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BMJ Case Reports

Francis Capule, Pramote Tragulpiankit, Surakameth Mahasirimongkol, Nuanjun Wichukchinda, Jiraphun Jittikoon, Lara Theresa Alentajan-Aleta, Jay-V James Barit, Josephine Casanova-Gutierrez, Leonor Cabral-Lim, Jose Paciano Baltazar Reyes, Francisca Roa, Katrina Faith San Gabriel, Catherine Lynn Silao
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two related mucocutaneous disorders with different severities. Although the incidence is low, SJS and TEN are life-threatening and predominantly drug-induced conditions. There is a strong relationship between the HLA-B*1502 allele and carbamazepine-induced SJS and TEN in different Southeast Asian populations. Here, we report a case of Filipino with SJS/TEN overlap probably induced by carbamazepine. The condition was treated with hydrocortisone followed by prednisone...
July 17, 2018: BMJ Case Reports
Nikita Wadhwani, Omesh Kumar Meena, Vivek Verma
Perforation of the gall bladder can occur due to a complication of acute (in 3%-10%) or chronic cholecystitis, presenting with or without gallstones. Other causes include trauma, neoplasms, steroid therapy or vascular compromise. In 1934, Niemeier classified the condition into three types: type I, acute perforation into the free peritoneal cavity; type II, subacute perforation with abscess formation; and type III, chronic perforation with fistula formation between the gall bladder and another viscus with type I experiencing the highest mortality rate...
July 17, 2018: BMJ Case Reports
Lauren Blayney, Paul Morrish
Neurological disease is the most common extrahepatic manifestation of autochthonous infection with hepatitis E virus (HEV). The association between acute neurological symptoms and hepatitis E is not well known, and hence HEV testing is often omitted. This case describes aberrant neurology in a 35-year-old woman with a background of HEV infection, highlighting the need for increased awareness of acute hepatitis E infection as a cause of unexplained neurological illness.
July 17, 2018: BMJ Case Reports
George Antunes, Karen Galloway, Nigel Clerk, Richard Hartley
Human bovine tuberculosis is a rare zoonotic infection in developed countries which has been achieved predominantly by effective eradication programmes in cattle. The principal modes of transmission are consumption of unpasteurised dairy products and close contact with infected cattle. The clinical and radiological presentation is indistinguishable from tuberculosis caused by Mycobacterium tuberculosis The diagnosis should be considered in individuals with relevant risk factors who present with intra/extrathoracic pathology...
July 16, 2018: BMJ Case Reports
Pedro Aguilar-Salinas, Roberta Santos, Manuel F Granja, Sabih Effendi, Eric Sauvageau, Ricardo Hanel, Amin Aghaebrahim
Stroke is the leading cause of serious long-term disability in the USA. Recent clinical trials, DAWN and DEFUSE 3, have expanded the endovascular therapeutic time window which has been adopted by the American Heart Association stroke guideline. However, there continues to be a dilemma as to what is the best approach for patients who present beyond the time window set by these trials and the current guideline. The interval from arterial occlusion to completion of brain tissue infarction varies from patient to patient and depends on the actual time and also a physiological clock or a tissue time window...
July 16, 2018: BMJ Case Reports
Siddharth Pandey, Ajay Aggarwal, Deepanshu Sharma, Apul Goel
No abstract text is available yet for this article.
July 15, 2018: BMJ Case Reports
Erin Finn, Laura Cannon, Katherine A Jordan
No abstract text is available yet for this article.
July 15, 2018: BMJ Case Reports
Mark W L van Geffen, Jan Willem A Straathof, Arijan A P M Luijten
No abstract text is available yet for this article.
July 15, 2018: BMJ Case Reports
Dorien Laenens, Mark Plazier, Jeroen C H van der Hilst, Peter Messiaen
Campylobacter fetus ( C. fetus ) is a rare condition and mostly seen in elderly or immunocompromised patients. We present the first case of C. fetus spondylodiscitis in a virologically suppressed HIV seropositive patient with low back pain. MRI was performed and showed spondylodiscitis of the L4-L5 region. Empirical antibiotic therapy with flucloxacillin was started after blood cultures were drawn and an image-guided disc biopsy was performed. Blood cultures remained negative. The anaerobic culture of the puncture biopsy of the disc revealed presence of C...
July 15, 2018: BMJ Case Reports
Jessica M Stevens, Matthew R Levine, Anne E Constantino, Gholam K Motamedi
Fatal familial insomnia (FFI) is a rare prion disease commonly inherited in an autosomal dominant pattern from a mutation in the PRioN Protein (PRNP) gene. Hashimoto's encephalopathy (HE) is characterised by encephalopathy associated with antithyroid peroxidase (TPO) or antithyroglobulin (Tg) antibodies. These two conditions characteristically have differing clinical presentations with dramatically different clinical course and outcomes. Here, we present a case of FFI mimicking HE. A woman in her 50s presented with worsening confusion, hallucinations, tremor and leg jerks...
July 15, 2018: BMJ Case Reports
Mark Tp Mujer, Manoj P Rai, Mohamed Hassanein, Subhashis Mitra
No abstract text is available yet for this article.
July 15, 2018: BMJ Case Reports
Harsh Bhatt, Gulam Zilani, Caroline Hayhurst
A 75-year-old man with type 2 diabetes mellitus presented with complete loss of vision in his right eye and severe headaches for the past 24 hours. He had been treated for suspected giant cell arteritis (GCA) with high-dose corticosteroids which were being tapered to stop after an inconclusive right temporal artery biopsy and an erythrocyte sedimentation rate (ESR) value of 8. His current acute presentation, however, raised further concern for partially treated GCA and precipitated treatment with pulsed methylprednisolone...
July 15, 2018: BMJ Case Reports
Kristin Huntoon, Sophia Shaddy, Norman Lehman, James Bradley Elder
A 55-year-old man with a history of Benign Paroxysmal Positional Vertigo unalleviated by Epley manoeuvre presented to an otolaryngologist for dizziness, right ear fullness and headache. MRI of the brain showed numerous marrow-replacing lesions throughout the calvarium, skull base and upper cervical spine which were hypointense on T1-weighted images, hyperintense on T2-weighted images and avidly enhanced following contrast, concerning for a malignant process such as metastatic disease or multiple myeloma (figure 1)...
July 15, 2018: BMJ Case Reports
Tom Brennan, Aileen McCabe, Arthur Hennessy
No abstract text is available yet for this article.
July 13, 2018: BMJ Case Reports
Filipa Tavares Almeida, Regina Caldas, Maria da Luz Duarte, Celeste Brito
Phakomatosis pigmentovascularis (PPV) is an uncommon dermatosis characterised by the presence of both pigmentary and vascular abnormalities.1 Its pathogenesis is not elucidated, and the prognosis is mainly determined by the presence of extracutaneous manifestations, such as Klippel-Trenaunay syndrome (KTS), that is defined by the triad of a port-wine stain (PWS), anomalous veins and progressive overgrowth of the affected extremity. Herein, we report a case of an adult patient, who presented with a large PWS, nevus of Ota, ocular melanosis, and limb hypertrophy and varicosities...
July 13, 2018: BMJ Case Reports
Jordi S Dahl, Claus Andersen, Stevo Duvnjak, Jacob Eifer Moller
We present two cases of females in their 40s presenting with biventricular heart failure being the consequence of a large arteriovenous fistula. Both patients had undergone abdominal surgery several years prior to the heart failure event with the initial finding of moderate pulmonary hypertension and high-output heart failure. CT revealed a large arteriovenous fistula between the common iliac artery and vein which subsequently was closed percutaneously.
July 13, 2018: BMJ Case Reports
Abtin Doroudinia, Fatemeh Kaghazchi, Payam Mehrian, Atosa Dorudinia
Inflammatory myofibroblastic tumour (IMT) is a rare neoplasm, occurring most often in children and young adults. IMTs have intermediate biological behaviour with the chance of local invasion, recurrence and even distant metastasis. Wide range of clinical presentations makes the precise diagnosis of IMT more challenging. The best method for definitive diagnosis is tissue biopsy and newer imaging modalities including fleurodeoxyglucose (FDG) positron emission tomography (PET)/CT are useful tools in detection of disease recurrence or distant metastasis...
July 13, 2018: BMJ Case Reports
Chandrasekharan Rajasekharan, Kavadisseril Vivekanandan Vysakha, Vijayakumar Karthik, Muralikrishnan Harikrishnan
No abstract text is available yet for this article.
July 12, 2018: BMJ Case Reports
Aakash Pandita, Namita Mishra, Girish Gupta, Amit Shukla
We report a case series of three idiopathic unilateral facial nerve palsies in neonates with no identified risk factors. Neuroimaging done was normal. All the neonates had complete spontaneous recovery within a month, with no residual deficits. As per our knowledge, there are very few case reports of facial palsy in a neonate reported in literature and are often labelled as idiopathic.
July 12, 2018: BMJ Case Reports
Natalie Constable, Carolyn Thomas, Martyn Jones, Matt Walters
We present the case of a 53-year-old man who attended our emergency department with stridor. He had recently undergone investigation for possible glottic cancer. We discuss the airway management of such a case. We believe this to be the first description of propofol target controlled infusion and clonidine to supplement a sevoflurane gas induction, in order to obtund response to intubation while maintaining spontaneous ventilation. We also consider how airway interventions may impact prognosis and need to be considered...
July 12, 2018: BMJ Case Reports
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