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Journal of Investigative Medicine High Impact Case Reports

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https://www.readbyqxmd.com/read/27900335/a-rare-presentation-of-peritoneal-tuberculosis-mimicking-malignancy
#1
Thein Swe, Akari Thein Naing, Zaw Win Phyo, Malar Thwin
Our search of literature revealed combined elevations of serum cancer antigen 125 levels and rheumatoid factor levels in a patient with peritoneal tuberculosis has rarely been reported. Thus, we describe the case of a 63-year-old female with large abdominal ascites and malignancy was ruled out with biopsy. High levels of serum cancer antigen and rheumatoid factor were noted. Physicians should be aware that tuberculosis infection could induce elevation of rheumatoid factor levels in the absence of rheumatologic symptoms or disease...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27896279/a-case-of-relapsing-polyarthritis-associated-with-hidradenitis-suppurativa-case-report-and-review-of-literature
#2
Avinash Adiga, John Pixley
Hidradenitis suppurativa (HS) is a chronic, inflammatory follicular skin disease with recurrent skin nodules, sinus tracts, and scarring. We observed a case of HS associated with relapsing polyarthritis. On presentation the patient had a flare of polyarthritis with an increase in the number and size of pustular nodules. He has had similar episodes 1 to 2 times yearly subsiding with antibiotic treatment. Radiographs revealed erosions and demineralization. Symptoms improved following institution of anti-inflammatory and antibiotic therapy...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27868075/novel-mutation-of-interferon-%C3%AE-receptor-1-gene-presenting-as-early-life-mycobacterial-bronchial-disease
#3
Maria J Gutierrez, Neelu Kalra, Alexandra Horwitz, Gustavo Nino
Mendelian susceptibility to mycobacterial diseases (MSMD) are a spectrum of inherited disorders characterized by localized or disseminated infections caused by atypical mycobacteria. Interferon-γ receptor 1 (IFNGR1) deficiency was the first identified genetic disorder recognized as MSMD. Mutations in the genes encoding IFNGR1 can be recessive or dominant and cause complete or partial receptor deficiency. We present the case of a 2½-year-old boy with a history of recurrent wheezing, diagnosed with endobronchial mycobacterial infection...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27847832/recurrent-parotid-carcinosarcoma-in-an-asymptomatic-patient
#4
Joshua Mansour, Abhishek Mangaonkar, Vamsi Kota
In this article, we present the case of a 52-year-old male with a history of parotid carcinosarcoma with initial diagnosis being 18 months prior. Initial treatment included a combination of gamma knife surgery coupled with high dosage chemotherapy and X-ray radiation therapy. At the time of follow-up, the patient presented with no complaints and had a nearly normal physical exam with the exception of some facial nerve weakness on the same side as the initial surgery. Despite being asymptomatic, the patient had a significant progression of disease that was manifested with intracranial lesions, multiple pathologic fractures, and a dramatic increase in overall tumor burden...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27847831/relapsed-acinic-cell-carcinoma-of-the-parotid-gland-with-diffuse-distant-metastasis-case-report-with-literature-review
#5
Yousef Khelfa, Munthir Mansour, Yousef Abdel-Aziz, Ali Raufi, Krista Denning, Yehuda Lebowicz
Acinic cell carcinoma (ACC) is an uncommon salivary gland neoplasm that generally displays an indolent growth pattern. Most cases arise in the major glands, particularly the parotid. However, it can arise from minor salivary glands in the oral cavity and aero-digestive tract. Although ACC is generally a low-grade malignant tumor, poorly differentiated and high-grade transformed variants exhibit a propensity for late recurrence and metastasis. There are no adequate clinical trials that define the optimal approach to patients with metastatic salivary gland tumors due to its rarity...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27826594/iron-overload-and-platelet-function-defects-possible-correlation
#6
Abdulkader A Dahi, Ehab Hanafy, Mohammed Al Pakra
Acquired platelet function defect might be a consequence of iron overload. Even though there are various complications of iron overload, only few reports have indicated some correlations with platelets dysfunction. We report a child with Diamond-Blackfan anemia who has significant complications from iron overload due to chronic blood transfusion, and one of these complications is acquired platelet function defect that manifests with frequent episodes of epistaxis. Therefore, we emphasize the necessity for further studies to confirm direct correlation between iron overload as a causative agent and platelets dysfunction...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27826593/pembrolizumab-therapy-triggering-an-exacerbation-of-preexisting-autoimmune-disease-a-report-of-2-patient-cases
#7
Sneha D Phadke, Ramez Ghabour, Brian L Swick, Andrea Swenson, Mohammed Milhem, Yousef Zakharia
Historically, metastatic melanoma was uniformly and rapidly lethal, and treatment options were limited. In recent years, however, checkpoint inhibitors have emerged as an accepted standard treatment for patients with advanced melanoma. In clinical trials, these agents have been largely well tolerated and have the potential to result in durable responses. Importantly though, one must recognize the unique side effect profile of these therapies, which can trigger or exacerbate underlying autoimmune disease. Whether this autoimmune activation is associated with a clinical response to therapy has been debated, and while not definitive, there is evidence in the literature of a possible association...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27790622/an-occult-malignancy-behind-a-demyelinating-disease-poems-syndrome
#8
Saberio Lo Presti, Prashanth Kanagarajah, Daniela Pirela, Diana Morlote, Mike Cusnir
We report a case of a 38-year-old man presenting with bilateral lower extremity weakness and paresthesias that progressed during a 4-month period to severe polyneuropathy forcing the patient to be bed bound. Throughout his multiple hospitalizations, he was treated erroneously for chronic inflammatory demyelinating polyneuropathy, without significant improvement in his symptoms. In addition, he developed hepatosplenomegaly (organomegaly); endocrinopathies such as diabetes mellitus, central hypogonadism, and hypothyroidism; monoclonal spike evidenced in the serum electrophoresis; and hyperpigmentation of skin, altogether consistent with POEMS syndrome...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27734018/methicillin-resistant-staphylococcus-schleiferi-subspecies-coagulans-infection-in-a-patient-with-hepatocellular-carcinoma
#9
Thein Swe, Akari Thein Naing, Aama Baqui, Ratesh Khillan
To our knowledge and literature search, Staphylococcus schleiferi subspecies coagulans infection in human beings has rarely been described in the medical literature. Furthermore, we believe that this is a first detailed case report of methicillin-resistant Staphylococcus schleiferi subspecies coagulans infection in a patient with hepatocellular carcinoma. Because of the possible association of Staphylococcus schleiferi infection and immunosuppression, any isolates of this bacterium in human beings should be presumed to be pathogenic, unless proven otherwise...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27722178/acute-lymphoblastic-leukemia-in-a-young-adult-presenting-as-hepatitis-and-acute-kidney-injury
#10
Marc Heincelman, Nithin Karakala, Don C Rockey
Acute lymphoblastic leukemia (ALL) in adults is a relatively rare malignancy. The typical presentation includes signs and symptoms associated with bone marrow failure, including fevers, infections, fatigue, and excessive bruising. In this article, we report an unusual systemic presentation of ALL in a previously healthy 18-year-old man. He initially presented with several-day history of nausea and vomiting, 10-pound weight loss, and right upper quadrant abdominal pain with evidence of acute hepatocellular liver injury (elevations in aspartate aminotransferase/alanine aminotransferase) and elevation in serum creatinine...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27689100/daptomycin-vancomycin-resistant-enterococcus-faecium-native-valve-endocarditis-successfully-treated-with-off-label-quinupristin-dalfopristin
#11
Khandakar Hussain, Saad Ullah, Hassan Tahir, Waseem Zaid Alkilani, Muhammad Naeem, Nagadarshini Ramagiri Vinod, Samuel Massoud
Multidrug-resistant enterococcal nosocomial invasive infections are a rising concern faced by the medical community. Not many options are available to treat these highly virulent organisms. Risk factors for developing these highly resistant organisms include prolonged hospital stay, previous antibiotic use, and immunosuppression. In this article, we report a case of daptomycin-resistant enterococcal native infective endocarditis treated with off-label use of quinupristin-dalfopristin.
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27660767/fetal-type-variants-of-the-posterior-cerebral-artery-and-concurrent-infarction-in-the-major-arterial-territories-of-the-cerebral-hemisphere
#12
Stephen L Lambert, Frank J Williams, Zhora Z Oganisyan, Lionel A Branch, Edward C Mader
Fetal-type or fetal posterior cerebral artery (FPCA) is a variant of cerebrovascular anatomy in which the distal posterior cerebral artery (PCA) territory is perfused by a branch of the internal carotid artery (ICA). In the presence of FPCA, thromboembolism in the anterior circulation may result in paradoxical PCA territory infarction with or without concomitant infarction in the territories of the middle (MCA) or the anterior (ACA) cerebral artery. We describe 2 cases of FPCA and concurrent acute infarction in the PCA and ICA territories-right PCA and MCA in Patient 1 and left PCA, MCA, and ACA in Patient 2...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27656660/severe-babesia-microti-infection-in-an-immunocompetent-host-in-pennsylvania
#13
Jeffrey Genda, Elizabeth A Negron, Mona Lotfipour, Samyuktha Balabhadra, Diana S Desai, David W Craft, Michael Katzman
Babesiosis, due to infection by a tick-borne protozoan (predominantly Babesia microti in North America), is an emerging health risk that is expanding into new areas and may be unfamiliar to clinicians in locations not previously considered endemic. Manifestations of infection can range from asymptomatic to life threatening, with severe disease more likely in those who have had a splenectomy, are immunocompromised, have chronic medical conditions, or are over 50 years of age. In this article, we describe an elderly but otherwise healthy man from an area not generally considered endemic for babesiosis who presented with severe hemolysis, acute renal failure, and high-level Babesia microti parasitemia; serological results suggestive of possible coinfection by Borrelia burgdorferi (the agent of Lyme disease, which is carried by the same tick as is Babesia microti) also was found...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27652275/unusual-presentation-of-central-diabetes-insipidus-in-a-patient-with-neurosarcoidosis
#14
Vedha Sanghi, Aanchal Kapoor
Hypernatremia is a frequent cause of intensive care unit admission. The patient presented in this article had hypernatremia refractory to D5W (dextrose 5% water) therapy, which led to a complex investigation. Workup revealed central diabetes insipidus most likely secondary to flare up of neurosarcoidosis. The challenge in terms of diagnosis was a presentation with low urine output in the setting of hypernatremia resistant to treatment with desmopressin. This case unfolded the role of hypothyroidism causing secondary renal dysfunction and hence needed continued treatment with thyroxine in addition to treatment for hypernatremia...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27635411/spontaneous-subdural-empyema-following-a-high-parasitemia-falciparum-infection-in-a-58-year-old-female-from-a-malaria-endemic-region-a-case-report
#15
Pedro Pallangyo, Frederick Lyimo, Paulina Nicholaus, Ulimbakisya Kain, Mohamed Janabi
Malaria remains a significant public health problem of the tropical world. Falciparum malaria is most prevalent in the sub-Saharan African region, which harbors about 90% of all malaria cases and fatalities globally. Infection by the falciparum species often manifests with a spectrum of multi-organ complications (eg, cerebral malaria), some of which are life-threatening. Spontaneous subdural empyema is a very rare complication of cerebral malaria that portends a very poor prognosis unless diagnosed and treated promptly...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27635410/klebsiella-oxytoca-endocarditis-with-complete-heart-block
#16
Saad Ullah, Omar Elbita, Mahmoud Abdelghany, Hassan Tahir, Puneet Tuli, Waseem Zaid Alkilani, Joshan Suri
Gram-negative bacterial endocarditis causes 5% of all bacterial endocarditis. Among gram-negative bacteria, Klebsiella species are rare causes of native valve endocarditis. Klebsiella oxytoca is an extremely rare subspecies that can infrequently cause endocarditis and is associated with poor outcome. We report a case of Klebsiella oxytoca endocarditis in an elderly man who initially presented with stroke but later developed sepsis and heart block secondary to endocarditis.
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27635409/canagliflozin-induced-diabetic-ketoacidosis-case-report-and-review-of-the-literature
#17
Jessica Turner, Tahmina Begum, Roger D Smalligan
INTRODUCTION: Sodium-glucose co-transporter 2 (SGLT-2) inhibitors are relatively new antihyperglycemic agents that lower renal glucose reabsorption. They are used as adjunctive therapy to standard diabetes treatment. CASE REPORT: We present the case of a 62-year-old woman with a past medical history of type 2 diabetes mellitus and sudden-onset diabetic ketoacidosis (DKA). Use of canagliflozin, a SGLT-2 inhibitor, was determined to be the cause of the DKA. The patient ultimately recovered after 5 days in the intensive care unit...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27635408/two-cases-of-rhabdomyolysis-haff-disease-after-eating-carp-fish
#18
Joey V Louis, Saw Sein, Claudia Lyon, George Apergis
Unexplained rhabdomyolysis after eating fish is a rare condition caused by an unidentified toxin. Most of the incidences in the United States have been linked to consuming buffalo fish or crawfish. We present 2 cases of Haff disease in which the patients consumed grass carp as opposed to the usual suspects of buffalo fish or crawfish.
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27606325/erdheim-chester-disease-a-rare-presentation-of-a-rare-disease
#19
Melissa Matzumura, Javier Arias-Stella, James E Novak
Erdheim-Chester disease (ECD) is a rare, xanthogranulomatous, non-Langerhans cell histiocytosis with frequent systemic involvement. Although the diagnosis is based on characteristic histological and radiological findings, its identification can be challenging because of its heterogeneous presentation. Osteosclerosis of long bones, often associated with bone pain, is the most common initial manifestation, followed by extraskeletal manifestations in approximately 50% of cases. There is no standard treatment for ECD, although recommendations have been made on the basis of small studies...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27570780/colonic-spirochetosis-in-a-60-year-old-immunocompetent-patient-case-report-and-review
#20
Taiwo Ngwa, Jennifer L Peng, Euna Choi, Sucharat Tayarachakul, Suthat Liangpunsakul
Spirochetes, a genetically and morphologically distinct group of bacteria, are thin, spiral-shaped, and highly motile. They are known causes of several human diseases such as syphilis, Lyme disease, relapsing fever, and leptospirosis. We report a case of colonic spirochetosis in a healthy patient presenting for surveillance colonoscopy. The diagnosis of intestinal spirochetosis was made accidentally during the histological examination of colonic polyps, which were removed during colonoscopy. We also performed an extensive review on intestinal spirochetosis with a focus on clinical presentation and outcomes of reported cases from the past two decades...
July 2016: Journal of Investigative Medicine High Impact Case Reports
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