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Oxford Medical Case Reports

Stewart Spence, Elena Pena, Rebecca E Thornhill, Pablo B Nery, David H Birnie
Presented is the case of a 62-year old male with a history of sarcoidosis and sinus node dysfunction, who underwent late gadolinium enhancement magnetic resonance imaging, which demonstrated left ventricular hyperenhancement and bi-atrial fibrosis.
May 2018: Oxford Medical Case Reports
Chloe Grace Meyer, Shayef Gabasha, Ravi Gurujal, Thomas Paul Vacek
Takotsubo cardiomyopathy is characterized by transient loss of systolic function in the absence of coronary artery disease. It is significantly more common in post-menopausal women and is typically brought on by intense emotional stress. Pathophysiology is not completely elucidated, but it appears to be related, in part, to excess catecholamine; this results in coronary artery vasospasm, ischemia and eventual ventricular dysfunction. Patient presentation can vary widely, but typically presents similar to acute coronary syndrome...
May 2018: Oxford Medical Case Reports
Janaki Rami Reddy Manne
Medications that are routinely used in clinical practice to treat hypertension such as beta blockers or non-dihydropyridine calcium channel blockers can depress sinus node function, resulting in symptoms and electrocardiographic changes consistent with sinus node dysfunction. In some patients, medications are potentially a reversible cause of apparent sinus node dysfunction. We report a patient who was taking atenolol for hypertension presented with recurrent near syncopal spells due to atenolol-induced sinus node dysfunction manifested in the form of an interesting and rare arrhythmia known as Escape-capture bigeminy...
May 2018: Oxford Medical Case Reports
Natasha Corballis, Sujay Chadran, Neil Mangrolia, Kashif Ashraf, Toomas Sarev, Alisdair Ryding
A chronically persistent left atrial pseudoaneurysm is a rare complication of valvular surgery, trauma, myocardial infarction and endocaritis but this is the first known description of a chronic pseudoaneurysm as a complication of coronary rupture during percutaneous coronary intervention (PCI). We report computed tomography images depicting this in the case of elective PCI in an 81-year-old gentleman for limiting angina.
May 2018: Oxford Medical Case Reports
Kalimullah Jan
A 61-year-old gentleman, with a long-standing history of alcohol abuse presented with altered sensorium and unsteady gait for 2 weeks. A diagnosis of Wernicke encephalopathy (WE) was considered. The magnetic resonance imaging brain showed features consistent with the WE, thus supporting the diagnosis. He was treated with parenteral thiamine with good outcome.
May 2018: Oxford Medical Case Reports
Habib R Khan, Mohammad I Ansari, Andrew P Thain, Sadia Abdullah, Ramya Parasa, Richard W Varcoe
A 46-year-old man presented with mass on chest x-ray along with a 6-month history of weight loss, dyspnea and cough. He was hypotensive and an echocardiogram showed large extra-cardiac mass compressing the right ventricular outflow tract resulting in features of cardiac tamponade. Chest computed tomography revealed a mediastinal mass invading the pericardium adjacent to right ventricular outflow tract. Biopsy of the mass confirmed primary monophasic synovial sarcoma. Chemotherapy and radiotherapy along with anti-inflammatories were given as surgery was too high risk due to the location of the tumour and pericardial involvement...
May 2018: Oxford Medical Case Reports
Rikesh Baral, Binit Vaidya
Primary amoebic meningoencephalitis (PAM) is a rare, fulminating, hemorrhagic infection of the brain caused by Naegleria fowleri , a thermophilic, free-living amoeba. A 74-year male presented with sudden severe global headache and fever with features of anomic aphasia. Magnetic resonance imaging (MRI) suggested herpes encephalitis and acyclovir (IV) was started but the patient developed altered sensorium, agitation and progressive weakness of lower limbs with gradual truncal weakness. Repeat MRI showed increase in lesion size and edema with confluent blood areas...
May 2018: Oxford Medical Case Reports
Kojiro Nagai, Hiroyuki Ono, Motokazu Matsuura, Michael Hann, Sayo Ueda, Sakiya Yoshimoto, Masanori Tamaki, Taichi Murakami, Hideharu Abe, Hisashi Ishikura, Toshio Doi
Alectinib is a second generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor and is generally effective and tolerated in patients who have demonstrated disease progression or adverse effects while on the first generation inhibitor, crizotinib. ALK inhibitors can cause a reversible chronic increase of serum creatinine concentration; however, they rarely induce progressive renal insufficiency. We herein report a case of a 68-year-old woman diagnosed with ALK-positive advanced non-small cell lung cancer and who received ALK inhibitors...
April 2018: Oxford Medical Case Reports
Ambalavanan Arunachalam, Syed Rizwan Ali, Brett J Wakefield, Charles R Lane, Atul C Mehta
Everolimus is a mechanistic target of rapamycin inhibitor used for the treatment of various cancers and prevention of allograft rejection in solid organ transplantation. We present a case of a lung transplant recipient on everolimus who was admitted with generalized weakness, hypoxia and new onset bilateral pulmonary infiltrates on imaging. Extensive workup revealed no infectious etiology and high levels of serum everolimus levels. Her condition deteriorated over the hospital course with symptoms and signs of systemic everolimus toxicity...
April 2018: Oxford Medical Case Reports
Veronica Mugarab Samedi, Jeanne Scotland, Deborah Clark
No abstract text is available yet for this article.
April 2018: Oxford Medical Case Reports
Manouchehr Aghajanzadeh, Hossein Hemmati, Mohammad Sadegh Esmaeili Delshad, Siamak Rimaz, Omid Mosaffaee Rad, Zakiyeh Jafaryparvar
Primary simultaneous multiple organs teratomas are extremely rare. They usually arise in the gonads, and only 1-3 % of them arise in the mediastinum. We present a case of simultaneous multiple organs immature teratomas who was admitted to Razi hospital because of cough, dyspnea, and left-side supraclavicular mass. Computed tomography (CT) showed a big mass with multiple high densities, nodular, semi-solid, heterogenic structures on the left side of the neck, left-side anterior mediastinum, right-side middle mediastinum and right-side suprarenal region...
April 2018: Oxford Medical Case Reports
Daisuke Miyawaki, Tetsuya Nomura, Yu Sakaue, Daisuke Ueno, Yusuke Hori, Kenichi Yoshioka, Hiroshi Kubota, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
Currently, there are more opportunities to treat patients complicated with critical limb ischemia (CLI), which is a very dismal medical condition associated with a high risk of major amputation, disability and death. Because CLI is usually caused by multi-level occlusive atherosclerotic disease, the condition of CLI induced by aorto-iliac occlusive disease (AIOD) alone is thought to be a rare pathological entity. We encountered a patient with severe CLI caused by solitary AIOD. Three vascular access routes were established and stiff guidewires retrogradely passed the occluded arteries on both sides...
April 2018: Oxford Medical Case Reports
Mayanka Kamboj, Vikrampal Bhatti, Abhilash Koratala
No abstract text is available yet for this article.
April 2018: Oxford Medical Case Reports
Sofia Kassou, Vassilios S Vassiliou
No abstract text is available yet for this article.
April 2018: Oxford Medical Case Reports
Kalimullah Jan, Melonie Kannamma Sriranganathan
Anti-synthetase syndrome is characterized by myositis associated with interstitial lung disease (ILD), the usual pattern of ILD being non-specific interstitial pneumonia type or usual interstitial pneumonia. We report a case of anti-synthetase syndrome presenting as acute interstitial pneumonia which is reported only once before. With this case, we emphasize the need to consider anti-synthetase syndrome even in patients presenting with acute onset ILD. Physicians should raise their index of suspicion in this clinical context as timely diagnosis, early treatment, and a multidisciplinary approach is paramount for optimal care of these patients...
April 2018: Oxford Medical Case Reports
Joud Jarrah, Varun Samji, Meron Meshesha, Chandrasekhar Kothuru, Samer Al Hadidi
Methicillin-resistant Staphylococcus aureus (MRSA) commonly causes infection of the skin, soft tissue, bones and heart. MRSA is a rarely reported organism of prostatic abscess (PA). We present a case of an intravenous drug user who presented with dyspareunia, dysuria and dyschezia after a traumatic injury to the rectum. He was diagnosed with PA, which was treated with transurethral resection of the prostate drainage and intravenous antibiotics. MRSA PA carries a low case fatality rate on early diagnosis and treatment with proper antibiotics with or without drainage of the abscess...
March 2018: Oxford Medical Case Reports
Daniela W C Chan, Diana Moir, Richard Standish, Mark A Kotowicz
We report a case of severe hyperparathyroidism complicated by osteitis fibrosa cystica in an 83-year-old man post-myocardial infarction. The lesions were evident on magnetic resonance imaging only. A diagnosis of parathyroid carcinoma was considered due to clinical appearance of the parathyroid intraoperatively and the presence of an invasive T3 lesion mimicking metastatic disease. Differentiating parathyroid carcinoma from the benign causes at presentation can be difficult due to overlapping clinical, biochemical, radiological and histological features...
March 2018: Oxford Medical Case Reports
Ricardo Alicea-Guevara, Michael Cruz Caliz, Jose Adorno, Ricardo Fernandez, Kelvin Rivera, Gustavo Gonzalez, Ricardo Alan Hernandez-Castillo, Rosangela Fernandez, Christian Castillo Latorre
Hereditary haemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare autosomal dominant vascular disorder. Patients with HHT may present with a wide spectrum of clinical manifestations, some considered to be life-threatening. We present the case of a 53-year-old male who presented with massive haemoptysis. Chest computed tomography scan was remarkable for a large anterior, left lower lobe arteriovenous malformation. The patient underwent a pulmonary angiogram with embolization of a large left lung arteriovenous malformation, which proved to be successful in controlling the bleeding...
March 2018: Oxford Medical Case Reports
Hirofumi Namiki, Tadashi Kobayashi
Clostridium difficile is one of the most common causes of antibiotic-associated diarrhoea. Despite C. difficile infection (CDI) has increased in all ages worldwide, episodes of CDI are often misdiagnosed due to the lack of clinical suspicion. Macrolides are also associated with CDI. Additionally, exposure to macrolides in the 12 weeks preceding infection is reported to be a significant risk factor of CDI in a child. We report here a 5-year-old Japanese boy who presented with acute onset of watery diarrhoea...
March 2018: Oxford Medical Case Reports
Saad Ezad, Hooria Cheema, Nicholas Collins
Rhabdomyolysis is a well-documented side effect of statin therapy. This risk is increased with concurrent use of medications that inhibit cytochrome p450-3A4 (CYP3A4), such as macrolide antibiotics. We present the case of a 67-year-old patient who was commenced on clarithromycin on a background of simvastatin therapy, resulting in rhabdomyolysis. This case highlights the need for awareness of common drug interactions associated with statins. It also emphasizes the significance of commencing statins at a lower dose in new patients, and lastly, the importance of early recognition and management of rhabdomyolysis to prevent the development of complications...
March 2018: Oxford Medical Case Reports
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