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BMJ Case Reports

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https://www.readbyqxmd.com/read/28446491/pure-form-of-ackermann-s-tumour-of-the-tongue-in-a-young-female-patient
#1
Varun Patnam
No abstract text is available yet for this article.
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446490/complicated-acute-cerebellitis-with-obstructive-hydrocephalus-and-tonsillar-herniation-in-a-child
#2
Manchikanti Venkatesh, Sunitha Vellathussery Chakkalakkoombil, Manju Bashini Duraipandi, Reena Gulati
Acute cerebellitis (AC) is a rare inflammatory syndrome presenting as cerebellar dysfunction, seen more frequently in children. AC can have a variable course with features of cerebellar dysfunction, raised intracranial pressure and neurological deficits, and can sometimes even be potentially fatal due to complications such as obstructive hydrocephalus and brainstem compression, warranting surgical intervention. We report a case of a 12-year-old boy who presented with raised intracranial pressure and ataxia...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446489/revisiting-propafenone-toxicity
#3
Ali A Alsaad, Yahaira Ortiz Gonzalez, Christopher O Austin, Fred Kusumoto
Propafenone is a Vaughan Williams class 1c antiarrhythmic medication widely used for treatment of arrhythmias. Although the long-term safety of propafenone use has not been established, it is commonly used for treatment of atrial fibrillation in patients with no structural heart disease. Propafenone is well known as pill-in-the-pocket treatment for its effect in terminating paroxysmal episodes of atrial fibrillation. Herein, we discuss an unusual adverse reaction to propafenone in a patient who presented with symptomatic bradycardia and hypotension...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446488/eculizumab-in-a-child-with-atypical-haemolytic-uraemic-syndrome-and-haemophagocytic-lymphohistiocytosis-triggered-by-cytomegalovirus-infection
#4
Gloria M Fraga-Rodriguez, Sonia Brió-Sanagustin, Eulalia Turón-Viñas, Bradley P Dixon, Eduardo Carreras-González
We present the case of a 21-month-old girl with two rare and life-threatening conditions, atypical haemolytic uraemic syndrome (aHUS) and haemophagocytic lymphohistiocytosis (HLH), triggered by a cytomegalovirus (CMV) infection. Soon after admission, the girl became anuric and required continuous venovenous haemodiafiltration.Initial treatments included methylprednisolone, fibrinogen and plasma infusion (for HLH), plasmapheresis (for thrombotic microangiopathy), immunoglobulins (for inflammation), ganciclovir (for CMV infection) and the antibiotic cefotaxime...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446487/haemophagocytic-lymphohistiocytosis-as-a-consequence-of-untreated-b-cell-chronic-lymphocytic-leukaemia
#5
Chris Bailey, Claire Dearden, Kirit Ardeshna
Haemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening syndrome characterised by defective cytotoxic function and hypercytokinaemia leading to macrophage expansion and haemophagocytosis. Patients often present with unexplained fevers, hepatosplenomegaly and pancytopenia, with elevation in serum ferritin and triglyceride. Acquired forms are triggered by infection, malignancy or rheumatological disorders. HLH in the setting of chronic lymphocytic leukaemia is rarely reported, however, and is usually associated with infection or as a consequence of chemotherapy...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446486/delayed-diagnosis-of-pulmonary-tuberculosis-in-a-13-year-old-malawian-boy
#6
Niall Johnston, Nichola Sandys
Childhood tuberculosis (TB) is a significant global health burden. There are more than 1 million new cases of childhood TB annually. Despite this, many national TB control programs largely focus on identification and treatment of smear positive adults. Early case detection is essential if childhood TB is to be controlled and eradicated.Delayed diagnosis of TB is associated with more advanced disease and worse treatment outcomes. Younger children who go undiagnosed for long periods are at risk of developing severe pulmonary and extrapulmonary disease, such as meningitis...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446485/primary-aortojejunal-fistula-a-rare-cause-for-massive-upper-gastrointestinal-bleeding
#7
Sylvester Paulasir, Rhami Khorfan, Christina Harsant, Harry Linne Anderson
A 68-year-old man presented to the emergency department with haematemesis and shock. Upper endoscopy and selective angiography could not identify the source of bleeding. He underwent selective embolisation of the gastroduodenal artery. The patient then had a period of about 24 hours with relative haemodynamic stability before having another episode of massive upper gastrointestinal bleed. A second attempt to embolise the common hepatic artery and distal coeliac axis was unsuccessful. Hence, he was urgently taken to the operating room for exploratory laparotomy...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446484/cystic-artery-pseudoaneurysm-following-acute-necrotising-pancreatitis
#8
Manoj Thillai, Pulkit Sethi, Ramachandran Narayana Menon, Nazar Puthukudiyil Kader
Cystic artery pseudoaneurysm is a rare pathology. Of the 20 cases reported so far, chronic cholecystitis and iatrogenic biliary injury form the majority of causes. Currently, there is no published report of such pseudoaneurysms caused secondary to pancreatitis, hence the management in such a scenario is unclear. We hereby present the first such report of cystic artery pseudoaneurysm occurring as a sequel of acute necrotising pancreatitis. A 33-year-old man who recovered from a recent attack of acute pancreatitis was readmitted for melena and fever...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446483/spontaneous-ruptured-iliac-artery-aneurysm-causing-acute-secondary-av-fistula
#9
Katherine-Helen Hurndall, Holly Carpenter, Jack Sandeman, Roland Fernandes
A 73-year-old woman presented with a 6-hour history of sudden onset lower abdominal pain. Her comorbidities included chronic obstructive pulmonary disease and hypertension. She was under surveillance for a known thoracoabdominal aneurysm. On presentation, she was hypotensive with a systolic blood pressure of 50 mm Hg and a pulse of 60 beats per minute. On examination, she had a pulsatile mass with bruit in her right lower abdomen. Pedal pulses were palpable in both feet. Blood gas analysis revealed a metabolic acidosis with a pH of 7...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446482/secondary-parkinsonism-in-a-patient-of-psychogenic-polydipsia
#10
Rimesh Pal, Liza Das, Pinaki Dutta, Anil Bhansali
A 44-year-old man presented with history of slurring of speech, slowness in activities, abnormal posturing of the upper limbs and drooling of saliva from the mouth. He had a 5-yearlong history of compulsive water drinking, consuming 12-15 L of water every day. He was earlier evaluated for the same and found to have low serum sodium (126 mEq/L). Presently, he was admitted at a primary care facility with fever and altered sensorium. He was found to have serum sodium of 94 mEq/L. His sensorium improved with hypertonic saline infusion; however, after a lucid interval of 48 hours, he developed florid extrapyramidal symptoms...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446481/alveolar-soft-part-sarcoma-presenting-with-back-pain
#11
Amari T Thompson, Samuel J Ford, Anant Desai, David Gourevitch
No abstract text is available yet for this article.
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446480/unusual-cause-for-testicular-swelling-in-a-child
#12
Jayashree Rajasekaran, Jigisa Tripathy, Mukul Vij, Julius Xavier Scott
Myeloid sarcoma is a rare solid tumour composed of primitive precursors of granulocytic series of white blood cells involving extramedullary anatomic site. Here we report the case of a 10-month-old with testicular swelling, who was finally diagnosed with granulocytic sarcoma. This case demonstrates that Granulocytic sarcoma should be considered as a part of the differential diagnosis for testicular swelling in spite of having normal peripheral counts and absence of hepatosplenomegaly.
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446479/severe-chronic-diarrhoea-secondary-to-primary-lymph-node-gastrinoma
#13
Mouhanna Abu Ghanimeh, Khalil Abuamr, Esmat Sadeddin, Osama Yousef
The existence of primary lymph node (LN) gastrinoma is questionable and controversial. In fact, the presence of gastrinoma in such uncommon site raises the possibility of metastasis from another occult primary site. An extensive evaluation and careful follow-up is always warranted. A female aged 48 years presented with chronic abdominal pain and watery diarrhoea. Her serum gastrin and chromogranin were elevated, and an underlying gastrinoma was suspected. Further evaluation with an octreotide scan, an endoscopic ultrasound and a secretin stimulation test confirmed the diagnosis...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446443/enteritis-with-pneumatosis-intestinalis-following-rotavirus-immunisation-in-an-infant-with-short-bowel-syndrome
#14
Robert N Lopez, Usha Krishnan, Chee Y Ooi
Rotavirus vaccines now form part of the national immunisation schedule in many countries. Contraindications to its use are few but do not currently include infants with short bowel syndrome (SBS). We present a nearly 3-month-old boy with SBS who developed enteritis with pneumatosis intestinalis following administration of the Rotarix vaccine.
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28446442/paracentral-acute-middle-maculopathy-precursor-to-macular-thinning-in-sickle-cell-retinopathy
#15
Syed Amal Hussnain, Patrick A Coady, Kathleen M Stoessel
We present a case of paracentral acute middle maculopathy (PAMM) in a patient with sickle cell disease (SCD). Though gradual capillary loss may contribute to pathophysiology of sickle cell retinopathy as well, our case suggests that PAMM may be the precursor lesion to macular thinning commonly observed in patients with SCD. In addition, fluorescein angiography may be unable to detect these acute vascular events occurring at the deep capillary plexus.
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28442457/a-pseudotumour-of-the-thigh-tensor-fasciae-latae-muscle-hypertrophy-due-to-an-underlying-abductor-tendon-tear
#16
Ruben Petrus Johannes Meijer, Jorrit Jasper, Barbara Snoeker, Joris Jansen
We present a patient with an asymptomatic unilateral swelling of the anterolateral thigh. MRI showed hypertrophy of the tensor fasciae latae muscle due to an underlying gluteus minimus tendon tear.Abductor tendon tears can present with swelling of the thigh due to secondary tensor fasciae latae muscle hypertrophy.
April 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28438795/cystic-tumour-of-the-atrioventricular-node-treatment-dilemma
#17
Wael Abuzeid, Robert B H Myers
An asymptomatic 18-year-old black woman was found to have an incidental finding of third-degree atrioventricular (AV) block on a routine ECG. 2-Dimensional transthoracic echocardiography showed a heterogeneous mass in the region of the peri-membranous septum in the AV node area. A cardiac MRI showed a well-defined cystic mass arising from the right side of the interatrial septal wall. An MRI compatible permanent pacemaker was implanted with plans to monitor the tumour with non-invasive imaging. Cystic tumour of the AV node is a rare primary cardiac tumour...
April 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28438794/intraductal-oncocytic-papillary-neoplasm-a-benign-hepatic-cystic-neoplasm
#18
Angela Tong, Gregory Veillette, Alexandra Budhai, Anthony Gilet
A 61-year-old Asian man presented with severe right upper quadrant pain which had been worsening for several months. Laboratory results indicated elevated aspartate aminotransferase and alanine aminotransferase. The subsequent ultrasound, CT and MRI showed a large cystic mass with solid components and severe intrahepatic and extrahepatic biliary ductal dilatation. The mass was resected and pathology showed a well-demarcated mucinous cystic lesion with polygonal cells containing ovoid nuclei and abundant pink oncocytic cytoplasm...
April 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28438773/mechanical-cpr-in-a-child-can-one-size-fit-all
#19
Leah Sugarman, David Hedley, Steve Crowe
This case report describes the successful resuscitation of an 11-year-old boy who suffered out-of-hospital cardiac arrest (OHCA) using mechanical cardiopulmonary resuscitation (CPR) by adapting the Lund University Cardiopulmonary Assist System (LUCAS)(2) Device by rolling a blanket under the patient's back to increase his chest height, thus allowing the LUCAS device to administer compliant CPR.
April 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28438772/severe-vincristine-induced-polyneuropathy-in-a-teenager-with-anaplastic-medulloblastoma-and-undiagnosed-charcot-marie-tooth-disease
#20
Yasmin Aghajan, Janet M Yoon, John Ross Crawford
Severe neuropathy is a known adverse effect of vincristine in patients with Charcot-Marie-Tooth disease (CMT). We present the case of a 16-year-old girl with anaplastic medulloblastoma treated with gross total resection and high-dose craniospinal radiation with adjuvant vincristine chemotherapy who developed acute-onset severe quadriplegia and vocal cord paralysis. Vincristine and radiation therapy were discontinued. Although her neuropathy slowly improved over several weeks, she developed metastatic extraneural medulloblastoma and died 5 months after diagnosis...
April 24, 2017: BMJ Case Reports
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