scholarly journals A Case of Meningococcal Pyomyositis in an Otherwise Healthy Adult

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Monique T. Barakat ◽  
Kiran Gajurel ◽  
Katrina Fischer ◽  
Kathryn Stevens ◽  
Errol Ozdalga ◽  
...  
Keyword(s):  
Neisseria Meningitidis ◽  
English Language ◽  
Healthy Adult ◽  
Clinical Spectrum ◽  
Nasopharyngeal Colonization ◽  
Etiologic Role ◽  
First Case ◽  
Invasive Diseases ◽  
Life Threatening

Abstract The clinical spectrum of Neisseria meningitidis can range from nasopharyngeal colonization to life-threatening invasive diseases such as meningitis. However, its etiologic role in invasive pyomyositis (PM) has never been reported before in the English language. In this study, we report the first case of PM in the English language and the second case in the literature caused by N meningitidis.

scholarly journals Haemophagocytic lymphohistiocytosis in an adult with postacute COVID-19 syndrome

2021 ◽  
Vol 14 (9) ◽  
pp. e245031
Author(s):  
Daniel Wiseman ◽  
John Lin ◽  
Jean-Pierre Routy ◽  
Gordan Samoukovic
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Clinical Presentation ◽  
Healthy Adult ◽  
Multiorgan Failure ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Initial Infection ◽  
First Case ◽  
Life Threatening

Haemophagocytic lymphohistiocytosis (HLH) causing multiorgan failure has been reported as an acute clinical presentation of COVID-19. However, the literature surrounding HLH in the context of a postacute COVID-19 syndrome is limited. This report presents a case of a life-threatening HLH occurring 6 weeks after a pauci-symptomatic COVID-19 infection in a previously healthy adult. A bone marrow aspirate confirmed the HLH and the patient was successfully treated with dexamethasone and etoposide. To our knowledge, this is the first case of HLH occurring as a postacute COVID-19 syndrome following a pauci-symptomatic initial infection.

scholarly journals Acute upper airway obstruction as a life-threatening complication of ventral bulla osteotomy: report of two consecutive cases

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692110059
Author(s):  
Michal Vlasin ◽  
Richard Artingstall ◽  
Barbora Mala
Keyword(s):  
Airway Obstruction ◽  
Clinical Signs ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Single Session ◽  
Inflammatory Polyp ◽  
Case Summary ◽  
First Case ◽  
Life Threatening

Case summary This paper presents two cases of acute postoperative upper airway obstruction following ventral bulla osteotomy (VBO) in cats. The first cat underwent a unilateral left-sided VBO for a suspected inflammatory polyp. The second cat underwent a single-session bilateral VBO procedure for bilateral otitis media. In the first case, immediate re-intubation and a gradual lightening of the anaesthetic plane resolved the clinical signs; in the second case, the patient deteriorated and went into acute cardiorespiratory arrest and received cardiopulmonary resuscitation. Both patients recovered well and were discharged home 3 days after surgery. Both cases were reported to show no further clinical signs on postoperative follow-up 3 weeks and 4 months after surgery, respectively. Relevance and novel information Upper airway obstruction should be regarded as a potential complication of VBO in cats.

scholarly journals Drug Induced Pneumonitis Secondary to Treatment with Paritaprevir/Ritonavir/Ombitasvir and Dasabuvir (VIEKIRA PAK®) for Chronic Hepatitis C: Case Report of an Unexpected Life-Threatening Adverse Reaction

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Shih Yea Sylvia Wu ◽  
Bridget Faire ◽  
Edward Gane
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Final Diagnosis ◽  
Community Acquired Pneumonia ◽  
Drug Induced ◽  
First Case ◽  
Life Threatening

VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis. One week into treatment with VIEKIRA PAK without ribavirin, she was admitted to hospital with respiratory distress and acute kidney injury requiring intensive care input. She was initially diagnosed with community acquired pneumonia and improved promptly with intravenous antibiotics and supported care. No bacterial or viral pathogens were cultured. Following complete recovery, she recommenced VIEKIRA PAK but represented 5 days later with more rapidly progressive respiratory failure, requiring intubation and ventilation, inotropic support, and haemodialysis. The final diagnosis was drug induced pneumonitis.

scholarly journals Acute Suppurative Thyroiditis in an Intravenous Drug User with a Preexisting Goiter

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Nikhil Yegya-Raman ◽  
Tabitha Copeland ◽  
Payal Parikh
Keyword(s):  
Drug User ◽  
Intravenous Drug User ◽  
Neck Mass ◽  
Subacute Thyroiditis ◽  
Suppurative Thyroiditis ◽  
First Case ◽  
Life Threatening ◽  
Acute Suppurative Thyroiditis ◽  
Limiting Condition ◽  
Iv Drug Use

Acute suppurative thyroiditis (AST) is an uncommon, potentially life-threatening cause of a rapidly enlarging neck mass. It may present similarly to subacute thyroiditis, a relatively benign and self-limiting condition. We report a case of AST in an adult intravenous (IV) drug user with a preexisting goiter who presented with a left forearm abscess that grew methicillin-sensitive Staphylococcus aureus. In this particular case, clinical suspicion for AST was high. As a result, early IV antibiotic therapy was initiated, and this led to rapid clinical improvement furthermore preventing airway compromise. To our knowledge, this is the first case of AST in the literature resulting from likely hematogenous spread in the setting of IV drug use and a preexisting goiter. Overall, this case highlights the importance of assessing risk factors for AST in patients whose presentations may seem more typical of subacute thyroiditis. Such an approach will lead to timely diagnosis and treatment to avoid potentially devastating consequences.

Syncopal Episodes Associated with Cisapride and Concurrent Drugs

1998 ◽  
Vol 32 (6) ◽  
pp. 648-651 ◽  
Author(s):  
Vanessa Seals Gray
Keyword(s):  
English Language ◽  
Motor Vehicle ◽  
Concomitant Administration ◽  
Qt Prolongation ◽  
Azole Antifungals ◽  
Vehicle Accidents ◽  
Cardiac Dysrhythmias ◽  
Case Summary ◽  
First Case ◽  
Patients At Risk

OBJECTIVE: To report a case of QT prolongation and syncopal episodes resulting from concomitant use of cisapride and agents known to inhibit its metabolism. CASE SUMMARY: A 53-year-old white woman was involved in two motor vehicle accidents on the same day after experiencing syncopal episodes. Cardiac and neurologic evaluations were negative; the syncopal episodes were attributed to QT prolongation associated with the concomitant use of cisapride and agents known to inhibit its metabolism. DISCUSSION: This is the first case published in the English-language literature describing QT prolongation resulting from the concomitant use of cisapride and agents known to inhibit its metabolism. Clarithromycin inhibits CYP3A4, the isoenzyme responsible for the metabolism of cisapride. Concomitant administration of cisapride with agents known to inhibit CYP3A4 (i.e., azole antifungals, erythromycin, clarithromycin) may result in elevated cisapride concentrations. Elevated cisapride concentrations have been associated with QT prolongation, syncopal episodes, and cardiac dysrhythmias. CONCLUSIONS: Acquired QT prolongation is a well-recognized adverse effect of several drugs. Recognition of newer drugs and drug combinations that place patients at risk for this potentially fatal adverse event is imperative for appropriate monitoring and prevention.

CONGENITAL MICROGASTRIA, A CASE REPORT WITH A 26-YEAR FOLLOW-UP

PEDIATRICS ◽  
1973 ◽  
Vol 51 (6) ◽  
pp. 1037-1041
Author(s):  
Eugene Blank ◽  
Alvin Chisolm
Keyword(s):  
Case Report ◽  
English Language ◽  
Normal Adult ◽  
Healthy Children ◽  
Adult Size ◽  
Persistent Vomiting ◽  
First Case ◽  
English Language Journal ◽  
Roentgenographic Examination

A 27-year-old woman had congenital microgastria, which was apparent in roentgenographic examination when she was 1 year of age. Despite inability to eat anything but pureed foods for the first 13 years and despite persistent vomiting during that time, she has reached normal adult size and has three healthy children. This report represents two firsts: the first case of congenital microgastria in an English language journal of pediatrics and the first with a long follow-up.

scholarly journals Spontaneous rupture of an unscarred uterus in early pregnancy: a rare but life-threatening emergency

2019 ◽  
Vol 12 (5) ◽  
pp. e228493 ◽  
Author(s):  
Bedayah Amro ◽  
Ghassan Lotfi
Keyword(s):  
Early Pregnancy ◽  
Uterine Rupture ◽  
Laparoscopic Approach ◽  
First Trimester ◽  
Rare Occurrence ◽  
Spontaneous Uterine Rupture ◽  
First Case ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Underlying Risk

Spontaneous uterine rupture during early pregnancy is an extremely rare occurrence and may vary in presentation and course of events, hence the clinical diagnosis is often challenging. We present our experience with two such cases of spontaneous uterine rupture in the first trimester of pregnancy without any identifiable underlying risk factors. The first case was at 12 weeks of gestation and the second case was at 6 weeks gestational age (GA). Both cases were diagnosed and managed by the laparoscopic approach. We are reporting the earliest documented GA in which spontaneous uterine rupture occurred. So far, the earliest GA reported in the literature according to our knowledge was at 7+3 weeks. Access to a laparoscopic facility is crucial in the early definitive diagnosis and prompt management of these cases, since this may significantly reduce the risk of severe morbidity and mortality.

scholarly journals Human Babesiosis in Europe

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1165
Author(s):  
Anke Hildebrandt ◽  
Annetta Zintl ◽  
Estrella Montero ◽  
Klaus-Peter Hunfeld ◽  
Jeremy Gray
Keyword(s):  
Clinical Management ◽  
Diagnostic Tools ◽  
Genetic Characteristics ◽  
Susceptibility To Infection ◽  
First Case ◽  
The Usa ◽  
Life Threatening ◽  
History Of ◽  
Etiological Agents ◽  
Human Babesiosis

Babesiosis is attracting increasing attention as a worldwide emerging zoonosis. The first case of human babesiosis in Europe was described in the late 1950s and since then more than 60 cases have been reported in Europe. While the disease is relatively rare in Europe, it is significant because the majority of cases present as life-threatening fulminant infections, mainly in immunocompromised patients. Although appearing clinically similar to human babesiosis elsewhere, particularly in the USA, most European forms of the disease are distinct entities, especially concerning epidemiology, human susceptibility to infection and clinical management. This paper describes the history of the disease and reviews all published cases that have occurred in Europe with regard to the identity and genetic characteristics of the etiological agents, pathogenesis, aspects of epidemiology including the eco-epidemiology of the vectors, the clinical courses of infection, diagnostic tools and clinical management and treatment.

scholarly journals An analysis of early morning acth levels in the first case of pembrolizumab-induced adrenalitis as a delayed immune-related event (dire) – case study

2020 ◽  
Vol 73 (2) ◽  
pp. 396-400
Author(s):  
Igor Alexander Harsch ◽  
Anastasiia Gritsaenko ◽  
Peter Christopher Konturek
Keyword(s):  
Replacement Therapy ◽  
Early Morning ◽  
Related Event ◽  
Special Situation ◽  
Melanocyte Stimulating Hormone ◽  
First Case ◽  
Life Threatening ◽  
Dual Release ◽  
One Year

The aim: The levels of adrenocorticotrophic hormone (ACTH) are elevated in primary adrenal failure (Addison’s disease) with a peak in the early morning hours. This also occurs under hydrocortisone replacement therapy due to the unphysiological substitution regime. The aim was to study ACTH levels under two different replacement regimens. This is exemplified in a patient with adrenalitis after immunotherapy for malignant melanoma (MM), since (elevated) levels of ACTH and its cleavage product alpha-melanocyte stimulating hormone (α-MSH) raise concerns since receptors for both hormones can be expressed in melanoma cells. Material and methods: A female with MM had immunotherapy with pembrolizumab and developed adrenalitis with Addison crisis about one year after discontinuation of this therapy (delayed immune-related event = DIRE). ACTH levels were measured hourly (4-8 a.m.) during a “conventional” hydrocortisone replacement therapy and during a therapy with dual-release hydrocortisone. Results: Salient differences between the morning ACTH profiles under the “conventional” hydrocortisone replacement regimen with 10-5-5 mg/die compared to the single-dose regimen with 20 mg dual-release hydrocortisone were not discernible. Conclusion: DIRE could be an underestimated problem in immunotherapy and could put the patients at hazard. Especially in case of an endocrinological DIRE concerning the adrenocorticotrophic axis, life-threatening situations can arise for the patients. As for the special situation with M. Addison and MM, where hormonal feedback mechanisms may cause further problems beyond the normal hormonal replacement therapy, we observed no salient differences in the early morning ACTH profiles under different hydrocortisone replacement regimens.

scholarly journals Reversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report

2020 ◽  
Vol 26 (2) ◽  
pp. 56-59
Author(s):  
Fahisham Taib ◽  
Laila Ab Mukmin
Keyword(s):  
Low Dose ◽  
Care Setting ◽  
Tertiary Hospital ◽  
Emergence Delirium ◽  
The Past ◽  
First Case ◽  
Midazolam Infusion ◽  
Standardized Treatment ◽  
Life Threatening ◽  
The Common

Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.

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