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Oxford Medical Case Reports

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https://www.readbyqxmd.com/read/29410787/a-secondary-syphilis-rash-with-scaly-target-lesions
#1
Xavier Marchand-Senécal, Sapha Barkati, Danielle Bouffard, Valérie Martel-Laferrière
A 40-year-old man reported a 5-day history of fever and malaise, followed by a pruritic generalized rash. He had well-demarcated erythematous papules and plaques with scaling. The patient was diagnosed with secondary syphilis. The skin biopsy showed a psoriasiform lichenoid dermatitis with plasma cells. The anti-T. pallidum antibody confirmed the presence of spirochetes. He was also found to be hepatitis C virus and human immunodeficiency virus positive. The characteristic rash of secondary syphilis may appear as maculopapular, evolving initially from macules to small reddish-brown papules with minor scaling later...
February 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29383264/acute-duodenal-intramural-hematoma-complicated-by-acute-pancreatitis-a-rare-complication-of-endoscopic-epinephrine-injection-therapy
#2
Emmanuel Ofori, Tagore Sunkara, Eric Then, Febin John, Vinaya Gaduputi
Intramural duodenal hematoma (IDH) is a rare complication in endoscopic management of ulcer hemorrhage. Usually noted in cases of blunt abdominal trauma, non-traumatic IDHs have been reported in individuals on anticoagulation, with blood disorders, pancreatic diseases and in endoscopic procedures such as biopsy, sclerotherapy and argon plasma coagulation. Patients may be asymptomatic or present with acute blood loss anemia, abdominal pain or vomiting. We report a case of an 83-year-old man with melena and syncope who underwent endoscopy for bleeding ulcer control and subsequently developed acute pancreatitis due to an acute IDH...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29383263/intracardiac-ultrasound-to-detect-aneurysm-in-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy
#3
Cismaru Gabriel, Mihai Puiu, Radu Rosu, Lucian Muresan, Raluca Rancea, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea
Arrhythmogenic right ventricular dysplasia/cardiomyopathy is a genetic disorder characterized by fibrofattty replacement of the right ventricular myocardium. In the revised 2010 Task Force Criteria, a major criteria for ARVD/C is the presence of RV aneurysm by 2D echo. Our report demonstrates that intracardiac ultrasound can detect RV aneurysms and also focal absence of trabeculations which brings additional value to the diagnosis of ARVD/C. A 26-year-old male patient suffering from multiple sustained episodes of ventricular tachycardia was implanted with an internal cardiac defibrillator after confirmation of the disease by cardiac magnetic resonance imaging...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29383262/the-role-of-external-eyelid-weights-in-acute-facial-palsy-functional-and-aesthetic-considerations
#4
Vishnu Sri Shanmuganathan, Aumie Kethees, Shu-Hong Chang, Konstantinos Papageorgiou
Purpose: Patients with acute paralytic lagophthalmos are at high risk for ocular surface breakdown due to exposure. External eyelid weights are a temporary solution for paralytic lagophthalmos that aim to reduce exposure and optimize blink excursion. Despite easy application and high efficacy, this product is under-utilized in clinical practice with few physicians employing this treatment adjunct. Results: Ocular surface health was maintained in all patients, and overall aesthetic satisfaction was high...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29383261/case-report-of-a-patient-with-one-and-a-half-plus-syndrome-nine-syndrome
#5
Muhammad Uthman, Mehreen Kamran
This case talks about 'One-and-a-half plus syndrome', a clinical syndrome affecting binocular vision and facial nerve. One-and-a-half plus syndrome is a less known clinical syndrome which constitutes of a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other direction. Despite the known association between ischemia, autoimmune disorders, multiple sclerosis, with mono neuritis multiplex resulting in extra ocular movement disorder, one-and-a-half plus syndrome is rarely considered in the differential diagnosis of eye ball movement disorders, as many clinicians are not able to diagnose such a case as ' the eyes don't see what the mind doesn't know'...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29345690/clozapine-induced-myocarditis
#6
COMMENT
Tanuka Datta, Allen J Solomon
Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology service with chest pain, ST segment elevations and elevated troponin concerning for acute myocardial infarction. Evaluation with imaging revealed decreased left ventricular function, however, no coronary artery disease was present on catheterization; findings consistent with a diagnosis of myocarditis...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29340162/iatrogenic-myocarditis-biomarkers-cardiovascular-mri-and-the-need-for-early-diagnosis
#7
EDITORIAL
Amrit S Lota, Brian P Halliday, Vassilios S Vassiliou
No abstract text is available yet for this article.
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29340161/direct-ice-imaging-from-inside-the-left-atrial-appendage-during-ablation-of-persistent-atrial-fibrillation
#8
Gabriel Cismaru, Mihai Puiu, Radu Rosu, Lucian Muresan, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea
We present the case of a 59-year-old patient with persistent atrial fibrillation, referred for atrial fibrillation ablation. The procedure was performed with the help of NAVX 3D mapping system (Saint Jude Medical) and iLAB Ultra ICE Plus ultrasound imaging catheter (Boston Scientific). The catheter permits cross-sectional images perpendicular to catheter's long axis. From inside left atrial appendage (LAA) looks trabeculated, due to pectinate muscles running parallel to each other. The presence of a thrombus was excluded from the appendage...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29340160/stereotactic-body-radiation-therapy-for-the-treatment-of-oligoprogression-on-androgen-receptor-targeted-therapy-in-castration-resistant-prostate-cancer
#9
Thu-Cuc Nguyen, Ravneet Bajwa, Shahla Bari, Azka Ali, William Paul Skelton, Roland-Austin Federico, Rohit Bishnoi, Justin W Wray, Robert A Zlotecki, Long H Dang, Jameel Muzaffar
Castration-resistant prostate cancer is an incurable disease. To date, six agents-abiraterone, enzalutamide, docetaxel, cabazitaxel, radium-223 and sipuleucel-T- have shown clinical efficacy in phase III clinical trials, leading to their FDA approval. Patients are typically sequenced through most or all of these agents, and then eventually succumb to their disease. Development of new treatments remains an unmet need. We report a case of a patient who progressed on enzalutamide with a single enlarging metastatic lesion, was treated with ablative stereotactic body radiation therapy while maintaining the same systemic treatment, who then had durable complete remission...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29308212/-the-efficacy-of-extracorporeal-liver-support-with-molecular-adsorbent-recirculating-system-in-severe-drug-induced-liver-injury
#10
Jaishvi Eapen, Rotimi Ayoola, Ram M Subramanian
We report a case of a 26-year-old man with no significant medical history, who presented with fatigue, pruritus, jaundice, dark urine and clay colored stool for one month. He had been taking methyl-1-etiochoenolol-epietiocholanolone, an androgenic anabolic steroid (AAS). He was initially found to have a total bilirubin (Tbili) of 6 mg/dL. He discontinued the AAS but the patients' symptoms worsened and Tbili increased to 36 mg/d. This prompted inpatient management of his drug-induced liver injury (DILI). Molecular adsorbent recirculating system (MARS) is an extracorporeal liver support system that replaces the detoxification function of the liver...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29308211/elevated-homocysteine-and-n-methyl-d-aspartate-receptor-antibodies-as-a-cause-of-behavioural-and-cognitive-decline-in-22q11-2-deletion-syndrome
#11
Simon Vann Jones, Subimal Banerjee, A David Smith, Helga Refsum, Belinda Lennox
A 19-year-old male with 22q11.2 deletion syndrome presented with a 4-year history of cognitive decline and symptoms suggestive of atypical psychosis. Potential for elevated homocysteine and NMDA-receptor antibodies in the pathogenesis of his symptoms was investigated. He had elevated blood homocysteine level (18.7 μmol/l), low-normal vitamin B12 and folate levels and was positive for NMDA-receptor antibodies. Treatment with daily folinic acid (0.8 mg) and vitamin B12 (1 mg) led to dramatic improvement in his cognitive and behavioural presentation...
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29308210/conglomerate-mediastinal-mass-of-a-different-etiology
#12
Shahistha Hameed, Jarmanjeet Singh, Lulette B Tricia, André Machado, Paul Ruggieri, Atul C Mehta
Streptococcus intermedius is a Gram-positive commensal of the oral cavity with tendency to cause brain and liver abscesses. Mediastinal involvement from S. intermedius is very rare. We present a case of 22-year-old male with newly detected mediastinal conglomerate nodal mass. On his way for bronchoscopy, he developed seizures and was found to have three brain lesions. The aspirate from brain biopsy grew S. intermedius whereas the aspirate from mediastinum showed only acute inflammation. Follow up imaging after antibiotic treatment showed interval resolution of brain abscesses and the mediastinal mass...
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29308209/duodenal-membranes-a-late-diagnosis-evidenced-by-foreign-bodies
#13
G Maldonado, C Paredes, H Cedeño, I M Salcedo, M I Sanchez, E Fabre, M V Astudillo, J Gonzalez
One of the causes of congenital incomplete duodenal obstruction is the presence of duodenal membranes. This condition requires a high index of suspicion for an early and accurate diagnosis. We present two cases of duodenal obstruction with initial diagnosis of foreign bodies that were surgically intervened and where incomplete duodenal membranes were an incidental finding. The clinical course of these patients had a different pattern than expected and thus, it is imperative to use a multidisciplinary approach in this group of patients and separate them from other subtypes of duodenal obstruction...
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29270297/breast-cancer-metastasis-to-the-spleen-a-case-report-and-literature-review
#14
Mohammed El Fadli, Khaldoun Kerrou, Hasnae Alaoui Mhamdi, Sandrine Richard, Ahmed Khalil, Jean-Pierre Lotz, Rhizlane Belbaraka, Joseph Gligorov
Splenic metastasis from cancers is extremely rare. They usually occur and are detected simultaneously with metastasis to other organs. We present a case of splenic metastasis from carcinoma of the breast occurring 5 years after initial treatment. The metastatic recurrence was an oligometastic form made from the association of a unique bone metastasis to a rib and the metastasis to the spleen. Treatment of the metastatic recurrence was a second line hormonotherapy as the primitive tumor was estrogen receptors positive and gave a 2 year's long control of the disease...
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29270296/squamous-cell-carcinoma-scc-arising-in-esophageal-colon-interposition
#15
Reza Taslimi, Akram Jowkar, Mohammad Reza Hasani Ghavam, Tayebeh Tavasol, Seyed Farshad Allameh, Naser Rakhshani
The idea of using the colon to replace a resected esophagus has a long history. The colon has become a favored organ for esophageal reconstruction in adults with esophageal cancer when the stomach is not suitable or is unavailable. In this article, we introduce an 84-year-old woman that she had surgery 40 years ago and presented with an invasive well differentiated squamous cell carcinoma of colonic origin in reconstructed esophagus.
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29255614/aggressive-and-fatal-statin-induced-dermatomyositis-a-case-report
#16
Raíssa Massaia Londero Chemello, Ana Maria Benvegnú, Lia Natália Diehl Dallazem, Diego Chemello
Statins are widely used and are currently the state-of-the-art treatment for primary and secondary prevention of cardiovascular disease. Although statins are generally well tolerated and present an excellent safety profile, adverse effects from muscle toxicity may occur in some patients. Statin-induced dermatomyositis (DM) is a rare adverse event associated with its use and very few fatal cases have been reported. We present the case of a 69-year-old man with early onset DM precipitated by a small dose of simvastatin...
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29255613/nocardia-cyriacigeorgica-threatening-an-immunocompetent-host-a-rare-case-of-paramediastinal-abscess
#17
Kelvin Rivera, Jeffrey Maldonado, Aixa Dones, María Betancourt, Ricardo Fernández, Miguel Colón
We describe a rare case of anterior paramediastnial abscess due to Nocardia cyriacigeorgica in an immunocompetent patient without pre-existing lung disease. High suspicious should be taken in those patients that failed to improve after first course of antibiotic therapy. Similarly, when suspected, isolation is crucial because of the variation in antibiotic susceptibilities among Nocardia spp. in order to provide adequate therapy to reduce associated comorbidities and mortality rate.
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29230304/coil-embolization-for-intrahepatic-haemorrhage-following-liver-biopsy-in-a-patient-with-hepatitis-c-virus-infection-and-hepatic-microaneurysms
#18
Apostolos Koffas, John Karani, Roger Williams
Intrahepatic bleeding secondary to rupture of hepatic microaneurysms is an uncommon clinical entity more frequently associated with polyarteritis nodosa (PAN) or rarely with other vasculitis or autoimmune disease. Hepatic vasculitis is reported in chronic hepatitis C virus (HCV) infection and an association between hepatitis C and PAN is described. The current report presents the case of a middle-aged female patient with a medical history remarkable for HCV infection who underwent a percutaneous liver biopsy, which was complicated by severe intrahepatic and perihepatic haemorrhage...
December 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29230303/case-series-of-paragonimiasis-from-nepal
#19
Ranjit Sah, Shusila Khadka
Paragonimiasis is an important food-borne parasitic zoonosis caused by trematodes of genus Paragonimus. We report case series of paragonimiasis with common symptoms of cough with blood tinged sputum, shortness of breath, chest pain with occasional fever, eosinophilia and radiological findings mimicking pulmonary tuberculosis and had taken anti-tubercular drug despite all investigation negative for tuberculosis without improvement. They all had common history of consumption of raw/undercooked crab. There is a local belief in remote villages of Nepal that eating raw crab helps in healing bone fracture and cure jaundice...
November 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29230302/letrozole-induced-hepatitis-with-autoimmune-features-a-rare-adverse-drug-reaction-with-review-of-the-relevant-literature
#20
Bharatsinh Gharia, Karan Seegobin, Satish Maharaj, Noor Marji, Amie Deutch, Lara Zuberi
While aromatase inhibitors (AIs) have been known to cause minor elevations in liver enzymes, severe hepatotoxicity is rare. To the best of our knowledge, this is the first reported case of Letrozole-induced hepatitis with autoimmune features. A 70-year-old female with estrogen positive, invasive ductal carcinoma of the breast, presented with jaundice 3 months after starting letrozole. Hepatic transaminases were markedly elevated and her ANA and anti-smooth muscle antibody was positive. Liver biopsy featured drug-induced hepatitis...
November 2017: Oxford Medical Case Reports
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