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Oxford Medical Case Reports

Iswaree Devi Balakrishnan, Chee Yang Chin, Louis Teo, Boon Yew Tan, Khung Keong Yeo
Culprit lesion identification in ST elevation myocardial infarction (STEMI) is often guided by electrocardiogram (ECG) changes. However, in the setting of multi-vessel coronary artery occlusion, this can be challenging. We describe an interesting case of dual territory STEMI with unanticipated ECG changes that bring forth the concept of 'balanced ischaemia'. These seemingly bizarre findings are well explained using the fundamentals of electrocardiography reinstating its relevance in modern day cardiology.
August 2018: Oxford Medical Case Reports
Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Alessandro Marchioni, Martina Garofalo, Enrico M Clini, Stefania Cerri
A 56-year-old, non-smoker male with no exposure, presented with right chest pain and a huge loss in forced vital capacity due to right lung volume reduction with consensual pleural thickening on high-resolution computed tomography. All serological and microbiological tests were negative. The surgical lung biopsy showed fibrinous pleurisy while the search for neoplastic cells resulted negative. Because of symptoms worsening he started low dose steroids without benefits until he died 3 months later for cardiac ischemic attack...
August 2018: Oxford Medical Case Reports
Andrew J Lewis, Deepa Jagadeesh, Sanjay Mukhopadyay, Marie Budev, Atul C Mehta
Post-transplant lymphoproliferative disorder (PTLD), a rare but serious complication of solid organ transplantation, is classified into early-onset and late-onset subtypes. Early-onset PTLD occurs a median of 4-11 months after lung transplantation. It rarely presents in the first 2 months post-transplant. Early-onset PTLD usually presents as a solitary pulmonary nodule. We present a unique case of early-onset PTLD that was diagnosed on post-operative Day 35 and presented as a pulmonary parenchymal infiltrate...
August 2018: Oxford Medical Case Reports
Hossam Abubakar, Ahmed S Ahmed, Omeralfaroug Adam, Ahmed S Yassin
A 54-year-old woman presents with a long history exertional chest pain and was found to have left ventricular systolic dysfunction on trans-thoracic echocardiogram. Coronary angiography revealed no evidence of atherosclerotic coronary artery disease and showed multiple micro-fistulae draining from all three major coronary arteries to the left ventricle. This rare abnormality is the result of failure of obliteration of intra-trabecular embryonic sinusoids and may cause myocardial ischemia through the coronary steal mechanism...
August 2018: Oxford Medical Case Reports
Ali S Ahmed, Mark C Flemmer
Chordomas are a rare type of bone tumor that arises from the embryological remnant of the notochord. They originate at any point along the axial spine with the sacrum and the skull based region being the most commonly affected sites. Chordomas are slowly growing, indolent tumors, presenting insidiously, but also carry a high recurrence rate with a tendency to invade contiguous structure making their treatment challenging. The current standard of care for localized chordoma is aggressive cytoreductive surgery followed by high dose adjuvant radiotherapy...
August 2018: Oxford Medical Case Reports
Matías Osaba, Víctor Eduardo Reviglio
This work reports on a clinical case of a female who presented with headache, bilateral eye pain and vision loss. Intraocular pressures were 40 mm Hg in the right eye and 45 mm Hg in the left eye. Optical Coherence Tomography examination shows the iridocorneal angle was collapsed and macular striae were also observed. The patient had been on topiramate due to migraines 7 days before presentation. Diagnosis for topiramate-induced acute angle closure was made in both eyes. The patient showed improvement in symptoms a few days after treatment initiation and images confirmed that the iridocorneal angle had been enlarged and macular striae had disappeared...
July 2018: Oxford Medical Case Reports
Anna M Zemke, Lindsay H Boles, Michelle Gillespie, Jill M Viljoen
Approximately 5% of hospitalized patients with Guillain-Barré syndrome (GBS) experience SIADH; but pseudohyponatremia has also been reported in patients treated with IVIG. We present a case of a 51-year-old male with GBS who developed acute hyponatremia the day after initiation of IVIG; his sodium levels began to improve within 24 h of completion of IVIG. Differentiating between pseudohyponatremia caused by the IVIG treatment and SIADH caused by GBS was the key to successfully treating this patient. This case exemplifies the importance of pursuing further studies to determine the exact cause of hyponatremia in GBS in order to prevent further neurologic damage to the patient...
July 2018: Oxford Medical Case Reports
Sreenivasa Rao Sudulagunta, Monica Kumbhat, Mahesh Babu Sodalagunta, Shiva Kumar Bangalore Raja
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized by white matter vasogenic edema affecting the posterior occipital and parietal lobes of the brain predominantly. A 48-year-old female patient presented to ER with complaints of breathlessness and developed sudden painless loss of vision while eliciting history. The patient had a heart rate of 104/min and accelerated hypertension (BP of 220/120 mm of Hg). MRI Brain showed subcortical white matter T2/Fluid-attenuated inversion recovery hyperintensities, suggestive of PRES...
July 2018: Oxford Medical Case Reports
Yoshitaka Nishikawa, Yasuaki Ozawa, Masaharu Tsubokura, Akihiko Ozaki, Toyoaki Sawano, Tomohiro Morita, Naoto Yoshida, Fumio Fujii
In 2011, an earthquake and tsunami struck Japan, and these were followed by the Fukushima Daiichi nuclear power plant accident. The long-term impact on hemodialysis care access in rural areas after the disaster is unknown. Here we report on a 66-year-old male hemodialysis patient who was forced to evacuate and relocate multiple times to receive hemodialysis after the accident. While he returned to his hometown in 2012, all the available hemodialysis facilities had been placed in different districts. Therefore, the patient needed to cross a mountain to visit the hemodialysis facility...
July 2018: Oxford Medical Case Reports
M Kasi, Samin Rashid, S A J Wallace, Vijayendran Sujendran, Bill Griffiths, Andrew Butler, Paul Gibbs, Loveena Sreedharan, A M Zaitoun, S Venkatachalapathy, M W James, G P Aithal
Delayed gastrointestinal metastasis is a rare complication of hepatocellular carcinoma (HCC). We present the case of a patient who presented with melaena and microcytic anaemia 6 years after receiving an orthotopic liver transplant for hepatitis B-induced HCC. Oesophagogastroduodenoscopy revealed a fungating gastric mass at the lesser curve and histology from biopsies confirmed metastatic recurrence of HCC in the stomach. The route of metastasis is likely due to iatrogenic seeding of tumour cells during pre-transplant endoscopic ultrasound (EUS) and fine needle aspiration (FNA) biopsy...
July 2018: Oxford Medical Case Reports
Amos O Mwasamwaja, Elifuraha W Mkwizu, Elichilia R Shao, Clement F Kalambo, Isaack Lyaruu, Ben C Hamel
Camurati-Engelmann disease is a rare autosomal dominant inherited condition belonging to the group of craniotubular hyperostosis with characteristic radiological features of the diaphyses of the long bones and the skull. A 35-year-old female is reported presenting with bone pain and waddling gait, since the age of 20 years. Motor activities were limited since the age of 10 years. Palpable bones, muscle weakness and protrusion of eyes were noted. Radiologically, hyperostosis of long bones was seen. Based on history, clinical and radiological features Camurati-Engelmann disease was diagnosed...
July 2018: Oxford Medical Case Reports
Marius Roman, Oliver Burbidge, Tom McCulloch, Andrzej Majewski
Peripheral nerve sheath tumours are rare within the thoracic cavity, with non-specific presentation. A 29-year-old patient presented with shortness of breath, cough, haemoptysis and recurrent chest infections. Suspicion of a primary lung carcinoma or a neuroendocrine tumour was raised following a CT and PET-CT. An endobronchial tumour suggested on histology a diagnosis of benign nerve sheath tumour, with positive staining for S100, CD56 and CD34. Following lung resection, the patient complained of fatigue and developed subcutaneous erythematous nodules on the anterior right chest, which raised the suspicion for a differential diagnosis of neurofibromatosis type I...
July 2018: Oxford Medical Case Reports
M F Vargas Gamarra, O Natsuki, M Flores, M Armengot Carceller
No abstract text is available yet for this article.
July 2018: Oxford Medical Case Reports
Andre Dik, Christine Strippel, Constanze Mönig, Kristin S Golombeck, Andreas Schulte-Mecklenbeck, Heinz Wiendl, Sven G Meuth, Andreas Johnen, Catharina C Gross, Nico Melzer
Cellular and humoral immunity towards distinct onconeural antigens is the hallmark of paraneoplastic neurological diseases (PNDs). Stable formation of immunoglobulin (Ig) G antibodies to particular onconeural antigens occurs in the majority of cases, whereas persistent coexistence of antibodies specific for multiple onconeural antigens is a relatively rare phenomenon of certain malignant tumors like small cell lung cancer (SCLC). We here describe onconeural antigen spreading in a 70-year-old Caucasian male with PND due to SCLC...
July 2018: Oxford Medical Case Reports
Øyvind Bruserud, Bent-Are Hansen, Nils Vetti, Silje Johansen, Håkon Reikvam
Plasma cell leukaemia (PCL) is a rare and aggressive form of malignant monoclonal gammopathy characterized by the presence of high levels of plasma cells in peripheral blood. Central nervous system involvement of PCL has no established treatment and an extremely poor prognosis. We here present a 59-year-old male patient diagnosed with PCL, initially treated with induction chemotherapy followed by autologous peripheral blood hematopoietic stem cell transplantation. After achieving a partial response, he relapsed and presented with leptomeningeal disease...
July 2018: Oxford Medical Case Reports
Giulia Reggiani, Damiano Pizzol, Daniele Trevisanuto, Mario Antunes
Abdominal distention and urinary retention are rare manifestations in newborns. The differential diagnosis of a female neonate presenting these signs, especially when combined, should include hydrocolpos due to imperforate hymen. The prognosis of imperforate hymen is generally good, although it can be associated with serious nephro-urologic and infectious complications. Early diagnosis and drainage of hydrocolpos allow prevention and/or improvement of these possible complications. In limited-resource settings, diagnostic imaging is more difficult to obtain, and, therefore, increased caution and an accurate physical exam with perineal inspection are essential...
July 2018: Oxford Medical Case Reports
Shinban Liu, George Ferzli
No abstract text is available yet for this article.
June 2018: Oxford Medical Case Reports
Samuel S Folkard, Michael C Quaye
Mycobacterium marinum infections are associated with specific occupational risk factors and often have a delay to diagnosis. We present the case of a young tropical fish whole-sale worker presenting with skin lesions on the hand.
June 2018: Oxford Medical Case Reports
Gianluca Porcaro, Lucio Tremolizzo, Ildebrando Appollonio, Marcello Maddalone
Persistent hiccup can conceal life-threatening clinical conditions of highly heterogeneous nature. Here, we report a case of a persistent hiccup that has been temporally associated with dental implant insertion in a patient with paroxysmal atrial fibrillation. This 67-year-old patient underwent dental implant in area 36 and the procedure was performed without acute complications. A prolonged hiccup started ~48 h after the procedure: it failed to respond to several medications and it lasted for ~18 days, after which it spontaneously disappeared...
June 2018: Oxford Medical Case Reports
Kalimullah Jan, Siau Chuin
Transient global amnesia (TGA) is a syndrome characterized by reversible impairment of short-term memory. TGA itself is a benign disease, however, it is reasonable to investigate and exclude sinister causes of global amnesia; such as stroke or a seizure activity. A case of TGA is presented here with special emphasis on the typical TGA lesion that was detected on the patient's magnetic resonance imaging (MRI) of Brain. In patients with TGA, the typical MRI Brain finding is a tiny focus of diffusion restriction in the mesiotemporal lobe...
June 2018: Oxford Medical Case Reports
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