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SAGE Open Medical Case Reports

Ronie Romelean Jayapalan, Nor Faizal Ahmad Bahuri, Kein Seong Mun, Vairavan Narayanan
Perivascular epithelioid cell tumour is a rare mesenchymal tumour with distinct immunohistochemical profile. While it is known to occur in various anatomical sites, the central nervous system had always been a protected site for primary or secondary perivascular epithelioid cell tumours. We describe a 61-year-old lady who presented with symptoms of raised intracranial pressure, 3 months after the resection of duodenal and thoracic tumours which were histologically consistent with perivascular epithelioid cell tumour...
2019: SAGE Open Medical Case Reports
Daria Gaut, Kyle Muir, Antonio M Pessegueiro
Reactive arthritis has been described infrequently in association with staphylococcal infections, both those secondary to Staphylococcus aureus and coagulase-negative staphylococci. We present a case of a 51-year-old male undergoing chemotherapy for pancreatic cancer who presented with joint pain and fevers and was found to have Staphylococcus lugdunensis bacteremia. Transthoracic and transesophageal echocardiograms were negative for endocarditis. Arthrocentesis from one large joint revealed culture-negative inflammatory synovitis...
2019: SAGE Open Medical Case Reports
Itsuro Kazama, Toshiyuki Nakajima
We report a case of right bundle branch block, in which the patient's symptoms and the electrocardiogram findings mimicked those of acute coronary syndrome. In this case report, we stress the significance of apparent ST segment elevation in right bundle branch block. The differential diagnosis is important because right bundle branch block is often complicated with acute coronary syndrome. In addition, right bundle branch block with an ST segment elevation in the specific leads can be a predictor of sudden cardiac death...
2019: SAGE Open Medical Case Reports
Maria Monica Haydock, Shahed Elhamdani, Mohamed Alsharedi
Osteonecrosis is a pathological condition that could lead to a debilitating physical disease and impede daily activities. It is generally categorised into aetiology - primary (idiopathic) or secondary. When direct damage to the bone vasculature or direct injury of the bone marrow is related to an identifiable cause such as traumatic injuries, steroid or bisphosphonate use, increased alcohol intake, sickle cell disease, autoimmune diseases, chemotherapy or malignancy, it is categorised as secondary osteonecrosis...
2019: SAGE Open Medical Case Reports
Haruki Ikawa, Sho Kanata, Akihisa Akahane, Mamoru Tochigi, Naoki Hayashi, Emi Ikebuchi
Methamphetamine, a potent psychostimulant, may cause a condition of mood disorder among users. However, arguments concerning methamphetamine-induced mood disorder remain insufficient. This case study describes a male with methamphetamine-induced bipolar disorder not accompanied by psychotic symptoms, who twice in an 11-year treatment period, manifested an ultra-rapid cycler condition alternating between manic and depressive mood states with 3- to 7-day durations for each. The conditions ensued after a bout of high-dose methamphetamine use and shifted to a moderately depressive condition within 1 month after the use under a treatment regimen of aripiprazole and mood stabilizers...
2019: SAGE Open Medical Case Reports
Agnethe May Ahnfeldt, Victoria Elizabeth de Knegt, Jesper Irving Reimers, Malene Landbo Børresen
Atrial standstill is a rare arrhythmia defined by the absence of mechanical and electrical activity in the atria. Few cases of atrial standstill have been described in children, none of which have presented with cerebral infarction confirmed by imaging. We report a unique case of a 7-year-old girl presenting with expressive aphasia, central facial palsy and irregular pulse with cerebral infarction secondary to atrial standstill. This case illustrates that cardiogenic cerebral embolism in children can be caused by rare conditions like atrial standstill and should be considered in paediatric patients undergoing evaluation for stroke...
2019: SAGE Open Medical Case Reports
Kiyoshi Sato, Satoshi Fumimoto, Takayuki Kataoka, Yoshio Ichihashi, Kaoru Ochi, Hidetoshi Satomi, Nobuharu Hanaoka, Yoshikatsu Okada, Takahiro Katsumata
Thymomas are tumors originating from the thymus epithelial cells and are the most common tumors of the anterior mediastinum. They have been classified into types A, AB, B1, B2, and B3 by the World Health Organization. Type B3 thymoma is composed of epithelial cell sheets with mild to moderate atypia and scant lymphocytes. An association between thymic carcinoma and neuroendocrine differentiation has been observed by some authors. However, cases of type B3 thymoma with neuroendocrine differentiation are very rarely discussed in the literature...
2019: SAGE Open Medical Case Reports
Noor S Bawahab, Osama Y Safdar, Sarah A Nagadi, Asalh T Saeedi, Raghad W Mohammed Hussain
Occurrence of early nephrotic syndrome in type 1 diabetes mellitus patients is extremely rare. Herein, we report the case of a 12-year-old boy who presented to our pediatric nephrology clinic with generalized edema. He had been diagnosed with type 1 diabetes mellitus at age 9 and had been treated with regular insulin. Examinations revealed normal kidney function, hypoalbuminemia, proteinuria (4+), hyperlipidemia, and low protein-to-creatinine ratio. The patient was diagnosed with idiopathic nephrotic syndrome and was empirically administered prednisolone for 12 weeks...
2019: SAGE Open Medical Case Reports
Brian Arturo Mondeja Rodríguez, Ernesto Alimañy, Yigani Vila de Armas, Nadia María Rodríguez Preval
Bacterial endophthalmitis is the most severe form of vision-threatening ocular infection. Mycoplasma pneumoniae is a primary respiratory pathogen that has been associated with several extrapulmonary manifestation, including ocular infection. In this work, we presented the microbiology diagnosis of an endophalmitis by M. pneumoniae using a novel A.R.I. WELL D-ONE® (CPM Scientifica, Italy) commercial micromethod in a Cuban pediatric patient. After positive M. pneumoniae confirmation, treatment with levofloxacin was initiated and successfully eliminated the ocular infection...
2019: SAGE Open Medical Case Reports
Julia Mayba, C Nicole Hawkins
We present a case of Sneddon-Wilkinson disease in a 52-year-old female at her first presentation to dermatology. Outlined in the case are various investigations undertaken at this initial presentation, including rheumatologic and hematologic malignancy markers, which identified immunoglobulin A gammopathy. The systemic and topical therapies used to treat the patient's condition are described, as well as her response to these treatments. In this discussion, we explain the epidemiology, pathophysiology, and clinical presentation of Sneddon-Wilkinson disease...
2019: SAGE Open Medical Case Reports
Hiroyuki Otsuka, Tomokazu Fukushima, Youhei Tsubouchi, Keiji Sakurai, Sadaki Inokuchi
Despite rapid advancements in medical technologies, the use of interventional radiology in a patient with hemodynamic instability or hollow viscus injury remains controversial. Here, we discuss important aspects regarding the use of interventional radiology for such patients. A 74-year-old Japanese male climber was injured following a 10 m fall. On admission, his systolic blood pressure was 40 mmHg. He had disturbance of consciousness and mild upper abdominal pain without peritoneal irritation. Focused assessment sonography for trauma indicated massive hemorrhage in the intra-abdominal cavity...
2019: SAGE Open Medical Case Reports
Monika P Debkowska, Ilvy H Cotterell, Aimee J Riley
A 24-year-old right-hand dominant male with severe Hemophilia A presented with acute elbow pain, associated paresthesias, and weakness in the ulnar nerve distribution after upper body weight lifting. In the week prior, he missed three doses of Factor VIII replacement. After no improvement with conservative measures, he was taken to the operating room urgently for decompression and was noted to have a perineural hematoma in the cubital tunnel. At final follow-up, the patient reported complete resolution of symptoms...
2019: SAGE Open Medical Case Reports
Andrew Koogler, Ganiyu Amusa, Michael Kushelev, Alec Lawrence, Laurah Carlson, Kenneth Moran
A 70 year-old female patient presented for a right humeral head replacement. Preoperatively an interscalene catheter was placed and postoperatively connected to an elastomeric pump for continuous infusion at 8 mL/h of Ropivacaine 0.2% with an additional 5 mL patient activated bolus available every 30 min. About 17 h after the elastomeric pump was connected to the catheter, the 550 mL reservoir was found to be empty, indicating the pump's infusion rate was more than 32 mL/h despite the pump still being set at an infusion rate of 8 mL/h with a possible 5 mL bolus every 30 min...
2019: SAGE Open Medical Case Reports
Sharad Khurana, Salman Ahmed, Victoria R Alegria, Sonikpreet Aulakh, Meghna Ailawadhi, Anshika Singh, Asher Chanan-Khan, Sikander Ailawadhi
Obinutuzumab is used for the treatment of chronic lymphocytic leukemia. So far there are no data of using this for retreatment in patients who have received it previously. We introduced obinutuzumab for the retreatment in a chronic lymphocytic leukemia patient, who had first achieved partial remission with it and eventually relapsed over a course of 2.5 years. After retreatment with single-agent obinutuzumab, the patient achieved a partial remission again within one cycle and continues to maintain the response status...
2019: SAGE Open Medical Case Reports
Iva Lisičar, Josip Begovac, Šime Zekan
Fitz-Hugh-Curtis syndrome, a rare complication of pelvic inflammatory disease, is an inflammation of the liver capsule (thus called perihepatitis) and the surrounding peritoneum. It occurs extremely rarely in men and is typically characterized by a sudden onset of severe pain in the right upper abdominal quadrant. Ultrasound examination of the liver does not reveal any morphologic changes, and liver function tests are usually normal. Computerized tomography shows the thickening of the perihepatic fat, but definitive diagnosis is only possible by direct visualization by laparoscopy or laparotomy...
2019: SAGE Open Medical Case Reports
Rex David S Gido, Amy L Wojciechowski, Rajinder Ps Bajwa
Mycobacterium szulgai is a non-tuberculous mycobacterium that is an uncommon cause of infection in humans. Risk factors for infection include immunosuppression and pre-existing lung pathology. Herein, we present a case of a 42-year-old male with chronic obstructive pulmonary disease with pulmonary infection caused by M. szulgai that was successfully treated with a regimen of rifampin, isoniazid, pyrazinamide and ethambutol for 2 months, followed by rifampin, isoniazid and azithromycin for an additional 8 months...
2019: SAGE Open Medical Case Reports
Yonatan Bardash, Tristan Tham, Caitlin Olson, Julian Khaymovich, Peter Costantino
Intra-arterial infusion of drugs shows promising results in terms of safety and efficacy. Intra-arterial cetuximab, a monoclonal antibody treatment, is currently being tested for its use in head and neck cancers. We present the case of a 45-year-old Asian male who developed an anaphylactoid hypersensitivity reaction, manifesting itself in the form of bronchospasm, tachycardia, and hypotension, during intra-arterial infusion of cetuximab. The symptoms were quickly diagnosed, and the patient was treated accordingly...
2019: SAGE Open Medical Case Reports
Nayif Alnaif, James Lee, Alain Joe Azzi, Salah Aldekhayel, Teanoosh Zadeh
The management of a mangled limb is a challenging endeavor. With the advancement in microsurgery, spare parts surgery (fillet flaps) has gained recent interest. In the context of lower extremity amputation secondary to trauma, viable spare parts can provide stump soft tissue coverage, potentially preserving critical length and obviating above-knee amputations. Commonly, spare parts surgery is performed in the acute setting but tissue preservation is sometimes necessary. The authors report their experience preserving a fillet flap of a mangled lower extremity for 48 h using the University of Wisconsin solution...
2019: SAGE Open Medical Case Reports
Xin Guo, Jiro Watanabe, Kenji Takahashi, Tatsuro Hayashi, Nozomu Kurose, Yasuyuki Sasaguri, Hidetaka Uramoto, Hiromi Iwagaki, Kazuki Nabeshima, Sohsuke Yamada
An 80-year-old male with previous workplace exposure to asbestos presented with a history of an increase in the pulmonary-to-hilar mass, measuring more than 50 mm in diameter, likely in the right lower lobe. We first interpreted it as suspicious of primary lung adenocarcinoma with direct invasion to the right hilar lymph node. A right middle and lower lobectomy with partial resection of upper lobe was performed, and gross examination showed a hilar tumor lesion, involving the middle/lower lobe to hilar lymph node and looking whitish to yellow-grayish, partly adjacent to the right pulmonary artery...
2019: SAGE Open Medical Case Reports
Andrea Boncoraglio, Giuseppe Caltabiano, Pietro Valerio Foti, Luca Mammino, Giovanni Failla, Stefano Palmucci, Antonio Basile
Transradial artery approach as primary access for transcatheter diagnosis and intervention is associated with lower risk of bleeding and major vascular complications, improved patient comfort and shorter time to hemostasis and ambulation than femoral one. Patient's adequate hand collateral perfusion, assessed by the Barbeau test, must be depicted prior to transradial artery approach in order to assess any absolute contraindication (D waveform). We describe the distal transradial artery approach, recently proposed for coronary interventions, used in emergency to embolize an intestinal bleeding in an 84-year-old woman and a left pectoralis major muscle bleeding in an 83-year-old woman, both with high risk of bleeding for femoral approach and contraindication for transradial artery approach (Barbeau D waveform)...
2019: SAGE Open Medical Case Reports
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