Clinical Case Reports最新文献

Early detection and treatment are critical for improving the prognosis of patients with leptomeningeal metastasis. However, heterogeneous clinical manifestations, non-specific imaging, and limited sensitivity of cerebrospinal fluid cytology posed challenges to identifying leptomeningeal metastasis in the early stage. Here we reported a case of lung adenocarcinoma complaining of rapid cognitive decline, whose magnetic resonance imaging showed interstitial brain edema. Under the circumstances of negative cerebrospinal fluid cytology, metagenome next-generation sequencing and copy number variations analysis were applied, which indicated leptomeningeal metastasis and was confirmed in the subsequent cytology.

This case report contributes to understanding the complexities of ameloblastoma recurrence despite meeting recommended guidelines and highlights the importance of long-term follow-up and tailored surgical approaches.

In the pediatric age group, FXIII deficiency can present as abnormal or delayed bleeding from the umbilical stump, soft tissue and subcutaneous bleeding, intracerebral hemorrhages, intraoral bleeding, and poor wound healing. This case report describes an atypical presentation of FXIII deficiency in a 3-year-old female who presented to the emergency department with complaints of abdominal pain and vomiting. She was managed conservatively under the care of the pediatric surgery team.

Vestibular syncope is a rare condition in which vertigo may cause syncopal attacks; however, the term has been associated with confusion because it has been ascribed to completely different vestibular and neurological conditions, from dizziness to Menière disease (MD), to the neurovegetative symptoms in benign paroxysmal positional vertigo (BPPV) and central vertebrobasilar hyperfusion. A 75-year-old woman with vasodepressive vasovagal syncope, confirmed by a tilt test with trinitrine administration, was referred for an audiological and vestibular assessment showing an acute unilateral peripheral vestibular deficit on the right side. The diagnosis is peripheral acute vestibular deficits. Interventions and outcomes are vestibular treatment and rehabilitation. The patient's vasovagal symptoms immediately improved and were completely resolved. Peripheral vestibular deficits might also trigger syncopal episodes and must be considered and studied by a complete audiological and vestibular evaluation. By restoring the peripheral vestibular function of the right labyrinth after vestibular treatment, a complete long-term resolution of multiple vasovagal syncopal episodes was observed together with normalization of the tilt test.

Varicella-zoster virus can be transmitted transplacentally to a fetus from symptomatic mothers developing skin lesions between 5 days before and 2 days after delivery. The diagnosis is clinical. Its management is challenging in limited-resource countries, namely Cambodia, due to the lack of varicella zoster immune globulin and intravenous acyclovir.

Cardiac hydatid cysts (CHC) are rare complications of echinococcosis, often presenting diagnostic and therapeutic challenges. We report a case of recurrent CHC in a 35-year-old male with a history of cerebral and pelvic hydatid cysts. Diagnostic imaging revealed significant cardiac involvement, necessitating surgical intervention. Postoperative management included a combination of albendazole and praziquantel, resulting in marked improvement during follow-up. This case highlights the complexities of treating recurrent CHC and suggests that combination therapy may offer benefits in managing extensive cysts. Further research is needed to refine treatment strategies for such cases.

Arteriovenous fistula is an abnormal connection between arteries and veins occurring usually following surgery, trauma, catheterization, or local procedures. Spontaneous arteriovenous fistulas are a rare clinical entity with very few cases reported in the literature with unclear mechanisms. We present a case report of a 54-year-old Ethiopian female with known chronic kidney disease on hemodialysis for 2 years thrice a week who presented with progressive pulsatile right thigh mass of 7 months duration in the absence of trauma, catheter insertion previously, or surgery. The arteriovenous fistula was confirmed by computed tomography angiography and it was intervened with open surgery with no complication.

The case report examines a rare presentation of tricuspid valve infective endocarditis (TVIE) following a septic abortion. A 31-year-old female presented with persistent high-grade fever, chills, and mild vaginal bleeding post medical termination of pregnancy. Despite initial management for septic abortion, including manual evacuation and antibiotics, her symptoms recurred, necessitating further evaluation. Diagnostic workup revealed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and echocardiographic evidence of vegetations on the tricuspid valve. Treatment included targeted intravenous antibiotics and supportive care, but due to family preference, the patient was referred for advanced management. The report underscores the importance of considering endocarditis in patients with unresolved infections post-gynecological procedures. It highlights the role of blood cultures and echocardiography in diagnosis and emphasizes prophylactic measures and sterile techniques to prevent such complications. This case exemplifies a critical need for prompt multidisciplinary interventions to mitigate morbidity associated with rare but severe sequelae of septic abortion.