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Case Reports in Medicine

Chimezie U Mbachi, Oyintayo Ajiboye, Olisa Ezegwu, Benjamin Mba
Sarcoidosis is a multisystem granulomatous disease that most commonly affects the lungs but can affect other organs including the heart due to granuloma infiltration. Atrioventricular block is a common manifestation of cardiac sarcoidosis which can progress to sudden cardiac death. We report a case of cardiac sarcoidosis presenting as complete heart block, progressing to diastolic and systolic dysfunction without extracardiac manifestations early in the disease. This case stresses the importance of having a high index of suspicion for cardiac sarcoidosis in patients presenting with atrioventricular block of unknown etiology...
2019: Case Reports in Medicine
Murilo Sérgio Valente-Aguiar, Bruno Gonçalves da Costa E Silva, Teresa Magalhães, Ricardo Jorge Dinis-Oliveira
Snakebite envenoming is a neglected tropical disease with relevant morbidity and mortality. In this report, we illustrate the clinical course of a suspected Bothrops snakebite envenoming of a patient that evidenced severe pain, edema, pallor, regional lymphadenopathy, ecchymosis, myonecrosis, and bullous erythema in the right lower limb, specially around the fang marks. The clinical course progressed to compartment syndrome followed with decompressive fasciotomies to reduce pressure within the affected compartment...
2019: Case Reports in Medicine
Allam Abuhamda, Aymen Elsous, Fadel A Sharif
Partial trisomy 13 is a rare syndrome that usually culminates in death within the first six months of the infant's life. We present a rare case of partial trisomy 13q with exclusive clinical manifestations. The full-term male baby was born by normal vaginal delivery, his birth weight was 3500 grams, and head circumference was 30 cm. He had dysmorphic features in the form of microcephaly, trigonocephaly, depressed nose bridge, hypotelorism, long philtrum, high arch palate, left-sided inguinal hernia, hydrocele, and laryngomalacia...
2019: Case Reports in Medicine
Chinmay Patel, Courtney Thompson, Megan Copley-Harris, Yousef Hattab
We report a case of rhabdomyolysis and severe acute kidney injury (AKI) requiring dialysis in a 69-year-old male who was recently started on sitagliptin while on chronic simvastatin therapy. This potential interaction is not included in the package insert for sitagliptin. A comprehensive literature review revealed six previous reports of rhabdomyolysis due to drug interaction between sitagliptin and statins including simvastatin, lovastatin, and atorvastatin. Of these six cases, only two had developed rhabdomyolysis-associated AKI, none of which were severe enough to require dialysis...
2019: Case Reports in Medicine
Guntram Krzok
Endoscopic surgery for highly downmigrated disc herniation at level L5-S1 is a challenging technique. Most surgeons prefer the interlaminar access because of the special anatomy of the L5-S1 disc level, i.e., narrow neuroforamen and large interlaminar window. Transforaminal access to the neuroforamen L5-S1 is difficult in cases with high iliac crest. Here, the access to the highly downmigrated disc herniation with the recently reported technique of transpedicular endoscopic surgery by Krzok et al. was described...
2019: Case Reports in Medicine
Osamah Hasan, Ankit A Patel, James J Siegert
Recreational use of synthetic cannabinoids (SCs), also known as "K2" or "Spice," is becoming a major public-health concern due to their potential for abuse and harmful consequences. New substances are constantly being added to the content of SCs. The dearth of information on these newly added contents as they are introduced into the black market hinders risk assessments of these compounds. We report a highly unusual case of gross hematuria in a 28-year-old male patient after SC use. He was found to have a supratherapeutic INR with no history of prior anticoagulation...
2019: Case Reports in Medicine
Rita Patrocínio-Jesus, João Cunha, Diva Trigo, Bárbara Flor-de-Lima, Patrícia Pacheco
The combination of artemether/lumefantrine is indicated for the treatment of acute uncomplicated Plasmodium falciparum malaria. There have been no clinical trials to assess the efficacy of this medication in patients with renal impairment. While it is unlikely that artemether/lumefantrine would be removed during dialysis, clinical experience regarding drug use in this setting is limited. In this article, the authors report successful treatment of Plasmodium malariae malaria on a patient with end-stage kidney disease undergoing hemodialysis...
2019: Case Reports in Medicine
Sundar Khadka, Rupendra Shrestha, Sanjeet Pandit, Roshan Pandit, Anup Bastola
Aim: Dual coinfection of HCV and HBV in HIV-1-infected population is a leading cause of morbidity and mortality. Also, they share routes of HIV transmission; however, it might be associated with an independent factor like injecting drug use for HCV and unsafe sex for HBV. This case report suggests that hepatitis virus coinfection may lead to late response of antiretroviral therapy (ART) in HIV-1 patients. Patients and Methods: A 49-year-old male patient visited for the routine follow-up investigation at the National Public Health Laboratory (NPHL), Teku, Nepal...
2019: Case Reports in Medicine
Adesola Olalekan, Faith Itua, Bamidele Mutiu, Tenny Egwuatu, Olubukola Akinloye, Bamidele Iwalokun
Chromobacterium violaceum has been implicated as an important cause of invasive diseases such as septicaemia in neonates and immune-compromised adults with high risk of misdiagnosis, mistreatment, and poor outcomes. Here, we report three new cases of C. violaceum infections in three different hospitalised patients with empyema thoracis (one case) and urinary tract infections (two cases) in a tertiary Hospital in Lagos, Nigeria, and the diagnosis was confirmed with the MALDI-TOF MS instrument. The patients were admitted and treated with parenteral antibiotics (ciprofloxacin, cefotaxime, and ceftriaxone) and discharged after clinical cure...
2019: Case Reports in Medicine
Yub Raj Sedhai, Soney Basnyat, Tawseef Dar, Deepak Acharya
Renal artery aneurysms are extremely uncommon with a reported incidence of less than one percent in general population. They are being more frequently detected due to increasing availability and use of abdominal imaging. Renal artery aneurysm rupture is an extremely unusual cause of acute flank pain with hemodynamic instability. Given the rarity of diagnoses, clinicians may not consider and address this ruptured renal artery aneurysm early which can potentially lead to adverse clinical outcomes. We report the case of a 55-year-old male who presented with retroperitoneal bleeding from a ruptured aneurysm of the interlobular branch of renal artery...
2019: Case Reports in Medicine
Maria Lagadinou, Virginia Mplani, Dimitrios Velissaris, Periklis Davlouros, Markos Marangos
Brucellosis remains an important public health problem with endemic characteristics in many countries. Brucellosis can affect almost all organs and systems of human body. Cardiac complications are unusual, occurring in less than 2% of patients and usually manifest as endocarditis. We present the case of a 21-year-old Caucasian man, who was admitted to the University Hospital of Patras, Western Greece, with fatigue, fever up to 39°C, and retrosternal pain. Musculoskeletal, genitourinary, gastrointestinal, hematologic, nervous, skin, and mucous membranes and respiratory complications have been reported in several cases of brucellosis...
2019: Case Reports in Medicine
Muhammad Asim Shahzad, Maryam Mukhtar, Asrar Ahmed, Waqas Ullah, Rehan Saeed, Mohsin Hamid
Gitelman syndrome is one of the few inherited causes of metabolic alkalosis due to salt losing tubulopathy. It is caused by tubular defects at the level of distal convoluted tubules, mimicking a thiazide-like tumor. It usually presents in late childhood or in teenage as nonspecific weakness, fatigability, polyuria, and polydipsia but very rarely with seizures. It is classically associated with hypokalemia, hypomagnesemia, hypocalciuria, hyperreninemia, and hyperaldosteronism. However, less frequently, it can present with normal magnesium levels...
2019: Case Reports in Medicine
Christoph Sossou, Ogechukwu Chika-Nwosuh, Christopher Nnaoma, Jose Bustillo, Asad Chohan, Etinosasere Okundaye, Pratik Patel
Acute chest syndrome (ACS) is a feared complication of sickle cell disease. Here is a case of a patient who presented with symptoms suggestive of acute chest syndrome yet had a delayed diagnosis presumably due to the lack of documented history of sickle cell disease of the patient, consequently evolving into acute respiratory distress syndrome (ARDS). He was subsequently diagnosed with heterozygous sickle cell SC disease on hemoglobin electrophoresis. After appropriate management with mechanical ventilator, broad-spectrum empiric intravenous antibiotics, exchange transfusion, and intravenous fluid resuscitation, the patient was medically optimized and safely discharged home, with significant improvement noted on successive follow-up visits...
2019: Case Reports in Medicine
B Achappa, D Madi, T Kanchan, N K Kishanlal
Ethylene glycol poisoning is not uncommon in India. The ill effects are primarily caused by its toxic metabolites: glycolic acid and oxalic acid. A 70-year-old female presented to our hospital with ataxia after ingestion of ethylene glycol. The reported case describes the management of ethylene glycol poisoning using oral ethyl alcohol as an alternative to the recommended intravenous ethyl alcohol and fomepizole that are not available for use in India. The need for high degree of clinical suspicion, targeted investigations, and early instigation of treatment is of prime importance in cases of ethylene glycol poisoning as it can lead to long-term complications or even death...
2019: Case Reports in Medicine
Camila D Odio, Charisse Mandimika, Thiago A Jabuonski, Maricar Malinis
Myositis is a rare and morbid complication of influenza infection that can rapidly progress to rhabdomyolysis with acute renal failure. Here, we describe a 35-year-old obese woman with severe influenza A(H1N1) virus infection complicated by myositis, refractory rhabdomyolysis, and compartment syndrome.
2019: Case Reports in Medicine
Ibrahim Toprak, Volkan Yaylali
This report describes two maneuvers in different steps of phaco surgery in a case with hard cataract, which provide debulking of the central dense nucleus and prevents posterior capsule rupture (PCR). In the current case, clear corneal incisions were created, and anterior chamber was filled with ophthalmic viscosurgical device (OVD). Anterior capsule was punctured, and capsulorhexis was completed. Nucleus was cracked into two halves following vertical groove formation. Core nucleus was hollowed sideward bilaterally in the capsular bag...
2019: Case Reports in Medicine
Takashige Kiyota, Seiji Shiota, Ryosuke Hamanaka, Daisuke Tsutsumi, Takeshi Takakura, Eishi Miyazaki
An 83-year-old man under warfarin therapy presented for assessment of prolonged prothrombin time and cough. High-resolution computed tomography findings of the chest showed diffuse alveolar hemorrhage. His international normalized ratio (INR) was 11.89. He had been treated with rifampicin for a persistent infection, but this had been discontinued about two months before admission. Rifampicin suppresses the anticoagulant activity of warfarin, which can lead to a need for increased doses of warfarin to achieve and maintain a therapeutic INR...
2019: Case Reports in Medicine
Manish M Karamchandani, Tej Ganti, Sunny Jaiswal, Julian K Wu, Muhammad Wasif Saif
Background: Gastric cancer is the fourth most common cancer worldwide and the second most common cause of cancer-related death. The majority of newly diagnosed gastric cancer cases present either as locally advanced tumor growth or with distant metastases. Case Report: Here, we describe a case of isolated brain metastases in a male patient with gastric cancer. Initially, our patient presented with dysphagia and was diagnosed with gastric cancer after a thorough evaluation...
2019: Case Reports in Medicine
Saada Alame, Eliane El-Houwayek, Caroline Nava, Sandra Sabbagh, Ali Fawaz, Anne-Celine Gillart, Dana Hasbini, Christel Depienne, André Mégarbané
Dravet syndrome, also known as severe myoclonic epilepsy in infancy, is a rare disease characterized by the appearance of different types of seizures in a healthy baby, triggered by various factors and stressful events. We report 8 Lebanese cases referred for molecular analysis of the SCN1A gene. Results were positive in 7 cases and revealed de novo variants at the heterozygous state in different exons of the gene for all except one, where the variant was intronic. Four variants were novel. Confirmation of Dravet syndrome is important for a better follow-up and treatment, preventing the occurrence of status epilepticus and severe neurological deterioration...
2019: Case Reports in Medicine
Eri Nakano, Tsubasa Fukuoka, Nao Takeuchi, Tomoyuki Seki, Michihiro Tamai, Makoto Araki
Cephalosporins are one of the most commonly used first-line antibiotics. In this report, we describe the case of a patient who developed alveolar bleeding due to clotting abnormality following the use of cefmetazole, one of cephalosporins containing an N -methylthiotetrazole (NMTT) side chain. Compared to other antibiotics, cephalosporins with an NMTT side chain cause a higher degree of bleeding events. The bleeding tendency is caused by the depletion of vitamin K-dependent clotting factors via inhibition of the vitamin K epoxide reductase...
2019: Case Reports in Medicine
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