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BMJ Case Reports

Subhanudh Thavaraputta, Ana Marcella Rivas
No abstract text is available yet for this article.
September 19, 2018: BMJ Case Reports
Siddharth Pandey, Deepanshu Sharma, Ajay Aggarwal, Ashish Sharma
No abstract text is available yet for this article.
September 19, 2018: BMJ Case Reports
Taufiq Khan, Anver Mahomed, Brijanand Ghoorun, Haider Ali
We present the case of a 56-year-old male smoker with a background of hypertension who presented with acute onset right testicular pain secondary to a leaking abdominal aortic aneurysm. Following urgent surgical repair and a complicated intensive care recovery, the patient was discharged with no residual disability. This case highlights an atypical presentation of what is a devastating illness.
September 19, 2018: BMJ Case Reports
Rohan Bir Singh, Priti Batta
A 36-year-old male, soft contact lens wearer was referred by his primary ophthalmologist for corneal ulcer of the right eye (OD), which was persistent despite topical fluoroquinolone therapy for 1 month. A ring-shaped infiltrate typically seen in Acanthamoeba infection was noted, and topical therapy with chlorhexidine and polyhexamethylene biguanide was initiated. However, the patient's condition deteriorated over the next several weeks; thus, diagnostic and therapeutic penetrating keratoplasty was performed...
September 19, 2018: BMJ Case Reports
Yukinori Harada, Itsumi Komori, Kouhei Morinaga, Taro Shimizu
Microangiopathic haemolytic anaemia with thrombocytopenia, called pseudo-thrombotic microangiopathy (TMA), is a clinically important complication in patients with vitamin B12 deficiency. We herein present a case of an 80-year-old woman with pseudo-TMA after gastrectomy. She was initially suspected with thrombotic thrombocytopenic purpura based on rapid progression of anaemia with schistocytes and thrombocytopenia; however, her anaemia and thrombocytopenia were improved by vitamin B12 supplementation alone, with a single session of plasma exchange...
September 19, 2018: BMJ Case Reports
Dileep Kumar, Ibrahim Batal, Belinda Jim, Barbara Mendez, Kisra Anis
Cocaine adulterated levamisole is an increasingly reported cause of skin necrosis, arthralgia and systemic vasculitis, but renal involvement is uncommon. We present a case of a 40-year-old Hispanic man with a history of cocaine abuse who presented with acute kidney injury to the rheumatology clinic where he was being treated for chronic inflammatory arthritis. He was found to have a serum creatinine of 2.5 mg/dL, microscopic haematuria and subnephrotic proteinuria, along with positive proteinase 3, myeloperoxidase, anticardiolipin antibodies and an elevated antinuclear antibody titre...
September 19, 2018: BMJ Case Reports
Michal Marek Woyton, Stefan Kluzek, Thamindu Wedatilake, Madeleine A M Davies
This case presents symptom resolution for a long-distance runner with chronic Achilles tendinopathy (AT), following a partial tear of his Achilles tendon. The patient reported a sudden pain during a morning run, with preserved function. Three hours postinjury, he was reviewed in a musculoskeletal clinic. An ultrasound scan confirmed a partial Achilles tear, associated with significant Doppler activity. His index of AT severity The Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A) 4 hours postinjury was markedly higher compared with 2 weeks preinjury, indicating reduced symptom severity...
September 19, 2018: BMJ Case Reports
Volker Pönitz, Karl Jakob Evensen
Accidental long-term dabigatran etexilate inhalation was associated with subtherapeutic dabigatran serum concentrations in an elderly female patient with restrictive lung disease. A significant improvement in her pulmonary function was noted without other therapy directed towards her bronchopulmonary disease.
September 19, 2018: BMJ Case Reports
Deepa Shunmugam, Sundaram Shanmugasundaram, Anitha Gandhi
Pelvic actinomycosis is a rare entity that occurs almost exclusively in women, the presentation of which is usually non-specific and variable. Pelvic actinomycosis is almost always associated with the use of an intrauterine contraceptive device (IUD). Pelvic actinomycosis unrelated to IUD use is almost always associated with previous surgical procedures. The symptoms, clinical signs and radiological findings are usually non-specific, mimicking an ovarian malignancy. So an awareness of this rare condition and a proper diagnosis can avoid unnecessary surgeries because these cases can be treated with a prolonged course of antibiotics...
September 19, 2018: BMJ Case Reports
Farah Shahi, Anda Samson
A retired businessman presented to the infectious diseases department with a history of ongoing fevers and myalgia and raised inflammatory markers. This continued despite adequate antibiotic treatment of an epididymo-orchitis. Extensive investigations, including bone marrow and liver biopsies and a positron emission tomography, did not reveal a cause but showed reactive change in the bone marrow. Later, he developed a vasculitic rash and vision loss due to non-arteritic anterior ischaemic optic neuropathy. High-dose steroids were immediately initiated...
September 19, 2018: BMJ Case Reports
Joshua Paul Harvey
No abstract text is available yet for this article.
September 18, 2018: BMJ Case Reports
Yashwant Agrawal, Dominika M Zoltowska, Abdul Halabi
No abstract text is available yet for this article.
September 18, 2018: BMJ Case Reports
Faisal Inayat, Fahad Zafar, Hanan Tahir Lodhi, Waqas Ullah
No abstract text is available yet for this article.
September 18, 2018: BMJ Case Reports
Sasmith Menakuru, Mir Inzamam Ali, Kashyap Karasala
No abstract text is available yet for this article.
September 18, 2018: BMJ Case Reports
Nuno André Almeida Costa, Gisela Rio, João Garrido Santos
No abstract text is available yet for this article.
September 18, 2018: BMJ Case Reports
Ganesh Kasinadhuni, Jasmine Sethi, Darshan Krishnappa, Yash Paul Sharma
Thirty-five-year-old man, underwent renal transplantation 4 years back and was doing well. He now presented with complaints of ascites with engorged neck veins and dyspnoea on exertion for last 6 months. Examination showed elevated jugular venous pressure with two prominent descents, high pitched diastolic heart sound (pericardial knock). Echocardiography showed characteristic features of thickened pericardium, septal bounce, expiratory flow reversal in hepatic veins and phasic variation of mitral inflow, suggestive of constrictive pericarditis...
September 18, 2018: BMJ Case Reports
Mona Mozaffari, Elena Boyd, Olivia Whiteside
Reported is the case of a 79-year-old woman initially diagnosed with periorbital abscess on the background of a recent upper respiratory tract infection. Unexpectedly, intraoperative findings were that of a haematoma rather than an abscess. Subperiosteal orbital haematoma (SOH) is an extremely rare complication of rhinosinusitis. In contrast to the more common periorbital abscess, it is seldom listed as a complication of sinusitis. A review of reported cases suggests an older patient demographic are affected by SOH in contrast to periorbital abscess which typically affects paediatric patients...
September 18, 2018: BMJ Case Reports
Andrew J Newman, Dustin Mullens, Sarah Estrada, Jason Barr
Cutaneous angioleiomyomas (ALMs) are uncommon benign tumours of the skin which derive from the smooth muscle layer of dermal blood vessels. They usually present as tender nodules in the fifth or sixth decade of life, predominantly in the legs of females. These tumours rarely present on the head and neck, especially the ear. Head and neck ALMs differ from their more common leg counterparts in that they are painless. Additionally, they do not manifest with a female predominance. Herein, a new case of a painless auricular ALM in a 63-year-old man is reported...
September 18, 2018: BMJ Case Reports
Sakolwat Montrivade, Patinya Maneesow, Thamonwan Osotthanakorn, Pairoj Chattranukulchai
We report a case of 46-year-old Asian woman with a history of recurrent epistaxis who presented with dyspnoea on exertion. Physical examination revealed mucocutaneous telangiectasias and signs of heart failure. Further evaluation showed huge hepatic arteriovenous malformation and severe pulmonary hypertension. This case demonstrates an uncommon manifestation of hereditary haemorrhagic telangiectasia presented with severe pulmonary hypertension.
September 18, 2018: BMJ Case Reports
Giovanni Beltrami
Giant cell tumours (GCT) of the finger phalanges are extremely rare but have a high rate of recurrence. This report details the case of a GCT of the proximal phalanx of the fourth finger in a 64-year-old man. The patient was initially subjected to systemic neoadjuvant denosumab treatment, and subsequent aggressive curettage, sparing of the articular joints, local cryotherapy and autologous intercalary fibular bone graft. Finger function after surgery was considered satisfactory, despite limited proximal interphalangeal (PIP) joint motion...
September 18, 2018: BMJ Case Reports
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