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Case Reports in Medicine

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https://www.readbyqxmd.com/read/28523071/forsaken-foregut-case-report-of-simultaneous-black-esophagus-and-ischemic-cholangiopathy
#1
Paul A Cameron, Franzjosef Schweiger
Black esophagus or acute esophageal necrosis rarely occurs after severe hemodynamic compromise or low-flow states. Other contributing factors may include corrosive injury from gastric contents and diminished mucosal repair mechanisms. Ischemic cholangitis, another rare clinical entity, is also usually the result of a significant vascular and/or hypotensive insult to the biliary tree. We describe the first case of combined acute esophageal necrosis and ischemic cholangiopathy in a 62-year-old male who completely recovered from the esophageal injury but developed progressive liver failure from ischemic cholangiopathy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28523070/a-curious-case-of-intestinal-diaphragm-disease-unmasked-by-perforation-of-a-duodenal-ulcer
#2
Mairéad McNally, Ion Cretu
Nonsteroidal anti-inflammatory drugs are a common cause of intestinal injury. A variety of NSAID-induced injuries may occur including ulcers, erosions, colitis, strictures, and diaphragm disease. Diaphragm disease refers to the development of multiple thin, concentric, stenosing strictures in the intestine. Strictures occur most often in the midintestine and are thought to be pathognomonic of NSAID damage. They can lead to intermittent or complete bowel obstruction. Diagnosis may be elusive as there is nothing specific about NSAID-induced injury at endoscopy and histology is also nonspecific...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28487744/atorvastatin-diltiazem-combination-induced-rhabdomyolysis-leading-to-diagnosis-of-hypothyroidism
#3
N D B Ehelepola, S M B Y Sathkumara, H M P A G S Bandara, K L R Kalupahana
Statins and hypothyroidism, independently, can rarely cause rhabdomyolysis. The combination of them especially with concurrent intake of drugs such as diltiazem increases the risk of rhabdomyolysis. Hashimoto's encephalopathy is a rare condition associated with Hashimoto's thyroiditis and some patients with that can present with a stroke like picture. An elderly male who has been on atorvastatin for three years and on diltiazem for a week presented with sudden onset inability to walk and confusion. On examination muscle tenderness was noticed and creatine kinase levels indicated rhabdomyolysis which we attributed to atorvastatin...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28487743/delirium-and-high-creatine-kinase-and-myoglobin-levels-related-to-synthetic-cannabinoid-withdrawal
#4
Ahmet Bulent Yazici, Esra Yazici, Atila Erol
Synthetic cannabinoids (SCs) are included in a group of drugs called new psychoactive substances. Effects of SCs on the central nervous system are similar to other cannabinoids, but 2-100 times more potent than marijuana. Thus, addiction and withdrawal symptoms are more severe than natural cannabinoids. Withdrawal symptoms of SCs were reported in the literature previously. But there is no report about SC withdrawal delirium and its treatment. Several studies reported that agonists of CB1 receptors play a role in GABA and glutamatergic neurotransmission, which is similar to the effects of alcohol on GABA and glutamatergic receptors...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28487742/serum-cytokine-profile-in-a-patient-diagnosed-with-dysferlinopathy
#5
Svetlana F Khaiboullina, Ekaterina V Martynova, Sergey N Bardakov, Mikhail O Mavlikeev, Ivan A Yakovlev, Arthur A Isaev, Roman V Deev, Albert A Rizvanov
Limb-girdle muscular dystrophy type 2 (LGMD2B) is a mild form of dysferlinopathy, characterized by limb weakness and wasting. It is an autosomal recessive disease, with currently 140 mutations in the LGMD2B gene identified. Lack of functional dysferlin inhibits muscle fiber regeneration in voluntary muscles, the main pathological finding in LGMD2B patients. However, the immune system has been suggested to contribute to muscle cell death and tissue regeneration. Serum levels of 27 cytokines were evaluated in a dysferlinopathy patient...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28479920/bacteremia-and-urinary-tract-infection-caused-by-chromobacterium-violaceum-case-reports-from-a-tertiary-care-hospital-in-kathmandu-nepal
#6
Narayan Dutt Pant, Subhash Prasad Acharya, Raju Bhandari, Uday Narayan Yadav, Dil Bahadur Saru, Manisha Sharma
Chromobacterium violaceum is ubiquitous in the environment of tropical and subtropical regions but the infections caused by this organism are rare and the urinary tract infections caused by it are even rarer. Due to the propensity for hematogenous spread leading to fatal sepsis, the infections caused by Chromobacterium violaceum have high mortality rate (65-80%) with death occurring in as less as one week of acquiring infection. So, prompt proper treatment is necessary for successful treatment of the infections but, due to the rarity of the infections caused by the organism, there is limited awareness among the clinicians regarding the infections caused by this organism...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28479919/nasogastric-tube-feeding-induced-esophageal-bezoar-case-description
#7
Jad A Degheili, Mikhael G Sebaaly, Ali H Hallal
Background. Bezoars are well established entities causing gastrointestinal obstructions. Depending on the prominent constituent of these bezoars, the latter are divided into four subtypes: pharmacobezoars, lactobezoars, trichobezoars, and phytobezoars. Less frequently reported types of bezoars are reported including those formed secondary to nasogastric tube feeding with casein-based formulas. Case Presentation. A 69-year-old male presented following cardiac arrest postmyocardial infarction. Patient sustained anoxic brain injury after resuscitation, rendering him ventilator dependant along with nasogastric tube feeding, initially...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28473857/severe-murine-typhus-presenting-with-acalculous-cholecystitis-a-case-report-and-literature-review
#8
Nikolaos Spernovasilis, Constantinos Tsioutis, Maria Zafeiri, Georgios Hamilos, Achilleas Gikas
A 54-year-old otherwise healthy male, who was being evaluated for prolonged fever, developed clinical and ultrasonographic signs compatible with acute acalculous cholecystitis. Diagnosis of murine typhus was confirmed by serology and the patient was treated with doxycycline. He improved rapidly and all clinical and laboratory abnormalities returned to normal. The present case dictates that knowledge of the local epidemiology and keeping a high index of clinical suspicion can help recognize uncommon manifestations of murine typhus, in order to treat appropriately and avoid unnecessary investigations and interventions...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28465689/reversible-inferolateral-st-segment-elevation-associated-with-small-bowel-obstruction
#9
Ankit Upadhyay, Sudheer Chauhan, Umair Jangda, Vipul Bodar, Ahmed Al-Chalabi
ST-segment elevation is an important and alarming electrocardiographic sign that necessitates immediate attention but does not always indicate that the primary pathology is cardiac in origin. It needs to be interpreted in the clinical context as several pathological conditions involving especially gastrointestinal tract may lead to delayed diagnosis and treatment as well as complications from invasive unnecessary interventions. We present two patients, a 64-year-old male and a 71-year-old female, who were admitted to the emergency room of a community-based hospital with similar complaints of worsening epigastric abdominal pain and were diagnosed later with small bowel obstruction...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28424736/a-case-of-xanthogranulomatous-pyelonephritis-associated-with-renoduodenal-fistula
#10
R Conor Holton-Burke, Mini Varughese
Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis associated with repeated infection, chronic inflammation, and obstruction. Various fistulas, including those to the intestine, are a known association with XGP. Here, a 55-year-old woman with a history of multiple previous renal calculi presented with dysuria and back pain. Contrast-enhanced computed tomography (CT) revealed a soft tissue density in her renal pelvis and perirenal space consistent with XGP along with a tract connecting the upper pole of her right kidney to the second portion of the duodenum...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28424735/tongue-necrosis-secondary-to-giant-cell-arteritis-a-case-report-and-literature-review
#11
Rafael Alex Barbosa de Siqueira Sobrinho, Karolina Cayres Alvino de Lima, Helena Carvalho Moura, Mônica Modesto Araújo, Christyanne Maria Rodrigues Barreto de Assis, Pedro Alves da Cruz Gouveia
Giant cell arteritis is a form of vasculitis involving the medium- and large-sized arteries that chiefly affects older people. Clinical findings are headache, jaw claudication, fever, pain, and thickening of the temporal artery. The most feared complication is visual loss due to impairment of the ophthalmic artery and posterior ciliary arteries. This a case report of an 85-year-old male presenting with headache and jaw pain, who was admitted with tongue necrosis as an initial manifestation of giant cell arteritis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28408933/endovascular-stent-grafting-for-aortic-arch-aneurysm-in-aortoiliac-occlusive-disease-following-aortic-arch-debranching-and-aortobifemoral-reconstruction
#12
Didem Melis Oztas, Cagla Canbay, Yilmaz Onal, Metin Onur Beyaz, Omer Ali Sayin, Mehmet Barburoglu, Mehmet Buget, Mesut Yornuk, Aziz Ari, Murat Ugurlucan, Bulent Acunas, Ufuk Alpagut, Enver Dayioglu
Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28408932/huge-lymphangioma-of-the-esophagus-resected-by-endoscopic-piecemeal-mucosal-resection
#13
Dinghai Luo, Liping Ye, Weidan Wu, Haihong Zheng, Xinli Mao
We present an unusual case of a 41-year-old male patient with a large lymphangioma of the esophagus. Endoscopy revealed that the structure measured 60 × 10 mm in the mucosa and the submucosa and had a heterogenous echo pattern. The esophageal mass was successfully resected by endoscopic piecemeal mucosal resection. However, most esophageal lymphangiomas that are larger than 2 cm in diameter reported in the literature can be removed only through open surgery. Thus far, we know of no reported cases of endoscopic resection as a treatment for this case...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28408931/drug-induced-pneumonitis-secondary-to-treatment-with-paritaprevir-ritonavir-ombitasvir-and-dasabuvir-viekira-pak%C3%A2-for-chronic-hepatitis-c-case-report-of-an-unexpected-life-threatening-adverse-reaction
#14
Shih Yea Sylvia Wu, Bridget Faire, Edward Gane
VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28408930/a-case-of-initially-undiagnosed-chikungunya-arthritis-developing-into-chronic-phase-in-a-nonendemic-area
#15
Pui Shan Julia Chan, Moon Ho Leung
This case report described a 40-year-old lady presented with fever, headache, arthralgia, myalgia, and impaired liver function after returning from the Philippines. Chikungunya virus (CHIKV) and dengue serology were negative. Eight weeks after initial presentation, she experienced inflammatory polyarthritis mimic rheumatoid arthritis. This time CHIKV-IgM was detected, together with a >4-fold rise of CHIKV-polyvalent-antibody titre. The first CHIKV-IgM negative sample was reexamined and was CHIKV-PCR positive...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28400822/pacemaker-placement-in-patients-with-stroke-mediated-autonomic-dysregulation
#16
Ali A Alsaad, Christopher O Austin, Maisha T Robinson, Michael B Phillips
Lateral medullary syndrome (LMS) is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28400821/the-great-impostor-transaminitis-masking-the-coinfection-of-syphilis-and-human-immunodeficiency-virus
#17
Sunit Tolia, Hassan Kassem, Ana Capatina-Rata
Introduction. The incidence of syphilis continues to rise in the United States over the past 15 years. This disease process is classified into stages and may present with a coinfection of Human Immunodeficiency Virus (HIV). Case Report. We present a case of a 32-year-old African American male who presented with cutaneous manifestations of secondary syphilis and transaminitis. A workup revealed that the transaminitis was secondary to underlying syphilitic hepatitis in the presence of HIV coinfection. The patient had a reactive rapid plasma reagin (RPR) of 1 : 64 TU and reactive Treponema pallidum particle agglutination assay (TPPA)...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28392804/a-case-of-cortical-deafness-due-to-bilateral-heschl-gyrus-infarct
#18
Santhosh Narayanan, K Abdul Majeed, Gomathy Subramaniam, Arathi Narayanan, K M Navaf
We report the case of a 58-year-old male who presented with an episode of seizure and abrupt onset hearing loss. Neuroimaging revealed acute infarcts in bilateral Heschl gyri. Objective tests of peripheral auditory function were essentially normal and a diagnosis of cortical deafness was made.
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28386283/rare-gingival-metastasis-by-hepatocellular-carcinoma
#19
Li-Jun Xue, Xiao-Bei Mao, Jian Geng, Ya-Nan Chen, Qian Wang, Xiao-Yuan Chu
Hepatocellular carcinoma (HCC) uncommonly metastasizes to the gingiva, which always means a poor outcome. We reported a rare HCC case with multiple metastases to gingiva, lungs, and brain. A 60-year-old man was initially diagnosed as HCC with metastases to double lungs. He was subjected to a transarterial chemoembolization (TACE) (5-fluorouracil, 750 mg) and two cycles of intravenous chemotherapy (gemcitabine 1.8 g at days 1 and 8, oxaliplatin 200 mg at day 2, every 4 weeks). However, the volume of liver tumor still increased...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28386282/ulcerated-lesion-of-the-tongue-as-manifestation-of-systemic-coccidioidomycosis
#20
Luis A Mendez, Sergio A Flores, Ricardo Martinez, Oslei Paes de Almeida
Systemic mycoses and their oral manifestations are very rare. We present a case of a 60-year-old man with an ulcerated lesion on the lateral border of the tongue. Histologic studies revealed a granulomatous fungal infection by Coccidioides immitis. After pharmacological treatment, the lesion resolved. Recently, northern Mexico has been reported to be an endemic zone of C. immitis infections; therefore it should be considered in the differential diagnosis of mouth lesions. A comprehensive clinical history, physical exploration, and complementary studies are essential for an accurate diagnosis...
2017: Case Reports in Medicine
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