scholarly journals Case report on Cotard’s syndrome (CS) in a patient with schizophrenia: a rare case from Malaysia

Author(s):  
Natasha Subhas ◽  
Khin Ohnmar Naing ◽  
Chaw Su ◽  
Jiann Lin Loo ◽  
Aishah Farhana Shahbudin ◽  
...  

Abstract Background Cotard’s syndrome (CS) is a neuropsychiatric condition marked by nihilistic delusional(s). Due to its rarity, misdiagnosis of the syndrome often occurs. The current case study is of a Malaysian woman who was misdiagnosed for several years by professionals due to the presence of hypochondriac symptoms before receiving the correct diagnosis. Case presentation In this case presentation, we describe the case of L, a 42-year-old Malaysian lady who was first misdiagnosed with depression. The diagnosis of schizophrenia and CS was confirmed after thorough clinical examination, diagnostic investigations, and deliberation at a departmental forum. The patient improved after receiving electroconvulsive therapy (ECT) along with antipsychotic medications. Conclusions This case study highlights the importance of early recognition of CS by professionals as it can save time for both parties when setting up a treatment plan. Essentially, early recognition of CS in schizophrenia is paramount in the process of rapid stabilization through ECT and promotion of patient recovery.

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Ting Zhu ◽  
Jin Wu ◽  
Li Yuan Wang ◽  
Xiao Mei Sun

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.


2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Bharat Mani Banjade ◽  
Ashish Rajbhandari ◽  
Rabin Koirala ◽  
Tuhin Shah ◽  
Chitra Lal Bhattachan

Abstract Background Extrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist. There are five different types of this anomaly and we present an unusual variant of duplication of an extrahepatic biliary system of type Va variety. Case presentation This case report describes a 63-year-old women from rural Nepal who presented with type Va of duplicated extrahepatic bile duct, with chronic calculous cholecystitis and choledocholithiasis. She was managed with cholecystectomy with hepatic ductoplasty and hepaticojejunostomy. Conclusion A rare case of double common bile duct (type Va) complicated by choledocholithiasis, cholangitis, and chronic cholecystitis is reported here. Rare cases are sometimes overlooked by modern diagnostic techniques. Correct diagnosis helps appropriate surgical intervention.


2018 ◽  
Vol 19 (4) ◽  
pp. 351-353
Author(s):  
E Forbat ◽  
MJ Rouhani ◽  
C Pavitt ◽  
S Patel ◽  
R Handslip ◽  
...  

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.


2020 ◽  
Vol 9 (10) ◽  
pp. e1519108461
Author(s):  
Rani Iani Costa Gonçalo ◽  
Cristiane Kalinne Santos Medeiros ◽  
Humberto Pereira Chaves Neto ◽  
Janaina Lessa de Moraes dos Santos ◽  
Adriano Rocha Germano ◽  
...  

Background: Osteosarcoma is a malignant neoplasm that occurs most often in long bones, with the head and neck region being rarely affected, accounting for less than 1% of all cancers in this region. Objective: To report a rare case of a large-extension osteosarcoma with emphasis on its clinical and diagnostic aspects. Case presentation: A 43-year-old woman presenting an intraoral exophytic lesion with involvement of other maxillofacial structures, such as nostril, zygoma and orbit. Despite the initial clinical diagnosis of actinomycosis, an incisional biopsy confirmed the histopathological diagnosis of osteosarcoma, showing a wide morphological variety. Conclusion: This case highlights the importance of clinical and histopathological findings for the correct diagnosis of osteosarcoma. Moreover, it shows that, although surgical resection is the primary treatment for this neoplasia, depending on the extent of the tumor and its proximity to vital anatomical structures, the most appropriate conduct is not always feasible.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Lana Nseir ◽  
Georget Mansour ◽  
Junior Makhoul ◽  
Luna Skaf ◽  
Mohammad Ziad Dahhan ◽  
...  

Endometrial stromal sarcoma (ESS) is a rare and challenging type of endometrial tumor, constituting only about 0.2% of all uterine malignancies and occurring in women 42–58 years of age. ESS is usually misdiagnosed as leiomyoma. They both have nonspecific symptoms, which makes the diagnosis of ESS difficult to achieve. As the ESS is infrequently encountered, optimal management is quite debatable. Here, we report a rare case of a 22-year-old Syrian female who presented with abnormal uterine bleeding; the preoperative diagnosis suggested leiomyoma while histopathological and immunohistochemical studies confirmed the diagnosis of LG-ESS stage IIA. Therefore, the treatment plan was shifted from a conservative myomectomy to a total hysterectomy with both adnexa. The aim of this case report is to draw attention to this uncommon tumor at young age of patients as well as to have awareness of the necessity to suspect this diagnosis especially with the presentation of rapid enlargement of uterine leiomyoma.


2019 ◽  
Vol 41 (2) ◽  
pp. 8-10
Author(s):  
Sahar Abdualkader Ismaeel ◽  
Saif Saadedeen Abdulrazaq

the entrance of a foreign body (FB) into the maxillary antrum is common in trauma patients where bullets or any other materials trapped in the maxillary sinus; however, iatrogenic cause by a dentist that results in FB entrapment in the maxillary antrum is rare. All these FBs can cause sinusitis. If not treated properly they will cause serious infection, which may spread to the other paranasal sinuses. A careful clinical examination and treatment plan will prevent further complications. In this review, we present a rare case of dental bur (DB) found in the left maxillary antrum. A review of literature revealed only a few cases published which describe a dental bur dislodged in the maxillary antrum.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. Z. van der Horst ◽  
F. van Houwelingen ◽  
J. J. Luykx

Abstract Background Clozapine is an atypical antipsychotic proven to be superior in the treatment of treatment-resistant schizophrenia. Myocarditis is a rare, but well-known complication of treatment with clozapine. Only few cases have been reported in which nausea and vomiting were prominent symptoms. This is the first described report in which nausea and vomiting were the only presenting symptoms of clozapine-induced myocarditis. Case presentation We report a case of a 58-year-old woman, suffering from schizoaffective disorder, who is being treated with clozapine. Two weeks after initiation of clozapine, she developed nausea and vomiting, in absence of any other clinical symptoms. Laboratory examination and magnetic resonance imaging confirmed the diagnosis of clozapine-induced myocarditis. Clozapine was discontinued and the patient recovered fully. Conclusions This case emphasizes the importance of recognizing myocarditis as a cause of isolated nausea and vomiting in patients treated with clozapine. Early recognition improves clinical outcome and reduces mortality.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Wang ◽  
Xu Lu ◽  
Chengbo Li ◽  
Myong Jun Ri ◽  
Wei Cui

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.


2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa

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.


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