{"title":"Surgical Treatment of Small Intestinal Bleeding Caused by Arterial Gastrointestinal Fistula: A 2-Case Report","authors":"Maieryemu Sulaiman, Sakarie Mustafe Hidig, Jie Yang, Tianshan Wu, Xiaokaiti Yibulayin","doi":"10.4236/crcm.2023.124011","DOIUrl":"https://doi.org/10.4236/crcm.2023.124011","url":null,"abstract":"","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74152758","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.128039
K. S. Dembélé, K. Mallé, Issiaka Diarra, Mahamadou Keita, Amara Dembele, Mamadou Diallo, Karifala Haidara, M. Coulibaly, Moussa Abdoulaye Diarra, Sadio Camara, S. Konaté, D. Fomba, Djibrilah Kanthé, D. Cissé, Ousmane Abdoul Aziz Dicko
{"title":"Strangulation of the Penis by a Ring in Children: About a Case","authors":"K. S. Dembélé, K. Mallé, Issiaka Diarra, Mahamadou Keita, Amara Dembele, Mamadou Diallo, Karifala Haidara, M. Coulibaly, Moussa Abdoulaye Diarra, Sadio Camara, S. Konaté, D. Fomba, Djibrilah Kanthé, D. Cissé, Ousmane Abdoul Aziz Dicko","doi":"10.4236/crcm.2023.128039","DOIUrl":"https://doi.org/10.4236/crcm.2023.128039","url":null,"abstract":"","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88776062","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.126027
Bu Youn Cho, M. Munksdorf, M. Rose
{"title":"Dermatofibrosarcoma Protuberans—An Atypical Breast Tumor","authors":"Bu Youn Cho, M. Munksdorf, M. Rose","doi":"10.4236/crcm.2023.126027","DOIUrl":"https://doi.org/10.4236/crcm.2023.126027","url":null,"abstract":"","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91463636","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.128038
Daouda Thioub, Viviane Marie Pierre Cisse-Diallo, apa Latyr Junior Diouf, Ndeye Aissatou Lakhe, Agbogbenkou TeviDéla-dem Lawson, Aboubakar Sidikh Badiane, Ndeye Maguette Fall, Khardiata Diallo-Mbaye, Daye Ka, Sylvie Audrey Diop, Moussa Seydi
Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form in 32.7%. The lethality rate was 21.8%; higher in women (46.2% vs 14.3%; p = 0.01), in patients with a delay in consultation > 1 month (p = 0.03), and in patients who presented with consciousness disorders (p = 0.007). Conclusion: Despite the availability of the GeneXpert MTB/RIF, diagnosis of NMT remains difficult. Because of its variable clinical expression and the low sensitivity of the GeneXpert MTB/rif in the CSF, it exposes patients to serious complications. Among the factors associated with death, we found consciousness disorders, a long delay in diagnosis.
{"title":"Neuro-meningeal Tuberculosis in Adult Senegalese Patients: Profile and Outcome of Cases Diagnosed at a Referral Service, from 2015 to 2020","authors":"Daouda Thioub, Viviane Marie Pierre Cisse-Diallo, apa Latyr Junior Diouf, Ndeye Aissatou Lakhe, Agbogbenkou TeviDéla-dem Lawson, Aboubakar Sidikh Badiane, Ndeye Maguette Fall, Khardiata Diallo-Mbaye, Daye Ka, Sylvie Audrey Diop, Moussa Seydi","doi":"10.4236/crcm.2023.128038","DOIUrl":"https://doi.org/10.4236/crcm.2023.128038","url":null,"abstract":"Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16 - 77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%). Meningeal signs were present in 94.55% of patients, and consciousness disorders and intracranial hypertension were present in 63.64% and 56.36% respectively. Nerve palsy was found in 38.18%. CSF was clear in 81.64%. GeneXpert MTB/RIF in CSF was performed in 33 patients and was positive in 4 patients. Brain CT was abnormal in 72.09% of cases. Tuberculoma, hydrocephalus and meningeal contrast enhancement were the main lesions. The neuro-meningeal localization was associated with a pulmonary form in 32.7%. The lethality rate was 21.8%; higher in women (46.2% vs 14.3%; p = 0.01), in patients with a delay in consultation > 1 month (p = 0.03), and in patients who presented with consciousness disorders (p = 0.007). Conclusion: Despite the availability of the GeneXpert MTB/RIF, diagnosis of NMT remains difficult. Because of its variable clinical expression and the low sensitivity of the GeneXpert MTB/rif in the CSF, it exposes patients to serious complications. Among the factors associated with death, we found consciousness disorders, a long delay in diagnosis.","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135828096","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.1210051
Farhan Murtaza, Samana Haider, Amna Amin, Aroosa Zahid, Atiq Ur Rehman
Background: Involvement of lumbar spinal nerve root, revealed as pain, numbness or weakness in the lower limbs. Typically caused by the compression of nerve at the spine level. Objective: The purpose of the study was to examine the patients with clinically presumed lumbar radiculopathy and find the correlation between their electrodiagnostic study and magnetic resonance imaging. Setting, duration and study type: Retrospective cross-sectional study of one year (January 2019 - February 2020) in Shifa International Hospital Islamabad. Methods: A total of 96 patients with clinically suspected lumbar radiculopathy were included. Chi-square test, international business machines (IBM) SPSS rendition 21.0 was applied on the clinical information, electrodiagnostic study and MRI were coordinated and affectability and particularity were judged. Selected patients were undergone both electrodiagnostic study and magnetic imaging resonance in the selected 1-year span. The study investigated correlation between both diagnostic tools in lumbar radiculopathy patients. Expected outcomes: Anatomical specificity in seen through magnetic resonance imaging while physiological through electrodiagnostic study, which may not correlate in the evaluation of lumbar radiculopathy.
{"title":"Correlation between Electrodiagnostic Study and Magnetic Resonance Imaging in Lumbar Radiculopathy Patients in a Tertiary Care Hospital","authors":"Farhan Murtaza, Samana Haider, Amna Amin, Aroosa Zahid, Atiq Ur Rehman","doi":"10.4236/crcm.2023.1210051","DOIUrl":"https://doi.org/10.4236/crcm.2023.1210051","url":null,"abstract":"Background: Involvement of lumbar spinal nerve root, revealed as pain, numbness or weakness in the lower limbs. Typically caused by the compression of nerve at the spine level. Objective: The purpose of the study was to examine the patients with clinically presumed lumbar radiculopathy and find the correlation between their electrodiagnostic study and magnetic resonance imaging. Setting, duration and study type: Retrospective cross-sectional study of one year (January 2019 - February 2020) in Shifa International Hospital Islamabad. Methods: A total of 96 patients with clinically suspected lumbar radiculopathy were included. Chi-square test, international business machines (IBM) SPSS rendition 21.0 was applied on the clinical information, electrodiagnostic study and MRI were coordinated and affectability and particularity were judged. Selected patients were undergone both electrodiagnostic study and magnetic imaging resonance in the selected 1-year span. The study investigated correlation between both diagnostic tools in lumbar radiculopathy patients. Expected outcomes: Anatomical specificity in seen through magnetic resonance imaging while physiological through electrodiagnostic study, which may not correlate in the evaluation of lumbar radiculopathy.","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136202560","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.1210056
Zoe Parker, Cary Chisholm
Cryptococcus is a yeast typically found in bird feces such as pigeon droppings. Infection may occur through inhalation of spores or via direct inoculation into the skin. Typically there is a history of immunosuppression, but cases are also reported in immunocompetent hosts. Cryptococcus may manifest as pulmonary disease or primary cutaneous infection, but dissemination to a systemic illness is the most life-threatening concern. We present the case of a 71-year-old man with a four-year history of idiopathic lung disease, treated with oral prednisone and mycophenolate, presents with a new onset skin rash on the right wrist. He has a history of cleaning and clearing barns and sheds after a recent storm devastated the area. Birds and bats were present in these structures while he was working. Initial therapy failed, and subsequent biopsy showed the presence of Cryptococcus yeast. Further investigation yielded a positive, low titer Cryptococcus antigen screen but negative blood cultures. This case illustrates three valuable facets of patient care. Ideally, one diagnosis will explain all of the clinical presentation, but when that is not the case then multiple etiologies must be explored. Sometimes first-line therapy is ineffective, and the clinician should not be afraid to recognize that and change course. Importantly with skin lesions, failure to respond to treatment or worsening of the lesion in the face of topical and/or oral steroids should lead one to consider the possibility of infection, particularly in an immunosuppressed patient, and prompt biopsy is prudent.
{"title":"Cutaneous Cryptococcosis Arising in a Patient with Idiopathic Lung Disease: Related Illnesses or “Ticks and Fleas”","authors":"Zoe Parker, Cary Chisholm","doi":"10.4236/crcm.2023.1210056","DOIUrl":"https://doi.org/10.4236/crcm.2023.1210056","url":null,"abstract":"Cryptococcus is a yeast typically found in bird feces such as pigeon droppings. Infection may occur through inhalation of spores or via direct inoculation into the skin. Typically there is a history of immunosuppression, but cases are also reported in immunocompetent hosts. Cryptococcus may manifest as pulmonary disease or primary cutaneous infection, but dissemination to a systemic illness is the most life-threatening concern. We present the case of a 71-year-old man with a four-year history of idiopathic lung disease, treated with oral prednisone and mycophenolate, presents with a new onset skin rash on the right wrist. He has a history of cleaning and clearing barns and sheds after a recent storm devastated the area. Birds and bats were present in these structures while he was working. Initial therapy failed, and subsequent biopsy showed the presence of Cryptococcus yeast. Further investigation yielded a positive, low titer Cryptococcus antigen screen but negative blood cultures. This case illustrates three valuable facets of patient care. Ideally, one diagnosis will explain all of the clinical presentation, but when that is not the case then multiple etiologies must be explored. Sometimes first-line therapy is ineffective, and the clinician should not be afraid to recognize that and change course. Importantly with skin lesions, failure to respond to treatment or worsening of the lesion in the face of topical and/or oral steroids should lead one to consider the possibility of infection, particularly in an immunosuppressed patient, and prompt biopsy is prudent.","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136373138","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.128037
Ndeye Amy Sarr, Daouda Thioub, A. Lawson, K. Fall, Haby Dione Kane, S. Diop
{"title":"An Atypical Ovarian and Peritoneal Pelvic Tuberculosis Complicated by Toxidermia","authors":"Ndeye Amy Sarr, Daouda Thioub, A. Lawson, K. Fall, Haby Dione Kane, S. Diop","doi":"10.4236/crcm.2023.128037","DOIUrl":"https://doi.org/10.4236/crcm.2023.128037","url":null,"abstract":"","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91461915","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.126023
Saad Abdul Kareem, Bharadwaj Adithya Sateesh, Lars J Berg, G. Ayele, Betelehem Atalay, M. Michael
{"title":"Stiff Person with Anti-GAD Antibodies","authors":"Saad Abdul Kareem, Bharadwaj Adithya Sateesh, Lars J Berg, G. Ayele, Betelehem Atalay, M. Michael","doi":"10.4236/crcm.2023.126023","DOIUrl":"https://doi.org/10.4236/crcm.2023.126023","url":null,"abstract":"","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80646573","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}
Pub Date : 2023-01-01DOI: 10.4236/crcm.2023.127031
Daouda Thioub, Aboubakar T. Ibrahim, Khardiata Diallo-Mbaye, Zande-Yindoni Jules, N. Lakhe, M. Seydi
{"title":"Atypical Presentation of Ramsay Hunt Syndrome without Facial Palsy in an Immunocompetent Senegalese Adulte Patient","authors":"Daouda Thioub, Aboubakar T. Ibrahim, Khardiata Diallo-Mbaye, Zande-Yindoni Jules, N. Lakhe, M. Seydi","doi":"10.4236/crcm.2023.127031","DOIUrl":"https://doi.org/10.4236/crcm.2023.127031","url":null,"abstract":"","PeriodicalId":9618,"journal":{"name":"Case Reports in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83076914","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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