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Oxford Medical Case Reports

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https://read.qxmd.com/read/30740231/a-case-of-pseudo-pseudo-meigs-syndrome
#1
Omnya Ahmed, Tamir Malley
Here we report a case of a patient with systemic lupus erythematosus presenting with pseudo-pseudo Meigs' syndrome (PPMS): a triad of pleural effusion, ascites and raised CA-125. There have only been nine other cases reported in the literature. To our knowledge, this is the first to have an oesophago-gastro-duodenoscopy and liver biopsy as part of the diagnostic work up. Its mechanism of action is not yet fully understood but PPMS is a treatable condition that is responsive to immunosuppression. It is therefore important to consider it in patients presenting like this, where alternative diagnoses, including malignancy, have been ruled out...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697439/concurrent-pulmonary-embolism-in-female-monozygotic-twins-affected-by-dercum-s-disease
#2
Roberta Eufrasia Ledda, Joanna Raikes, Paola Crivelli, Immo Weichert
We describe a pair of female monozygotic twins with Dercum's disease (DD) who presented simultaneously with unprovoked pulmonary emboli. Several genetic determinants have been associated with venous thromboembolism (VTE) but the overall influence of genetic factors is unknown. As yet there is no published evidence to support an increase in the risk of VTE in female monozygotic twins. DD is a rare condition characterized by multiple, painful lipomas. The underlying pathology of it is poorly understood. To date, there has been no recorded association with an increased risk of VTE but there have been reports of stroke-like events...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697438/amiodarone-induced-life-threatening-torsade-de-pointes-in-an-end-stage-lung-cancer-patient-receiving-gefitinib
#3
Dan Han, Hui Tan, Chaofeng Sun, Guoliang Li
The risk factors of acquired long QT syndrome (aLQTS) are sometimes overlooked in clinics. Drugs, hypokalemia, age and female sex are well-known risk factors of QT prolongation-dependent torsade de pointes (TdP), which explains the high incidence of sudden cardiac death in LQT patients. Here, we report a case of an elderly female patient with lung cancer who was in poor condition, for whom amiodarone was mistakenly prescribed to rectify premature ventricular contractions. QT prolongation-dependent TdP immediately followed intravenous injection of amiodarone...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697437/medial-pontomedullary-junctional-infarction-presenting-vertigo-ipsilateral-facial-paresis-contralateral-thermal-hypoalgesia-and-dysphagia-without-lateral-gaze-palsy-curtain-sign-and-hoarseness-a-case-presentation-of-a-novel-brain-stem-stroke-syndrome-with-sensory
#4
Yuichiro Yoneoka, Ryo Ikeda, Naotaka Aizawa, Yasuhiro Seki, Katsuhiko Akiyama
In this report, we describe unilateral medial pontomedullary junction (MPMJ) syndrome as a novel brain stem stroke syndrome. A 68-year-old woman suddenly developed vertigo, ipsilateral facial paresis, contralateral thermal hypoalgesia (TH) and dysphagia without lateral gaze palsy, curtain sign and hoarseness. Magnetic resonance (MR) imaging showed a small infarction at the right MPMJ. MR angiography did not show vertebrobasilar arterial dissection, thrombosis or vasospasm. Finally, her dysphagia regressed over 4 weeks in synchronization with recovery of TH...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697436/hemobilia-from-arteriobiliary-fistula
#5
Puneet Menaria, Venkata Muddana
No abstract text is available yet for this article.
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697435/cerebral-venous-thrombosis-as-an-initial-manifestation-of-acute-myeloid-leukemia
#6
Andy Sing Ong Tang, Siaw Tze Yeo, Wan Chung Law, Lee Ping Chew
Cancer-associated thromboembolism is not an uncommon complication in patients with malignancies. No study has reported the occurrence of thromboembolism prior to the diagnosis of acute myeloid leukemia (AML). Most reports are anectodal and data are scarce on this subject. In this report, we present a case of extensive cerebral venous thrombosis (CVT) that was detected a few weeks before the diagnosis of AML, in which case the patient responded well to chemotherapy and anticoagulation.
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697434/heads-up-don-t-forget-the-ordinary
#7
Eric R Gottlieb, Meghan M Nahass, Francis X Basile
A 72-year-old woman presented to the emergency department with shortness of breath, diffuse swelling and a haemoglobin of 4.2 g/dl. Her history was notable for an unusual necrotic occipital neck mass that had begun to enlarge and intermittently bleed over the past year. The patient was initially unable to tolerate a CT scan because of the neck mass, and care was further complicated by extended boarding for more than 24 h in the emergency department. Initial fevers were attributed to blood transfusion, but she subsequently developed septic shock and disseminated intravascular coagulation from Escherichia coli bacteraemia, which led to anuric renal failure requiring haemodialysis...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697433/perianal-abscess-in-a-2-year-old-presenting-with-a-febrile-seizure-and-swelling-of-the-perineum
#8
Gregory M Taylor, Andrew H Erlich
An anorectal abscess, specifically a perianal abscess, is a relatively uncommon infection in children. It is a purulent fluid collection under the soft tissue outside the anus. Some of these abscesses may spontaneously drain and heal by themselves, while others may result in sepsis and require surgical intervention. The transition to a systemic illness requiring hospital admission is considered rare. We present the case of a 2-year-old male presenting with a febrile seizure and found to be systemically ill secondary to a perianal abscess...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697432/perivascular-epithelioid-cell-tumour-and-mesonephric-adenocarcinoma-of-the-uterine-cervix-an-unknown-co-existence
#9
Dimitrios Papoutsis, Banchhita Sahu, Joanna Kelly, Angeliki Antonakou
A 67-year-old woman with post-menopausal bleeding and a suspicious endocervical mass was referred to gynaecology outpatients' for diagnosis and management. Cervical punch biopsies taken showed a benign cervical perivascular epithelioid cell tumour (PEComa), with MRI imaging and PET-CT scan indicating a 3-4 cm endocervical tumour with malignant features. The patient underwent radical hysterectomy with lymph node dissection and the surgical specimen histopathology demonstrated a residual benign PEComa and a stage IIB mesonephric adenocarcinoma (MNA) of the cervix...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697431/a-rare-case-of-malignant-meningitis-from-a-likely-bronchogenic-melanoma-primary-cancer
#10
Jessica Little, Christopher Rajkumar, Waqar Saleem
Malignant meningitis is a rare condition with varied clinical presentations, often mimicking other neurological conditions. Here we report a rare case of malignant meningitis from primary bronchogenic melanoma. The patient initially presented with vomiting and headache. Over the next 12 days she developed rapidly progressive neurology: losing mental faculties, vision, hearing and limb power. Lumbar puncture results revealed malignant cells. Computer tomography of the chest found an endobronchial lesion which was later biopsied and histology revealed a melanoma...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697430/the-nd-yag-laser-as-first-line-treatment-for-fibrin-pupillary-block-glaucoma-following-uncomplicated-cataract-surgery
#11
Selina Khan, Mohamed Elashry
A 43-year-old lady presented with painful, loss of vision in the right eye 2 weeks after cataract surgery. This is on a background of previous central retinal vein occlusion in the right eye and bilateral diabetic retinopathy. Her past medical history included mixed connective tissue disease for which she is on systemic immunosuppressants. Ocular examination revealed significant corneal oedema, a shallow anterior chamber with an intraocular pressure of 45 mmHg. Intraocular pressure lowering medications were administered and repeat examination identified a fine fibrinous membrane attached to the pupillary margin with a substantial third space that had formed between the posterior edge of the membrane and the anterior lens surface...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697429/angioedema-after-thrombolysis-with-tissue-plasminogen-activator-an-airway-emergency
#12
Kimberly M Rathbun
Recombinant tissue plasminogen activator (rtPA), an enzyme that catalyzes the conversion of plasminogen to plasmin resulting in fibrinolysis, is used for the treatment of acute ischemic strokes. The use of this medication is not without complication. One complication of this therapy is angioedema. This complication can be life-threatening if not recognized quickly. However, the potential for the development of angioedema after rtPA administration is not widely known. This is a case of a 60-year-old man who suffered an acute ischemic stroke and was given rtPA...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697428/the-mystery-of-saturation-gap-a-case-of-dapsone-induced-methaemoglobinemia-in-a-pregnant-mother-with-leprosy
#13
Andy Sing Ong Tang, Siaw Tze Yeo, Yeon Chiat Teh, Wee Meng Kho, Lee Ping Chew, Pubalan Muniandy
Limited data regarding methemoglobinemia in pregnancy, particularly secondary to dapsone is available up to date. We report a case of dapsone-induced methemoglobinemia in a pregnant mother with multibacillary leprosy who presented with fever, productive cough and cyanosis of 2 days duration 2 weeks after multidrug therapy was commenced. On examination, she had central cyanosis with low oxygen saturation (SpO2 = 84-88%). Arterial blood gas analysis showed PO2 of 111 mmHg and SO2 of 98 mmHg. Patient was administered 100% oxygen inhalation, but there was no improvement in cyanosis...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30697427/grossly-elevated-plasma-bnp-does-not-exclude-the-diagnosis-of-constrictive-pericarditis
#14
Kyriacos Mouyis, Donald Singer, Constantinos Missouris
Pericardial effusion with constrictive physiology describes a condition in which the pericardial fluid and thickened and dense pericardium limit left ventricular (LV) diastolic filling and prevent ventricular stretch. This leads to equalization of the end-diastolic pressure in cardiac chambers and poor ventricular filling. We report two patients, who presented with symptoms and signs of severe heart failure and with significantly raised BNP levels who were subsequently diagnosed to have pericardial effusion with constrictive physiology...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30619614/platypnea-orthodeoxia-syndrome-after-right-lower-lobectomy-for-lung-cancer
#15
Andre C D'Mello, Kawa Haji, Stuart Moir, Paul Leong
Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea and deoxygenation in an upright position that is relieved by supine positioning. There are only five published accounts of it occurring post-lobectomy. We present the case of a 72-year-old male with 3 months of supposedly unexplained dyspnoea after right lower lobectomy for lung cancer who was confirmed to have POS. We highlight the importance of recognition and management as well as provide a brief summary of the pathophysiology...
January 2019: Oxford Medical Case Reports
https://read.qxmd.com/read/30538820/corrigendum-to-post-transplant-lymphoproliferative-disorder-presenting-on-post-transplant-day-35-as-a-pulmonary-parenchymal-infiltrate-a-case-report
#16
Andrew J Lewis, Deepa Jagadeesh, Sanjay Mukhopadhyay, Marie Budev, Atul C Mehta
[This corrects the article DOI: 10.1093/omcr/omy035.][This corrects the article DOI: 10.1093/omcr/omy035.].
December 2018: Oxford Medical Case Reports
https://read.qxmd.com/read/30524747/isolated-end-stage-renal-disease-in-sj%C3%A3-gren-s-syndrome-due-to-immune-complex-mediated-glomerulonephritis
#17
Shashank Agarwal, Jaishvi Eapen, Ming Wu, Bruce Garner, Adib Alhaddad
Renal involvement is an uncommon extra-glandular manifestation in Sjogren's syndrome (SS). We present the case of a young male who presented with nephrotic range proteinuria and advanced irreversible renal disease, with positive anti-Ro antibody (Ab) and antineutrophil cytoplasmic antibody (ANCA) with myeloperoxidase (MPO) specificity. He was initially treated with steroids for suspected ANCA vasculitis but treatment was discontinued as there was no response and renal biopsy revealed interstitial lymphocytic infiltrates, advanced glomerular disease with immune complex mediated glomerulonephritis more suspicious for SS...
December 2018: Oxford Medical Case Reports
https://read.qxmd.com/read/30487993/septic-pulmonary-embolism-complicated-by-pyogenic-spondylitis-and-psoas-abscesses-in-a-patient-with-methicillin-sensitive-staphylococcus-aureus-bacteraemia
#18
Eriko Kashihara, Kohei Fujita, Hiroshi Koyama, Tadashi Mio
Septic pulmonary embolism (SPE) is a rare condition, indicating bacteraemia. We report a rare case of Staphylococcus aureus bacteraemia causing SPE and multiple abscesses in a previously healthy patient. A previously healthy 33-year-old man presented to our hospital with fever and back pain for 3 weeks. Chest contrast-enhanced computed tomography image was suggestive of SPE, and the blood culture showed methicillin-susceptible S. aureus . Additional focus identification revealed pyogenic spondylitis and abscesses in the psoas muscles...
December 2018: Oxford Medical Case Reports
https://read.qxmd.com/read/30487992/disseminated-aids-related-kaposi-s-sarcoma
#19
Andy Sing Ong Tang, Yeon Chiat Teh, Chin Yung Chea, Siaw Tze Yeo, Hock Hin Chua
We present a case of disseminated Kaposi's sarcoma with both cutaneous and extracutaneous involvement in an HIV-infected patient with a relatively high CD4 count of 369 cell/mm3 . He developed chronic diarrhea, constitutional symptoms, worsening bilateral pleural effusion with respiratory distress, and progression of skin lesions distributed over his chest and extremities. The temporal relationship between rapid clinical progression and initiation of HAART suggested the possibility of Kaposi's sarcoma-associated immune reconstitution inflammatory syndrome, which eventually resulted in the death of this patient...
December 2018: Oxford Medical Case Reports
https://read.qxmd.com/read/30487991/-salmonella-enteritidis-causing-myocarditis-in-a-previously-healthy-22-year-old-male
#20
Per Sundbom, Anne-Marie Suutari, Karim Abdulhadi, Wojciech Broda, Melinda Csegedi
Myocarditis is mostly caused by viral infections and rarely caused by bacterial pathogens, especially in immunocompetent individuals. Bacterial myocarditis due to Salmonella is rare, especially in countries with improved sanitation that minimize contamination of Salmonella typhi serotypes. We here present a case of a previous healthy 22-year-old male that came to the emergency room with chest pain. His symptoms occurred after a period of profuse diarrhea, fever and hematochezia. Magnetic resonance imaging confirmed the diagnosis of myocarditis...
December 2018: Oxford Medical Case Reports
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