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Bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient: a case report. 一名人类免疫缺陷病毒阳性患者的双侧结核腰大肌脓肿:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-25 DOI: 10.1186/s13256-024-04769-9
A A Olasinde, J B Munihire, M Mugenyi, F T Kasereka, O Adetan, J K Bankole

Background: Worldwide, there is an increase in the frequency of reports of psoas abscesses due to advances in imaging technology, which has led to early diagnosis and treatment. A bilateral psoas abscess is rare and, when it occurs, is usually secondary and in immunocompromised patients. We present a case of a bilateral tuberculosis psoas abscess in a human immunodeficiency virus-positive patient.

Case presentation: A 21-year-old Ugandan female undergraduate who contracted human immunodeficiency virus through vertical transmission and has been on highly active antiretroviral drugs presented with bilateral lower abdominal pain with associated fever and headache. Clinical examination revealed abdominal tenderness in both iliac fossae with palpable masses. Ultrasonography revealed fluid collection in both psoas muscles confirming bilateral abscesses. The aspirate was acid-fast bacilli positive. A diagnosis of bilateral tuberculosis psoas abscess was made. Open drainage was performed and antituberculosis drugs were commenced.

Conclusions: Bilateral tuberculosis psoas abscesses occurring in human immunodeficiency virus-positive patients, although uncommon, is not unexpected. It is a form of secondary psoas abscess in immunocompromised patients. Here, the outcome was successful with a combination of early surgical drainage and appropriate medical therapy.

背景:在世界范围内,由于成像技术的进步,腰大肌脓肿的报告频率不断增加,从而实现了早期诊断和治疗。双侧腰肌脓肿很少见,即使发生,也通常是继发性的,且多发生在免疫力低下的患者身上。我们报告了一例人类免疫缺陷病毒阳性患者的双侧结核性腰大肌脓肿病例:一名 21 岁的乌干达女大学生通过垂直传播感染了人类免疫缺陷病毒,并一直服用高活性抗逆转录病毒药物,出现双侧下腹痛,伴有发热和头痛。临床检查发现双侧髂窝有腹部压痛,可触及肿块。超声波检查发现双侧腰肌有积液,证实为双侧脓肿。抽吸出的脓液呈耐酸杆菌阳性。诊断结果为双侧结核性腰肌脓肿。进行了开放引流,并开始服用抗结核药物:结论:人类免疫缺陷病毒阳性患者出现双侧结核性腰大肌脓肿虽然并不常见,但并非意料之外。这是免疫力低下患者继发腰大肌脓肿的一种形式。在本病例中,通过早期手术引流和适当的药物治疗取得了成功。
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引用次数: 0
Enterobius vermicularis (pinworm) infestation mimicking acute appendicitis in two children from Palestine: a case report. 巴勒斯坦两名儿童模仿急性阑尾炎的蛲虫感染:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-24 DOI: 10.1186/s13256-024-04785-9
Issam Jawabreh, Ahmad Amro, Kifaya Azmi, Hamza Batran, Ziad Abdeen, Omar Hamarsheh

Background: Pinworm, Enterobius vermicularis, is a common parasitic illness, particularly among children in Palestine. On rare occasions, it can cause serious consequences such as acute appendicitis, which can still present a challenging diagnosis especially in children.

Case presentation: This report describes two cases (a 9 year old male and a 11 year old female, both Palestinian children from Hebron district) of acute appendicitis referred to Queen Alia Hebron Governmental Hospital in Palestine. The clinical examination revealed a lower abdominal pain, and they were diagnosed with appendicitis. The pathological examination after appendectomy showed the presence of eggs and pinworms. Anthelminthic medication was provided, and they were followed up for 6 weeks after the operation without any incidents.

Conclusion: These cases highlight the importance of considering Enterobius vermicularis infestation in children with abdominal pain, as the parasites can mimic appendicitis. Prompt recognition and cautious laparoscopic appendectomy are crucial to prevent unnecessary surgery and peritoneal contamination, with the infestation being easily treatable with anthelmintic medication.

背景:蛲虫(Enterobius vermicularis)是一种常见的寄生虫病,在巴勒斯坦儿童中尤为常见。在极少数情况下,蛲虫病会导致严重后果,如急性阑尾炎,但这仍然是一个具有挑战性的诊断,尤其是在儿童中:本报告描述了两例转诊至巴勒斯坦阿丽雅王后希伯伦政府医院的急性阑尾炎病例(男 9 岁,女 11 岁,均为希伯伦地区的巴勒斯坦儿童)。临床检查发现他们下腹疼痛,被诊断为阑尾炎。阑尾切除术后的病理检查显示存在虫卵和蛲虫。他们接受了驱虫药治疗,术后随访 6 周,未发生任何意外:这些病例突出表明,在儿童腹痛时考虑蛲虫感染非常重要,因为寄生虫可能会诱发阑尾炎。及时发现和谨慎进行腹腔镜阑尾切除术对防止不必要的手术和腹膜污染至关重要,而且这种寄生虫感染很容易用驱虫药治疗。
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引用次数: 0
Spontaneous hepatic hemorrhage as presentation of metastasized papillary thyroid carcinoma: a case report. 甲状腺乳头状癌转移引起的自发性肝出血:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-23 DOI: 10.1186/s13256-024-04797-5
Jacob Thomasson, Bodil Andersson, Lo Hallin Thompson, Caroline Williamsson

Background: Spontaneous hepatic hemorrhage is a rare condition, most commonly diagnosed in patients with hepatocellular carcinoma or hepatic adenomas, and is seldom caused by metastatic disease. In this case report, we present a patient with spontaneous hepatic hemorrhage due to hepatic metastasis of papillary thyroid carcinoma, an exceptionally rare occurrence.

Case presentation: The patient was a 77-year-old white male with a history of atrial fibrillation treated with apixaban. He presented at a local hospital with abdominal pain and nausea. A CT scan revealed a hepatic lesion in segment 3 with an adjacent hematoma. He was referred to our tertiary center and treated conservatively. Further evaluation revealed an intrathoracic goiter containing a tumorous process diagnosed as a papillary thyroid carcinoma (PTC), and the patient subsequently underwent thyroidectomy. A biopsy of the hepatic lesion confirmed it as a PTC metastasis. Due to worsening abdominal pain and anorexia, the patient underwent subacute hepatic segmental resection. Postoperatively, he developed iodine-refractory disease with disseminated metastasis and passed away 22 months after the initial admission.

Conclusions: To our knowledge, this is the first recorded case of metastasized papillary thyroid carcinoma presenting with spontaneous hepatic hemorrhage-adding to the list of rare causes for this condition.

背景:自发性肝出血是一种罕见病,最常见于肝细胞癌或肝腺瘤患者,很少由转移性疾病引起。在本病例报告中,我们介绍了一名因甲状腺乳头状癌肝转移而导致自发性肝出血的患者,这种情况非常罕见:患者是一名 77 岁的白人男性,有心房颤动病史,曾接受阿哌沙班治疗。他因腹痛和恶心前往当地一家医院就诊。CT 扫描显示肝脏第 3 节段有病变,邻近有血肿。他被转诊到我们的三级医院,接受了保守治疗。进一步评估发现胸内甲状腺肿包含一个肿瘤过程,诊断为甲状腺乳头状癌(PTC),患者随后接受了甲状腺切除术。肝脏病变活检证实为 PTC 转移。由于腹痛和厌食症状加重,患者接受了亚急性肝段切除术。术后,他出现了碘难治性疾病,并伴有播散性转移,在入院 22 个月后去世:据我们所知,这是首例甲状腺乳头状癌转移并伴有自发性肝出血的病例,为这种罕见病因增添了新的病例。
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引用次数: 0
Colonoscopy diagnosis of recurrent abdominal pain in a 4-year-old boy with intestinal duplication cyst involving colon, appendix, and ileum: a case report. 结肠镜诊断一名 4 岁男童反复腹痛并伴有结肠、阑尾和回肠肠重复囊肿:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-23 DOI: 10.1186/s13256-024-04780-0
Faling Chen, Jiangbin Liu

Background: Intestinal duplication cyst is an infrequent congenital malformation that can involve all the segments of the gastrointestinal tract. The cases of intestinal duplication cyst involving the colon, appendix, and ileum in children are particularly uncommon. The symptoms of abdominal pain are similar to other acute abdominal diseases in children, such as appendicitis, intussusception, and intestinal obstruction, so sometimes its diagnosis is challenging and leads to misdiagnosis.

Case presentation: We report a 4-year-old Asian boy who presented to the pediatric emergency department with abdominal pain and vomiting but no fever, peritonitis, or mass. No abdominal abnormality was found via radiology and ultrasonography. After 2 days' anti-inflammatory therapy, the patient was discharged with pain relief. A total of 9 months later, he was readmitted to the pediatric emergency department for the same complaint as the first admission. Abdominal physical examination and ultrasound examination were still negative. Barium examination found a large mass in the colon. Colonoscopy was performed before operation to confirm the rare co-cavity intestinal duplication cyst involving the colon, appendix, and ileum. After resection of intestinal duplication and ileocolonic anastomosis, the patient's abdominal pain and vomiting has not recurred for 5 years postoperatively.

Conclusions: The diagnosis of intestinal duplication cyst in children is difficult, especially the rare co-cavity and long segmental intestinal duplication, which is easily misdiagnosed. Colonoscopy may be an effective auxiliary diagnostic method, especially for diseases that are difficult to diagnosed clinically, such as recurrent abdominal pain.

背景:肠重复囊肿是一种不常见的先天性畸形,可累及胃肠道的所有节段。儿童肠重复囊肿累及结肠、阑尾和回肠的病例尤其少见。腹痛的症状与阑尾炎、肠套叠和肠梗阻等其他儿童急腹症相似,因此有时其诊断具有挑战性并导致误诊:我们报告了一名 4 岁的亚洲男孩,他因腹痛和呕吐就诊于儿科急诊,但没有发烧、腹膜炎或肿块。放射科和超声波检查均未发现腹部异常。经过两天的抗炎治疗后,患者疼痛缓解出院。9 个月后,他因与第一次入院时相同的主诉再次被送入儿科急诊室。腹部体格检查和超声波检查仍为阴性。钡餐检查发现结肠内有一个大肿块。手术前进行了结肠镜检查,确认了罕见的共腔肠重复囊肿,涉及结肠、阑尾和回肠。切除肠重复囊肿并进行回结肠吻合术后,患者的腹痛和呕吐症状在术后5年未再复发:结论:儿童肠重复囊肿的诊断比较困难,尤其是罕见的同腔肠和长段肠重复,很容易被误诊。结肠镜检查可能是一种有效的辅助诊断方法,尤其适用于临床难以诊断的疾病,如反复腹痛。
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引用次数: 0
A lifesaving improvised peritoneal dialysis on a toddler with acute kidney injury following a swarm of bees' sting at Iringa Regional Referral Hospital, Southern Highland-Tanzania: a case report. 坦桑尼亚南部高原地区伊林加地区转诊医院对一名因被蜂群蜇伤而急性肾损伤的幼儿进行了简易腹膜透析,挽救了其生命:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-22 DOI: 10.1186/s13256-024-04777-9
Isaac Erasto Mlay, Haji Mwarizo Jaddi, Marco Patrick Sanga, Iddy Omary Ramadhan, Mwita Magasi Ryoki, Tatu Seif Mbotoni, Alfred Mwakalebela Laison

Background: Peritoneal dialysis as one of the nephrology services in children with acute kidney injury is a safe and cost-effective modality of treatment in low and lower-middle income countries. Despite evidence of its effectiveness in limited resource settings, the service is still provided only in tertiary level healthcare facilities in Tanzania.

Case presentation: In this case report, we narrate the survival of a 22-month-old male patient of African descent with an acute kidney injury following a swarm of bees' stings at home. A lifesaving, although low-quality and high-risk, peritoneal dialysis was performed for 5 days at Iringa Regional Referral Hospital, a secondary level health facility in rural Tanzania with lack of standard and recommended expertise, laboratory investigations, and equipment.

Conclusion: Lower- and middle-income countries in collaboration with stake holders should ensure that this service is available, accessible, and safe in the lower-level health facilities, given that access to the tertiary-level facilities is inadequate and time limited, hence serving a larger population.

背景:腹膜透析是治疗急性肾损伤患儿的肾内科服务之一,在低收入和中低收入国家是一种安全且经济有效的治疗方式。尽管有证据表明腹膜透析在资源有限的环境中非常有效,但坦桑尼亚仍只有三级医疗机构提供腹膜透析服务:在本病例报告中,我们讲述了一名 22 个月大的非洲裔男性患者在家中被成群蜜蜂蜇伤后,因急性肾损伤而存活下来的故事。伊林加地区转诊医院是坦桑尼亚农村地区的一家二级医疗机构,缺乏标准和推荐的专业知识、实验室检查和设备:结论:中低收入国家应与利益相关者合作,确保在较低级别的医疗机构也能提供这种服务,并确保这种服务的可及性和安全性,因为三级医疗机构的服务能力不足,而且时间有限,因此服务的人口更多。
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引用次数: 0
Veno-venous extracorporeal membrane oxygenation in devastating bacterial pneumonia: a case report and review of the literature. 静脉体外膜氧合治疗破坏性细菌性肺炎:病例报告和文献综述。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-22 DOI: 10.1186/s13256-024-04795-7
Štěpán Josef, Šedivý Jiří, Kuta Bohuslav, Tesařík Richard, Schaffelhoferová Dita, Petra Cihlářová, Šulda Mirek

Background: Bacterial pneumonia is one of the most common causes of acute respiratory distress syndrome. In fulminant cases, when mechanical ventilation fails, veno-venous extracorporeal membrane oxygenation is required. However, this method is still associated with significant mortality and a wide range of potential complications. However, there are now many case reports of good outcomes even in patients with prolonged extracorporeal oxygenation, as in our rather complicated case report.

Case presentation: Our case report describes a complicated but successful treatment of a severe, devastating bacterial pneumonia in a 39-year-old European polymorbid woman with a rare form of diabetes mellitus, which had been poorly compensated for a long time with limited compliance, in the context of a combined immunodeficiency that strongly influenced the course of the disease. The patient's hospitalization required a total of 30 days of veno-venous extracorporeal membrane oxygenation therapy and more than 50 days of mechanical ventilation. Numerous complications, particularly bleeding, required seven chest drains, two extracorporeal membrane oxygenation circuit changes, and one surgical revision. The patient's mental state required repeated psychiatric intervention.

Conclusion: It is possible that even the initially severely damaged lung parenchyma can develop its regenerative potential if suitable conditions are provided for this process, including a sufficiently long period of extracorporeal membrane oxygenation. We believe that this case report may also contribute to the consideration of the indications and contraindications of extracorporeal support. The authors also discuss the limitations and risks of prolonged veno-venous extracorporeal membrane oxygenation support and periprocedural anticoagulation strategies.

背景:细菌性肺炎是急性呼吸窘迫综合征最常见的病因之一。在急性病例中,当机械通气失败时,需要进行静脉体外膜肺氧合。然而,这种方法仍会导致大量死亡和多种潜在并发症。不过,现在有许多病例报告称,即使患者长期接受体外膜肺氧合治疗,也能取得良好的疗效,我们的病例报告就是一个相当复杂的病例:我们的病例报告描述了一名 39 岁的欧洲多病女性在合并免疫缺陷的情况下,因严重影响病程而长期代偿能力差、依从性有限的罕见糖尿病,在复杂但成功的情况下治疗了严重的破坏性细菌性肺炎。患者住院期间共接受了 30 天的静脉体外膜氧合治疗和 50 多天的机械通气。大量并发症,尤其是出血,需要进行七次胸腔引流、两次体外膜氧合回路更换和一次手术修正。患者的精神状态需要反复进行心理干预:结论:如果为这一过程提供合适的条件,包括足够长的体外膜氧合时间,即使最初严重受损的肺实质也有可能开发出再生潜力。我们认为,本病例报告也有助于考虑体外支持的适应症和禁忌症。作者还讨论了长时间静脉体外膜氧合支持的局限性和风险以及围术期抗凝策略。
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引用次数: 0
Surgical management for the case of scrotal myiasis in a 7-day-old neonate: a case report. 7 天大新生儿阴囊肌炎的手术治疗:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-21 DOI: 10.1186/s13256-024-04759-x
Mahmoud Khoshkhabar, Amirkamal Hardani, Ahmad Shamsizadeh, Mehran Peyvasteh, Hossein Ghaedamini

Introduction: Neonatal myiasis is a rare condition, with few reports available on the subject. Surgical management is recommended in some cases. In this study, we present the case of a 7-day-old male neonate with larvae in his scrotum who underwent surgery.

Case presentation: A full-term 7-day-old male infant (Aryan race) was referred to a children's hospital. On the sixth day after birth, three 3-4 mm long larvae crawled out from his scrotum, with the number increasing over time. He was given intravenous antibiotics and topical mupirocin to combat secondary infections. The surgical treatment involved two steps: first, the larvae were extracted, and then the infection site was washed with betadine and hydrogen peroxide to help remove any possible remaining larvae.

Conclusion: Scrotal myiasis is a rare disease that occurs in infants and requires immediate treatment. Surgical treatment is effective in removing dead or decaying larvae from a deep-seated location and washing the infection site to prevent secondary infection.

导言:新生儿肌炎是一种罕见病,相关报道很少。在某些情况下,建议采用手术治疗。在本研究中,我们介绍了一例阴囊内有幼虫并接受了手术的 7 天大男新生儿病例:病例介绍:一名出生 7 天的足月男婴(雅利安人种)被转诊到一家儿童医院。出生后第六天,他的阴囊里爬出三条 3-4 毫米长的幼虫,随着时间的推移,幼虫的数量不断增加。他接受了静脉注射抗生素和局部使用莫匹罗星以防止继发感染。手术治疗包括两个步骤:首先提取幼虫,然后用倍他丁和双氧水清洗感染部位,帮助清除可能残留的幼虫:结论:阴囊肌炎是一种发生在婴儿身上的罕见疾病,需要立即治疗。结论:阴囊肌炎是一种发生在婴儿身上的罕见疾病,需要立即治疗。手术治疗能有效清除深部的死亡或腐烂幼虫,并清洗感染部位以防止继发感染。
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引用次数: 0
Pediatric coronary cameral fistula in a structurally normal heart: a case report and review of the literature. 心脏结构正常的小儿冠状动脉瘘:病例报告和文献综述。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-20 DOI: 10.1186/s13256-024-04784-w
Hojjat Mortezaeian, Maryam Taheri, Mohsen Anafje, Zahra Esmaeili, Golnar Hassanzadeh, Pouya Ebrahimi

Introduction: Coronary cameral fistulas (CCFs) are rare congenital anomalies characterized by abnormal connections between a coronary artery and one of the cardiac chambers. These abnormal connections can lead to significant clinical implications, including heart failure and myocardial ischemia, necessitating timely diagnosis and intervention.

Case presentation: A 5-year-old Iranian boy was brought to the emergency room at Heart Hospital Center complaining of chest pain and dyspnea on exertion. He had experienced similar episodes over the past 4 months, which had not been evaluated. Physical examination revealed stable vital signs and no remarkable findings. Transthoracic echocardiography demonstrated a dilated left coronary artery with a large aneurysm and a small orifice to the right ventricular body. The left ventricular ejection fraction was 55%. Cardiac computed tomography angiography confirmed the diagnosis. Cardiac angiography showed a dilated left coronary artery and a coronary cameral fistula to the right ventricular . The aneurysm was successfully occluded using two Amplatzer™ devices.

Conclusion: This case underscores the critical role of multimodal imaging in diagnosing and managing coronary cameral fistulae. Early detection and appropriate intervention are paramount in preventing the progression of symptoms and potential complications such as heart failure and myocardial ischemia. The successful closure with Amplatzer™ devices highlights the efficacy of minimally invasive techniques in treating complex cardiovascular anomalies. Regular follow-up and careful monitoring are essential to ensure long-term success and to manage any potential recurrences.

Clinical key message: Timely identification and management of coronary cameral fistulae are crucial to prevent complications. Advances in imaging techniques and minimally invasive treatments, such as transcatheter closure, offer effective solutions. A multidisciplinary approach and regular follow-up are essential for comprehensive care and successful long-term management.

导言:冠状动脉瓣膜瘘(CCF)是一种罕见的先天性畸形,其特点是冠状动脉与心腔之一的连接异常。这些异常连接可导致严重的临床影响,包括心力衰竭和心肌缺血,因此需要及时诊断和干预:一名 5 岁的伊朗男孩被送到心脏医院中心急诊室,主诉胸痛和用力时呼吸困难。在过去的 4 个月中,他曾出现过类似的症状,但未进行过评估。体格检查显示生命体征平稳,无明显异常。经胸超声心动图显示,左冠状动脉扩张,有一个大动脉瘤,通向右心室体的开口很小。左心室射血分数为 55%。心脏计算机断层扫描血管造影确诊。心脏血管造影显示左冠状动脉扩张,右心室有冠状动脉瘘。使用两个 Amplatzer™ 装置成功堵塞了动脉瘤:本病例强调了多模态成像在诊断和治疗冠状动脉瘘中的关键作用。早期发现和适当干预对于防止症状恶化和潜在并发症(如心力衰竭和心肌缺血)至关重要。Amplatzer™ 装置的成功闭合凸显了微创技术在治疗复杂心血管畸形方面的功效。定期随访和仔细监测对确保长期成功和处理任何可能的复发至关重要:临床要旨:及时发现和治疗冠状动脉瘘对于预防并发症至关重要。成像技术和微创治疗(如经导管闭合术)的进步提供了有效的解决方案。多学科方法和定期随访对于全面护理和成功的长期管理至关重要。
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引用次数: 0
Light-chain amyloidosis with dysphagia as the main symptom: a case report. 以吞咽困难为主要症状的轻链淀粉样变性:病例报告。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-20 DOI: 10.1186/s13256-024-04774-y
Maomao Ai, Tao Lin, Ruoyu Guo, Haiyao Zheng, Haiyan Deng, Feng Yu

Background: Immunoglobulin light-chain amyloidosis is a relatively rare condition with a worldwide incidence of 5.1-12.8 cases per million person-years (Baker, 2022). It is characterized by a clonal population of immunoglobulin-secreting cells that produce a monoclonal light chain of κ or λ type as either an intact molecule or a fragment.

Case presentation: A 69-year-old East Asian (Chinese) male patient who presented with progressive dysphagia visited multiple hospitals repeatedly for more than 2 years and was finally diagnosed with immunoglobulin light-chain amyloidosis.

Conclusions: Otolaryngologists should consider immunoglobulin light-chain amyloidosis when encountering suspicious clinical manifestations and intervene early to avoid misdiagnosis.

背景:免疫球蛋白轻链淀粉样变性是一种相对罕见的疾病,全球发病率为每百万人年 5.1-12.8 例(Baker,2022 年)。它的特征是免疫球蛋白分泌细胞的克隆群体产生κ或λ型单克隆轻链,这种轻链既可以是完整的分子,也可以是片段:一位69岁的东亚(中国)男性患者因进行性吞咽困难在多家医院反复就诊2年多,最终被诊断为免疫球蛋白轻链淀粉样变性:结论:耳鼻喉科医生在遇到可疑临床表现时应考虑免疫球蛋白轻链淀粉样变性,并及早干预以避免误诊。
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引用次数: 0
Calcification following tongue necrosis induced by vasopressor use in a nonintubated patient with septic shock: a case report 一名未插管的脓毒性休克患者因使用血管加压素导致舌头坏死后出现钙化:病例报告
IF 1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-19 DOI: 10.1186/s13256-024-04796-6
So-yun Kim, Soo-Ho Kim, Hyun Seok Lee, Song-I Lee
Tongue necrosis is a rare and relatively uncommon condition, usually caused by vasculitis, thrombosis, severe hypotension due to septic or cardiogenic shock, vasopressor use, or intubation. Following damage such as necrosis, dystrophic calcification, a type of soft tissue calcification, can occur. Case presentation: Herein, we present a unique case of bilateral tongue necrosis in a patient with nonintubated septic shock. A 70-year-old East Asian man with no significant medical history presented to the emergency department with postprandial epigastric pain. The patient was admitted to the intensive care unit with hypotension due to septic shock and disseminated intravascular coagulation. After a short course of vasopressors, the patient developed tongue discoloration and swelling without limb ischemia. Computed tomography was performed to observe the tongue necrosis, and calcification of the tongue was found. The patient was successfully treated by wiping the area with a hexamidine-soaked gauze. Tongue necrosis remains a rare finding, and its occurrence as a complication of vasopressor use is even rarer. Therefore, even with relatively short courses of vasopressors in the intensive care unit, daily visualization of the tongue to check for discoloration, along with daily inspection and pulse checks of the limbs, can help identify vasospasms. These measures allow for prompt intervention, minimizing permanent damage and shortening the recovery time.
舌头坏死是一种罕见的病症,通常由血管炎、血栓形成、脓毒性或心源性休克导致的严重低血压、使用血管加压药或插管引起。在发生坏死等损伤后,可能会出现萎缩性钙化(一种软组织钙化)。病例介绍:在此,我们介绍一例独特的非插管脓毒性休克患者双侧舌头坏死的病例。一名 70 岁的东亚男子因餐后上腹痛到急诊科就诊,无明显病史。患者因脓毒性休克和弥散性血管内凝血导致低血压而被送入重症监护室。短期使用血管加压药后,患者出现舌头变色和肿胀,但没有肢体缺血。为观察舌头坏死情况,对其进行了计算机断层扫描,发现舌头钙化。患者用浸过洗必泰的纱布擦拭患处,成功治愈。舌头坏死仍然是一种罕见的发现,而作为使用血管加压药的并发症出现则更为罕见。因此,即使在重症监护室使用血管加压剂的疗程相对较短,每天观察舌头以检查是否变色,同时每天检查四肢并把脉,也有助于识别血管痉挛。这些措施有助于及时干预,最大限度地减少永久性损伤并缩短康复时间。
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引用次数: 0
期刊
Journal of Medical Case Reports
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