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American Journal of Case Reports

William J Nahm, Jorge A Mota, Sarah Rojas, Brian J Hizon, Chris Gordon
BACKGROUND Classical pyoderma gangrenosum is a rare, inflammatory, neutrophilic dermatosis that commonly presents with severe ulcerations on the lower extremities and is often misdiagnosed and mistreated. Delay in treatments can lead to worsening of the ulcerations and allows for multiple comorbid factors. Pyoderma gangrenosum is most commonly treated with immunosuppressants or anti-inflammatory agents and is often worsened by surgical procedures due to the presence of pathergy. In acute cases, a course of anti-inflammatory treatments works well in alleviating symptoms and reducing ulcerations and residual scarring...
July 19, 2018: American Journal of Case Reports
Mwaffaq Elheis, Qusai Aljarrah, Hussein Heis, Adam Haque
BACKGROUND There is a paucity of published literature on carotid-jugular fistulae in children. These injuries are uncommon in the pediatric age group and most of the current practice in managing such injuries is extrapolated from similar injuries in the adult population. CASE REPORT We report a case of an acquired carotid-jugular fistula (CJF) following penetrating neck trauma in a 12-year-old male, treated by minimally invasive endovascular covered stent. Successful endovascular management was achieved in this case with anatomical and symptomatic resolution at 6 weeks and normal duplex ultrasound at 18 months...
July 18, 2018: American Journal of Case Reports
Matthew R Smith, Carl Faingold, John D Mellinger
BACKGROUND Nutraceutical formulations are an area in which physicians should be increasingly aware of their side effects. This case study shows the adverse effects that ginkgo biloba can have when combined with tadalafil following an inguinal hernia repair. CASE REPORT A 74-year-old male presented for repair of a recurrent inguinal hernia and for which the procedure was performed without complication. Upon follow-up, it was noted that he had significant ecchymosis not only in the inguinal region but in the ventral aspect of his penis...
July 17, 2018: American Journal of Case Reports
Nathan J Smischney, Emily M Pollard, Asha U Nookala, Oludare O Olatoye
BACKGROUND Serotonin syndrome is a life-threatening condition that can lead to neurologic complications and is associated with the use of serotonergic medications. As the use of antidepressant medications has increased, the incidence of perioperative serotonin syndrome has transitioned from a rare diagnosis to one that should be considered as a differential diagnosis for any patient displaying signs of neuroexcitation. CASE REPORT A 70-year-old man (ASA 2) with a history of vestibular migraines (treated with venlafaxine), gastroesophageal reflux disease, and benign prostatic hyperplasia presented to our institution for photoselective vaporization of the prostate...
July 16, 2018: American Journal of Case Reports
Yehuda Galili, Meghan Lytle, Steve Carlan, Mario Madruga
BACKGROUND Right-sided infective endocarditis is a classic complication of intravenous drug abuse. Without timely bactericidal antibiotics, the disease process can progress to septic pulmonary emboli. Rarely, a pneumothorax can occur as a result of the emboli, and progressive persistent valvular disease may require a valve replacement. Tricuspid valve replacement has a high morbidity rate even in stable patients. CASE REPORT We present a case of tricuspid valve replacement in a 39-year-old man with peripheral intravenous drug abuse who had bilateral pneumothoraces secondary to septic pulmonary emboli originating on large tricuspid valve infected vegetations...
July 14, 2018: American Journal of Case Reports
Ching Soong Khoo, Hui Jan Tan, Syazarina Sharis Osman
BACKGROUND Dermal fillers are increasingly used for medical and aesthetic purposes in clinical practice. Common complications following filler injections include bruising, itching, infections, allergic reactions, and tissue necrosis. This case is the first report of Herpes simplex virus type 1 (HSV-1) encephalitis as a possible complication of dermal filler injection. CASE REPORT A 27-year-old woman with no past medical history presented with altered mental state, headaches, and seizures. She had a nasal dermal filler injection for aesthetic purpose five weeks before her acute presentation...
July 13, 2018: American Journal of Case Reports
Karolina E Kryczka, Zofia Dzielińska, Maria Franaszczyk, Izabela Wojtkowska, Jan Henzel, Mateusz Śpiewak, Janina Stępińska, Zofia T Bilińska, Rafał Płoski, Marcin Demkow
BACKGROUND Peripartum cardiomyopathy (PPCM) is a potentially life-threatening, pregnancy-associated cause of heart failure affecting previously healthy women. Recent research suggests a possible role of 16-kDa prolactin in promoting cardiomyocyte damage. However, the genetic predisposition is not well recognized. CASE REPORT We report the case of a 25-year-old woman with a severe course of PPCM with left ventricle ejection fraction of 25-30%, complicated by ventricular arrhythmia and postpartum thyroiditis...
July 12, 2018: American Journal of Case Reports
Guglielmo Niccolò Piozzi, Elisa Reitano, Valerio Panizzo, Barbara Rubino, Davide Bona, Domenico Tringali, Giancarlo Micheletto
BACKGROUND Bleeding is a major intraoperative complication during surgical procedures. When conventional methods such as ligature and diathermocoagulation are ineffective for bleeding management, hemostatic agents should be used. Oxidized cellulose is one of the major hemostatic agents used worldwide. Oxidized cellulose is often left in situ after hemostasis because of its high level of reabsorption that lasts up to 8 weeks. However, 38 cases of retaining-associated complications are reported in the literature...
July 11, 2018: American Journal of Case Reports
Dina M Hijazi, Firas A Addas, Najla M Alghanmi, Hani Z Marzouki, Mazin A Merdad
BACKGROUND Diffuse lipomatosis of the thyroid gland is a particularly rare histopathological condition characterized by diffuse fatty infiltration within the thyroid stroma. CASE REPORT We report a case of a 53-year-old woman who presented with a 2-year history of massive neck goiter and mild dysphagia. A computed tomography (CT) scan revealed heterogeneous enhancing of an enlarged thyroid gland with left lobe cranial extension and compression of the pharynx, and caudal bilateral retrosternal growth. The patient underwent total thyroidectomy and histopathological examination revealed mature fatty tissue diffusely distributed throughout the thyroid gland...
July 10, 2018: American Journal of Case Reports
Abubaker O Abdalla, Jaafar Al-Khafaji, Mohamed Taha, Samira Malik
BACKGROUND Calciphylaxis is a rare cutaneous disease, also known as calcific uremic arteriolopathy, that occurs most frequently in patients with advanced chronic kidney disease and on long-term hemodialysis. CASE REPORT We describe the case of a 61-year-old female patient with worsening chronic kidney disease not on dialysis therapy, who presented with severe progressive calciphylaxis on both lower limbs. CONCLUSIONS Calcific uremic arteriolopathy is a rare fatal condition that requires prompt diagnosis and treatment...
July 9, 2018: American Journal of Case Reports
Munish Sharma, Milkeesso Foge, Daniel Mascarenhas
BACKGROUND Hydralazine is an effective antihypertensive agent but may rarely have devastating hepatotoxic effects that are extremely variable, thus making the diagnosis difficult. CASE REPORT We report the case of a 74-year-old male patient who had transaminitis after being started on hydralazine by his cardiologist for poorly controlled hypertension. He had extreme dizziness, nausea, and weakness, which all resolved after discontinuation of hydralazine, and liver function test results also dramatically improved...
July 7, 2018: American Journal of Case Reports
Paraskevas Stamopoulos, Richard Viebahn, Peter Schenker
BACKGROUND Short bowel syndrome (SBS) is a malabsorption syndrome that results from an extensive intestinal resection or repeated small bowel resections. Postoperative small bowel obstruction is a well-known complication of abdominal surgeries requiring readmission and reoperation after failed conservative management. A combination of the above factors poses a clinical challenge for surgeons due to lack of applicable treatment options. CASE REPORT A 68-year-old man underwent repetitive laparotomies and multiple small bowel resections for an incarcerated inguinal hernia, resulting in SBS...
July 6, 2018: American Journal of Case Reports
Toni M Dick, Mohamed El Hag, J Shawn Mallery, Khalid Amin
BACKGROUND Esophageal carcinoma cuniculatum (CC) is an exceptionally rare, well-differentiated squamous cell carcinoma (SCC) with initial microscopic evaluation often yielding inconclusive diagnoses due to its characteristically bland histomorphologic appearance on superficial endoscopic biopsy. This can lead to delayed diagnosis and pose challenges in further management of these cases. CASE REPORT We present the case of a 52-year-old man with symptoms of dysphagia and odynophagia. The initial chest CT scan showed gastroesophageal (GE) junction wall thickening and regional lymphadenopathy...
July 5, 2018: American Journal of Case Reports
Riley G Jones, Felix Karthik, Anushree Dugar, Karthik Kanagarajan, Kalpan Desai, Manish Bhandari
BACKGROUND Malignant pleural mesothelioma (MPM) is a highly lethal cancer with a median survival of ~12 months even with aggressive intervention. Frontline therapy relies on systemic cisplatin and pemetrexed chemotherapy and has a response rate of ~35-41%; currently, there are no US Food and Drug Administration approved second-line therapies for MPM. Herein, we present a patient with MPM who experienced rapid disease progression after standard therapy but who had an exceptional and sustained response to immune checkpoint inhibition with single agent nivolumab...
July 4, 2018: American Journal of Case Reports
Nadejda Cojocari, Leonard David
BACKGROUND Neuroendocrine tumors found in skin or soft tissues usually represent metastasis from other organs and are considered late manifestations of disease. Therefore, primary cutaneous and soft tissue neuroendocrine tumors are extremely rare. CASE REPORT We report a case of a 48-year-old male with a neuroendocrine tumor occurring in the subcutaneous abdominal fat, which had an echographic appearance of a vascular malformation. The finding was diagnosed as compatible with neuroendocrine tumor based on histopathological and immunohistochemical studies...
July 3, 2018: American Journal of Case Reports
Mohamed Elshazzly, Fuad Bashjawish, Muhammad A Shahid, Dana A Marrero, Joel Horowitz
BACKGROUND Crohn's disease (CD) is an inflammatory bowel disease affecting approximately 1 in 3000 people in the United States. Since the inflammation of CD is transmural, patients are at risk for fistula and abscess formation. Retroperitoneal abscesses are one type of which physicians must be aware. CASE REPORT We present the case of a 29-year-old woman with CD who complained of right hip and flank pain that began when she was 6-months pregnant. After delivery, she continued to complain of severe right flank pain and was admitted to the hospital 1 month later...
July 2, 2018: American Journal of Case Reports
Aiman Obed, Abdalla Bashir, Anwar Jarrad
BACKGROUND Acute-on-chronic liver failure was first defined within the last 10 years as acute decompensation of chronic liver disease accompanied by multiorgan failure and poor outcome. Budd-Chiari syndrome is a rare and potentially deadly hepatic condition. To the best of our knowledge, this is the first case report of a live liver donor recipient with antiphospholipid antibody syndrome. CASE REPORT A 47-year-old woman from Sudan with acute-on-chronic liver failure and subacute Budd-Chiari syndrome triggered by active pneumonia was evacuated to Amman, Jordan...
June 30, 2018: American Journal of Case Reports
Raffaele Longo, Véronique Dorvaux, Eric Chatelain, Philippe Quétin, Francesca Plastino, Nada Eid, Nathalie Marcon, Laurent Hennequin, Marco Campitiello
BACKGROUND Myeloid sarcoma is a rare extramedullary soft tissue neoplasm composed of myeloblastic cells, usually associated to hematologic tumor disorders and a poor prognosis. Its diagnosis is very difficult as radiological images are not specific. Histology and immunohistochemistry are necessary for an accurate diagnosis. CASE REPORT We report the case of 46-year-old, Caucasian, non-smoker male, treated in 2014 by orchiectomy and systemic chemotherapy for a stage IIB testicular seminoma. Considering the rapid increase of lactate dehydrogenase (LDH) levels without any evident medical reason, a computed tomography/positron emission tomography (CT/PET) scan was performed and revealing a diffuse, nodular, peritoneal tumor infiltration associated with multiple mesenteric and mediastinal adenopathies...
June 29, 2018: American Journal of Case Reports
Michael Alatsakis, Maria Drogouti, Chrysoula Tsompanidou, Anastasios Katsourakis, Iosif Chatzis
BACKGROUND Thyroglossal duct cyst is a common congenital anomaly of the thyroid gland, usually found centrally. The presence of malignancy occurring in a thyroglossal duct cyst is a rare condition, accounting only for 1% of all cases of thyroglossal duct cyst. This report is of a rare case of papillary carcinoma arising in a thyroglossal duct cyst and includes a review of the literature. CASE REPORT A 27-year-old female patient was referred to our department with a painless cystic mass in the neck. After initial physical examination and endocrinology investigations, a fine needle aspiration (FNA) of the cyst was performed...
June 28, 2018: American Journal of Case Reports
Martin J C van Gemert, Marianne Vlaming, Eric Osinga, Cornelis M A Bruijninckx, H A Martino Neumann, Pieter J J Sauer
BACKGROUND Pediatric condition falsification (PCF) is a rare form of child abuse in which a caregiver fabricates or induces illness in the child. The diagnosis is difficult and controversial and can easily include false positives. CASE REPORT A boy, 3.18 kg birthweight (P25 curve), lost weight between age 56 to120 days. Cow milk allergy was suspected, feeding was changed to elementary formula, and he started catch-up weight growth while remaining significantly underweight. His pediatrician continuously interpreted his low weight as insufficient growth, despite prescribing 3 times the normal caloric intake, concluded that the mother purposely malnourished her son, diagnosed PCF, and the boy was separated from his family (days 502-755 of age)...
June 27, 2018: American Journal of Case Reports
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