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Oxford Medical Case Reports

Darren Fernandes, Pushpakaran Munuswamy, Sami Khan
Biliary ascariasis is a tropical infectious disease, endemic in regions such as the Far East, Indian subcontinent and parts of the Middle East. The responsible organism is the Ascaris lumbricoides worm. This case study presents a 54-year-old British Caucasian female patient, admitted with a 1-week history of generalized abdominal pain. Ultrasound scan of the abdomen showed a collapsed and abnormal image of the gallbladder. Further imaging for better visualization by magnetic resonance cholangiography showed a 6 cm linear structure in the gallbladder...
November 2018: Oxford Medical Case Reports
Yasemin Ozdamar Erol, Merve Inanc
Purtscher-like retinopathy has been rarely described during postpartum period in patients with pre-eclampsia. We present an unusual combination of serous macular detachment coexisting with Purtscher-like retinopathy as a complication of pre-eclampsia during postpartum period.
November 2018: Oxford Medical Case Reports
Motoaki Yasukawa, Tomoko Uchiyama, Chiho Ohbayashi, Takeshi Kawaguchi, Norikazu Kawai, Noriyoshi Sawabata, Shigeki Taniguchi
A mediastinal Müllerian cyst is composed of heterotopic cystic Müllerian tissue resembling structures of the fallopian tube. We herein report a case of a mediastinal Müllerian cyst discovered during a medical check-up of a 41-year-old woman. She had no symptoms but had been diagnosed with hyperprolactinemia at the age of 24 years, for which she received hormonal therapy for 3 years. Chest computed tomography demonstrated a 3-cm-diameter cystic tumor in front of the Th10 vertebra. Thoracic surgery was performed to remove the tumor...
November 2018: Oxford Medical Case Reports
Ai Sawaoka, Toshiki Ito, Takayuki Yoshida, Koichiro Muromachi, Tomoko Sakai, Kunio Hamada, Nobuyuki Tani-Ishii, Akihide Ito
Altered mental status is a common, yet challenging, clinical presentation encountered by physicians. Here, we report a case of a 68-year-old Japanese female who was transferred to the emergency department due to faint. The laboratory results showed hyponatremia, ketonuria, hyperglycemia and acute kidney injury without fever or inflammatory findings. Although these abnormalities were corrected, her mental status was exacerbated, and apnea/tachypnea appeared. She was eventually diagnosed with acute apical abscess and recovered immediately after dental extractions...
November 2018: Oxford Medical Case Reports
Pierre-Nicolas Boyer, Michael Devlin, Mike Boggild
A 30-year-old man presented with new onset severe headache and homonymous hemianopia, with a subsequent seizure, on a background of a right parietal astrocytoma resected at age 5 with adjuvant chemotherapy and radiotherapy. Magnetic resonance imaging of the brain revealed post-surgical and radiotherapy changes only and a clinical diagnosis of Stroke-like Migraine Attacks after Radiation Therapy (SMART) syndrome was made. Vision subsequently recovered gradually over a 6-week period, however, during the recovery phase he reported well formed hallucinations in the affected hemi-field consisting of small mammals, particularly possums, which gradually became less distinct as vision recovered; a phenomenon which was felt likely to represent the Charles Bonnet syndrome...
October 2018: Oxford Medical Case Reports
Connor G O'Leary, Lynda Corrigan, Petra Martin, Anne Horgan, Miriam O'Connor, Paula Calvert
A 66-year-old non-smoker was diagnosed with stage IIIB, epidermal growth factor receptor (EGFR) mutated, squamous cell lung carcinoma. Treatment included chemotherapy, 35 fractions of radiotherapy and later Gefitinib for 3.5 years. On progression he developed a solitary brain and liver lesion. The brain lesion was excised and histology revealed adenocarcinoma of a lung primary. Afatanib was commenced for 1 further year. At the second time of progression re-biopsy identified small cell carcinoma. He completed four cycles of Carboplatin and Etoposide however deteriorated on completion of chemotherapy...
October 2018: Oxford Medical Case Reports
MuneerAbas Malik, Umesh Bahadur Singh, Shalini Hedge, J K Mahajan, Ram Samujh
In heteropagus twins, the parasitic twin is incompletely formed which is attached to the autosite. We report a case of epigastric heteropagus twins with omphalocele. The parasite had two lower limbs, a rudimentary upper limb, genitalia with developed phallus and scrotum but absent testis. An omphalocele was present just below the attachment of the parasitic twin. A single kidney with ureter and a bladder filled with urine seen during exploration. The parasite bowel was attached to a sleeve of liver tissue from the autosite within the omphalocele sac and this connection was also the main source of its blood supply...
October 2018: Oxford Medical Case Reports
Scott A Helgeson, Alexander J Heckman, Josiah D McCain, Jennifer B Cowart, Michael J Maniaci, Jeffrey L Garland
Diffuse alveolar hemorrhage (DAH) is a rare, but potentially fatal, complication of antiphospholipid syndrome, and may present with acute and fulminant symptoms. We report a case of DAH presenting as sudden onset dyspnea in a gentleman with known antiphospholipid syndrome. Chest computed tomography angiography with pulmonary embolism protocol showed right lower lobe segmental filling defects, upper-lobe predominant diffuse ground-glass opacities, and centrilobular nodules bilaterally. The presence of DAH can be confirmed by bronchoalveolar lavage with serial aliquots, but this procedure typically does not elucidate the specific etiology for the hemorrhage...
October 2018: Oxford Medical Case Reports
Amon Ryakitimbo, Misso Kennedy, Elichilia Shao, Maria E Itana, Ronald Mbwasi, Grace Kinabo, Karen Yeates, Kajiru Kilonzo
Bee sting has been identified as among causative agents of nephrotoxic acute tubular necrosis which may lead to acute kidney injury. Bee envenomation has medicinal properties but when a higher dose is inoculated may cause severe anaphylaxis with very poor prognosis. We report a 12-year-old boy with acute kidney injury following multiple bee stings who recovered well after hemodialysis.
October 2018: Oxford Medical Case Reports
Bairavi Manoharan, Asma S Haider, Asgari Mowahed Samira, Balamurali Bharathan, Adolfo Parra-Blanco
An inverted (intussuscepted) appendix is a rare finding, often mistaken for a polyp as it presents with vague symptoms. This can result in misdiagnosis and inappropriate management. Diagnosis is usually made through surgery. Rarely, endometriosis has been found as the cause of the intussusception. A 42-year-old woman presented with frequent loose stools over 2 years, an elevated calprotectin over 400 μg/g faeces (normal <110) and a serum C-reactive protein of 40 mg/l (normal <5 mg/l). Endoscopy showed an inverted appendix...
October 2018: Oxford Medical Case Reports
Mouhamed Amr Sabouni, David Benedict, Md Saiful Alom, Stephen Petty, Keyoor Patel
The frequency of 18q- is estimated to be approximately 1/40 000 live births and is more commonly associated with certain clinical features including short stature, intellectual disability and malformations of many major organ systems. Congenital cardiac abnormalities are present in 24-36% of cases and screening can prove difficult. A 28-year-old Caucasian female with a history of long arm chromosome 18q deletion was evaluated for persistent dyspnea and decreased activity level. Multiple hospitalizations failed to identify the etiology of her symptoms...
October 2018: Oxford Medical Case Reports
Jussi O T Sipilä, Eero Rissanen, Jaana Korpela, Markku Päivärinta
Being treatable, steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), or Hashimoto's encephalopathy, should be distinguished from untreatable conditions. Our patient was a previously healthy 89-year-old man, who presented with cognitive and balance deterioration over several months. His cerebrospinal fluid (CSF) examination was positive for protein 14-3-3 but no other test suggested Creutzfeldt-Jacob disease. His condition improved markedly, although not fully, with intravenous corticosteroids...
October 2018: Oxford Medical Case Reports
Ana Goico, Jose Henao, Karla Tejada
Blastomycosis is a fungal infection caused by Blastomyces species. This infection is endemic to North America particularly states bordering the Mississippi, Ohio and St Lawrence Rivers, and the Great Lakes but also occurs worldwide. While the most common site of infection is the lung, it can also manifest in the bones, skin and central nervous system. Blastomycosis is a great masquerader and it can present in a manner difficult to distinguish from bacterial pneumonia, tuberculosis (TB), histoplasmosis or carcinoma...
October 2018: Oxford Medical Case Reports
Jagdish Prasad Meena, Abdul Ahad, Aditya Kumar Gupta, Saumyaranjan Mallick, Rachna Seth
Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. T-cell ALL accounts for 10-15% of cases. ALL can rarely relapse in unusual extramedullary sites like bone. Hereby, we report a case of 7-year-old male child who was being treated for T-cell ALL and then presented with left arm swelling. This swelling was initially thought to be a bone tumor but later it was found to be infiltrated by leukemic blasts. We reviewed all previous cases and suggest that in a patient of ALL presenting with a bone swelling during or after completion of therapy, one should suspect of bone relapse...
October 2018: Oxford Medical Case Reports
Dominic Heining, Jonathan Senior, Abheesh Prasad, Michael Thomas, Andrew Bentall, Phillip J Yates
We present a case of angiosarcoma at an arteriovenous fistula site in a non-immunocompromised patient presenting as a soft tissue swelling with associated findings suggestive of lung malignancy, metastases and bleeding diathesis. This patient died of an otherwise unexplained subdural haematoma. Given the ability of this tumour to metastasise early and the poor prognosis of angiosarcoma without adequate resection, this needs to be considered early in any differential diagnosis of soft tissue masses near an arteriovenous fistula...
October 2018: Oxford Medical Case Reports
Mohanad Al-Obaidi, Pamela Younes, Luis Ostrosky-Zeichner
Invasive mucormycosis is typically seen in patients with hematological malignancies, diabetes and other conditions that affect the immune system. However, locally invasive disease can also be seen in both immunocompromised and immunocompetent hosts after trauma and direct inoculation. Since historically post-exposure prophylaxis with lipid-based amphotericin B compounds has not been feasible because of a high toxicity profile, there is no experience regarding the role of post-exposure prophylaxis after injuries contaminated with agents of mucormycosis...
October 2018: Oxford Medical Case Reports
Casmir Wambura, Ahmed Jusabani, Omar Sherman, Salim Surani
Pseudomyxoma peritonei (PMP) is a rare condition resulting from mucin-producing tumors that have disseminated into intraperitoneal implants and mucinous ascites. The extra-abdominal spread of PMP is exceptionally rare, with few reported cases in the medical literature. Pseudomyxoma pleurii is an infrequently encountered clinical syndrome characterized by transdiaphragmatic pleural extension and spread of PMP. The disease is highly fatal. We hereby report a case of 58 years old woman who presented with an abdominal distension and shortness of breath of 2 months duration...
October 2018: Oxford Medical Case Reports
Osamu Imataki, Makiko Uemura
A 39-year-old male diagnosed as chronic myeloid leukemia, had no abdominal symptoms. However, his physical examination revealed apparent abdominal fullness. His liver and spleen were palpable. His abdominal CT revealed that a narrow space to pass intestinal digestive contents. Asymptomatic hepatosplenomegaly is somewhat typical in these chronic type hematological diseases.
October 2018: Oxford Medical Case Reports
Nang Hnin Nu Nu Kyi, Gary Tse, Panagiota Anna Chousou
No abstract text is available yet for this article.
October 2018: Oxford Medical Case Reports
Sabina Aursulesei, Gelu Simu, Cristian Florea, Paul Boarescu, Cristina Gheorghiu, Florina Frangu, Gabriel Cismaru, Mihai Puiu, Radu Rosu, Dumitru Zdrenghea, Dana Pop
We present the case of a 14-year-old female patient with recurrent episodes of paroxysmal supraventricular tachycardia (PSVT). Her ECG showed a PR interval of 160 ms in lead II, and a delta wave pattern in leads V2 and V3, with a normal QRS interval of 100 ms. We analyzed the three criteria for confirmation of minimal pre-excitation: (i) absence of a Q wave in V6; (ii) presence of an R wave in V1 and (iii) absence of an R wave in avR. The 3 criteria were not met and failed to establish a diagnosis of ventricular pre-excitation...
October 2018: Oxford Medical Case Reports
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