scholarly journals Severe COVID-19 and long COVID in a 31-year-old woman with incontinentia pigmenti: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110592
Author(s):  
Sylvie Rheault
Keyword(s):  
Case Report ◽  
Caucasian Woman ◽  
Incontinentia Pigmenti ◽  
Type I ◽  
Protective Measures ◽  
Present Case Report ◽  
Inflammatory Phase ◽  
Intravenous Antibiotics ◽  
Life Threatening ◽  
Evidence Based Guidelines

Incontinentia pigmenti is a rare genetic disease affecting the skin, microvasculature, and central nervous system, in which a hyperactive inflammatory response is observed. Due to the inflammatory phase of COVID-19 and associated cytokine storm, infection with SARS-CoV-2 in individuals with incontinentia pigmenti is a concern. Furthermore, type I interferon autoantibodies are found in life-threatening COVID-19 pneumonia and in 25% of individuals with incontinentia pigmenti. The present case report describes a 31-year-old Caucasian woman with incontinentia pigmenti and severe COVID-19. She was hospitalized for oxygen therapy, intravenous antibiotics, and corticosteroids. Eight months later, she is still symptomatic. To our knowledge, she is the first reported case of long COVID in incontinentia pigmenti. Increased autoimmunity may be implicated in both incontinentia pigmenti and long COVID. Pending evidence-based guidelines, COVID-protective measures including vaccination should be recommended to all patients with incontinentia pigmenti. Specific interferon therapy may be considered along with usual COVID treatment.

Cardiac and Respiratory Arrest in a 12-Year-Old Girl with Acute Permethrin Toxicity: A Case Report

2021 ◽  
Author(s):  
Hesam Adin Atashi ◽  
Hamid Zaferani Arani ◽  
Seyyed Mojtaba Ghorani ◽  
Mahya Sadat Teimouri Khorasani ◽  
Masoumeh Moalem
Keyword(s):  
Case Report ◽  
Brain Damage ◽  
Respiratory Arrest ◽  
Spontaneous Circulation ◽  
Type I ◽  
Medical Problems ◽  
Present Case Report ◽  
Case Presentation ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain

Abstract Background: Permethrin (PER) is widely employed as the most frequently used type I synthetic pyrethroid insecticide. Despite its worldwide application, reports of pediatric toxicity following permethrin administration are scarce.Case presentation: The present case report involves a 12-year-old Afghan girl, with no previous medical problems, who drank an unknown insecticide covertly at home. Two hours after ingestion, she was taken to the emergency room with neither breathing signs nor a heartbeat. She was immediately transferred to the cardiopulmonary resuscitation (CPR) room, and her spontaneous circulation was returned after a few minutes of CPR. She was then intubated, volume resuscitated with intravenous normal saline, and connected to the mechanical ventilator after being transferred to the ICU ward. The patient remained comatose without spontaneous breathing, her pupils became bilateral mydriasis, and central diabetes insipidus became evident after three days due to apnea and hypoxic brain damage following insecticide ingestion. The chemical analysis of the insecticide bottle showed 10% permethrin without organophosphates, as initially expected. Unfortunately, after seven days, the patient passed away due to resistant hypotension and severe brain damage.Conclusion: Permethrin is widely used globally as an insecticide. However, there are many unmet needs in permethrin toxicity treatment, and the treatment is mainly supportive. Depending on the amount and dose of permethrin, the most common symptoms can vary from headache, dyspnea, and vomiting to metabolic acidosis and cardiac and respiratory arrest, which can lead to hypoxic brain damage and death, as was the outcome in our case.

scholarly journals Chronic Tubal Ectopic Pregnancy with Diagnostic Conundrum: A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 192-194
Author(s):  
Vishal Sharma ◽  
Ravi Dutt Wadhwa
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
Present Case Report ◽  
Tubal Ectopic Pregnancy ◽  
Threatening Condition ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Ectopic Pregnancies

Ectopic pregnancy is a life threatening condition and mostly ectopic pregnancies occurs in fallopian tube. The most common site of ectopic tubal pregnancy is ampulla. Ectopic pregnancy is a complication of pregnancy and usually easy to diagnose by ultrasonography during the first trimester of pregnancy. Due to limited healthcare resources in developing countries, women do not undergo for ultrasound examination during pregnancy which leads to late diagnosis. In most of cases women with ectopic pregnancy are asymptomatic, unless ruptured. The mean gestational age for clinical presentation of ectopic pregnancy is 7.2 weeks after the last normal menstrual period. In rural population, late presentations of ectopic pregnancies are more commonly seen because of lack of modern diagnostic ability. Present case report is a rare case of non-viable, unruptured, tubal ampullary chronic ectopic pregnancy of 12 weeks gestational age. Keywords: Ectopic pregnancy, Unruptured, gestational age, ultrasonography.

scholarly journals Giant Squamous Cell Carcinoma on Chronic Lichen Planus on the Ankle - A Case Report and Short Literature Review

2019 ◽  
Vol 7 (18) ◽  
pp. 3061-3063 ◽  
Author(s):  
Uwe Wollina ◽  
Claudia Krönert ◽  
Jacqueline Schönlebe ◽  
Aleksandra Vojvodic ◽  
Torello Lotti
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Literature Review ◽  
Cell Carcinoma ◽  
Lichen Planus ◽  
Squamous Cell ◽  
Caucasian Woman ◽  
Increased Risk ◽  
Life Threatening ◽  
Threatening Situation

BACKGROUND: Cutaneous squamous cell carcinoma (SCC) is the second most common malignancy of skin. Although a major risk factor is a chronic exposure to ultraviolet radiation, preexistent chronic inflammatory disorders may also possess an increased risk for SCC. That is not the case for cutaneous lichen planus in contrast to oral lichen planus and oral SCC.  CASE REPORT: We report the case of an 87-year-old Caucasian woman presenting with a giant verrucous tumour on the left ankle. She suffered from long-standing disseminated lichen planus. Histology confirmed the diagnosis of SCC on partly verrucous lichen planus. The course was complicated due to sepsis. An emergency transfemoral amputation became necessary. The patients survived and could be released into her nursery. A literature review underlined the rarity of SCC on lichen planus of the skin. Most of these rare cases were in patients in their second half of life on the lower legs. Hypertrophic lichen plnaus was overrepresented.   CONCLUSIONS: Although very rare by number, SCC can complicate lichen planus and lead to the life-threatening situation. Atypical verrucous lesions on lichen planus warrant a histologic analysis. Surgery is the treatment of choice for cutaneous SCC.

scholarly journals Failed videolaryngoscopy in an infant with giant vallecular cyst managed successfully with a ‘three-person technique’ of fibre-optic intubation

2019 ◽  
Vol 12 (9) ◽  
pp. e231035
Author(s):  
Anju Gupta ◽  
Nishkarsh Gupta
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Airway Management ◽  
Airway Obstruction ◽  
Muscle Relaxants ◽  
Rare Entity ◽  
Fibre Optic ◽  
Present Case Report ◽  
Rescue Technique ◽  
Life Threatening

Vallecular cysts are a rare entity but can complicate the airway management due to the physical impediment and distortion of the laryngeal inlet. It can lead to fatal life-threatening airway obstruction postinduction of anaesthesia. Infancy compounds the risks due to lack of cooperation and physiological reserves. The literature review suggested most anaesthesiologists avoided muscle relaxants and aspiration of the cyst was used as a rescue technique. The present case report illustrates the successful airway management of an infant with a huge vallecular cyst using fibre-optic intubation by a ‘three-person’ technique after paraglossal videolaryngoscopy failed to secure the airway.

Severe Acute Thromboinflammation: Case Report of Individualized Homeopathic Treatment

Homeopathy ◽  
2021 ◽  
Vol 110 (02) ◽  
pp. 132-136
Author(s):  
Silvia Waisse
Keyword(s):  
Case Report ◽  
Clinical Manifestations ◽  
Acute Phase Reactants ◽  
Present Case Report ◽  
Homeopathic Treatment ◽  
Accurate Picture ◽  
Life Threatening ◽  
Very High ◽  
Suspect Case

AbstractThromboinflammation is a still not well-understood phenomenon, which has recently come to the foreground as a function of its relevance in the pathophysiology of coronavirus disease 2019 (COVID-19). The patient described in the present case report exhibited acute fever, giant urticaria, elevated acute phase reactants, and very high d-dimer levels, thus characterizing thromboinflammation. She was diagnosed as a COVID-19 suspect case, which was not confirmed; urticarial vasculitis was ruled out. Homeopathic treatment was started with the earliest clinical manifestations, resulting in rapid and drastic reduction of inflammation and hypercoagulability within the first 12 hours, and full recovery on 10-day follow-up assessment. This case demonstrates the effectiveness of homeopathy in a severe acute disorder, and points to the need to include laboratory testing in homeopathic clinical assessment to achieve an accurate picture of disease, and to avoid the risk of passing over life-threatening disorders.

scholarly journals Clozapine-Induced Cardiotoxicity Presenting as Sepsis: A Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Mazin Khalid ◽  
Oluwole Jegede ◽  
Vijay Gayam ◽  
Ying Chi Yang ◽  
Binav Shrestha ◽  
...  
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Postural Hypotension ◽  
Systolic Function ◽  
Antipsychotic Agent ◽  
Elevated Troponin ◽  
Medical Unit ◽  
Psychiatric Illnesses ◽  
Intravenous Antibiotics ◽  
Life Threatening

Clozapine is an atypical antipsychotic agent indicated in the treatment of medication-resistant schizophrenia. It is often reserved as a last line of treatment owing to the potential for serious and potentially life-threatening side effects, the most serious being agranulocytosis requiring close hematological monitoring and possible discontinuation of the medication from further use in the patient even when the agranulocytosis resolves. Other complications of clozapine include sedation, weight gain, elevated triglyceride levels, postural hypotension, and tachycardia. However, the potentially serious complication of myocarditis, though rare (with an incidence of 3%), may lead to cardiomyopathy as described in our present case. We present a 21-year-old patient who was started on clozapine for management of schizophrenia. He developed fever and tachycardia and was admitted to the medical unit on intravenous antibiotics for management of sepsis as he met the criteria for systemic inflammatory response syndrome. His labs revealed an elevated troponin and trending eosinophilia, which, in the context of clozapine use, raises the suspicion of clozapine cardiotoxicity. Echocardiogram showed reduced systolic function (45%). Clozapine was immediately discontinued, and his repeat echocardiogram showed normalization of his systolic function. In view of the increased prevalence of psychiatric illnesses, internists should be aware of rare but potentially life-threatening side effects.

scholarly journals Transient Hyperinsulinemic Hypoglycemia Linked to PAX6 Mutation

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 582
Author(s):  
Jee-Min Kim ◽  
Seul-Ki Kim ◽  
Shin-Hee Kim ◽  
Won-Kyoung Cho ◽  
Kyoung-Soon Cho ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Glucose Metabolism ◽  
Glucose Homeostasis ◽  
Hyperinsulinemic Hypoglycemia ◽  
Present Case Report ◽  
Insulin Regulation ◽  
Life Threatening ◽  
Pax6 Mutation

Prolonged hyperinsulinemic hypoglycemia in infancy can result in developmental sequelae. A mutation in the paired box-6 gene (PAX6) has been reported to cause disorders in oculogenesis and neurogenesis. A limited number of cases of diabetes mellitus in adults with a PAX6 mutation suggest that the gene also plays a role in glucose homeostasis. The present case report describes a boy with a PAX6 mutation, born with anophthalmia, who underwent hypoglycemic seizures starting at 5 months old, and showed a prediabetic condition at 60 months. This patient provides novel evidence that connects PAX6 to glucose homeostasis and highlights that life-threatening hypoglycemia or early onset glucose intolerance may be encountered. The role of PAX6 in glucose metabolism and insulin regulation should be further investigated.

Management of prolonged epistaxis in pregnancy: case report

2013 ◽  
Vol 127 (8) ◽  
pp. 811-813 ◽  
Author(s):  
K Cornthwaite ◽  
K Varadharajan ◽  
M Oyarzabal ◽  
H Watson
Keyword(s):  
Case Report ◽  
Multidisciplinary Approach ◽  
Surgical Intervention ◽  
Pregnant Patient ◽  
Evidence Based ◽  
Second Trimester ◽  
Severe Epistaxis ◽  
Life Threatening ◽  
Evidence Based Guidelines ◽  
In Pregnancy

AbstractObjectives:To report a case of life-threatening epistaxis in a pregnant patient, describe the links between pregnancy and epistaxis, and discuss the management of such cases. Life-threatening epistaxis in pregnancy is rare, and there are no specific evidence-based guidelines regarding the management of these patients.Case report:A 31-year-old primigravida presented with severe epistaxis in the second trimester of her pregnancy. Conservative measures failed, thereby necessitating surgical intervention.Conclusion:This case illustrates the importance of a multidisciplinary approach in the management of a pregnant patient presenting with severe epistaxis, and highlights the surgical challenges presented in such a situation.

scholarly journals Cardiac and Respiratory Arrest in a 12-Year-Old Girl with Acute Permethrin Toxicity: A Case Report

2021 ◽  
Author(s):  
Hesam Adin Atashi ◽  
Hamid Zaferani Arani ◽  
Seyyed Mojtaba Ghorani ◽  
Mahya Sadat Teimouri Khorasani ◽  
Masoumeh Moalem
Keyword(s):  
Case Report ◽  
Brain Damage ◽  
Unmet Needs ◽  
Respiratory Arrest ◽  
Spontaneous Circulation ◽  
Type I ◽  
Medical Problems ◽  
Present Case Report ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain

Abstract BackgroundPermethrin (PER) is widely employed as the most frequently used type I synthetic pyrethroid insecticide. Despite its worldwide application, reports of pediatric toxicity following permethrin administration are scarce.Case presentationThe present case report involves a 12-year-old Afghan girl, with no previous medical problems, who drank an unknown insecticide covertly at home. Two hours after ingestion, she was taken to the emergency room with neither breathing signs nor a heartbeat. She was immediately transferred to the cardiopulmonary resuscitation (CPR) room, and her spontaneous circulation was returned after a few minutes of CPR. She was then intubated, volume resuscitated with intravenous normal saline, and connected to the mechanical ventilator after being transferred to the ICU ward. The patient remained comatose without spontaneous breathing, her pupils became bilateral mydriasis, and central diabetes insipidus became evident after three days due to apnea and hypoxic brain damage following insecticide ingestion. The chemical analysis of the insecticide bottle showed 10% permethrin without organophosphates, as initially expected. Unfortunately, after seven days, the patient passed away due to resistant hypotension and severe brain damage.ConclusionPermethrin is widely used globally as an insecticide. However, there are many unmet needs in permethrin toxicity treatment, and the treatment is mainly supportive. Depending on the amount and dose of permethrin, the most common symptoms can vary from headache, dyspnea, and vomiting to metabolic acidosis and cardiac and respiratory arrest, which can lead to hypoxic brain damage and death, as was the outcome in our case.

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