International Medical Case Reports Journal最新文献

Ludwig's angina is a potentially fatal condition characterized by a rapid onset of cellulitis that bilaterally involves the submandibular, sublingual, and submental spaces. This report describes the case of a 29-year-old female who presented to us with Ludwig's angina following a tooth extraction performed by a traditional healer in Southwestern Uganda. The patient stayed home for over a week before she could seek formal treatment, and this delay led to severe infection and necrotizing fasciitis with extensive tissue necrosis. Despite multiple in-hospital interventions which included incision, drainage, and debridement, the patient succumbed to complications such as secondary lung infection, septicemia, and disseminated intravascular coagulation (DIC). This case report highlights the importance of timely medical intervention, socioeconomic barriers, and antibiotic resistance challenges.

Dopamine receptor antagonists like metoclopramide are frequently used in a variety of clinical contexts to treat gastrointestinal disorders and control nausea and vomiting. However, it is associated with a high incidence of extrapyramidal side effects (EPS) in children, including dystonic movements and torticollis. This is the instance of a 9-year-old girl who developed abnormal movements of the neck and tongue, along with torticollis, within 48 hours of receiving intravenous metoclopramide for gastroenteritis. The metoclopramide therapy was discontinued, and supportive measures, including diphenhydramine, were initiated, resulting in the resolution of symptoms. This case highlights the importance of recognizing and managing metoclopramide-induced EPS in pediatric patients.

Purpose: To report a case of partial detachment of an inverted internal limiting membrane (ILM) flap following a successful closure of a full-thickness traumatic macular hole.

Observations: A 24-year-old male patient presented with a history of a blunt trauma and a full-thickness macular hole. Visual acuity was (20/50) then deteriorated to (20/100) prior to surgery. He underwent pars plana vitrectomy with an inverted ILM flap and gas tamponade. Postoperatively, successful closure of the hole was noted with a visible hinged ILM flap observed over the retina in optical coherence tomography (OCT). Three months later, the patient presented with a complaint of a central floater. Visual acuity was (20/30) and a partially detached ILM flap was noted in the OCT.

Conclusions and importance: Inverted ILM flap might detach from the retinal surface after gas resolution and successful closure of a full-thickness macular hole.

Primary umbilical endometriosis is a rare condition in which there is endometrial glands and stroma in the umbilicus. Primary umbilical endometriosis is also called villar's nodule. This condition is a diagnostic challenge, the pathophysiology of the disease is not well defined and should be considered in all other pathologies of the umbilicus. Surgery is the treatment of choice. Here we present a case of villar's nodule in a 33-years-old multiparous woman that was successfully treated with surgery.

Background: Implantable collamer lens (ICL) could be an effective and safe treatment option for patient with keratoconus. The presence of cataract is considered a relative contraindication to the use of ICL. In this case report, we describe the outcomes of ICL implantation in an eye with keratoconus and splinter cortical cataract sparing the visual axis.

Case report: Thirty-six-year-old female patient diagnosed with keratoconus was followed in the outpatient department and sought to be independent of glasses in the right eye. Upon examination she was found to have bilateral splinter cortical cataract not involving the visual axis. She had the best spectacle corrected visual acuity of 20/30; she underwent uneventful implantation of ICL in the right eye with an uncorrected visual acuity of 20/30 post-operatively with no progression of the cataract during the follow-up period.

Conclusion: The patient achieved a stable uncorrected visual acuity of 20/30 with no cataract progression after 18 months. Splinter cataract remains stable over time, thus it should not be considered as a contraindication for the implantation of ICL in patients with keratoconus.

Background: Juvenile xanthogranuloma is a rare condition, and femoral involvement is even rarer. We report a case of juvenile xanthogranuloma affecting the femur. To the best of our knowledge, this is the first reported case of femoral juvenile xanthogranuloma in China.

Case presentation: A 19-year-old boy began experiencing swelling in various parts of his body at the age of 1 year, followed by pain in his left hip. Preoperative pathology and imaging indicated juvenile xanthogranuloma of the left femur, leading to surgical intervention. Postoperatively, the patient experienced significant relief from left hip discomfort.

Conclusion: Surgery can be an effective treatment for juvenile xanthogranuloma involving the femur.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating multifactorial illness characterized by profound fatigue persisting for more than six months, post-exertional malaise, cognitive impairments, and a range of systemic symptoms. Until now, no accepted causal treatment regimens have been available; therapeutic options include different approaches, such as alleviation of symptoms and promotion of energy conservation. In this study, we report the case of a 49-year-old female presented to our center suffering from ME/CFS for more than 15 years, characterised by a strong energy loss and neurological and systemic symptoms; previous therapies remained unsuccessful. Therefore, we decided to perform double-filtration apheresis. After comprehensive laboratory evaluation, including investigation of persistent viral infections, the patient was treated eight times with double-filtration apheresis within a period of 2 years, which resulted in a remarkable sustained clinical remission and significant improvement in her quality of life. Therefore, we conclude that double-filtration apheresis could be an effective therapeutic tool for the treatment of ME/CFS.

Imperforate hymen is a rare congenital anomaly that can cause mild to severe complications, which leads to an increase in morbidity rates. The incidence is 1:1000, and there was often a delay in diagnosis since the symptoms were not specific until it caused several complications in other organ systems. We reported a case of obstructive uropathy and constipation in an 11-year-old girl who presented with huge hematocolpos due to imperforate hymen. The main symptom was severe lower abdominal pain with a visual analogue scale of 8. This case shows the significance of a physical examination in diagnosing, increasing efficiency in terms of time and cost, and supporting an earlier diagnosis. A corrective hymenectomy, blood drainage, and hymenoplasty were performed as the definitive management. The patient was able to urinate and defecate within seven hours after surgery. The patient also had her period three weeks after surgery.

Introduction: Optic neuritis is an uncommon complication of autoimmune hypothyroidism, which is often referred to as thyroid-associated optic neuropathy (TAON).

Case report: The case features a 22-year-old Somali woman who had no previous medical conditions. She had sudden vision loss, mainly in her right eye. This was accompanied by joint discomfort, muscular weakness, headaches, and weariness. The clinical examination showed complete absence of light perception in the right eye and there was a relative afferent pupillary deficit, and the thyroid function tests indicated severe hypothyroidism with significantly high levels of thyroid-stimulating hormone (TSH) and low levels of free Triiodothyronine (T3) and Thyroxine (T4). The diagnosis of autoimmune hypothyroidism was confirmed by the presence of positive anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies. Treatment was promptly initiated with high-dose corticosteroids (methylprednisolone) and levothyroxine replacement medication. Subsequently, her field of vision and visual acuity, when corrected with the best possible lenses, showed a considerable improvement. Further assessments demonstrated the restoration of normal thyroid function and the complete remission of symptoms related to ocular neuritis, with no further instances of recurrence.

Conclusion: The present case emphasizes the crucial need of promptly identifying and handling TAON in order to achieve positive visual results. This highlights the need of taking into account autoimmune hypothyroidism as a potential cause of ocular neuritis. Additional study is necessary to clarify the exact pathophysiological pathways that link autoimmune hypothyroidism to inflammation of the optic nerve, as well as to investigate the most effective therapy strategies.

We present a patient of a 46-year-old female patient was admitted to our hospital due to chest tightness and shortness of breath that lasted for over a month. Echocardiography revealed left-ventricle diameter (anteroposterior) of 54 mm, electrocardiogram showed sinus bradycardia, and QRS duration of 90 ms. The patient experienced no chest tightness or shortness of breath, and there was a marked improvement in exercise tolerance and quality of life after cardiac contractility modulation implantation.