scholarly journals Leptospirosis presenting as severe cardiogenic shock: A case report

2018 ◽  
Vol 19 (4) ◽  
pp. 351-353
Author(s):  
E Forbat ◽  
MJ Rouhani ◽  
C Pavitt ◽  
S Patel ◽  
R Handslip ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiogenic Shock ◽  
Social History ◽  
Rare Case ◽  
Clinical Course ◽  
Unknown Origin ◽  
Case Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Severe Cardiogenic Shock ◽  
Infectious Illness

Background Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Phenylketonuria and juvenile idiopathic arthritis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Ting Zhu ◽  
Jin Wu ◽  
Li Yuan Wang ◽  
Xiao Mei Sun
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Autoimmune Diseases ◽  
Hip Joint ◽  
Metabolic Disorder ◽  
Rare Case ◽  
Molecular Data ◽  
Methotrexate Therapy ◽  
Case Presentation

Abstract Background Phenylketonuria (PKU) is a genetic metabolic disorder in which patients have no ability to convert phenylalanine to tyrosine. Several autoimmune diseases have been reported to combine with PKU, co-existent of PKU and Juvenile Idiopathic Arthritis (JIA) has not been presented. Case presentation The girl was diagnosed with PKU at the age of 1 month confirmed by molecular data. At the age of 3.5 years, she presented with pain and swelling of her right ankle, right knee, and right hip joint. After a serial of examinations, she was diagnosed with JIA and treated with a nonsteroidal anti-inflammatory drug. Conclusions We report a rare case of a 4-year-old girl with PKU and JIA, which supports a possible interaction between PKU and JIA. Long-term metabolic disturbance may increase the susceptibility to JIA. Further chronic inflammation could alter the metabolism of tryptophan and tyrosine to increase blood Phe concentration. In addition, corticosteroid and methotrexate therapy for JIA may increase blood Phe concentration.

Primary prostatic lymphoma: A rare case report

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 94-96 ◽  
Author(s):  
P. Tognoni ◽  
R. Banchero ◽  
U. Repetto ◽  
C. Caviglia ◽  
M. Cussotto ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Clinical Course ◽  
Rare Case Report

— We present a rare case report of a non-Hodgkin primary prostatic lymphoma. In the article we focus on the increasing number of primary urologic lymphomas, the usual indolent clinical course of such a neoplasm and the combination of surgery and chemotherapy that we performed in this case.

Imipramine Poisoning

1980 ◽  
Vol 1 (10) ◽  
pp. 317-320
Author(s):  
Quang X. Nghiem ◽  
Randy C. Randel ◽  
Thomas L. Leach
Keyword(s):  
Case Report ◽  
Cardiogenic Shock ◽  
Cardiac Toxicity ◽  
Gastric Lavage ◽  
Anticholinergic Syndrome ◽  
Case Presentation ◽  
Common Cause ◽  
Adults And Children ◽  
Electrocardiographic Changes ◽  
Good Agent

The incidence of imipramine poisoning in adults and children is increasing. Toxic effects include an anticholinergic syndrome in the early phase and direct cardiotoxicity that produces abnormalities in rhythm, conduction, and depression of contractility in later phases. In fatal cases, the cardiotoxicity is the most common cause of death. Electrocardiographic changes are so characteristic of imipramine poisoning that the diagnosis can be made or at least suspected on the basis of electrocardiographic alteration. This is illustrated by the case report. Treatment includes induced emesis and/or gastric lavage to remove unabsorbed drug. Diazepam followed by phenobarbital is used to control seizures. Physostigmine is a good agent for treatment of the anticholinergic syndrome, including supraventricular hyperexcitability. Lidocaine is useful for ventricular hyperexcitability. As shown in the case presentation, epinephrine can be effective in reversing the most advanced manifestation of cardiac toxicity, cardiogenic shock.

scholarly journals A man with recurrent fever, arthritis, and rashes-brucellosis? A case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Wang ◽  
Xu Lu ◽  
Chengbo Li ◽  
Myong Jun Ri ◽  
Wei Cui
Keyword(s):  
Infectious Disease ◽  
Bone Marrow ◽  
Case Report ◽  
Myelodysplastic Syndrome ◽  
Skin Biopsy ◽  
Rare Case ◽  
Glucocorticoid Therapy ◽  
Recurrent Fever ◽  
Neutrophilic Dermatosis ◽  
Case Presentation

Abstract Background We report a rare case of chronic brucellosis accompanied with myelodysplastic syndrome and neutrophilic dermatosis, which to the best of our knowledge, has never been reported. Case presentation A young man was admitted to our hospital complaining of recurrent fever, arthritis, rashes and anemia. He had been diagnosed with brucellosis 6 years prior and treated with multiple courses of antibiotics. He was diagnosed with myelodysplastic syndrome and neutrophilic dermatosis following bone marrow puncture and skin biopsy. After anti-brucellosis treatment and glucocorticoid therapy, the symptoms improved. Conclusions Clinicians should consider noninfectious diseases when a patient who has been diagnosed with an infectious disease exhibits changing symptoms.

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.

scholarly journals Extensive eye-oral-bronchial mucosal nodules with eosinopgillia: a rare case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lujin Wu ◽  
Qianru Leng ◽  
Yan Wang ◽  
Daowen Wang ◽  
Danlei Yang
Keyword(s):  
Biopsy Specimen ◽  
Rare Case ◽  
Unknown Origin ◽  
Neoplastic Disease ◽  
Multisystem Disease ◽  
Case Presentation ◽  
Large Numbers ◽  
Detailed Medical History ◽  
Mucous Membranes ◽  
Rare Case Report

Abstract Background Mucosal nodules can be caused by infection, inflammation and neoplastic disease. Many noninfectious diseases, such as eosinophilia, amyloidosis, sarcoidosis, Wegener’s granuloma, langerhans cell histiocytosis etc., are associated with the formation of multisytem mucosal nodules, especially significant bronchial lesions. Detailed medical history, comprehensive metabolic profile, biopsy specimen and imaging examinations are required for differentiating among these disorders. The process of diagnosis and treatment of our patient’s mucosal nodules was challenging, which could be helpful to similar cases. Case presentation We represent a case of a 29-year-old woman with plentiful nodules of unknown origin on extensive mucous membranes. Biopsy specimen reports inflammatory lesions with large numbers of neutrophils, lymphocytes, and varying degrees of eosinophils. Treatment of anti-infection, anti-tussive and anti-allergic was ineffective, but glucocorticoid showed great improvement to her symptoms. Conclusion We experienced a rare case with plentiful nodules of unknown origin on extensive mucous membranes. She may be a specific phenotype of eosinophilia or may be a novel multisystem disease with respiratory system as the primary symptom. The diagnosis of our patient remains unclear, but tentative glucocorticoid therapy was beneficial.

scholarly journals Case Report: Migrainous Infarct without Aura

2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Case Presentation ◽  
The Past ◽  
Need To Evaluate ◽  
History Of ◽  
Complicated Migraine ◽  
Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

scholarly journals Recurrent endobronchial fibro-epithelial polyposis in a 73-year-old woman

2021 ◽  
Vol 7 (2) ◽  
pp. e14-e14
Author(s):  
Ramin Sami ◽  
Mina Nickpour ◽  
Noushin Afshar Moghaddam
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Rare Case ◽  
Benign Tumor ◽  
Main Bronchus ◽  
Rare Condition ◽  
Genitourinary Tract ◽  
Fibroepithelial Polyp ◽  
Interventional Bronchoscopy ◽  
Case Presentation

Introduction: Fibroepithelial polyp (FEP) is a benign tumor that is presented frequently in some of the organs like oral cavity, skin, colon and genitourinary tract, but in airway is rare. Case Presentation: We present a rare case in this paper, with recurrent bronchial FEP that was near completely obstructed right main bronchus that we managed her successfully with interventional bronchoscopy. In this case report we describe this rare condition. Conclusion: Airway FEP is uncommon benign tumor that may obstruct airways and rarely may be recurrent like our case.

scholarly journals Subacute Thyroiditis After SARS-CoV-2 Infection Presenting With Pyrexia of Unknown Origin

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A957-A957
Author(s):  
Santosh Singh
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Unknown Origin ◽  
Subacute Thyroiditis ◽  
Pathophysiological Mechanism ◽  
Rare Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Upper Limit ◽  
First Case ◽  
Heart Rhythm Disorders

Abstract Subacute thyroiditis(SAT) is associated with viral(destructive) or post-viral(inflammatory) origin.[1]The most common clinical characteristics of SAT are female sex preponderance, anterior neck pain and fever.[2,3] Heart rhythm disorders and silent cervical forms have been described in SAT associated with SARS-CoV-2 infection,which occurs 16 to 36 days after resolution of COVID-19.[1,3] Symptomatic improvement occurs in a few days after initiation of therapy with sterods or NSAID.[3] Pyrexia of Unknown Origin (PUO) is a very rare presentation of SAT.[2] Hereby, a case of SAT, presenting with painful neck swelling and persistent fever (5weeks duration), two weeks after resolution of COVID-19, is being discussed. The index patient was a 50-year old obese,normotensive, diabetic (10 years duration, HbA1c-6.6% on SU, metformin, sitagliptin and dapagliflozin) male. TSH was suppressed (0.02 mIU/L), FT4 (3.06 ng/dl, upper limit of normal-1.48ng/dl) and FT3 (3.9 pg/ml, upper limit of normal-3.71 pg/ml) were elevated. Total T4 and T3 were normal. HS-CRP was markedly elevated. IL-6 and TBG were not estimated. Cervical USG revealed diffuse hypoechogenecity of thyroid gland and thyromegaly. There was reduced uptake in thyroid scan (technetium). The patient became afebrile after 4 days of initiation of 30 mg prednisolone (tapered by 10 mg every 5 days). The initial tachycardia reverted to sinus rhythm with marked reduction of neck tenderness. This case highlights certain considerations for SAT associated with SARS-CoV-2 infection. Firstly, it can present with PUO (first case report). Secondly, it may be associated with normal total T4 and T3 which can happen due to reduced TBG consequent upon increased IL-6.[4] References: 1. Caron Philippe: Thyroid disorders and SARS-CoV-2 infection: From pathophysiological mechanism to patient management. Ann Endocrinol (Paris), 2020, Sept. 2. Fever of Unknown Origin as a Sole Presentation of Subacute Throiditis in an Elderly Patient. A Case Report with Literature Review. Raj R, Yada S, Jacob A et al: Hindawi Case Reports in Endocrinology, 2018, Article ID 5041724 3. Brancatella A, Ricci D, Latrofa F et al: Is subacute thyroidits an underestimated manifestation of SARS-CoV-2 infection? Insights from a case serie. J Clin Endocrinol Metab, 2020, Aug 11, dgaa537. 4. Bartaleno L, Brogioni S, Grasso L and Martino E: Increased serum interleukin-6 concentration in patients with subacute thyroiditis:relationship with concomitant changes in serum T4-binding globulin concentration. Journal of Endocrinological Investigation, 1993, 16, 213-218.

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