scholarly journals Late Response of Antiretroviral Therapy in an HIV-1-Infected Patient due to Hepatitis B and C Coinfections: The First Case Report in Nepal

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Sundar Khadka ◽  
Rupendra Shrestha ◽  
Sanjeet Pandit ◽  
Roshan Pandit ◽  
Anup Bastola
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Treatment Guidelines ◽  
Hepatitis Virus ◽  
Late Response ◽  
Infected Population ◽  
First Case ◽  
Monitoring Therapy ◽  
Hiv 1

Aim. Dual coinfection of HCV and HBV in HIV-1-infected population is a leading cause of morbidity and mortality. Also, they share routes of HIV transmission; however, it might be associated with an independent factor like injecting drug use for HCV and unsafe sex for HBV. This case report suggests that hepatitis virus coinfection may lead to late response of antiretroviral therapy (ART) in HIV-1 patients. Patients and Methods. A 49-year-old male patient visited for the routine follow-up investigation at the National Public Health Laboratory (NPHL), Teku, Nepal. He was an HIV-1-positive injecting drug user (IDU) co-infected with HCV and HBV. The patient was under ART as per the National HIV Testing and Treatment Guidelines 2017, Nepal. Further, serological and viral load testing was performed for confirmation and monitoring therapy, respectively. Results. It is the first report that highlights the dual coinfection of HCV and HBV in an HIV-1 patient from Nepal. The follow-up investigation shows improved response to ART with an increase in CD4+ cells. However, detectable viral loads indicated for a late response might be due to effects of coinfections or viral interactions. Conclusions. Dual coinfection is rare; however, it is more serious with poorly defined epidemiology and evolution in an HIV-1-infected population. Thus, universal screening of HBV or/and HCV coinfection in HIV-1-infected population requires immediate implementation for true prevalence, proper management, and early intervention.

scholarly journals P1346 Not all chest pains are scary: a case report of an important - but often forgotten - diagnosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Neto ◽  
D Seabra ◽  
N Moreno ◽  
S Magalhaes ◽  
L Pires ◽  
...  
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Treatment Guidelines ◽  
Disease Onset ◽  
Nodular Lesion ◽  
Thoracic Wall ◽  
Fat Necrosis ◽  
Benign Condition ◽  
First Case

Abstract INTRODUCTION Epipericardial fat necrosis (EFN) is an uncommon self-limiting benign condition that curses with chest pain. The first case was reported in 1957 and since than only few cases were reported. Recently, new imaging modalities have increased its diagnosis. CASE REPORT An otherwise healthy 42 years-old man presented with severe left-sided pleuritic chest pain, non-radiating, with 4 days duration, mildly relieved by an analgesic. No other symptoms nor history of infection. Physical examination, chest x-ray (CXR), ECG, routine laboratory testing, d-dimer and troponin measurements were unrevealing. Chest CT with contrast showed an increased density of anterior pericardial fat with nodular appearance consistent with EFN. The transthoracic echocardiogram was normal. For better characterization, a cardiac MRI was performed, and confirmed a small nodular lesion (10x17mm) with regular contours, externally to the pericardium, in relation to the apex of the right ventricle and the anterior thoracic wall (hypersignal on T1 and T2, loss of signal in fat saturation sequences, no contrast capture during the first pass nor late enhancement). The mass was delimited from the remaining pericardiac fat by a regular halo. Combined antiinflamatory therapy was started with favourable evolution. Cardiac surgery concluded that there was no need to perform a biopsy of the lesion unless there was recurrence of the symptoms. At 3 and 6-month follow-up, chest pain had resolved (no recurrence) - CT was performed for comparison and still showed a slight densification of the anterior mediastinum’s fat. DISCUSSION EFN is an often-overlooked etiology of chest pain in patients with a negative cardiopulmonary workup. The aetiology of EFN is still unknown but appears to be similar to other analogous conditions such as epiploic appendagitis and fat necrosis in the omentum or breast. It’s not expectable that patients with EFN have a higher risk of coronary heart disease. Onset is usually acute but can persist up to a year. Increased heart rate and diaphoresis may be found. ECG and lab tests are usually normal. CXR often shows a paracardiac opacity, occasionally with an associated pleural effusion. CT typically shows a fatty lesion anterior to the pericardium, in the epipericardial fat, with stranding of surrounding soft tissue. In most cases the adjacent pericardium is also thickened. CT enables prompt diagnosis in most cases, preventing further invasive procedures. No evidence-based treatment guidelines are available due to the rarity and benign behaviour of the disease. Treatment is usually conservative with analgesics and non-steroidal anti-inflammatory drugs. Follow-up imaging is recommended to confirm resolution and exclude neoplastic diseases such as liposarcoma. It is important to be familiar with its features since the clinical and radiologic characteristics suggest a presumptive diagnosis, thereby avoiding more aggressive techniques. Abstract P1346 Figure. MRI - small nodular lesion

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

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 Teratoma of larynx: case report

2021 ◽  
Vol 7 (10) ◽  
pp. 1700
Author(s):  
Rakesh Srivastava ◽  
Vini Tandon
Keyword(s):  
Carbon Dioxide ◽  
Case Report ◽  
Germ Cells ◽  
Carbon Dioxide Laser ◽  
Rare Case ◽  
Histopathological Examination ◽  
Flexible Laryngoscopy ◽  
First Case ◽  
Congenital Teratoma

<p class="abstract">Teratomas are embryonal neoplasm arises from totipotent germ cells. They are having tissues from all the three blastodermic layers. There are various locations of congenital teratoma. Naso-oropharyngeal site teratoma are either sessile or pedunculated. We describe a rare case of laryngeal teratoma in a five years old patient presented with change in voice and breathing difficulty. On flexible laryngoscopy, it appeared like supraglottic cyst but on CT scan it was confirmed as teratoma. Pre-operative tracheostomy and transoral carbon dioxide laser assisted excision done. Histopathological examination showed osteoid trabeculae, chondroid tissue with loose myxoid islands and adipose tissue. No recurrence of tumor on 18 months follow-up. This is the first case report of pediatric larynx teratoma reported in present century.</p>

Transmission of integrase strand-transfer inhibitor multidrug-resistant HIV-1: case report and response to raltegravir-containing antiretroviral therapy

2011 ◽  
Vol 16 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Benjamin Young ◽  
Signe Fransen ◽  
Kenneth S Greenberg ◽  
Amy Thomas ◽  
Sharon Martens ◽  
...  
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Multidrug Resistant ◽  
Strand Transfer ◽  
Transfer Inhibitor ◽  
Integrase Strand Transfer Inhibitor ◽  
Hiv 1

scholarly journals Inflammatory Myofibroblastic Tumor of the Epiglottis Excised with a Carbon Dioxide Laser: Case Report and Literature Review

2018 ◽  
Vol 97 (8) ◽  
pp. E31-E33 ◽  
Author(s):  
Blake Raggio ◽  
Neil Chheda
Keyword(s):  
Carbon Dioxide ◽  
Case Report ◽  
Adjuvant Therapy ◽  
Literature Review ◽  
Carbon Dioxide Laser ◽  
Inflammatory Myofibroblastic Tumor ◽  
Benign Neoplasm ◽  
First Case ◽  
Laser Excision

Inflammatory myofibroblastic tumor (IMT) is a benign neoplasm of intermediate biologic potential. It rarely occurs in the larynx, and it has not been previously reported in the epiglottis. We treated a 66-year-old woman who presented with progressive dysphonia and a mass on her suprahyoid epiglottis. The tumor was completely excised with a CO2 laser; no adjuvant therapy was administered. Histopathology revealed that the mass was an IMT. No evidence of recurrence was noted after 6 months of follow-up. We present what we believe is the first case of an epiglottic IMT to be reported in the literature, and we propose CO2 laser excision without adjuvant therapy as an acceptable treatment.

Is choriocapillaris the early target in acute maculopathy secondary to hand, foot, and mouth disease? A case report

2020 ◽  
pp. 112067212098252
Author(s):  
Pietro Maria Talli ◽  
Edlira Bendo ◽  
Emilio Pedrotti ◽  
Alberto Pazzaglia
Keyword(s):  
Case Report ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Ocular Involvement ◽  
Primary Target ◽  
Retrospective Case ◽  
First Case ◽  
Foot And Mouth ◽  
Acute Maculopathy

Purpose: To report the case of a 33-year old man who disclosed the first case of bilateral ocular involvement of hand, foot, and mouth disease (HFMD) with a different stage of the disease in each eye. Methods: Retrospective case report. Results: The study included a patient who incurred in a bilateral HFMD maculopathy. During 6 months follow-up period persistent abnormalities in fundus examination and in OCT scans were reported. Conclusion: We consider that our case shows that choriocapillaris is the primary target of HFMD maculopathy, for this reason we consider that ICGA is mandatory for early diagnosis and an effective treatment.

scholarly journals Susac's syndrome: the first case report in a Nordic country, with an 8-year follow-up

2005 ◽  
Vol 83 (6) ◽  
pp. 757-758 ◽  
Author(s):  
Nicolai Gruhn ◽  
Line Kynemund Pedersen ◽  
Niels Vesti Nielsen
Keyword(s):  
Case Report ◽  
Nordic Country ◽  
Susac’S Syndrome ◽  
First Case

scholarly journals Citalopram intoxication in four week old infant

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jo-Anne Janson ◽  
Arthur T. M. Wasylewicz ◽  
Marianne Eijkemans ◽  
Marieke Kerskes
Keyword(s):  
Case Report ◽  
Cardiac Rhythm ◽  
Clinical Course ◽  
Screening Methods ◽  
Pharmacokinetic Data ◽  
Pediatric Practice ◽  
Case Presentation ◽  
Young Infants ◽  
First Case

Abstract Background In contrast to intoxications in toddlers which can be due to accidental ingestions, many intoxications in infants are due to medication errors. To our knowledge, this is the first case report of a citalopram intoxication in an infant, and may offer new insight on possible screening methods for intoxication as well as pharmacokinetics of citalopram in small infants. Case presentation This case report describes an unintentional citalopram intoxication in a 4 week old infant due to a vitamin D drops ‘look alike’ error. The infant showed extreme jitteriness and opisthotonus at presentation, as well as prolonged signs of gastro-oesophageal reflux. No cardiac rhythm disturbances or convulsions were seen. The clinical course combined with Finnegan scores was correlated to and supported by pharmacokinetic and pharmacokinetic data of citalopram in the patient. Conclusions Using Finnegan scores in general pediatric practice could help objectify follow-up of acute intoxications in young infants with neurological symptoms.

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