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Case Reports in Emergency Medicine

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https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#1
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29098095/medical-approach-to-right-colon-diverticulitis-with-perforation
#2
James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29085682/exercise-induced-acute-bilateral-upper-arm-compartment-syndrome
#3
Brian C Traub, Mark K Lane, Jeff A Traub
We present a rare case of acute exercise-induced bilateral upper-arm compartment syndrome in a patient who, after a year-long hiatus from exercise, subjected his upper-extremities to the stress of over 100 pushups. The patient presented with severe pain of the bilateral biceps and triceps and complaints of dark urine. Decompressive fasciotomy was performed followed by an intensive care unit (ICU) stay for associated myoglobinuria secondary to rhabdomyolysis. The patient suffered no long-term sequelae as a result of his conditions and recovered full function of the bilateral upper-extremities...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28912981/physician-beware-severe-cyanide-toxicity-from-amygdalin-tablets-ingestion
#4
Tam Dang, Cham Nguyen, Phu N Tran
Despite the risk of cyanide toxicity and lack of efficacy, amygdalin is still used as alternative cancer treatment. Due to the highly lethal nature of cyanide toxicity, many patients die before getting medical care. Herein, we describe the case of a 73-year-old female with metastatic pancreatic cancer who developed cyanide toxicity from taking amygdalin. Detailed history and physical examination prompted rapid clinical recognition and treatment with hydroxocobalamin, leading to resolution of her cyanide toxicity...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28900548/a-case-of-female-acute-urinary-retention-presenting-to-the-ed
#5
Kylen Swartzberg, Ahmed Adam, Feroza Motara, Abdullah E Laher
INTRODUCTION: Acute urinary retention is a rare occurrence in women necessitating further investigation. Potential underlying causes may be broadly classified into obstructive, neurological, pharmacological, and psychogenic categories. CASE: A 36-year-old nulliparous female presented to the Emergency Department with a two-day history of acute urinary retention. Point-of-care ultrasonography and CT scan imaging confirmed the presence of a large uterine mass causing compression of the bladder...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28894612/combined-dorsal-and-ulnarward-carpometacarpal-dislocation-associated-with-open-fracture-of-the-base-of-first-metacarpal-and-severe-degloving-injury
#6
Ali J Electricwala, Jaffer T Electricwala
We report a rare case of dislocation of second to fourth carpometacarpal (CMC) joints of the right hand with combined dorsal and ulnarward displacement of the second to fourth digits and fracture of the shaft of the first metacarpal associated with degloving injury. These injuries were diagnosed early and treated successfully with closed reduction and internal fixation using Kirschner wires. The functional outcome was good at follow-up at 5 years. A high index of suspicion is required to successfully diagnose and treat this condition...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28894611/cigarette-lighter-fluid-induced-gastric-ulcer-a-severe-complication-of-delayed-foreign-body-removal
#7
Ciel Harris, Lauren Stemboroski, Asim Shuja
The majority of foreign bodies ingested pass uneventfully through the gastrointestinal tract without endoscopic intervention. Nevertheless, certain ingested objects pose a greater risk for complications and are more challenging to remove than others. This case report describes a 49-year-old male who swallowed a cigarette lighter causing a gastric ulcer. The lighter was successfully removed by flexible endoscopy using a polypectomy snare. Urgent removal is required due to the shape of the object and its hazardous contents...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28884031/a-case-of-lionfish-envenomation-presenting-to-an-inland-emergency-department
#8
Rachel F Schult, Nicole M Acquisto, Crystal K Stair, Timothy J Wiegand
Lionfish envenomation can cause erythema, edema, necrosis, and severe pain at the exposed site. Treatment often includes supportive wound care, pain management, and hot water immersion. We report a case of lionfish exposure presenting to an inland emergency department treated successfully with these measures.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28781904/second-report-of-accidental-intestinal-myiasis-due-to-eristalis-tenax-diptera-syrphidae-in-iran-2015
#9
Ramezani Awal Riabi Hamed, Ramezani Awal Riabi Hamid, Naghizade Hamid
We have described a new case of accidental intestinal myiasis that had occurred due to Eristalis tenax in Iran. A 4-year-old girl living in rural area near Bajestan city located in the south of Khorasan Razavi province visited the hospital lab with complaints of one live larva in feces and did not have other symptoms, except anal itching. This case had a history of consuming subterranean village water and did not have a history of traveling outside the city or contact with other patients. Conclusion. Based on the morphology characteristic, the larva was identified as "rat-tailed maggot" or larvae fly E...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28698812/treatment-of-community-acquired-pneumonia-a-case-report-and-current-treatment-dilemmas
#10
Glenn Harnett
Resistance to macrolides is rising in the USA and warrants careful consideration when confronted with a patient with suspected pneumonia in the urgent care clinic. This case study exemplifies the potentially serious consequences of treatment failure following prescription of a macrolide for community-acquired bacterial pneumonia. Furthermore, the consequential treatment dilemmas currently faced by physicians are briefly discussed.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28638667/the-semantics-of-priapism-and-the-first-sign-of-chronic-myeloid-leukemia
#11
Michael R Minckler, Ellie Conser, Javier J Figueroa, Aaron J Scott, Joshua Gaither, Richard Amini
Priapism is defined as an erection that persists beyond four hours, lasting beyond or unrelated to sexual stimulation (Salonia et al., 2014). Because the risk of ischemic damage and impotence is high with priapism (35%), management guidelines are directed towards rapid treatment of this condition (Salonia et al., 2014). This report describes the rare case of an 18-year-old male who presented to the Emergency Department (ED) three times with recurrent and worsening episodes of sustained penile erections. On the patient's third visit, he presented with priapism of greater than six-hour duration that was found to be the result of chronic myeloid leukemia...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28630774/lead-poisoning-can-be-easily-misdiagnosed-as-acute-porphyria-and-nonspecific-abdominal-pain
#12
Ming-Ta Tsai, Shi-Yu Huang, Shih-Yu Cheng
Lead poisoning (LP) is less commonly encountered in emergency departments (ED). However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#13
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28593057/clomiphene-associated-inferior-stemi-in-a-young-female-due-to-right-coronary-artery-dissection
#14
Feras Husain Abuzeyad, Eltigani Seedahmed Ibnaouf, Mudhaffar Al Farras
Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is an uncommon cause of myocardial infarction. It most commonly affects females in the perimenopausal age. NA-SCAD has been associated with many predisposing factors including pregnancy and hormonal therapy for both contraception and ovulation induction. The presented case is a previously healthy 41-year-old woman diagnosed with inferior ST-elevation myocardial infarction due to right descending coronary artery dissection associated with recent use of clomiphene monotherapy for ovulation induction (a previously fertile woman), which was not previously reported...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28555165/tissue-hypoperfusion-hypercoagulopathy-and-kidney-and-liver-dysfunction-after-ingestion-of-a-naphazoline-containing-antiseptic
#15
Yuko Ono, Nozomi Ono, Kazuaki Shinohara
Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28540092/anti-musk-positive-myasthenic-crisis-in-a-7-year-old-female
#16
Harrison J Matthews, Apisadaporn Thambundit, Brandon R Allen
A seven-year-old African American female with anti-MuSK-positive Juvenile Myasthenia Gravis collapsed while at school from progressively worsening weakness and dyspnea. On initial emergency department presentation, she required 15 liters per minute of supplemental oxygen to maintain oxygen saturation above 92%. Initial pulmonary function tests and venous blood gas led to the decision to place her on noninvasive positive pressure ventilation (NPPV) with BiPAP in the emergency department. Due to worsening hypercarbia, she later required mechanical intubation in the PICU and underwent IVIG therapy followed by plasmapheresis in order to achieve a stable discharge from the hospital...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28480086/vertebral-arteriovenous-fistula-an-unwelcome-thrill
#17
Matthew K Edwards, Erica N Christenson, Brian M Corliss, Adam J Polifka, Brandon R Allen
Cervical vertebral AV fistulae are uncommon vascular lesions involving abnormal communication between the extradural vertebral artery and surrounding venous structures. We examine the case of a female evaluated in the emergency department with a vertebral AV fistula presenting classically as pulsatile tinnitus and later successfully treated with standard endovascular techniques. A discussion on the etiology, pathophysiology, and management of vertebral AV fistulae follows.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28465845/bilateral-pulmonary-embolism-after-a-short-haul-flight-in-a-man-with-multiple-risk-factors-including-sickle-cell-trait
#18
Kamille Abdool, Kanterpersad Ramcharan, Antonio J Reyes, Nadiene Lutchman, Adrian Alexander
We report a case of pulmonary embolism (PE) in an Afro-Caribbean man following a short commercial flight of less than 5,000 kilometers (Km) in economy class with a 1-month interval between journeys. He had an elevated body mass index (BMI) and sickle cell trait (SCT) with hyperhomocysteinemia. No other preexisting source of venous thrombosis was found. We posit that venous thromboembolism (VTE) and/or PE may have been a complication of SCT in an individual with other multiple risk factors. We discuss the possible interaction of these risk factors for VTE and/or PE and the implications for travelers at risk...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28458933/an-exceptional-case-of-diabetic-ketoacidosis
#19
Celine Van de Vyver, Jorn Damen, Carl Haentjens, Dominique Ballaux, Benoit Bouts
We present a case of diabetic ketoacidosis, known as one of the most serious metabolic complications of diabetes. We were confronted with rapid neurological deterioration and unseen glycaemic values, which reached almost 110 mmol/L, subsequently resulting in hyperkalaemia and life-threatening dysrhythmias. This is the first reported live case with such high values of blood glucose and a favourable outcome.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28392950/diffuse-subcutaneous-emphysema-and-pneumomediastinum-secondary-to-a-minor-blunt-chest-trauma
#20
Maximilian Andreas Storz, Eric P Heymann, Aristomenis K Exadaktylos
Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall...
2017: Case Reports in Emergency Medicine
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