scholarly journals Catecholaminergic Crisis After a Bleeding Complication of COVID-19 Infection: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Angel Rebollo-Román ◽  
Maria R. Alhambra-Expósito ◽  
Yiraldine Herrera-Martínez ◽  
F. Leiva-Cepas ◽  
Carlos Alzas ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Medical Treatment ◽  
Bleeding Complication ◽  
Adrenal Mass ◽  
Symptom Control ◽  
Clinical Manifestations ◽  
First Case ◽  
Thrombotic Complications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents in some cases with hemostatic and thrombotic complications. Pheochromocytomas are unusual, though potentially lethal tumors. Herein we describe the first case of hemorrhage in a pheochromocytoma related to SARS-CoV-2 infection. A 62-year-old man consulted for syncope, fever, and palpitations. He was diagnosed with SARS-CoV-2 pneumonia and presented with a hemorrhage in a previously unknown adrenal mass, which resulted in a catecholaminergic crisis. Medical treatment and surgery were required for symptom control and stabilization. We hereby alert clinicians to watch for additional/unreported clinical manifestations in COVID-19 infection.

scholarly journals Case Report: Post-mortem Histopathological and Molecular Analyses of the Very First Documented COVID-19-Related Death in Europe

2021 ◽  
Vol 8 ◽  
Author(s):  
Milenko Bogdanović ◽  
Ivan Skadrić ◽  
Tatjana Atanasijević ◽  
Oliver Stojković ◽  
Vesna Popović ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Unknown Origin ◽  
Vitreous Humor ◽  
Post Mortem ◽  
Molecular Analyses ◽  
First Case ◽  
The Republic

In Europe, the first case of coronavirus disease (COVID-19) and the first COVID-19-related death were reported in France on January 24th and February 15th, 2020, respectively. Officially, the first case of COVID-19 infection in the Republic of Serbia was registered on March 6th. Herein, we presented the first case of retrospective detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the post-mortem-obtained vitreous humor (VH), which took place on February 5th, 2020. This is the first death in Europe proven to be caused by COVID-19 by means of post-mortem histopathological and molecular analyses. Based on this finding, it appears that SARS-CoV-2 has been spreading faster and started spreading much earlier than it had been considered and that COVID-19 was probably the cause of the much-reported pneumonia of unknown origin in January and February 2020.

scholarly journals Severe Acute Respiratory Syndrome Corona Virus-2 Infection in a Pediatric Kidney Transplant Recipient: A Case Report from India

2021 ◽  
pp. 367-373
Author(s):  
Ravi Raju Tatapudi ◽  
Venkateswara Rao Kopparti ◽  
Anusha Poosapati ◽  
Srinivas Metta ◽  
Vedita Palli ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Solid Organ Transplantation ◽  
Clinical Manifestations ◽  
Severe Illness ◽  
Solid Organ ◽  
Corona Virus

COVID-19 pandemic affected millions of people across India. COVID-19 cases are fewer in children with less severity and better outcomes than in adults. However, a small proportion develop severe illness and succumb to the disease. Clinical manifestations and optimal management of COVID-19 in immunocompromised children are not clearly known. Remdesivir was shown to be efficient in reducing the recovery time in COVID-19 patients requiring supplemental oxygen. Remdesivir is approved for use in children with severe COVID-19, but there are no guidelines in patients with risk factors like recent solid organ transplantation. We report a case of a 10-year-old kidney transplant recipient (KTR) infected with severe acute respiratory syndrome corona virus-2, 2.5 months after the transplantation. Unlike most children, he presented with high fever, cough, and vomiting. His inflammatory markers were elevated. In this case report, we discussed management and clinical outcomes of this patient. In view of recent kidney transplantation and the severity of infection with emergent oxygen requirement, we gave him remdesivir. We continued prednisolone and tacrolimus and stopped mycophenolate. He recovered completely in 7 days. We feel that severely immunosuppressed KTR children with COVID-19 will benefit with remdesivir administration. Monitoring tacrolimus trough levels is essential for maintaining adequate immunosuppression.

scholarly journals First Reported Case of Donor Related Candida Endophthalmitis after Descemet Membrane Endothelial Keratoplasty

2017 ◽  
Vol 11 (1) ◽  
pp. 117-121 ◽  
Author(s):  
Matthew Thompson ◽  
David Carli
Keyword(s):  
Case Report ◽  
Medical Treatment ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Retrospective Case ◽  
Descemet Membrane ◽  
Donor Material ◽  
First Case ◽  
Culture Positive ◽  
Candida Endophthalmitis

Purpose: To report the first case of Candida donor to host transmission following descemet membrane endothelial keratoplasty (DMEK) Methods: A retrospective case report. Results: A patient underwent uneventful DMEK. Following surgery the donor rim was culture positive for Candida. The patient developed fungal endophthalmitis that was treated medically with multiple injections of voriconazole and amphotericin. Medical treatment was unable to clear the infection and removal of the donor material was required. Following removal the infection subsided. Conclusion: Candida interface keratitis and endophthalmitis can occur following DMEK and may be difficult to treat medically. Early removal of the donor material should be considered.

scholarly journals Case Report: A Homozygous Mutation (p.Y62X) of Phospholipase D3 May Lead to a New Leukoencephalopathy Syndrome

2021 ◽  
Vol 13 ◽  
Author(s):  
Yi-Hui Liu ◽  
Hai-Feng Zhang ◽  
Jie-Yuan Jin ◽  
Yan-Qiu Wei ◽  
Chen-Yu Wang ◽  
...  
Keyword(s):  
Case Report ◽  
White Matter ◽  
Kidney Disease ◽  
Messenger Rna ◽  
Vision Loss ◽  
Clinical Manifestations ◽  
White Matter Lesions ◽  
Homozygous Mutation ◽  
Inherited Disorders ◽  
First Case

Leukodystrophies are a heterogeneous group of inherited disorders with highly variable clinical manifestations and pathogenetic backgrounds. At present, variants in more than 20 genes have been described and may be responsible for different types of leukodystrophies. Members of the phospholipase D family of enzymes catalyze the hydrolysis of membrane phospholipids. Meanwhile, phospholipase D3 (PLD3) has also been found to exhibit single stranded DNA (ssDNA) acid 5′ exonuclease activity. Variants in phospholipase D3 (PLD3) may increase the risk of Alzheimer's disease and spinocerebellar ataxia, but this hypothesis has not been fully confirmed. In this study, we identified a novel homozygous mutation (NM_012268.3: c.186C>G/ p.Y62X) of PLD3 in a consanguineous family with white matter lesions, hearing and vision loss, and kidney disease by whole exome sequencing. Real-time PCR revealed that the novel mutation may lead to non-sense-mediated messenger RNA (mRNA) decay. This may be the first case report on the homozygous mutation of PLD3 in patients worldwide. Our studies indicated that homozygous mutation of PLD3 may result in a novel leukoencephalopathy syndrome with white matter lesions, hearing and vision loss, and kidney disease.

scholarly journals Frameshift Mutation in Polar Rich Domain (PRD) of PQBP1 Gene Associated with Asymmetric Cerebellar Hemispheres: A Case Report of Renpenning Syndrome

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Dejan Aleksic ◽  
Milan Borkovic ◽  
Jelena Krivacic ◽  
Igor Petrusic ◽  
Vedrana Milic Rasic
Keyword(s):  
Case Report ◽  
Frameshift Mutation ◽  
Clinical Manifestations ◽  
Brain Magnetic Resonance Imaging ◽  
Cerebellar Hemisphere ◽  
Mild Intellectual Disability ◽  
Chordae Tendineae ◽  
Nasal Bridge ◽  
First Case ◽  
Midfacial Hypoplasia

Introduction: In 1962, Renpenning et al. published an article with 20 male patients from three generations with mental retardation. Scientists suggested that the syndrome with mutation mapped to the locus Xp11.2-p11.4 should be called Renpenning syndrome. The deletion/duplication of an AG dinucleotide on proximal Xp in the polyglutamine tract-binding protein 1 (PQBP1) gene causing frameshift in the fourth coding exon was identified as the most frequent mutation in this syndrome. Renpenning syndrome with asymmetric cerebellar hemispheres has not been reported previously. Case Presentation: In this case report, we presented an 11-year-old male with mild developmental delay and mild intellectual disability, microcephaly, dysmorphic face, short stature, and seizures. The following morphological abnormalities were detected: a wide nasal bridge, midfacial hypoplasia, short philtrum, low-set ears, low hanging columella, high palate, and narrow face. Neurological examination showed upper and lower extremities hypotonia with joint hypermobility. The patient had his first seizure at the age of seven, and he experienced a total of 10 seizures by the age 11. A systolic murmur of intensity 2/6 was present, and echocardiography showed chordae tendineae abnormalities in the left ventricle. Brain magnetic resonance imaging (MRI) showed asymmetric cerebellar hemispheres (mild right cerebellar hemisphere hypoplasia). A frameshift mutation in the polar reach domain (PRD) of the PQBP1 gene (c.459-462 delAGAG) was detected by exome sequencing. Conclusions: We showed the first case of genetically confirmed Renpenning syndrome in Serbia. Our patient had classical clinical manifestations for Renpenning syndrome as a consequence of frameshift mutation in the PRD of the PQBP1 gene. To the best of our knowledge, according to the literature, this is the first patient with Renpenning syndrome with asymmetric cerebellar hemispheres (mild right cerebellar hemisphere hypoplasia).

scholarly journals Understanding COVID-19: From Origin to Potential Therapeutics

2020 ◽  
Vol 17 (16) ◽  
pp. 5904
Author(s):  
Muhammad Moazzam ◽  
Muhammad Imran Sajid ◽  
Hamza Shahid ◽  
Jahanzaib Butt ◽  
Irfan Bashir ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Respiratory Infections ◽  
Middle Eastern ◽  
Clinical Manifestations ◽  
Current Status ◽  
The Public ◽  
Global Pandemic ◽  
First Case ◽  
Human Coronaviruses ◽  
Potential Therapeutics

Currently, a global pandemic era of public health concerns is going on with the Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first case of COVID-19 was reported from Wuhan’s Huanan seafood market in China late December 2019. Bats, pangolins, and snakes have been nominated as salient carriers of the virus. Thanks to its high pathogenicity, it can cause severe respiratory infections. Fever, dry cough, sore throat, pneumonia, septic shock, and ground-glass opacities are the foremost clinical manifestations of COVID-19. Immunocompromised patients are at high risk for COVID-19 infection and may lead to death. Scientist and government agencies around the globe are putting forward their best efforts and resources for the effective treatment of human coronavirus infections; however, neither vaccines nor antiviral drugs are available for the treatment of human coronaviruses (HCoV) infections such as SARS (severe acute respiratory syndrome), MERS (Middle Eastern respiratory syndrome), and COVID-19. Since the outbreak, a plethora of research and review articles have been published. Moreover, the mass media has bombarded the public with conflicting opinions about the pandemic. There is a dire need for accurate and reliable information concerning this pandemic. In this review, we have compiled the up to date information about the origins, evolution, epidemiology, and pathogenesis of this disease. Moreover, very few reports have addressed the clinical features and current status of treatment for COVID-19; we have adequately addressed these topics in detail in this review. Finally, a detailed account of clinical trials of vaccines and other therapeutics currently in progress has been delineated.

scholarly journals Sphingomonas paucimobilis keratitis post cataract surgery: First case report from India

2019 ◽  
Vol 11 (1) ◽  
pp. 82-85 ◽  
Author(s):  
Manisha Acharya ◽  
Javed Hussain Farooqui ◽  
Hayden Spencer ◽  
Vinay Arora ◽  
Umang Mathur
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Medical Treatment ◽  
Cataract Surgery ◽  
Sphingomonas Paucimobilis ◽  
Gram Negative ◽  
Ophthalmic Manifestations ◽  
First Case ◽  
Surgery First ◽  
Patch Graft

Sphingomonas paucimobilis is a rare, aerobic Gram-negative soil bacillus rarely associated with intraocular infections. With only 3 cases of ophthalmic manifestations reported so far, we are presenting the fi rst case of S. Paucimobilis, causing keratitisafter cataract surgery, from India. The organism, which was resistant to initial medical treatment, eventually responded to a patch graft and the patient improved to a final visual acuity of 20/40.

scholarly journals Severe acute respiratory syndrome coronavirus 2-induced acute aortic occlusion: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Artem Minalyan ◽  
Franklin L. Thelmo ◽  
Vincent Chan ◽  
Stephanie Tzarnas ◽  
Faizan Ahmed
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Vascular Tissue ◽  
Viral Infections ◽  
Fatal Outcome ◽  
Aortic Occlusion ◽  
Bilevel Positive Airway Pressure ◽  
Thrombotic Complications ◽  
Acute Aortic Occlusion

Abstract Background Severe acute respiratory syndrome coronavirus 2 infection can lead to a constellation of viral and immune symptoms called coronavirus disease 2019. Emerging literature increasingly supports the premise that severe acute respiratory syndrome coronavirus 2 promotes a prothrombotic milieu. However, to date there have been no reports of acute aortic occlusion, itself a rare phenomenon. We report a case of fatal acute aortic occlusion in a patient with coronavirus disease 2019. Case report A 59-year-old Caucasian male with past medical history of peripheral vascular disease presented to the emergency department for evaluation of shortness of breath, fevers, and dry cough. His symptoms started 5–7 days prior to the emergency department visit, and he received antibiotics in the outpatient setting without any effect. He was found to be febrile, tachypneic, and hypoxemic. He was placed on supplemental oxygen via a non-rebreather mask. Chest X-ray showed multifocal opacifications. Intravenous antibiotics for possible pneumonia were initiated. Hydroxychloroquine was initiated to cover possible coronavirus disease 2019 pneumonia. During the hospitalization, the patient became progressively hypoxemic, for which he was placed on bilevel positive airway pressure. D-dimer, ferritin, lactate dehydrogenase, and C-reactive protein were all elevated. Severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction was positive. On day 3, the patient was upgraded to the intensive care unit. Soon after he was intubated, he developed a mottled appearance of skin, which extended from his bilateral feet up to the level of the subumbilical plane. Bedside ultrasound revealed an absence of flow from the mid-aorta to both common iliac arteries. The patient was evaluated emergently by vascular surgery. After a discussion with the family, it was decided to proceed with comfort-directed care, and the patient died later that day. Discussion Viral infections have been identified as a source of prothrombotic states due to direct injury of vascular tissue and inflammatory cascades. Severe acute respiratory syndrome coronavirus 2 appears to follow a similar pattern, with numerous institutions identifying elevated levels of thrombotic complications. We believe that healthcare providers should be aware of both venous and arterial thrombotic complications associated with coronavirus disease 2019, including possible fatal outcome.

scholarly journals Tracheo-oesophageal fistula in a patient with chronic sarcoidosis

2015 ◽  
Vol 97 (7) ◽  
pp. e100-e102 ◽  
Author(s):  
A Darr ◽  
S Mohamed ◽  
D Eaton ◽  
MS Kalkat
Keyword(s):  
Case Report ◽  
Respiratory System ◽  
Granulation Tissue ◽  
Clinical Manifestations ◽  
Unknown Aetiology ◽  
First Case ◽  
Video Fluoroscopy ◽  
Tracheal Stricture ◽  
Stent Stenosis

Sarcoidosis is a common multisystem granulomatous condition of unknown aetiology, predominantly involving the respiratory system. Tracheal stenosis has been described but we believe that we present the first case of a tracheo-oesophageal fistula secondary to chronic sarcoidosis. A 57-year-old woman with sarcoidosis, a known tracheal stricture and a Polyflex® stent in situ presented with stridor. Bronchoscopy confirmed in-stent stenosis, by exuberant granulation tissue. The stent was removed and the granulation tissue was resected accordingly. Postoperatively, the patient was noticed to have an incessant cough and video fluoroscopy raised the suspicion of a tracheo-oesophageal fistula. A repeat bronchoscopy demonstrated marked granulation tissue, accompanied by a fistulous connection with the oesophagus at the mid-lower [middle of the lower] third of the trachea. Three Polyflex® stents were sited across the entire length of the trachea. Sarcoidosis presents with varying clinical manifestations and disease progression. Tracheal involvement appears to be a rare phenomenon and usually results in stenosis. To date, there has been little or no documented literature describing the formation of a tracheo-oesophageal fistula resulting from sarcoidosis. Early reports documented the presence of sarcoidosis induced weakening in the tracheal wall, a process termed tracheal dystonia. Weaknesses are more apparent in the membranous aspect of the trachea. Despite the rare nature of such pathology, this case report highlights the need to consider the presence of a tracheo-oesophageal fistula in sarcoidosis patients presenting with repeat aspiration in the absence of an alternate pathology.

scholarly journals Case Report: Effective Treatment for Acute Chlorpyrifos Poisoning Complicated by a Non-ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 8 ◽  
Author(s):  
Changqing Ye ◽  
Qiang Zhang ◽  
Yongsheng Chao ◽  
Chun Yin
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Organophosphorus Pesticide ◽  
Coronary Intervention ◽  
Organophosphate Insecticide ◽  
St Segment Elevation ◽  
First Case ◽  
St Segment

Background: Acute myocardial infarction (AMI) is a rare complication of acute organophosphorus pesticide poisoning. Although chlorpyrifos has been widely used as an organophosphate insecticide, a few cases of AMI complicated by chlorpyrifos poisoning have been reported thus far. Hence, a suitable treatment strategy remains to be explored.Case Presentation: Based on the clinical manifestations, medical history, results of an auxiliary examination, and serum biomarkers, a 65-year-old male farmer with complaints of nausea, vomiting, chest tightness, and pain was clearly diagnosed as having a severe chlorpyrifos self-poisoning with acute non-ST-segment elevation MI. Because the patient and his family confirmedly refused a coronary intervention, conservative treatment was used instead. It should be noted that there were some conflicts of the management for chlorpyrifos poisoning and AMI. Although rapid atropinization would contribute to the relief of muscarinic symptoms, it would also lead to an increased heart rate and myocardial oxygen consumption in AMI. Furthermore, the reduction of platelet aggregation, which is necessary for coronary recanalization of an AMI patient, is known to aggravate the gastrointestinal injury caused by poisoning. In this case, these conflicts were properly addressed, which led to an excellent effect and prognosis of the patient.Conclusions: To our knowledge, this is the first case report of acute chlorpyrifos poisoning with AMI. It is emphasized that patients with chest pain or coronary heart disease should be treated with atropine more cautiously because of the possible AMI. Moreover, proper resolution of conflicts in the management for chlorpyrifos poisoning and AMI played contributing roles in patient improvement.

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