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BMJ Case Reports

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https://www.readbyqxmd.com/read/28104723/traumatic-septal-coronary-perforation-after-a-motor-vehicle-collision
#1
Wael Abuzeid, Kareem Morant, Navneet Singh, Jeffrey Pang
No abstract text is available yet for this article.
January 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28104722/paradoxical-insomnia-in-a-patient-taking-zopiclone
#2
Adam Abba-Aji, Prajjita Bardoloi
We present a case of a man aged 20 years who was diagnosed with a major depressive disorder and was started on escitalopram and zopiclone. The patient had a significant response to escitalopram except that he developed severe insomnia which dramatically resolved following discontinuation of zopiclone. The patient was recommenced on low dose of zopiclone and unfortunately redeveloped moderate insomnia. The patient was thoroughly investigated and zopiclone was determined to have paradoxically caused the insomnia...
January 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28104721/gastrointestinal-stromal-tumour-gist-presenting-as-a-strangulated-inguinal-hernia-with-small-bowel-obstruction
#3
Marco Massani, Giovanni Capovilla, Cesare Ruffolo, Nicolò Bassi
Gastrointestinal stromal tumours (GISTs) can arise everywhere along the gastrointestinal (GI) tract. Their presentation in unusual locations should always be taken into account. A 74-year-old man referred to the emergency department for small bowel obstruction caused by an incarcerated inguinal hernia. A CT scan showed a mesenchymal tumour originating from the herniated bowel loop and a mass in the ascending colon. Laparoscopic resection of the mass and laparoscopic right hemicolectomy were performed. The histology showed a ruptured GIST arising from the herniated small bowel and a high-grade dysplasia villous adenoma of the right colon...
January 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28104720/when-dizziness-becomes-sinister-oropharyngeal-carcinoma-presenting-as-a-paraneoplastic-neurological-disorder
#4
Li Yong, Panagiotis Asimakopoulos, Colin Mumford, Ioanna Fragkandrea Nixon
Paraneoplastic neurological disorders are uncommon presentations of head and neck cancers. We present a case of a 68-year-old male patient who presented with dizziness, nausea and memory problems. MRI of his brain showed bilateral cerebellar leptomeningeal enhancing signal abnormality with cervical lymphadenopathy. CT imaging of his neck raised the suspicion of a tonsillar primary, which was later confirmed on biopsy. His poorly differentiated HPV positive squamous cell carcinoma was treated with chemoradiotherapy...
January 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100579/acute-mania-after-levothyroxine-replacement-for-hypothyroid-induced-heart-block
#5
Marc Gregory Yu, Karen Marie Flores, Iris Thiele Isip-Tan
Psychiatric disturbances can manifest after levothyroxine (LT4) treatment for severe hypothyroidism. We present the case of a young Filipino man with Hashimoto's thyroiditis and high-grade heart block, who was given a full replacement LT4 dose on admission. Twenty-four hours after this dose, he developed manic symptoms, which were addressed with sedatives and neuroleptics with gradual restoration of euthymia the following day. A comprehensive workup did not reveal any findings suggestive of another aetiology for either mania or heart block...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100578/ocular-surface-squamous-neoplasia-treated-with-topical-interferon-%C3%AE-2b
#6
Amar Pujari
No abstract text is available yet for this article.
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100577/late-spontaneous-decapsulation-of-the-kidney-graft-in-a-patient-with-hepatitis-c-and-treated-with-sirolimus-possible-pathophysiological-association-in-a-rare-complication
#7
Rita Leal, Helena Pinto, Rui Alves, Arnaldo Figueiredo
Late decapsulation with fluid collection is a rare complication of renal transplantation with deleterious effects on kidney function. Its physiopathology is unclear but there might be an association with mammalian target of rapamycin (m-TOR) inhibitors, especially in patients with chronic hepatitis C. We report a case of late spontaneous decapsulation 12 years after kidney transplant in a patient infected with hepatitis C under treatment with sirolimus. He underwent marsupialisation of the collection, sirolimus was converted to cyclosporine and hepatitis C treatment was performed with success...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100576/perioperative-management-of-a-large-late-presenting-phaeochromocytoma
#8
Duncan Macrosson, Andrew Love
A 77-year-old man presenting to the emergency department with an acute coronary syndrome was later found to have a phaeochromocytoma. The lateness of this presentation was likely due to the protective α blocking effects of long-term terazosin therapy for his prostatism. α blockers such as terazosin are a well-recognised medical therapy in the perioperative optimisation of phaeochromocytoma because they treat the adrenergic effects of catecholamine release from the tumour such as hypertension. This patient was diagnosed with an ST elevation myocardial infarction (STEMI)...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100575/atrophic-pityriasis-versicolor-occurring-in-a-patient-with-sj%C3%A3-gren-s-syndrome
#9
Elena Marinello, Stefano Piaserico, Mauro Alaibac
Pityriasis versicolor is one of the most frequent epidermal mycotic infections in the world, but its atrophic variant is rarely described. The aetiology of the atrophy is still unknown, and two main hypotheses have been formulated, one suggesting a correlation with long-term use of topical steroids and the other a delayed type hypersensitivity to epicutaneous antigens derived from components of the fungus. Atrophic pityriasis versicolor is a benign disease, but needs to be distinguished from other more severe skin diseases manifesting with cutaneous atrophy...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100574/clostridium-hastiforme-bacteraemia-secondary-to-pyometra-in-a-64-year-old-woman
#10
Matilde Ørum, David Fuglsang-Damgaard, Hans Linde Nielsen
The Gram-negative, rod-shaped, anaerobe bacteria Tissierella praeacuta was first described in 1908 by Tissier. However, during the past decade, Clostridium hastiforme has been recognised as a later synonym of T. praeacuta. C. hastiforme/T. praeacuta has only rarely been described in previous literature as a cause of human infection. We present here a case report of C. hastiforme/T. praeacuta bacteraemia secondary to pyometra in a 64-year-old woman with a history of multiple sclerosis and an intrauterine device inserted three decades earlier...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100573/mucormycosis-pulmonary-abscess-containment-in-a-patient-with-uncontrolled-diabetes-mellitus
#11
Faraz Jaffer, Norman Beatty, Kareem Ahmad
A 56-year-old Hispanic male with solo risk factor of uncontrolled diabetes mellitus presented with recurrent haemoptysis. Initial concern was for malignancy with postobstructive pneumonia; however, invasive testing and biopsy confirmed infectious mass of fungal aetiology requiring surgical resection followed by a prolonged course of anti-fungal therapy. Discussion centred on approach to, progression of and course of action in the management of pulmonary abscess due to mucormycosis.
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100572/pain-in-the-neck
#12
Zaid Makzal, Alison Evans, Kavitha Masilamani
No abstract text is available yet for this article.
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100571/primary-squamous-cell-carcinoma-of-the-thyroid-with-complete-response-to-radical-radiotherapy-and-concurrent-cisplatin-based-chemotherapy
#13
Michael Del Rosario, Constantin Dasanu, Henry Tsai, Robert Johnson
Chemoradiotherapy and/or surgery are both potentially radical treatments for squamous cell carcinomas. Squamous cell carcinomas are considered chemosensitive tumours compared to adenocarcinomas or anaplastic thyroid malignancies. A 76-year-old man was found to have T4bN0M0 primary squamous cell carcinoma of the thyroid with encasement of the internal carotid artery. The disease was deemed unresectable. Therefore, he was treated with radical radiotherapy with concurrent cisplatin-based chemotherapy. We discuss herein the aetiology, diagnosis and management of primary squamous cell carcinoma of the thyroid...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100570/a-rare-cause-of-constrictive-pericarditis
#14
Shane Patrick Flood, Omar Ayah, Satoshi Furukawa, Robert B Norris
A 67-year-old man presented with 3 months of exertional dyspnoea and 1 week of oedema. Examination revealed elevated neck veins, pulsus paradoxus, muffled heart sounds, decreased breath sounds and pedal oedema. Transthoracic echocardiogram (TTE) demonstrated cardiac tamponade, and chest X-ray showed pleural effusion. Pericardiocentesis, thoracocentesis, laboratory investigations and CT did not elucidate an underlying aetiology. Three weeks later, he presented with recurrent cardiac tamponade and pleural effusion...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100569/multiple-pregnancy-in-a-primigravida-with-uncorrected-pentalogy-of-fallot
#15
Pamela Partana, Jarrod Kah Hwee Tan, Ju Le Tan, Lay Kok Tan
Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100568/stentriever-thrombectomy-with-distal-protection-device-for-carotid-free-floating-thrombus-a-technical-case-report
#16
Suresh Giragani, Ankit Balani, Vikas Agrawal
We report the clinical details, imaging findings and management of a 45-year-old man who presented with recurrent transient ischemic attacks due to carotid free floating thrombus. Free floating thrombus of the carotid artery is a very rare condition with a high risk of distal embolic shower. The optimal treatment options are debatable and include medical management, surgical thrombectomy and endovascular thrombectomy. We describe the use of a stentriever with filter protection in the management of carotid free floating thrombus as a novel treatment option...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28096230/haemodialysis-in-acute-paracetamol-poisoning
#17
L Serjeant, J Evans, F Sampaziotis, W G Petchey
A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigating N-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as a treatment option in selected cases of paracetamol overdose, consistent with the international guidelines...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28096229/disseminated-melioidosis-in-the-head-and-neck
#18
Tze Ling Loh, Sergios Latis, Graeme Crossland, Hemi Patel
A 35-year-old man was admitted to an intensive care unit with unilateral facial swelling and septic shock after multiple presentations to the emergency department with non-specific unilateral pain over the parotid area. A CT scan of his neck showed diffuse right-sided facial soft tissue infection, mastoid effusion and temporal lobe cerebritis. The upper lobes of his lungs had cannonball lesions that were suggestive of septic lung metastases. Blood cultures and ear canal swabs were positive for Burkholderia pseudomallei The temporal lobe cerebritis eventually developed into an abscess, necessitating a cortical mastoidectomy, craniectomy and temporal lobectomy...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28096228/ingestion-of-cylindrical-batteries-and-its-management
#19
Tony Tien, Sudeep Tanwar
In contrast to the ingestion of coin batteries, the ingestion of cylindrical batteries is an uncommon medical presentation. Owing to their larger size, cylindrical battery ingestion can lead to serious complications including intestinal haemorrhage, bowel obstruction, bowel perforation, peritonitis and even death. We discuss the case of a 17-year-old girl who presented after swallowing three cylindrical batteries. Her medical history included depression and previous battery ingestion that required surgical removal...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28096227/atypical-presentation-of-bezold-s-and-citelli-s-abscesses-with-recollection-following-an-incomplete-postoperative-course-of-antibiotics
#20
Sadik Quoraishi, Jayan George, Amir Farboud, Conor Marnane
Bezold's and Citelli's abscesses are rare complications of otitis media. We present a case of a 44-year-old Eastern European man, with a history of recurrent otitis media, who was admitted to hospital with mastoiditis and initially treated with antibiotics. Despite clinical improvement, a CT scan showed mastoiditis with Bezold's and Citelli's abscesses. The patient underwent a myringotomy and grommet insertion, in addition to a cortical mastoidectomy and curettage of the neck abscesses. After a good recovery, he was discharged home...
January 17, 2017: BMJ Case Reports
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