Case reports: Advancing knowledge of rare or unusual medical conditions

Catatonia is a syndrome that has been associated with several mental illness disorders but that has also presented as a result of other medical conditions. Schizophrenia and other psychiatric disorders such as mania and depression are known to be associated with catatonia; however, several case reports have been published of certain medical conditions inducing catatonia, including hyponatremia, cerebral venous sinus thrombosis, and liver transplantation. Neuroleptic Malignant Syndrome and anti-NMDA receptor encephalitis are also prominent causes of catatonia. Patients taking benzodiazepines or clozapine are also at risk of developing catatonia following the withdrawal of these medications—it is speculated that the prolonged use of these medications increases gamma-aminobutyric acid (GABA) activity and that discontinuation may increase excitatory neurotransmission, leading to catatonia. The treatment of catatonia often involves the use of benzodiazepines, such as lorazepam, that can be used in combination therapy with antipsychotics. Definitive treatment may be found with electroconvulsive therapy (ECT). Aberrant neuronal activity in different motor pathways, defective neurotransmitter regulation, and impaired oligodendrocyte function have all been proposed as the pathophysiology behind catatonia. There are many clinical challenges that come with catatonia and, as early treatment is associated with better outcomes, it becomes imperative to understand these challenges. The purpose of this manuscript is to provide an overview of these challenges and to look at clinical studies regarding the pathophysiology, diagnosis, and treatment of as well as the complications and risk factors associated with catatonia.

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ADENOTONSILLECTOMY AS THE TREATMENT OF SERIOUS MEDICAL CONDITIONS: FIVE CASE REPORTS

The Laryngoscope ◽

10.1288/00005537-197407000-00007 ◽

1974 ◽

Vol 84 (7) ◽

pp. 1135-1141 ◽

Cited By ~ 11

Author(s):

I Sidney Jaffee

Keyword(s):

Case Reports ◽

Medical Conditions

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The Safety of Cruciferous Plants in Humans: A Systematic Review

Journal of Biomedicine and Biotechnology ◽

10.1155/2012/503241 ◽

2012 ◽

Vol 2012 ◽

pp. 1-28 ◽

Cited By ~ 7

Author(s):

Ori Scott ◽

Elaine Galicia-Connolly ◽

Denise Adams ◽

Soleil Surette ◽

Sunita Vohra ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Adverse Events ◽

Drug Metabolism ◽

Observational Studies ◽

Case Reports ◽

Medical Conditions ◽

Preventative Medicine ◽

Warfarin Resistance ◽

Cruciferous Plants

Some cruciferous plants may serve as preventive treatments for several medical conditions; our objective was to systematically investigate their safety in humans. Four electronic databases were searched, and, of 10,831 references identified, 50 were included. Data were extracted by two independent reviewers, whereafter the association between interventions and adverse events was assessed. Adverse events in 53 subjects were identified through clinical trials; of these, altered drug metabolism was rated as certainly/likely caused by cruciferous plants. Adverse events in 1247 subjects were identified through observational studies, of which none received high causality ratings. Adverse events in 35 subjects were identified through case reports, of which allergies and warfarin resistance were rated as certainly/likely caused by cruciferous plants. We conclude that cruciferous plants are safe in humans, with the exception of allergies. Individuals treated with warfarin should consult their physician. Further investigation of uses of cruciferous plants in preventative medicine is warranted.

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Spontaneous Clostridium Perfringens Lung Abscess Unresponsive to Penicillin

Anaesthesia and Intensive Care ◽

10.1177/0310057x9302100131 ◽

1993 ◽

Vol 21 (1) ◽

pp. 117-119 ◽

Cited By ~ 3

Author(s):

L. Baldwin ◽

A. Henderson ◽

M. Wright ◽

M. Whitby

Keyword(s):

Septic Shock ◽

Foreign Body ◽

Clostridium Perfringens ◽

Conventional Treatment ◽

Case Reports ◽

Rare Complication ◽

Lung Abscess ◽

Medical Conditions ◽

Pulmonary Infarction

Clostridial necrotising pneumonia is a rare complication of aspiration, bronchial tumour or foreign body, pulmonary infarction, trauma and debilitating medical conditions. Although spontaneous clostridial pneumonia has been reported previously, close scrutiny of those case reports suggests that most of the patients had a recognised predisposing cause. We report a case of true spontaneous Clostridium perfringens pneumonia complicated by septic shock, pneumothorax and pulmonary necrosis. The patient responded poorly to conventional treatment with benzylpenicillin, and although the addition of metronidazole produced dramatic resolution of the sepsis, lobectomy was required to effect cure.

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A–Z of conditions in obstetric anaesthesia

Obstetric Anaesthesia ◽

10.1093/med/9780199688524.003.0025 ◽

2020 ◽

pp. 613-672

Author(s):

David Leslie ◽

Rachel Collis

Keyword(s):

Case Reports ◽

Night Shift ◽

Case Series ◽

Anaesthetic Management ◽

Medical Conditions ◽

Management Planning ◽

Obstetric Anaesthesia ◽

Key Points ◽

Obstetric Anaesthetist

The final chapter is a comprehensive A–Z index of less familiar medical conditions, which may present to the obstetric anaesthetist during any busy day or night shift. The conditions described are a compilation of referenced case reports or case series from peer-reviewed publications in recent years. The information provided should instantly guide the reader to the known characteristics of the condition, and the key points to consider in the antenatal, peripartum and anaesthetic management planning.

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Brucella suisbiovar 2 infection in humans in France: emerging infection or better recognition?

Epidemiology and Infection ◽

10.1017/s0950268817001704 ◽

2017 ◽

Vol 145 (13) ◽

pp. 2711-2716 ◽

Cited By ~ 14

Author(s):

A. MAILLES ◽

M. OGIELSKA ◽

F. KEMICHE ◽

B. GARIN-BASTUJI ◽

N. BRIEU ◽

...

Keyword(s):

Wild Boar ◽

Case Reports ◽

Epidemiological Data ◽

Raw Milk ◽

Reference Laboratory ◽

Chronic Medical Conditions ◽

Medical Conditions ◽

Wild Boars ◽

Increased Risk ◽

Mandatory Notification

SUMMARYBrucellosis is usually acquired by humans through contact with infected animals or the consumption of raw milk from infected ruminants.Brucella suisbiovar 2 (BSB2) is mainly encountered in hares and wild boars (Sus scrofa), and is known to have very low pathogenicity to humans with only two case reports published in the literature. Human cases of brucellosis caused by BSB2 were identified through the national mandatory notification of brucellosis. The identification of the bacterium species and biovar were confirmed by the national reference laboratory. Epidemiological data were obtained during medical follow-up visits. Seven human cases were identified between 2004 and 2016, all confirmed by the isolation of BSB2 in clinical specimens. All patients had direct contact with wild boars while hunting or preparing wild boar meat for consumption. Five patients had chronic medical conditions possibly responsible for an increased risk of infection. Our findings suggest that BSB2 might be an emerging pathogen in hunters with massive exposure through the dressing of wild boar carcasses. Hunters, especially those with chronic medical conditions, should be informed about the risk of BSB2 infection and should receive information on protective measures.

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Weighing in on the risks and benefits of probiotic use in HIV-infected and immunocompromised populations

Beneficial Microbes ◽

10.3920/bm2017.0106 ◽

2018 ◽

Vol 9 (2) ◽

pp. 239-246 ◽

Cited By ~ 4

Author(s):

A.U. Happel ◽

S.L. Barnabas ◽

R. Froissart ◽

J.S. Passmore

Keyword(s):

Case Reports ◽

Terminally Ill ◽

The Elderly ◽

Adjunctive Treatment ◽

Medical Conditions ◽

Risks And Benefits ◽

History Of ◽

At Risk Populations ◽

Potential Risks ◽

Irritable Bowel

Probiotics are used in the prophylaxis and treatment of several conditions, including irritable bowel syndrome, diarrhoea, necrotising enterocolitis (NEC) and colic in infants. Despite the long history of probiotic use in humans, there is still significant debate about their efficacy and safety, particularly in HIV-infected and immunocompromised individuals. Here, we reviewed the safety and adverse event (AE) reporting from clinical trials that have tested probiotics in at risk populations, including HIV-infected individuals, the terminally ill and elderly, and neonates. Our analysis suggests that the benefits of probiotic therapy outweigh their potential risks in HIV-infected populations, and in the treatment of colic and NEC in low birth weight or premature neonates. Most case reports of severe AEs were in the elderly and terminally ill, or in those with additional severe medical conditions. We conclude that probiotic use, as adjunctive treatment, is effective and safe in the majority of patients including HIV-infected individuals, although special care should be taken in individuals with extreme immunosuppression and severe medical conditions in all ages.

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