Clinical Medicine Insights. Case Reports最新文献

Excessive water consumption is an extremely rare and potential asthma risk factor with very few cases reported in the literature. Common triggers of asthma include genetic factors, smoking, allergens, and viral respiratory infections. The adult patient with asthma reportedly drank too much water and was unable to get relief from his asthma while hospitalized. The patient's asthma was better controlled with the use of diuretics and control of the patient's fluid intake and output. This case explores asthma induced by excessive drinking of water.

Idiopathic granulomatous vulvitis is an uncommon anogenital area disease described in the last few decades. It causes an inflammatory reaction that culminates in swelling and possibly distortion of the female anogenital area. Many reported cases consider this non-infectious entity the genital counterpart to granulomatous cheilitis. We here present a 64 years old female patient with idiopathic granulomatous vulvitis co-existing with lipodermatosclerosis, with the excellent response of the former condition to hydroxychloroquine and potent topical steroids.

Pharyngeal tuberculosis without pulmonary involvement is very rare and may be confused with malignant lesions. We present a 45-year-old female patient with a history of HIV presenting with a history of cough, sore throat, and oral ulcers with chronic use of antibiotics. The evolution would indicate a probable malignant tumor, but the biopsy was consistent with Pharyngeal TB. The patient initiated anti-tuberculosis therapy and demonstrated improved conditions and remission of ulcers. In the context of HIV, this treatment could be a major contributor to the underdiagnosis of the disease and may lead to alternative diagnoses. Therefore, it is vital to consider this condition in patients who do not respond to antibiotics.

Background: Kartagener's syndrome, a rare autosomal recessive genetic disorder, is characterized by primary ciliary dyskinesia (PCD), resulting in defective cilia function in the respiratory tract and fallopian tubes.

Case presentation: This case report discusses a 23-year-old female with Kartagener's syndrome, bronchiectasis, and cardiac involvement, who presented with shortness of breath, cough, and syncope. Notably, she received home oxygen therapy but became exhausted, leading to loss of consciousness. Clinical examination revealed prominent heart sounds and abnormal lung findings. Laboratory results indicated leukocytosis, and an ECG confirmed dextrocardia and cardiac abnormalities. Doppler studies identified mitral and tricuspid regurgitation along with severe pulmonary arterial hypertension. Antibiotics were administered for coagulase-negative Staphylococcus infection. The patient improved with a treatment regimen, including oxygenation and nebulization. Regular follow-up and patient education were emphasized.

Conclusion: This case underscores the complexity of Kartagener's syndrome and the importance of a multidisciplinary approach in managing its respiratory and cardiac manifestations.

Infertility affects 15% of couples in reproductive age worldwide. In women in particular, infertility can be caused by various abnormalities, with polycystic ovary syndrome (PCOS) being the most common. Currently, there are many assisted reproductive techniques (ART) available to combat the burden of infertility. However, positive results are not guaranteed. The administration of inositol has been shown to increase positive reproductive outcomes in women undergoing ART. Here we present a series of clinical cases in which women with a history of infertility and previously failed ART, supplemented with a specific 3.6:1 MYO:DCI ratio, antioxidants, vitamins, and minerals for a period of 1 to 3 months before undergoing in vitro fertilization (IVF). In this series of case reports, we provide preliminary evidence that supplementation with a specific 3.6:1 MYO to DCI ratio, as well as antioxidants, vitamins, and minerals may contribute positively to female fertility in women undergoing IVF, with a history of primary or secondary infertility and previously failed ART.

Introduction: Pulmonary artery aneurysms encompass a wide range of presentations and forms. Mycotic aneurysms represent a particular subset of focal dilatation of the vessel wall with high morbidity and mortality rates. Herein, we report the case of a 32 year old patient, with a prior history of ventricular septal defect presenting with a mycotic pulmonary artery aneurysm associated with infective endocarditis and septic emboli.

Case presentation: We present the case of a 32 year old male with known history of congenital ventricular septal defect presented to the emergency department with signs of sepsis and dyspnea. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. An echocardiogram found evidence of endocarditis with multiples intra cavitary vegetations. A CT angiogram demonstrated major right ventricular dilatation, multiple nodules and peripheral opacities, scattered throughout the lungs, indicative of septic emboli. Segmental saccular dilatation of the left lateral basal pulmonary artery consistent with a mycotic aneurysm formation was found. The patient was started on intravenous antibiotics and given the overall satisfactory evolution a conservative approach was pursued. The patient was discharged with antibiotics and scheduled for surgical repair of the ventricular septal defect.

Conclusion: To our knowledge, mycotic aneurysms associated to congenital heart malformation like ventricular septal wall defect remains a rare condition with few reported cases in the literature. Being aware of this entity is important for every practicing radiologist to allow for early diagnosis and treatment.

Quadricuspid aortic valve is a very rare congenital anomaly. Its association with rheumatoid arthritis is exceptional with this being the third case reported in the literature. We report a case of a 52 year old female patient with quadricuspid aortic valve type C accompanied by moderate to severe aortic regurgitation and longstanding, advanced form of rheumatoid arthritis. Having refused surgical aortic valve intervention 4 years ago, the patient is currently under a watchful follow-up strategy. The patient received a diagnosis of rheumatoid arthritis over 15 years before and presently has serious deformities in the hands, legs, feet, and spine. In conclusion, quadricuspid aortic valve and rheumatoid arthritis together are extremely rare. While it is possible that this association is coincidental, considering the genetic background of both disorders, there is a potential for them to be interconnected comorbidities. This report is the first to highlight the association between the 2 disorders.

Pulmonary alveolar microlithiasis (PAM) is a rare genetic disorder that causes calcium phosphate microliths to form in the alveoli. Symptoms usually appear in a person's third or fourth decade of life. A definitive diagnosis does not always demand a lung biopsy but can be achieved in families with more than one member with PAM and compatible chest imaging. We present the case of a 47-year-old woman referred to us for shortness of breath. Chest imaging revealed bilateral diffuse ground-glass opacities, interlobar fissure calcification, and subpleural linear calcifications, leading to a diagnosis of PAM. Although there is no specific treatment for this condition, early diagnosis can help prevent it from progressing rapidly by avoiding exposure to risk factors.

Most individuals with ventricular septal defect survive to adulthood which allows time for other complications such as pulmonary arterial hypertension to gradually develop over a period of time. When there are other associated cardiac conditions that also contribute to the development of pulmonary hypertension such as valvular heart disease, the pulmonary hypertension may be exaggerated. Because these different etiologies of the pulmonary hypertension have different mechanisms, their coexistence can complicate patient management. We present a 26-year-old man with a large ventricular septal defect and rheumatic mitral valve disease who developed severe pulmonary hypertension that became complicated by atrial fibrillation and later sudden cardiac death.

Hirschsprung's disease is a congenital disorder characterized by the absence of nerve cells in the colon muscles, leading to difficulties in evacuating stool. This case report describes a newborn patient presenting with typical symptoms of the disease, including abdominal distension, constipation, diarrhea, and fever. The patient's initial laboratory investigations revealed anemia (Hb: 9.80 g/dL), low RBC count (3.50 million/cu mm), elevated RDW (16.70%), increased WBC count (11 000/cu mm), and raised platelet levels (891 000/µL) along with an elevated CRP (3.22). The baby received a comprehensive treatment regimen, including blood transfusion, Syp. MVBC, Enterogermina, Inj. Pan, Inj. Metro, Inj. Piptaz, Inj. Vancomycin, Calcium gluconate, and Inj. Aminoven. Following this treatment and necessary surgical intervention, the patient demonstrated significant improvement in frequent bowel movements and alleviation of other symptoms. This case highlights the importance of prompt diagnosis and multidisciplinary management for favorable outcomes in infants with Hirschsprung's disease.