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Journal of Medical Case Reports

P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Stephanie Rutledge, Michele Harrison, Martin O'Connell, Tadhg O'Dwyer, Maria M Byrne
BACKGROUND: We report the case of a giant intrathyroidal parathyroid adenoma weighing 59 g in a young woman presenting acutely with severe hypercalcemia requiring correction and adequate preoperative management prior to surgery. Parathyroid adenomas account for 85 % of cases of primary hyperparathyroidism. Those weighing more than 3.5g are classified as giant parathyroid adenomas. There are only 25 cases of parathyroid adenomas weighing over 30g reported in the literature. With the wide availability of biochemical screening tests in Western countries, mildly elevated calcium levels are often discovered incidentally...
October 19, 2016: Journal of Medical Case Reports
Pedro Pallangyo, Isaac Mawenya, Paulina Nicholaus, Henry Mayala, Amida Kalombola, Godwin Sharau, Naiz Majani, Mohamed Janabi
BACKGROUND: Congenital complete heart block is a life-threatening condition which is highly associated with autoimmune and connective tissue disorders. Presence of maternal autoantibodies for associated conditions increases the risk of delivering a child with congenital complete heart block, however, less than a half of all women with such antibodies are symptomatic even after delivery. Mortality rate is highest during the neonatal period (45 %) and about two-thirds of all cases will require permanent pacing at some point in their lives...
October 19, 2016: Journal of Medical Case Reports
Dat T Vo, George F Cravens, Robert E Germann
BACKGROUND: Intramedullary abscess is a rare neurosurgical condition that usually arises in the setting of penetrating trauma to the spinal cord, infected congenital dural sinuses, or tuberculosis. CASE PRESENTATION: We describe a case of a 35-year-old African American male who presented with sepsis and a clinical picture of meningitis. The patient continued to have declining neurological status with decreasing sensation and worsening motor strength in all four extremities...
October 19, 2016: Journal of Medical Case Reports
Valirie Ndip Agbor, Tsi Njim, Leopold Ndemnge Aminde
BACKGROUND: Inguinal hernias in women of reproductive age containing the ovary are very rare. When they occur in this age group, they are mostly associated with malformations of the urogenital system. Prompt surgical intervention is the key to ensure survival of the ovary. Here we present a case of an ectopic ovary presenting like an acute appendicitis. CASE PRESENTATION: A 16-year-old Cameroonian girl presented at our emergency service with an acute exacerbation of a mild and intermittent right iliac fossa pain of 5 days' duration...
October 19, 2016: Journal of Medical Case Reports
Axel Marx, Alexander Beier, Pouria Taheri, Martin Röpke, Thomas Kalinski, Andreas M Halder
BACKGROUND: Avascular necrosis after arthroscopic surgery of the knee has already been published. The purpose of this article is to report on the frequently misdiagnosed entity of osteonecrosis of the medial tibial plateau. CASE PRESENTATION: Charts and radiographs of a consecutive series with isolated medial tibial plateau osteonecrosis were analyzed. The criterion for inclusion was the absence of trauma. Six caucasian female patients with an average age of 76...
October 19, 2016: Journal of Medical Case Reports
Vicky Dhooghe, David Reynders, Peter Cools
BACKGROUND: Omental torsion is a rare and very unusual cause of acute abdominal pain. If often mimics other acute pathologies and it is very difficult to diagnose preoperatively, which can lead to deterioration of the patient. It is seldom reported in the literature. CASE PRESENTATION: We report a well-documented case of a 67-year-old white woman who complained about abdominal pain, which was slowly increasing in severity. She had no previous abdominal interventions...
October 19, 2016: Journal of Medical Case Reports
Yu Sugawara, Ryuji Okamura, Shigeki Taniguchi
BACKGROUND: Left atrial thrombi have traditionally been treated with heparin and warfarin, and many physicians have limited experience with direct oral anticoagulants such as apixaban. Furthermore, the efficacy of apixaban for the treatment of left atrial thrombi has not been established. We experienced a case of left atrial thrombus formation before breast cancer surgery, which was resolved by apixaban. CASE PRESENTATION: Computed tomography for a 74-year-old Japanese woman with breast cancer incidentally revealed a left atrial mass with a root before the breast surgery...
October 19, 2016: Journal of Medical Case Reports
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
Kerstin Eckhoff, Thilo Wedel, Marcus Both, Kayhan Bas, Nicolai Maass, Ibrahim Alkatout
BACKGROUND: Rectus sheath hematoma is a rare clinical diagnosis, particularly in pregnancy. Due to unspecific symptoms, misdiagnosis is likely and could potentially endanger a patient as well as her fetus. CASE PRESENTATION: A 26-year-old white woman presented with mild right-sided abdominal pain, which increased during palpation and movement, at 26 + 3 weeks' gestational age. Ultrasound imaging initially showed a round and well-demarcated structure, which appeared to be in contact with her uterine wall, leading to a suspected diagnosis of an infarcted leiomyoma...
October 19, 2016: Journal of Medical Case Reports
Atsushi Musha, Jun-Ichi Saitoh, Katsuyuki Shirai, Satoshi Yokoo, Tatsuya Ohno, Takashi Nakano
BACKGROUND: Oral mucosal melanoma is a rare disease with a relatively poor prognosis. Carbon ion radiotherapy has been shown to be effective against radiotherapy-resistant tumors owing to its excellent dose concentration and high biological effect. CASE PRESENTATION: Our patient was a 66-year-old Japanese man with oral mucosal melanoma of his right maxillary gingiva (T4aN0M0). He received carbon ion radiotherapy at 57.6 Gy (relative biological effectiveness) in 16 fractions for 4 weeks...
October 18, 2016: Journal of Medical Case Reports
Maud A W Hermans, Annemiek Broijl, Paul L A van Daele
BACKGROUND: Systemic mastocytosis is a rare myeloproliferative disease characterized by the uncontrolled proliferation of aberrant mast cells. It has varying clinical manifestations. For unknown reasons, pulmonary localization of mastocytosis is extremely rare. CASE PRESENTATION: In this report, we describe a case of a young Caucasian female with systemic mastocytosis who had an associated hematological non-mast-cell lineage disease with pulmonary interstitial disease directly related to her mastocytosis...
October 13, 2016: Journal of Medical Case Reports
Fernanda Pacella, Enzo Agostinelli, Sandra Cinzia Carlesimo, Marcella Nebbioso, Roberto Secondi, Michele Forastiere, Elena Pacella
BACKGROUND: Ozurdex is a 700 mcg dexamethasone intravitreal implant, approved for the management of macular edema secondary to retinal vein occlusion, and other related pathoglogiesAnterior chamber dislocation of Ozurdex represents an uncommon complication of the intravitreal injection, which can be managed by repositioning the implant into the vitreous cavity. We describe the case of a successful repositioning of an Ozurdex implant by mobilization and subsequent balanced saline solution injection in the anterior chamber...
October 13, 2016: Journal of Medical Case Reports
Joseph Frankl, Cassi Grotepas, Baldassare Stea, G Michael Lemole, Alexander Chiu, Rihan Khan
BACKGROUND: Chordoma is a rare invasive bone tumor that may occur anywhere along the neuraxis. A total of three primary histological varieties have been identified: conventional, chondroid, and dedifferentiated. CASE PRESENTATION: We report a case of an 8-year-old white girl who presented with conventional chordoma, was treated with surgical resection and mixed proton and photon beam therapy, and had a recurrence in the resection cavity 2.5 years later with dedifferentiated morphology...
October 12, 2016: Journal of Medical Case Reports
Ramy Sedhom, Sophia Hu, Anupam Ohri, Dorian Infantino, Sara Lubitz
BACKGROUND: Malignant steroid cell tumors of the ovary are rare and frequently associated with hormonal abnormalities. There are no guidelines on how to treat rapidly progressive Cushing's syndrome, a medical emergency. CASE PRESENTATION: A 67-year-old white woman presented to our hospital with rapidly developing signs and symptoms of Cushing's syndrome secondary to a steroid-secreting tumor. Her physical and biochemical manifestations of Cushing's syndrome progressed, and she was not amenable to undergoing conventional chemotherapy secondary to the debilitating effects of high cortisol...
October 12, 2016: Journal of Medical Case Reports
Nobumasa Ohara, Yasuyuki Uemura, Naomi Mezaki, Keita Kimura, Masanori Kaneko, Hirohiko Kuwano, Katsuya Ebe, Toshio Fujita, Takeshi Komeyama, Hiroyuki Usuda, Yuto Yamazaki, Takashi Maekawa, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi
BACKGROUND: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear. CASE PRESENTATION: A 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains...
October 12, 2016: Journal of Medical Case Reports
Radu Campean, Matthias Hasun, Claudia Stöllberger, Johannes Bucher, Josef Finsterer, Christoph Schnack, Franz Weidinger
BACKGROUND: Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown. CASE PRESENTATION: A 41-year-old white woman with a history of autoimmune Hashimoto thyroiditis diagnosed 3 years earlier and acute adrenal insufficiency diagnosed 3 weeks earlier presented with new onset of heart failure New York Heart Association class IV, which had started shortly after initiation of hormone replacement therapy with hydrocortisone 20 mg/day and fludrocortisone 0...
October 12, 2016: Journal of Medical Case Reports
Tae Hyun Kim, Jun Jae Shin, Woo Yong Lee
BACKGROUND: Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported...
October 6, 2016: Journal of Medical Case Reports
Mario Schiavoni, Antonella Coluccia
BACKGROUND: Evidence from clinical trials shows rivaroxaban to be effective for the treatment of deep vein thrombosis. Switching to rivaroxaban following failure of indirect anticoagulants in deep vein thrombosis has not been demonstrated in a real-life setting. CASE PRESENTATION: A 43-year-old white woman was switched from warfarin to rivaroxaban for the treatment of thrombosis of her right common femoral vein after saphenectomy. The reason for the switch was due to the instability of anti-coagulation therapy with vitamin K antagonists over a period of 3 months during which she did not reach the "therapeutic range" of prothrombin time-international normalized ratio...
October 5, 2016: Journal of Medical Case Reports
Glenn J Rapsinski, Jina Makadia, Nitin Bhanot, Zaw Min
BACKGROUND: Gram-negative microorganisms are uncommon pathogens responsible for infective endocarditis. Pseudomonas mendocina, a Gram-negative water-borne and soil-borne bacterium, was first reported to cause human infection in 1992. Since then, it has rarely been reported as a human pathogen in the literature. We describe the first case of native valve infective endocarditis due to P. mendocina in the USA. CASE PRESENTATION: A 57-year-old white man presented with bilateral large leg ulcers, fever, and marked leukocytosis...
October 4, 2016: Journal of Medical Case Reports
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