro Asai, Yusuke Koizumi, Atsuko Yamada, Daisuke Sakanashi, Hiroki Watanabe, Hideo Kato, Arufumi Shiota, Mao Hagihara, Hiroyuki Suematsu, Yuka Yamagishi, Hiroshige Mikamo
BACKGROUND: Pantoea is a Gram-negative, non-encapsulated, non-spore-forming, ubiquitous straight rod which can be isolated from geographical and ecological sources such as plant surfaces, buckwheat seeds, human feces, and the environment. The genus Pantoea is a rare pathogen in a clinical setting, and is divided into 20 different species such as Pantoea agglomerans, Pantoea ananatis, Pantoea deleyi, Pantoea dispersa, Pantoea septica, Pantoea stewartii or Pantoea rwandensis. Pantoea dispersa has been reported to cause other infections, including respiratory infections, neonatal sepsis, and bloodstream infections...
February 13, 2019: Journal of Medical Case Reports
Carine Mekoguem, Cécile Triboulet, Alexandre Gouveia
BACKGROUND: Mycetoma is a neglected infectious disease caused by a fungus (eumycetoma) or bacteria (actinomycetoma); it is characterized by chronic local inflammation with sinus formation and purulent discharge. Its course can be quite devastating because of the difficulty in diagnosing the infection and in eliminating the causative agent. Although endemic in many countries in the tropics and subtropics, the migration of Africans to Europe may increase the presence of this neglected disease in European countries...
February 12, 2019: Journal of Medical Case Reports
Tarek Bayyoud, Jens Martin Rohrbach, Karl Ulrich Bartz-Schmidt, Sebastian Thaler
BACKGROUND: We report the first histopathologically proven occurrence of a retrocorneal membrane after Descemet's membrane endothelial keratoplasty. CASE PRESENTATION: A white Caucasian 76-year-old woman received penetrating keratoplasty on her right eye 2 years after Descemet's membrane endothelial keratoplasty surgery with combined cataract extraction and intraocular lens implantation for Fuchs' endothelial corneal dystrophy due to an allograft rejection with ensuing graft failure...
February 6, 2019: Journal of Medical Case Reports
Masao Takigami, Keiichi Itatani, Naohiko Nakanishi, Kosuke Nakaji, Yo Kajiyama, Satoaki Matoba, Hitoshi Yaku, Masaaki Yamagishi
BACKGROUND: Pulmonary regurgitation is a common complication after tetralogy of Fallot repair, resulting in right ventricular dysfunction, arrhythmia, and sudden death. However, the indications and optimal timing for pulmonary valve replacement are not fully known. We describe a case in which a four-dimensional imaging tool was useful in the decision to re-operate, thus resulting in decreased energy loss and improved right ventricular function after the re-operation for tetralogy of Fallot...
February 5, 2019: Journal of Medical Case Reports
Christine B French, Sharon L McDonnell, Reinhold Vieth
BACKGROUND: Vitamin D nutrition research requires accurate measures of circulating 25-hydroxyvitamin D. Our objectives were to test whether a diurnal fluctuation in blood-spot concentrations of 25-hydroxyvitamin D can be demonstrated statistically in a single individual, and whether such fluctuation is affected by the pre-dose versus post-dose timing of the blood draw. CASE PRESENTATION: The participant in this case study was a generally healthy Caucasian woman in her 40s who has taken 5000 IU vitamin D3 supplement at midday for over 1 year...
February 4, 2019: Journal of Medical Case Reports
J Snijder, N Mihyawi, A Frolov, A Ewton, G Rivero
BACKGROUND: Spontaneous remission in solid malignancies has been documented. However, spontaneous remission in aggressive diffuse large b cell lymphoma is exceedingly rare. Previous reports of lymphoma remission suggest that not yet fully characterized tumor-intrinsic and microenvironment mechanisms cooperate with spontaneous regression. CASE DESCRIPTION: Here, we report the case of an 88-year-old white woman with diffuse large b cell lymphoma (follicular lymphoma transformed) who achieved morphologic spontaneous remission 3 months after her diagnostic core biopsy...
February 1, 2019: Journal of Medical Case Reports
Susanne Bejerot, Eva Hesselmark, Fariborz Mobarrez, Håkan Wallén, Max Albert Hietala, Rolf Nybom, Lennart Wetterberg
BACKGROUND: Neuromyelitis optica spectrum disorders are severe autoimmune inflammatory diseases of the central nervous system associated with the presence of immunoglobulin G antibodies against the water channel protein aquaporin-4. During exacerbation, specific aquaporin-4 immunoglobulin G may be produced intrathecally. We measured extracellular aquaporin-4 microparticles in the cerebrospinal fluid of a patient who later developed the typical symptoms and signs of a neuromyelitis optica spectrum disorder...
January 30, 2019: Journal of Medical Case Reports
Ken-Ichi Aoyama, Masashi Tamura, Masahiro Uchibori, Yasuhiro Nakanishi, Toshihiro Arai, Takayuki Aoki, Yuko Osawa, Akihiro Kaneko, Yoshihide Ota
BACKGROUND: Trousseau syndrome is known as a variant of cancer-associated thrombosis. Trousseau syndrome commonly occurs in patients with lung or prostate cancer. Hypercoagulability is thought to be initiated by mucins produced by the adenocarcinoma, which react with leukocyte and platelet selectins to form platelet-rich microthrombi. This is the first report of Trousseau syndrome in a patient with oral cancer. CASE PRESENTATION: Here, we describe the case of a 61-year-old Japanese man diagnosed as having advanced buccal carcinoma (T4bN2bM1; the right scapula, erector spinae muscles, and the right femur), who experienced aphasia and loss of consciousness...
January 29, 2019: Journal of Medical Case Reports
Tarinee Rungjirajittranon, Weerapat Owattanapanich
BACKGROUND: Immune thrombocytopenia is an acquired autoimmune disease. Recently, there has been evidence of thrombotic risk in patients with immune thrombocytopenia, but the mechanism is still inconclusive. Intravenous immunoglobulin infusion therapy is considered an efficient treatment; however, it still is associated with adverse events of fever, chills, and hypotension, as well as serious complications such as thrombosis. We report a case a patient with relapsed immune thrombocytopenia who developed ischemic stroke after an intravenous immunoglobulin infusion...
January 28, 2019: Journal of Medical Case Reports
Nicholas Sajko, Shannon Murphy, Allen Tran
BACKGROUND: Fever of unknown origin is often a diagnostic dilemma for clinicians due to its extremely broad differential. One of the rarer categories of disease causing fever of unknown origin is malignancies; of these, soft tissue sarcoma is one of the least common. Soft tissue sarcomas make up < 1% of all adult malignancies and often do not present with any systemic manifestations or neoplastic fevers. CASE PRESENTATION: A 73-year-old Caucasian woman presented with a 2-week history of fever and profound fatigue...
January 27, 2019: Journal of Medical Case Reports
Xiaodong Song, Zili Shao, Huihong Liang
BACKGROUND: Pancreatic cancer is one of the most common fatal malignancies and has a poor prognosis. Surgical treatment is the most important treatment method, but there is a low rate of radical excision; moreover, the postoperative recurrence rate is high, with a local recurrence rate greater than 50%. The usefulness of intraoperative radiotherapy for pancreatic cancer has previously been examined. However, prior research was based on the traditional high-energy electron beam, which causes serious radiation toxicity...
January 26, 2019: Journal of Medical Case Reports
Josef Finsterer, Claudia Stollberger
INTRODUCTION: Simultaneous occurrence of transient global amnesia and Takotsubo syndrome has been only rarely reported. Here we report another patient with a transient global amnesia and concomitant Takotsubo syndrome. CASE PRESENTATION: Our patient is a 64-year-old white man with a previous history of myocarditis from borreliosis who developed sudden-onset confusional state with perseverations and repetition of the same questions during a funeral for his brother-in-law...
January 25, 2019: Journal of Medical Case Reports
Joanna Wasielica-Poslednik, Norbert Pfeiffer, Adrian Gericke
BACKGROUND: In this report, we present the results of a severe case of Sjögren's syndrome-related keratopathy after fluocinolone acetonide 190-μg intravitreal implant (Iluvien®; Alimera Sciences Inc.) therapy. CASE PRESENTATION: A 52-year-old Caucasian woman with Sjögren's syndrome secondary to autoimmune hepatitis and primary sclerosing cholangitis was admitted to our emergency department owing to bilateral corneal ulcers and corneal perforation in the left eye following exposure keratopathy in an artificially induced coma...
January 24, 2019: Journal of Medical Case Reports
Halil Tozum, Ahmet Nadir Aydemir, Murat Demiroglu, Korhan Ozkan, Ayse Bahar Ceyran, Bulent Kılıc
INTRODUCTION: Masses which develop on the surface of the rib bones are rare. The differential diagnosis includes benign and malignant lesions. CASE PRESENTATION: A 23-year-old European woman presented at an out-patient clinic with a 9-month history of a painless swelling on the right posterolateral side of her chest wall. The case reported here is of a very rarely seen parosteal osteosarcoma of the rib that was treated with wide resection and chest wall reconstruction...
January 23, 2019: Journal of Medical Case Reports
Giustino Parruti, Antonella Frattari, Ennio Polilli, Vincenzo Savini, Antonina Sciacca, Augusta Consorte, Donatella Concetta Cibelli, Adriana Agostinone, Francesco Di Masi, Alessandro Pieri, Pierluigi Cacciatore, Giancarlo Di Iorio, Paolo Fazii, Tullio Spina
BACKGROUND: Infections caused by multidrug-resistant Enterobacteriaceae are hard to treat and life-threatening due to reduced therapeutic options. Systemic infections caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae strains have increased in many European regions, becoming frequent in many clinical settings, and are associated with high mortality. The co-formulation of ceftazidime, a third-generation cephalosporin, with avibactam, a new suicide inhibitor beta-lactamase inhibitor able to block most Klebsiella pneumoniae carbapenemases, has been recently licensed, with promising results in patients with limited or absent therapeutic options...
January 22, 2019: Journal of Medical Case Reports
Hanife Usta Atmaca, Feray Akbas
BACKGROUND: The porphyrias are a rare group of metabolic disorders that can either be inherited or acquired. Along the heme biosynthetic pathway, porphyrias can manifest with neurovisceral and/or cutaneous symptoms, depending on the defective enzyme. Porphyria cutanea tarda, the most common type of porphyria worldwide, is caused by a deficiency of uroporphyrinogen decarboxylase, a crucial enzyme in heme biosynthesis, which results in an accumulation of photosensitive byproducts, such as uroporphyrinogen, which leads to the fragility and blistering of sun-exposed skin...
January 21, 2019: Journal of Medical Case Reports
Motofumi Koguchi, Yukiko Nakahara, Ryo Ebashi, Atsushi Ogata, Shoko Shimokawa, Jun Masuoka, Tatsuya Abe
BACKGROUND: Dopamine agonists are the standard first-line medical therapy for prolactinoma. We report a rare case of giant prolactinoma with a first epileptic seizure due to rapid reduction of the tumor as a complication of dopamine agonist therapy. CASE PRESENTATION: A 27-year-old Japanese man presented to our institution with a history of visual disturbance for 1 year and general fatigue for 3 months. Magnetic resonance imaging showed a tumor that arose from the pituitary and extended to the bilateral anterior skull base, the clivus, and the cavernous sinus, with compression of the optic chiasm and the bilateral frontal and temporal lobes...
January 20, 2019: Journal of Medical Case Reports
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