ABSTRACT
Introduction: Juniper Tar has been utilized in traditional folk medicine to treat various ailments. Despite its historical use, documented cases are scarce regarding the potential complications associated with Juniper Tar, some of which have been fatal.
Case Report: A 62-year-old male patient with no previous medical history presented to the emergency department complaining of confusion and respiratory distress after drinking a glass of Juniper Tar approximately four hours ago. The patient, who experienced multiple seizures and cardiac arrest at the emergency department, was discharged after an 11-day intensive care unit monitoring period.
Conclusion: We present this case to raise awareness among emergency physicians about Juniper Tar, which is widely used for various purposes in folk medicine and cosmetics but can cause poisoning due to its content of essential oils, triterpenes, and phenols. This is a case of cardiac arrest and status epilepticus associated with juniper tar poisoning.
Keywords: Juniper tar; toxicity; emergency department
{"title":"Acute Systemic Toxicity Associated with Ingestion of Juniper Tar","authors":"Yasemin ÖZDAMAR, Mehmet Cihat DEMİR","doi":"10.33706/jemcr.1374559","DOIUrl":"https://doi.org/10.33706/jemcr.1374559","url":null,"abstract":"ABSTRACT
 Introduction: Juniper Tar has been utilized in traditional folk medicine to treat various ailments. Despite its historical use, documented cases are scarce regarding the potential complications associated with Juniper Tar, some of which have been fatal.
 Case Report: A 62-year-old male patient with no previous medical history presented to the emergency department complaining of confusion and respiratory distress after drinking a glass of Juniper Tar approximately four hours ago. The patient, who experienced multiple seizures and cardiac arrest at the emergency department, was discharged after an 11-day intensive care unit monitoring period. 
 Conclusion: We present this case to raise awareness among emergency physicians about Juniper Tar, which is widely used for various purposes in folk medicine and cosmetics but can cause poisoning due to its content of essential oils, triterpenes, and phenols. This is a case of cardiac arrest and status epilepticus associated with juniper tar poisoning.
 Keywords: Juniper tar; toxicity; emergency department","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136183810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Buket BADDAL, Aysegul BOSTANCI, Tutku AKSOY, Yasemin KUCUKCİLOGLU, Kaya SÜER
Herpes simplex viruses (HSVs) belong to the Herpesviridae family. Close contact is the primary mode of transmission for both HSV-1 and HSV-2, leading to a persistent lifelong infection. HSVs are widely recognized as causative agents of viral infections affecting the central nervous system, capable of presenting as both meningitis and encephalitis. Herpes simplex virus type 1 (HSV-1) is the predominant viral cause of encephalitis, accounting for the majority of cases. Here, a rare co-infection case of meningoencephalitis, associated with HSV-1 and rickettsia is described. A 42-year-old man presenting with non-remitting headache for 6 days, fever, sweating, and muscle aches was admitted to the Emergency Department. His Weil-Felix test was positive for Proteus OX2 indicating rickettsial infection. Therapy started promptly however patient’s condition deteriorated. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, and elevated protein concentration. CSF molecular analysis was positive for HSV-1. His cranial MRI indicated cytotoxic edema and gyral enhancement at the right temporal lobe. He was administered acyclovir for 14 days during hospital stay and was successfully discharged. This case report highlights that HSV-1 meningoencephalitis can co-occur with rickettsia infection in immunocompetent individuals, and co-infection with other agents should always be considered to avoid the progression of the disease.
{"title":"A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis","authors":"Buket BADDAL, Aysegul BOSTANCI, Tutku AKSOY, Yasemin KUCUKCİLOGLU, Kaya SÜER","doi":"10.33706/jemcr.1325932","DOIUrl":"https://doi.org/10.33706/jemcr.1325932","url":null,"abstract":"Herpes simplex viruses (HSVs) belong to the Herpesviridae family. Close contact is the primary mode of transmission for both HSV-1 and HSV-2, leading to a persistent lifelong infection. HSVs are widely recognized as causative agents of viral infections affecting the central nervous system, capable of presenting as both meningitis and encephalitis. Herpes simplex virus type 1 (HSV-1) is the predominant viral cause of encephalitis, accounting for the majority of cases. Here, a rare co-infection case of meningoencephalitis, associated with HSV-1 and rickettsia is described. A 42-year-old man presenting with non-remitting headache for 6 days, fever, sweating, and muscle aches was admitted to the Emergency Department. His Weil-Felix test was positive for Proteus OX2 indicating rickettsial infection. Therapy started promptly however patient’s condition deteriorated. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, and elevated protein concentration. CSF molecular analysis was positive for HSV-1. His cranial MRI indicated cytotoxic edema and gyral enhancement at the right temporal lobe. He was administered acyclovir for 14 days during hospital stay and was successfully discharged. This case report highlights that HSV-1 meningoencephalitis can co-occur with rickettsia infection in immunocompetent individuals, and co-infection with other agents should always be considered to avoid the progression of the disease.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136183811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foreign body aspiration (FBA) is one of the leading causes of accidental death in children. Patients with severe respiratory failure and upper airway obstruction who need resuscitation due to FBA apply to emergency services. In this case report, we present a 22-month-old male patient who applied to the pediatric emergency department due to foreign body aspiration, and whose saturation value increased by providing unilateral lung ventilation by pushing the foreign body from the trachea into the bronchi during intubation for advanced airway
{"title":"LIFE-SAVING MANEUVER IN FULL AIRWAY OBSTRUCTION CAUSED BY FOREIGN BODY ASPIRATION : PUSHING THE FOREIGN BODY TO THE RIGHT MAIN BRONCHUS","authors":"Merve Çelenk, Selin Akyüz Oktay, M. A. Oktay","doi":"10.33706/jemcr.1314257","DOIUrl":"https://doi.org/10.33706/jemcr.1314257","url":null,"abstract":"Foreign body aspiration (FBA) is one of the leading causes of accidental death in children. Patients with severe respiratory failure and upper airway obstruction who need resuscitation due to FBA apply to emergency services. In this case report, we present a 22-month-old male patient who applied to the pediatric emergency department due to foreign body aspiration, and whose saturation value increased by providing unilateral lung ventilation by pushing the foreign body from the trachea into the bronchi during intubation for advanced airway","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43735539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatih Mehmet Aksoy, Erdal Yavuz, Kasım Turgut, Umut Gülaçti, İ. Aydın
A Rare Cause of Abdominal Pain: Herlyn-Werner-Wunderlich Syndrome Abstract Herlyn-Werner-Wunderlich (HWW) syndrome is a congenital urogenital syndrome. Typical features are unilateral blind-ending hemivagina with uterine didelphy and ipsilateral renal agenesis. Patients usually progress asymptomatically until menarche, and they are diagnosed with radiological imaging by applying to the hospital with these conditions such as abdominal pain, abdominal bloating, primary amenorrhea along with menarche. In this case report, it is aimed to present a patient who applied to our emergency department with abdominal pain and is diagnosed with HWW syndrome. In this case, it is emphasized that emergency physicians should regard to HWW syndrome in the differential diagnosis of abdominal pain. Keywords: Herlyn-Werner-Wunderlich, Müllerian Anomaly, Abdominal Pain Introduction Abdominal pain constitutes an important part of emergency admissions. It has been observed that 40% of these not complying with the known symptoms and concluded any clear and understandable outcome and come up with a spontaneous sight (1). It is very difficult to determine the prevalence and incidence of uterine anomalies due to the use of different classifications, diagnosis with different methods and the absence of symptoms of many anomalies. On the other hand, in all studies conducted between 1950 and 2007, it was determined as 6.7% in the general population and 7.3% in the infertile population and women with recurrent pregnancy loss, this rate varies between 3% and 25% (2). No matter how the exact factors that caused these anomalies are not clear, it has been determined in studies that ionizing radiation, infective processes and some medicine (Diethylstilbestrol (DES), Thalidomide, etc.) exposed during the genital development process causing Müllerian anomalies (3). Herlyn-Werner-Wunderlich (HWW) syndrome is among the uterine anomalies and important for early diagnosis of complications and permanency of fertility. Most of the patients consult with these complaints such as abdominal pain, abdominal mass, bloating, inability to menstruate and acute abdominal pain(4). Dysmenorrhea is the main symptom of HWW syndrome and it is usually established after puberty. The increase in pain is related to a rise in the volume of hematocolpus caused by an obstructed hemivagina. Endometriosis, inflammation, twisted cysts, and appendicitis are other differential causes of pelvic pain and these must be excluded. Although it is possible to interfere diagnoses with similar symptoms and there is not a typical examination finding, differential diagnosis can be easily made with scanning methods. Observing unilateral blind-ending hemivagina and uterus didelphy and ipsilateral renal agenesis on computed tomography (CT) or ultrasonography (USG) imaging performed on the patient is important for diagnosis(5). Making diagnosis in time makes it possible to prevent possible complications with further examin
摘要herlin - werner - wunderlich综合征(HWW)是一种先天性泌尿生殖系统综合征。典型的特征是单侧盲尾半阴道伴子宫凹陷和同侧肾发育不全。患者通常无症状进展，直到月经初潮，通过申请到医院进行影像学诊断，这些情况如腹痛，腹胀，原发性闭经伴月经初潮。在这个病例报告中，它的目的是提出一个病人申请到我们的急诊科腹痛，并被诊断为HWW综合征。在这种情况下，强调急诊医生在鉴别诊断腹痛时应考虑HWW综合征。关键词:herlin - werner - wunderlich， 勒氏异常，腹痛介绍腹痛是急诊就诊的重要组成部分。据观察，其中40%不符合已知症状，没有明确可理解的结局，出现自发性视力(1)。由于使用的分类不同，诊断方法不同，许多异常没有症状，因此很难确定子宫异常的患病率和发病率。另一方面，在1950年至2007年间进行的所有研究中，确定在一般人群中为6.7%，在不育人群和复发性流产妇女中为7.3%，这一比率在3%至25%之间变化(2)。无论导致这些异常的确切因素如何尚不清楚，研究已经确定电离辐射，感染过程和一些药物(己烯雌酚(DES)，沙利度胺，(3)。Herlyn-Werner-Wunderlich (HWW)综合征是子宫异常之一，对并发症的早期诊断和生育的永久性具有重要意义。大多数患者问诊的主诉包括腹痛、腹部肿块、腹胀、月经不来和急性腹痛(4)。痛经是HWW综合征的主要症状，通常在青春期后发病。疼痛的增加与半阴道梗阻引起的血量增加有关。子宫内膜异位症、炎症、扭曲囊肿和阑尾炎是骨盆疼痛的其他不同原因，这些必须排除。虽然有可能对类似症状进行干扰诊断，并且没有典型的检查发现，但通过扫描方法可以很容易地进行鉴别诊断。在对患者进行的计算机断层扫描(CT)或超声成像(USG)上观察单侧盲端半阴道和子宫凹陷以及同侧肾发育不全对诊断很重要(5)。及时诊断，可以根据异常情况，预防可能出现的并发症，进一步检查、治疗和手术(6)。在本病例中，我们的目的是介绍急诊医生在一名因腹痛申请急诊科的19岁女性患者中发现的HWW综合征。病例报告一名19岁女性患者因腹痛到急诊科就诊。在进入急诊服务时，观察到病人的总体健康状况良好，意识清醒。第一生命体征;血压:115/75 mmHg，饱和度:96%，心率:88次/分，发烧:36.6℃。在体检中;右腹股沟和腹下区有压痛和防御。在急诊室无法对患者进行阴道检查，但据了解，她在此声明中具有童贞。在患者的其他全身检查中未发现明显的发现。在她的背景下，我们了解到病人偶尔腹痛，但没有持续的排尿或痛经。患者事先没有向任何医疗机构提出这一投诉。通过在急诊室关闭患者的口服摄入，开始静脉补水，并要求进行必要的实验室检查。在试验结果中;b-Hcg
{"title":"A Rare Cause of Abdominal Pain: Herlyn-Werner-Wunderlich Syndrome","authors":"Fatih Mehmet Aksoy, Erdal Yavuz, Kasım Turgut, Umut Gülaçti, İ. Aydın","doi":"10.33706/jemcr.1333411","DOIUrl":"https://doi.org/10.33706/jemcr.1333411","url":null,"abstract":"A Rare Cause of Abdominal Pain: Herlyn-Werner-Wunderlich Syndrome \u0000 \u0000Abstract \u0000Herlyn-Werner-Wunderlich (HWW) syndrome is a congenital urogenital syndrome. Typical features are unilateral blind-ending hemivagina with uterine didelphy and ipsilateral renal agenesis. Patients usually progress asymptomatically until menarche, and they are diagnosed with radiological imaging by applying to the hospital with these conditions such as abdominal pain, abdominal bloating, primary amenorrhea along with menarche. In this case report, it is aimed to present a patient who applied to our emergency department with abdominal pain and is diagnosed with HWW syndrome. In this case, it is emphasized that emergency physicians should regard to HWW syndrome in the differential diagnosis of abdominal pain. \u0000Keywords: Herlyn-Werner-Wunderlich, Müllerian Anomaly, Abdominal Pain \u0000 \u0000Introduction \u0000Abdominal pain constitutes an important part of emergency admissions. It has been observed that 40% of these not complying with the known symptoms and concluded any clear and understandable outcome and come up with a spontaneous sight (1). It is very difficult to determine the prevalence and incidence of uterine anomalies due to the use of different classifications, diagnosis with different methods and the absence of symptoms of many anomalies. On the other hand, in all studies conducted between 1950 and 2007, it was determined as 6.7% in the general population and 7.3% in the infertile population and women with recurrent pregnancy loss, this rate varies between 3% and 25% (2). No matter how the exact factors that caused these anomalies are not clear, it has been determined in studies that ionizing radiation, infective processes and some medicine (Diethylstilbestrol (DES), Thalidomide, etc.) exposed during the genital development process causing Müllerian anomalies (3). \u0000Herlyn-Werner-Wunderlich (HWW) syndrome is among the uterine anomalies and important for early diagnosis of complications and permanency of fertility. Most of the patients consult with these complaints such as abdominal pain, abdominal mass, bloating, inability to menstruate and acute abdominal pain(4). Dysmenorrhea is the main symptom of HWW syndrome and it is usually established after puberty. The increase in pain is related to a rise in the volume of hematocolpus caused by an obstructed hemivagina. Endometriosis, inflammation, twisted cysts, and appendicitis are other differential causes of pelvic pain and these must be excluded. Although it is possible to interfere diagnoses with similar symptoms and there is not a typical examination finding, differential diagnosis can be easily made with scanning methods. Observing unilateral blind-ending hemivagina and uterus didelphy and ipsilateral renal agenesis on computed tomography (CT) or ultrasonography (USG) imaging performed on the patient is important for diagnosis(5). Making diagnosis in time makes it possible to prevent possible complications with further examin","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46899965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Loxosceles is a genus of spiders belongs to the family Sicariidae, known as recluse spiders. These spiders are considered venomous and are distinguished by three pairs of eyes, arranged in triangular pattern. In Jordan, only Loxosceles rufescens was recorded. Case Report: A 75-year-old female with history of hypertension was bitten by a recluse spider. The case developed cellulitis and secondary infection at the site of the bite. The patient showed no response to the treatment with antibiotics either at home or in the emergency department. She was admitted as an inpatient and given Tinam (Cephalosporin / 4th generation). The patient left the hospital after improvement of the symptoms on day 14. Conclusion: Bite of Loxosceles spider cause serious poisoning and lead to severe skin infection that needs hospitalization.
{"title":"Recluse Spider Bite (Loxosceles sp.): A case report from Jordan","authors":"H. AL-TALAFHA, Ishraq Abudarweesh, Z. Amr","doi":"10.33706/jemcr.1293334","DOIUrl":"https://doi.org/10.33706/jemcr.1293334","url":null,"abstract":"Introduction: Loxosceles is a genus of spiders belongs to the family Sicariidae, known as recluse spiders. These spiders are considered venomous and are distinguished by three pairs of eyes, arranged in triangular pattern. In Jordan, only Loxosceles rufescens was recorded. \u0000Case Report: A 75-year-old female with history of hypertension was bitten by a recluse spider. The case developed cellulitis and secondary infection at the site of the bite. The patient showed no response to the treatment with antibiotics either at home or in the emergency department. She was admitted as an inpatient and given Tinam (Cephalosporin / 4th generation). The patient left the hospital after improvement of the symptoms on day 14. \u0000Conclusion: Bite of Loxosceles spider cause serious poisoning and lead to severe skin infection that needs hospitalization.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44972678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ezgi Çay, İkbal Türker, F. Ekinci, S. Bilen, Ozden OZGUR HOROZ, H. Yılmaz, D. Yıldızdaş
Pregabalin is a drug used to treat neuropathic pain, epilepsy, and fibromyalgia. However, the number of reported cases of pregabalin abuse is steadily growing. This case showed dystonia, an effect not previously documented as a consequence of pregabalin administration. A 16-year-old male patient with no known pre-existing medical conditions was admitted to the pediatric emergency department for the first time, complaining of drowsiness caused by pregabalin abuse. During the patient's follow-up, dystonia was observed, and biperiden was administered at a repeating dose. Subsequently, he was moved to the pediatric intensive care unit (PICU) for further tests and treatment. After three days of follow-up, the patient was discharged due to the absence of complaints. This case report presents dystonia resulting from pregabalin abuse, a condition that has not previously been documented in the literature.
{"title":"Acute Dystonia Due to Pregabalin Abuse in an Adolescent","authors":"Ezgi Çay, İkbal Türker, F. Ekinci, S. Bilen, Ozden OZGUR HOROZ, H. Yılmaz, D. Yıldızdaş","doi":"10.33706/jemcr.1252728","DOIUrl":"https://doi.org/10.33706/jemcr.1252728","url":null,"abstract":"Pregabalin is a drug used to treat neuropathic pain, epilepsy, and fibromyalgia. However, the number of reported cases of pregabalin abuse is steadily growing. This case showed dystonia, an effect not previously documented as a consequence of pregabalin administration. \u0000 A 16-year-old male patient with no known pre-existing medical conditions was admitted to the pediatric emergency department for the first time, complaining of drowsiness caused by pregabalin abuse. During the patient's follow-up, dystonia was observed, and biperiden was administered at a repeating dose. Subsequently, he was moved to the pediatric intensive care unit (PICU) for further tests and treatment. After three days of follow-up, the patient was discharged due to the absence of complaints. \u0000This case report presents dystonia resulting from pregabalin abuse, a condition that has not previously been documented in the literature.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43822572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Herpes simplex virus type-2 (HSV-2) associated aseptic meningitis is rarely seen in healthy individuals. Herein, we report a rare case of meningitis, associated with HSV-2, without the presence of genital lesions. A healthy, 40-year-old female was presented to the emergency service with unremitting headache, vomiting and nausea. Her cerebrospinal fluid (CSF) revealed elevated protein level of 308,2 mg/dL, high leukocyte cell count of 1,118,000 cells/µL with 98% lymphocytes and 2% polymorphonuclear neutrophils (PMNs). The bacterial culture and gram staining of CSF were negative. Real-time quantitative polymerase chain reaction (RT-qPCR) CSF analysis indicated the presence of HSV-2. The cranial MRI revealed meningeal contrast enhancement. The patient was administered acyclovir for 10 days during her hospital stay and she was discharged without any neurological sequela. The patient has a history of herpes infection. This case report shows that HSV-2 meningitis can occur in immunocompetent individuals via re-activation and should always be considered by the clinicians even in the absence of genital lesions.
{"title":"HSV-2 associated meningitis case: a challenging diagnosis in an immunocompetent woman","authors":"B. Baddal, A. Bostanci, Kaya Süer","doi":"10.33706/jemcr.1278277","DOIUrl":"https://doi.org/10.33706/jemcr.1278277","url":null,"abstract":"Herpes simplex virus type-2 (HSV-2) associated aseptic meningitis is rarely seen in healthy individuals. Herein, we report a rare case of meningitis, associated with HSV-2, without the presence of genital lesions. A healthy, 40-year-old female was presented to the emergency service with unremitting headache, vomiting and nausea. Her cerebrospinal fluid (CSF) revealed elevated protein level of 308,2 mg/dL, high leukocyte cell count of 1,118,000 cells/µL with 98% lymphocytes and 2% polymorphonuclear neutrophils (PMNs). The bacterial culture and gram staining of CSF were negative. Real-time quantitative polymerase chain reaction (RT-qPCR) CSF analysis indicated the presence of HSV-2. The cranial MRI revealed meningeal contrast enhancement. The patient was administered acyclovir for 10 days during her hospital stay and she was discharged without any neurological sequela. The patient has a history of herpes infection. This case report shows that HSV-2 meningitis can occur in immunocompetent individuals via re-activation and should always be considered by the clinicians even in the absence of genital lesions.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43023560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Ectopic pregnancy is a serious condition in which the gestational sac settles outside the uterine cavity. Here we aim to present a case that underwent unilateral salpingectomy due to ectopic pregnancy five years ago and developed an ectopic pregnancy again in the remnant site of the same tube. Although tubal stump ectopic pregnancy is rarely seen in the literature, maternal mortality and morbidity rates are higher than for other tubal ectopic pregnancies. A woman's history of salpingectomy does not rule out ipsilateral recurrent ectopic pregnancy. This is also the first stump tubal ectopic pregnancy case presented from Turkey. Introduction: Ectopic pregnancy, which occurs in 1-2% of all pregnancies, is a leading cause of first-trimester maternal mortality. The incidence of ectopic pregnancy has increased due to factors such as maternal age, pelvic inflammatory disease, and assisted reproductive technology practices. Ipsilateral ectopic pregnancy in the tubal stump after salpingectomy is extremely rare and can cause diagnostic delay and life-threatening intraabdominal bleeding. Case Report: A 26-year-old patient with a history of laparoscopic right salpingectomy due to a ruptured right tubal ectopic pregnancy experienced another ectopic pregnancy in the remaining tube. Emergency laparotomy was performed due to hemorrhagic shock and suspected ruptured ectopic pregnancy. The ectopic pregnancy focus was excised, and the patient was discharged after three days without complications. Conclusion: Recurrent ectopic pregnancy in the remaining tubal stump after salpingectomy can have significant clinical consequences. Diagnosis is difficult, so clinicians should be vigilant, especially during early pregnancy in patients with a history of salpingectomy. Partial salpingectomy is not recommended for women of reproductive age, and all possible precautions should be taken to avoid delay in diagnosing tubal stump ectopic pregnancy and preventing its occurrence. References 1. Saraiya M, Berg CJ, Shulman H, Green CA, Atrash HK. Estimates of the annual number of clinically recognized pregnancies in the United States, 1981-1991. American journal of epidemiology. 1999;149(11):1025-9. 2. Ko PC, Liang CC, Lo TS, Huang HY. Six cases of tubal stump pregnancy: complication of assisted reproductive technology? Fertility and sterility. 2011;95(7):2432.e1-4. 3. Perkins KM, Boulet SL, Kissin DM, Jamieson DJ. Risk of ectopic pregnancy associated with assisted reproductive technology in the United States, 2001-2011. Obstetrics and gynecology. 2015;125(1):70-8. 4. Sun F, Yang S, Yang Y, Liu X, Xu H. Laparoscopic Management of 42 Cases of Tubal Stump Pregnancy and Postoperative Reproductive Outcomes. Journal of minimally invasive gynecology. 2020;27(3):618-24. 5. Samiei-Sarir B, Diehm C. Recurrent ectopic pregnancy in the tubal remnant after salpingectomy. Case reports in obstetrics and gynecology. 2013;2013:753269. 6. Sturlese E, Retto G, Palmara V,
摘要:宫外孕是一种严重的妊娠情况，妊娠囊沉淀在子宫腔外。在这里，我们的目的是提出一个病例，五年前，由于异位妊娠接受单侧输卵管切除术，并在同一输卵管的残余部位再次发生异位妊娠。虽然输卵管残端异位妊娠在文献中很少见，但产妇死亡率和发病率高于其他输卵管异位妊娠。妇女输卵管切除术的历史不能排除同侧复发异位妊娠。这也是土耳其首例残端输卵管异位妊娠病例。引言:宫外孕发生在所有妊娠的1-2%，是妊娠早期产妇死亡的主要原因。由于产妇年龄、盆腔炎和辅助生殖技术等因素，异位妊娠的发生率增加。输卵管切除术后同侧异位妊娠在输卵管残端是极其罕见的，可导致诊断延误和危及生命的腹腔出血。病例报告:一位26岁的患者因右侧输卵管异位妊娠破裂而行腹腔镜右侧输卵管切除术，剩余输卵管再次发生异位妊娠。因失血性休克及疑似异位妊娠破裂，急诊剖腹手术。切除异位妊娠病灶，3天后出院，无并发症。结论:输卵管切除术后输卵管残端复发异位妊娠具有重要的临床意义。诊断是困难的，因此临床医生应保持警惕，特别是在怀孕早期的患者有输卵管切除术的历史。育龄妇女不建议行部分输卵管切除术，应采取一切可能的预防措施，避免延误输卵管残端异位妊娠的诊断和预防其发生。引用1。Saraiya M, Berg CJ, Shulman H, Green CA, Atrash HK。1981-1991年美国每年临床确认的怀孕人数的估计。美国流行病学杂志。1999年,149(11):1025 - 9。2. 柯永平，梁春春，罗少生，黄海燕。输卵管残端妊娠6例:辅助生殖技术的并发症?生育和不育。2011, 95 (7): 2432. e1-4。3.Perkins KM, Boulet SL, Kissin DM, Jamieson DJ。2001-2011年美国辅助生殖技术相关异位妊娠风险分析产科和妇科。2015年,125(1):70 - 8。4. 孙峰，杨松，杨艳，刘霞，徐华。输卵管残端妊娠42例腹腔镜治疗及术后生殖结局[j]。微创妇科杂志。2020; 27(3): 618 - 24。5. 王晓明，王晓明。输卵管切除术后输卵管残端复发性异位妊娠。产科和妇科病例报告。2013; 2013:753269。6. Sturlese E, Retto G, Palmara V, De Dominici R, Lo Re C, Santoro G.胆囊畸胎瘤切除术后输卵管残端异位妊娠。妇产科档案。2009年,280(6):1015 - 7。7. Takeda A, Manabe S, Mitsui T, Nakamura H.同侧附件切除术后残余管的峡部发生自发性异位妊娠:2例报告。妇产科学研究杂志。2006年,32(2):190 - 4。8. 张丽娟，张丽娟。同侧输卵管部分切除术后复发性异位妊娠。新加坡医学杂志。2005; 46(9): 476 - 8。9. Milingos DS, Black M, Bain C.手术治疗同侧自发性异位妊娠3例。产科和妇科。2008;11(2):458- 459。10. 刘少华，杜兰迪。间质性异位妊娠的保守内外科治疗。生育和不育。72(2): 207 - 1999; 15。11. 王晓明，王晓明，王晓明，等。腹腔镜下治疗异位妊娠的临床研究进展。微创妇科杂志。2017; 24(1): 8 - 9。12. 钱文华，梁春杰。腹腔镜输卵管切除术后输卵管残端重复异位妊娠。2(4): 311 - 2005; 2。13. Nishida M, Miyamoto Y, Kawano Y, Takebayashi K, Narahara H.输卵管切除术后输卵管残端妊娠腹腔镜手术成功一例。临床医学见解病例报告。2015; 4节。14. 高美，朱华，郑飞。同侧输卵管切除术后间质性妊娠46例分析并文献复习。微创妇科杂志。2020; 27(3): 613 - 7。15. 腹腔镜输卵管凝固后输卵管内瘘(“输卵管内母细胞病”)是异位妊娠的一个病因因素。美国妇产科杂志。1982年,143(1):12 - 24。
{"title":"Tubal Stump Ectopic Pregnancy with Acute Abdomen: A Rare Case Report","authors":"Cenk Soysal, Ö. Erten","doi":"10.33706/jemcr.1289226","DOIUrl":"https://doi.org/10.33706/jemcr.1289226","url":null,"abstract":"Abstract: Ectopic pregnancy is a serious condition in which the gestational sac settles outside the uterine cavity. Here we aim to present a case that underwent unilateral salpingectomy due to ectopic pregnancy five years ago and developed an ectopic pregnancy again in the remnant site of the same tube. Although tubal stump ectopic pregnancy is rarely seen in the literature, maternal mortality and morbidity rates are higher than for other tubal ectopic pregnancies. A woman's history of salpingectomy does not rule out ipsilateral recurrent ectopic pregnancy. This is also the first stump tubal ectopic pregnancy case presented from Turkey. \u0000 \u0000 \u0000Introduction: Ectopic pregnancy, which occurs in 1-2% of all pregnancies, is a leading cause of first-trimester maternal mortality. The incidence of ectopic pregnancy has increased due to factors such as maternal age, pelvic inflammatory disease, and assisted reproductive technology practices. Ipsilateral ectopic pregnancy in the tubal stump after salpingectomy is extremely rare and can cause diagnostic delay and life-threatening intraabdominal bleeding. \u0000 \u0000Case Report: A 26-year-old patient with a history of laparoscopic right salpingectomy due to a ruptured right tubal ectopic pregnancy experienced another ectopic pregnancy in the remaining tube. Emergency laparotomy was performed due to hemorrhagic shock and suspected ruptured ectopic pregnancy. The ectopic pregnancy focus was excised, and the patient was discharged after three days without complications. \u0000 \u0000Conclusion: Recurrent ectopic pregnancy in the remaining tubal stump after salpingectomy can have significant clinical consequences. Diagnosis is difficult, so clinicians should be vigilant, especially during early pregnancy in patients with a history of salpingectomy. Partial salpingectomy is not recommended for women of reproductive age, and all possible precautions should be taken to avoid delay in diagnosing tubal stump ectopic pregnancy and preventing its occurrence. \u0000 \u0000References \u00001. Saraiya M, Berg CJ, Shulman H, Green CA, Atrash HK. Estimates of the annual number of clinically recognized pregnancies in the United States, 1981-1991. American journal of epidemiology. 1999;149(11):1025-9. \u00002. Ko PC, Liang CC, Lo TS, Huang HY. Six cases of tubal stump pregnancy: complication of assisted reproductive technology? Fertility and sterility. 2011;95(7):2432.e1-4. \u00003. Perkins KM, Boulet SL, Kissin DM, Jamieson DJ. Risk of ectopic pregnancy associated with assisted reproductive technology in the United States, 2001-2011. Obstetrics and gynecology. 2015;125(1):70-8. \u00004. Sun F, Yang S, Yang Y, Liu X, Xu H. Laparoscopic Management of 42 Cases of Tubal Stump Pregnancy and Postoperative Reproductive Outcomes. Journal of minimally invasive gynecology. 2020;27(3):618-24. \u00005. Samiei-Sarir B, Diehm C. Recurrent ectopic pregnancy in the tubal remnant after salpingectomy. Case reports in obstetrics and gynecology. 2013;2013:753269. \u00006. Sturlese E, Retto G, Palmara V,","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44949100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orçun Barkay, F. Karakeçili, U. Binay, Betül Sümer
Introduction: Brucellosis and Crimean-Congo Hemorrhagic Fever (CCHF) are diseases that can present with similar clinical and laboratory findings to those of COVID-19, leading to misdiagnosis or confusion by visiting multiple departments. This can delay diagnosis and increase the risk of nosocomial transmission in the case of CCHF. Although misdiagnosis of Brucellosis and CCHF, and even a case of coinfection have been reported in the literature, no case report mentioning CCHF and Brucellosis coinfection hospitalized with the pre-diagnosis of COVID-19 was found. Case Report: A 35-year-old female patient presented to the emergency service with complaints of fever and fatigue. The patient was evaluated in the emergency triage and was taken to the area where COVID-19 pre-diagnosed patients were being examined. A thorax computed tomography (CT) without intravenous contrast usage was reported as normal, and the patient was discharged after being informed about COVID-19 transmission routes. The patient re-applied to the emergency service with complaints of fever, fatigue, headache, and myalgia four days later. The laboratory findings showed a white-cell count of 1600/mm³, haemoglobin of 12.8 g/liter, platelet of 146000/mm³, urea of 21.5 mg/dl, creatinine of 0.81 mg/dl, alanine aminotransferase (ALT) of 134 U/liter, aspartate aminotransferase (AST) of 303 U/liter, lactate dehydrogenase (LDH) of 714 U/liter, creatine kinase (CK) of 1796 U/liter, C-reactive protein (CRP) of 3 mg/liter, D-dimer of 2000 µg/liter, and a thorax CT showed minimal ground-glass opacity. The patient was hospitalized with a preliminary diagnosis of COVID-19 by the chest diseases clinic. Conclusion: A patient with Brucellosis and CCHF coinfection was hospitalized with a preliminary diagnosis of COVID-19. This case highlights the importance of considering other diseases with similar clinical and laboratory findings in endemic regions of Brucellosis and CCHF to avoid misdiagnosis and delay in treatment. Early diagnosis and appropriate management are crucial for improving patient outcomes and preventing nosocomial transmission. References: 1. Zhu J, Ji P, Pang J, et al. (2020), Clinical characteristics of 3,062 COVID‐19 patients: a meta‐analysis. J Med Virol. Accepted Author Manuscript. doi:10.1002/jmv.25884 2. Özer S, Oltan N, Gencer S. Bruselloz: 33 olgunun değerlendirilmesi. Klimik Derg 1998; 11(3): 82-4. 3. Karakecili F, Cikman A, Aydin M, et al. Evaluation of epidemiological, clinical, and laboratory characteristics and mortality rate of patients with Crimean-Congo hemorrhagic fever in the North east region of Turkey. J Vector Borne Dis 2018;55:215-221. 4. Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 6th ed. Churchill Livingstone, Philadelphia, 2005:2669-74. 5. Almış H, Yakıncı C. A case of brucellosis misdiagnosed as Crimean-Congo hemorrhagic fever. Mikrobiyol Bul 2012;4
{"title":"Significance of Diffferential Diagnosis for Febrile and Fatigued Patients in an Endemic Area During The COVID-19 Pandemic: Consideration of COVID-19, Brucellosis, and Crimean-Congo Hemorrhagic Fever","authors":"Orçun Barkay, F. Karakeçili, U. Binay, Betül Sümer","doi":"10.33706/jemcr.1258769","DOIUrl":"https://doi.org/10.33706/jemcr.1258769","url":null,"abstract":"Introduction: Brucellosis and Crimean-Congo Hemorrhagic Fever (CCHF) are diseases that can present with similar clinical and laboratory findings to those of COVID-19, leading to misdiagnosis or confusion by visiting multiple departments. This can delay diagnosis and increase the risk of nosocomial transmission in the case of CCHF. Although misdiagnosis of Brucellosis and CCHF, and even a case of coinfection have been reported in the literature, no case report mentioning CCHF and Brucellosis coinfection hospitalized with the pre-diagnosis of COVID-19 was found. \u0000Case Report: A 35-year-old female patient presented to the emergency service with complaints of fever and fatigue. The patient was evaluated in the emergency triage and was taken to the area where COVID-19 pre-diagnosed patients were being examined. A thorax computed tomography (CT) without intravenous contrast usage was reported as normal, and the patient was discharged after being informed about COVID-19 transmission routes. The patient re-applied to the emergency service with complaints of fever, fatigue, headache, and myalgia four days later. The laboratory findings showed a white-cell count of 1600/mm³, haemoglobin of 12.8 g/liter, platelet of 146000/mm³, urea of 21.5 mg/dl, creatinine of 0.81 mg/dl, alanine aminotransferase (ALT) of 134 U/liter, aspartate aminotransferase (AST) of 303 U/liter, lactate dehydrogenase (LDH) of 714 U/liter, creatine kinase (CK) of 1796 U/liter, C-reactive protein (CRP) of 3 mg/liter, D-dimer of 2000 µg/liter, and a thorax CT showed minimal ground-glass opacity. The patient was hospitalized with a preliminary diagnosis of COVID-19 by the chest diseases clinic. \u0000Conclusion: A patient with Brucellosis and CCHF coinfection was hospitalized with a preliminary diagnosis of COVID-19. This case highlights the importance of considering other diseases with similar clinical and laboratory findings in endemic regions of Brucellosis and CCHF to avoid misdiagnosis and delay in treatment. Early diagnosis and appropriate management are crucial for improving patient outcomes and preventing nosocomial transmission. \u0000References: \u00001. Zhu J, Ji P, Pang J, et al. (2020), Clinical characteristics of 3,062 COVID‐19 patients: a meta‐analysis. J Med Virol. Accepted Author Manuscript. doi:10.1002/jmv.25884 \u00002. Özer S, Oltan N, Gencer S. Bruselloz: 33 olgunun değerlendirilmesi. Klimik Derg 1998; 11(3): 82-4. \u00003. Karakecili F, Cikman A, Aydin M, et al. Evaluation of epidemiological, clinical, and laboratory characteristics and mortality rate of patients with Crimean-Congo hemorrhagic fever in the North east region of Turkey. J Vector Borne Dis 2018;55:215-221. \u00004. Young EJ. Brucella species. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 6th ed. Churchill Livingstone, Philadelphia, 2005:2669-74. \u00005. Almış H, Yakıncı C. A case of brucellosis misdiagnosed as Crimean-Congo hemorrhagic fever. Mikrobiyol Bul 2012;4","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42876169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract; Coronary artery anomalies are uncommon cardiac diseases. It is mostly detected incidentally in the adult population as well as being usually asymptomatic. Although its prevalence is low, its association with atherosclerosis, arrhythmias, and hypertrophic cardiomyopathy is important for sudden cardiac death. According to the literature, the association of hypertrophic cardiomyopathy with the coronary anomaly is rare. No case of hypertrophic cardiomyopathy accompanied by the absence of the left anterior descending artery has been reported. Therefore our case is special and valuable.
{"title":"RARE CASE OF CORONARY ANOMALY, OVERVIEW OF HYPERTROPHIC CARDIOMYOPATHY WITH A DIFFERENT PRESENTATION","authors":"İrem Oktay, Serhat Kesri̇kli̇oğlu, A. Soylu","doi":"10.33706/jemcr.1268972","DOIUrl":"https://doi.org/10.33706/jemcr.1268972","url":null,"abstract":"Abstract; \u0000Coronary artery anomalies are uncommon cardiac diseases. It is mostly detected incidentally in the adult population as well as being usually asymptomatic. Although its prevalence is low, its association with atherosclerosis, arrhythmias, and hypertrophic cardiomyopathy is important for sudden cardiac death. According to the literature, the association of hypertrophic cardiomyopathy with the coronary anomaly is rare. No case of hypertrophic cardiomyopathy accompanied by the absence of the left anterior descending artery has been reported. Therefore our case is special and valuable.","PeriodicalId":41189,"journal":{"name":"Journal of Emergency Medicine Case Reports","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48818251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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