L. Maričić, Damir Mihić, T. Turk, Domagoj Loinjak, Vedran Zubčić
Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. The condition typically begins with an oropharyngeal infection and frequently involves inflammation within the wall of the vein, infected thrombus within the lumen, surrounding soft tissue inflammation, persistent bacteremia, and septic emboli. Lemierre's syndrome is a rare disease; it occurs most commonly in otherwise healthy young adults. The most common etiologic agent is Fusobacterium necrophorum. We present a case of Lemierre's syndrome in a young girl and the role of extracorporeal method of blood purification with continuous venous hemodiafiltration with the use of a highly adsorptive membrane (AN69 HeprAN), thus achieving the combined elimination of cytokines and endotoxins. The use of advanced methods, along with an antibiotic and surgical treatment, will certainly help reduce mortality in this syndrome.
{"title":"The Role of Extracorporeal Blood Purification in the Treatment of a Patient with Lemierre's Syndrome","authors":"L. Maričić, Damir Mihić, T. Turk, Domagoj Loinjak, Vedran Zubčić","doi":"10.1155/2022/8522398","DOIUrl":"https://doi.org/10.1155/2022/8522398","url":null,"abstract":"Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. The condition typically begins with an oropharyngeal infection and frequently involves inflammation within the wall of the vein, infected thrombus within the lumen, surrounding soft tissue inflammation, persistent bacteremia, and septic emboli. Lemierre's syndrome is a rare disease; it occurs most commonly in otherwise healthy young adults. The most common etiologic agent is Fusobacterium necrophorum. We present a case of Lemierre's syndrome in a young girl and the role of extracorporeal method of blood purification with continuous venous hemodiafiltration with the use of a highly adsorptive membrane (AN69 HeprAN), thus achieving the combined elimination of cytokines and endotoxins. The use of advanced methods, along with an antibiotic and surgical treatment, will certainly help reduce mortality in this syndrome.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"61 2 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89794394","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}
Jacques Lowe, Brad Kaptur, A. Baltaji, Daniel Rosenblat, J. Kumar, Vishesh Paul
A 53-year-old male presented to the emergency room with chest pain, shortness of breath, and back pain. He had recently recovered from COVID-19 infection and returned home on room air. Chest imaging showed bilateral hydropneumothoraces that were not present on the imaging performed during his prior admission three weeks ago. The patient was treated with bilateral chest tube drainage and oxygen support and responded well to treatment. This case represents a unique occurrence of spontaneous loculated bilateral hydropneumothoraces in the context of recent clinical recovery from COVID-19 infection requiring inpatient treatment. This case highlights the importance of an awareness of a potential sequela of COVID-19 that may occur even after presumed clinical recovery.
{"title":"Spontaneous Loculated Bilateral Hydropneumothoraces in a Patient with Recent COVID-19 Infection","authors":"Jacques Lowe, Brad Kaptur, A. Baltaji, Daniel Rosenblat, J. Kumar, Vishesh Paul","doi":"10.1155/2022/3284857","DOIUrl":"https://doi.org/10.1155/2022/3284857","url":null,"abstract":"A 53-year-old male presented to the emergency room with chest pain, shortness of breath, and back pain. He had recently recovered from COVID-19 infection and returned home on room air. Chest imaging showed bilateral hydropneumothoraces that were not present on the imaging performed during his prior admission three weeks ago. The patient was treated with bilateral chest tube drainage and oxygen support and responded well to treatment. This case represents a unique occurrence of spontaneous loculated bilateral hydropneumothoraces in the context of recent clinical recovery from COVID-19 infection requiring inpatient treatment. This case highlights the importance of an awareness of a potential sequela of COVID-19 that may occur even after presumed clinical recovery.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90449215","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}
Lintu Ramachandran, David Lyu, Luqman Baloch, Mario Affinati
Tuberculosis, while rare, is a disease that can have several extrapulmonary manifestations. One such known extrapulmonary manifestation of disseminated TB is vertebral osteomyelitis, often referred to as “Pott's Disease.” We present the case of a patient who underwent back surgery with allogenic bone graft who developed vertebral osteomyelitis and subsequently had disseminated tuberculosis, from an infected bone graft. We review current guidelines for allograft tissue screening and discuss the possible need for standardizing tuberculosis screening for bone allografts.
{"title":"First Reported Case of Reverse Pott's Disease","authors":"Lintu Ramachandran, David Lyu, Luqman Baloch, Mario Affinati","doi":"10.1155/2022/3527704","DOIUrl":"https://doi.org/10.1155/2022/3527704","url":null,"abstract":"Tuberculosis, while rare, is a disease that can have several extrapulmonary manifestations. One such known extrapulmonary manifestation of disseminated TB is vertebral osteomyelitis, often referred to as “Pott's Disease.” We present the case of a patient who underwent back surgery with allogenic bone graft who developed vertebral osteomyelitis and subsequently had disseminated tuberculosis, from an infected bone graft. We review current guidelines for allograft tissue screening and discuss the possible need for standardizing tuberculosis screening for bone allografts.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"5 5","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72410097","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}
Tomasz Zemleduch, Anna Czapla, Piotr Kimla, B. Kudliński
Hypereosinophilic syndrome (HES) is a rare condition characterized by profound peripheral eosinophilia and various organ dysfunction. Diagnostic criteria and classification of this challenging medical entity changed over time. Elevated absolute eosinophil count with extensive tissue infiltration and signs of organ damage of unknown origin is termed idiopathic HES. Hypereosinophilia is a highly hypercoagulable state; thus, a variety of thromboembolic complications may occur. Only a few reports of idiopathic HES patients with different forms of thrombosis are being published. We document a case of a young male presented with persistent abdominal pain with two eosinophilic colon tumors. The patient suffered from phlegmasia cerulea dolens and portal vein thrombosis, followed by pulmonary embolism and overt disseminated intravascular coagulation (DIC). Corticosteroids successfully reduced and controlled eosinophil level while skilled anticoagulation and supportive management overcome DIC-associated complications.
{"title":"Rare Case of a Young Male Presented with Abdominal Pain, Solid Colon Tumors, and Eosinophilia, Followed by Tremendous Thromboembolic Complications and Eventually Diagnosed with Idiopathic Hypereosinophilic Syndrome","authors":"Tomasz Zemleduch, Anna Czapla, Piotr Kimla, B. Kudliński","doi":"10.1155/2022/1424749","DOIUrl":"https://doi.org/10.1155/2022/1424749","url":null,"abstract":"Hypereosinophilic syndrome (HES) is a rare condition characterized by profound peripheral eosinophilia and various organ dysfunction. Diagnostic criteria and classification of this challenging medical entity changed over time. Elevated absolute eosinophil count with extensive tissue infiltration and signs of organ damage of unknown origin is termed idiopathic HES. Hypereosinophilia is a highly hypercoagulable state; thus, a variety of thromboembolic complications may occur. Only a few reports of idiopathic HES patients with different forms of thrombosis are being published. We document a case of a young male presented with persistent abdominal pain with two eosinophilic colon tumors. The patient suffered from phlegmasia cerulea dolens and portal vein thrombosis, followed by pulmonary embolism and overt disseminated intravascular coagulation (DIC). Corticosteroids successfully reduced and controlled eosinophil level while skilled anticoagulation and supportive management overcome DIC-associated complications.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77216915","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}
Nodular lymphoid hyperplasia of the lung is a rare disease of polyclonal lymphoid proliferation. The incidental finding of a solid nodular lesion with irregular margins adjacent to the visceral pleura in the reported case was highly suggestive of malignancy. The present report underscores the typical immunohistochemical findings and the benign course of nodular lymphoid hyperplasia. The current knowledge about disease aetiology and the value of different diagnostic tools to distinguish nodular lymphoid hyperplasia from other pulmonary lymphoid lesions are summarized by a review of the literature. Surgical resection is not only diagnostic but also curative with no evidence so far that NLH can regress without operation. The present case shows the spontaneous regression of NLH after CT-guided biopsy indicating that an alternative, less invasive diagnostic approach has curative potential.
{"title":"Nodular Lymphoid Hyperplasia as Incidental Finding of Suspect Pulmonary Mass","authors":"H. Reuter, S. Reuter","doi":"10.1155/2022/2242418","DOIUrl":"https://doi.org/10.1155/2022/2242418","url":null,"abstract":"Nodular lymphoid hyperplasia of the lung is a rare disease of polyclonal lymphoid proliferation. The incidental finding of a solid nodular lesion with irregular margins adjacent to the visceral pleura in the reported case was highly suggestive of malignancy. The present report underscores the typical immunohistochemical findings and the benign course of nodular lymphoid hyperplasia. The current knowledge about disease aetiology and the value of different diagnostic tools to distinguish nodular lymphoid hyperplasia from other pulmonary lymphoid lesions are summarized by a review of the literature. Surgical resection is not only diagnostic but also curative with no evidence so far that NLH can regress without operation. The present case shows the spontaneous regression of NLH after CT-guided biopsy indicating that an alternative, less invasive diagnostic approach has curative potential.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81377332","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}
Mateo Zuluaga-Gómez, Daniel González-Arroyave, C. Ardila
This article reports the case of a woman with tracheal perforation due to closed neck trauma and the presence of SARS-CoV-2. The physical examination revealed subcutaneous emphysema in zone II of the neck. The tomography revealed an anterior and proximal tracheal lesion, a 2-mm solution of continuity of the anterior infraglottic airway in the proximal third with subcutaneous emphysema and a decrease in the diameter of the airway at the level of the glottis. The PCR result for SARS-CoV-2 was positive. The medical procedure consisted of orotracheal intubation to guarantee the safety of the airway, in addition to close surveillance in the intensive care unit and constant monitoring of vital signs. In tracheal perforation due to closed neck trauma, it is recommended to evaluate the clinical parameters periodically, including the stability of respiration and subcutaneous emphysema.
{"title":"Conservative Medical Management of a Tracheal Perforation after Blunt Trauma in a Patient with SARS-CoV-2","authors":"Mateo Zuluaga-Gómez, Daniel González-Arroyave, C. Ardila","doi":"10.1155/2022/7344476","DOIUrl":"https://doi.org/10.1155/2022/7344476","url":null,"abstract":"This article reports the case of a woman with tracheal perforation due to closed neck trauma and the presence of SARS-CoV-2. The physical examination revealed subcutaneous emphysema in zone II of the neck. The tomography revealed an anterior and proximal tracheal lesion, a 2-mm solution of continuity of the anterior infraglottic airway in the proximal third with subcutaneous emphysema and a decrease in the diameter of the airway at the level of the glottis. The PCR result for SARS-CoV-2 was positive. The medical procedure consisted of orotracheal intubation to guarantee the safety of the airway, in addition to close surveillance in the intensive care unit and constant monitoring of vital signs. In tracheal perforation due to closed neck trauma, it is recommended to evaluate the clinical parameters periodically, including the stability of respiration and subcutaneous emphysema.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88802114","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 Currently, there are few reports describing the use of reconstructive techniques in the treatment of cesarean scar endometriosis (CSE). Here, we report a case of CSE, a rare form of endometriosis caused by scars from obstetric and gynecological surgeries. Case Report. A 50-year-old woman became aware of a painful, deep scar mass in her lower abdomen during her menstrual period 10 years after her second cesarean section. This was diagnosed as CSE after the biopsy. Under general anesthesia, the mass, a portion of the rectus abdominis, and a 1 cm tumor-free margin were resected as a whole, and the abdominal wall was reconstructed with a soft artificial mesh. Results No obvious recurrence or subjective symptoms were observed postoperatively or reported in the 1-year follow-up period. Discussion. Endometriosis appearing in a cesarean scar is rare; it is chiefly triggered by intraoperative mechanical implantation. In cases of surgical scar masses with a history of gynecological surgery and associated menstrual symptoms, this syndrome should be considered during diagnosis and treatment.
{"title":"Resection and Abdominal Wall Reconstruction for Cesarean Scar Endometriosis","authors":"Kento Takaya, Hirokazu Shido, S. Yamazaki","doi":"10.1155/2022/7330013","DOIUrl":"https://doi.org/10.1155/2022/7330013","url":null,"abstract":"Introduction Currently, there are few reports describing the use of reconstructive techniques in the treatment of cesarean scar endometriosis (CSE). Here, we report a case of CSE, a rare form of endometriosis caused by scars from obstetric and gynecological surgeries. Case Report. A 50-year-old woman became aware of a painful, deep scar mass in her lower abdomen during her menstrual period 10 years after her second cesarean section. This was diagnosed as CSE after the biopsy. Under general anesthesia, the mass, a portion of the rectus abdominis, and a 1 cm tumor-free margin were resected as a whole, and the abdominal wall was reconstructed with a soft artificial mesh. Results No obvious recurrence or subjective symptoms were observed postoperatively or reported in the 1-year follow-up period. Discussion. Endometriosis appearing in a cesarean scar is rare; it is chiefly triggered by intraoperative mechanical implantation. In cases of surgical scar masses with a history of gynecological surgery and associated menstrual symptoms, this syndrome should be considered during diagnosis and treatment.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89509367","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}
A 71-year-old man who was recently hospitalized for COVID-19 pneumonia complicated by acute hypoxemic respiratory failure and severe ARDS requiring noninvasive ventilation was transferred to our hospital from a rehabilitation facility for new onset right wrist and hand pain and swelling which had been attributed to arterial thrombosis and empirically treated with therapeutic anticoagulation. He developed numbness and paralysis in his right hand and was diagnosed with right forearm compartment syndrome requiring emergent fasciotomy. After a prolonged hospital stay complicated by respiratory failure requiring mechanical ventilation, he was discharged with improved, but not resolved, sensorimotor deficits. Arterial blood gas sampling is commonly performed in patients with acute hypoxemic respiratory failure, for assessment of oxygenation and acid-base status. It is considered a benign procedure, but it can lead to serious complications, such as bleeding and compartment syndrome. Risks and benefits of any procedure need to be weighed carefully and less is often more. Compartment syndrome is characterized by the 5 P's—pain, pallor, paresthesia, pulselessness, and paralysis.
{"title":"Development of Compartment Syndrome after Radial Artery Puncture in a Patient with Acute Hypoxemic Respiratory Failure due to COVID-19","authors":"O. Garner, K. Nunna, A. Braun","doi":"10.1155/2022/8241057","DOIUrl":"https://doi.org/10.1155/2022/8241057","url":null,"abstract":"A 71-year-old man who was recently hospitalized for COVID-19 pneumonia complicated by acute hypoxemic respiratory failure and severe ARDS requiring noninvasive ventilation was transferred to our hospital from a rehabilitation facility for new onset right wrist and hand pain and swelling which had been attributed to arterial thrombosis and empirically treated with therapeutic anticoagulation. He developed numbness and paralysis in his right hand and was diagnosed with right forearm compartment syndrome requiring emergent fasciotomy. After a prolonged hospital stay complicated by respiratory failure requiring mechanical ventilation, he was discharged with improved, but not resolved, sensorimotor deficits. Arterial blood gas sampling is commonly performed in patients with acute hypoxemic respiratory failure, for assessment of oxygenation and acid-base status. It is considered a benign procedure, but it can lead to serious complications, such as bleeding and compartment syndrome. Risks and benefits of any procedure need to be weighed carefully and less is often more. Compartment syndrome is characterized by the 5 P's—pain, pallor, paresthesia, pulselessness, and paralysis.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82956446","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}
A. Ghosh, S. Bhushan, L. D. López, D. Sampat, Z. Salah, C. Hatoum
Immune thrombocytopenic purpura (ITP) has been reported following vaccinations such as MMR as well as after viral infections such as hepatitis C and HIV. Few case reports have been reported of ITP after COVID-19 infections and COVID-19 vaccines. Herein, we present a patient who presented with severe ITP with a platelet count of 0 after receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine (also known as the Pfizer BioNTech). She subsequently recovered with a prolonged treatment course.
{"title":"BNT162b2 COVID-19 Vaccine Induced Immune Thrombocytopenic Purpura","authors":"A. Ghosh, S. Bhushan, L. D. López, D. Sampat, Z. Salah, C. Hatoum","doi":"10.1155/2022/5603919","DOIUrl":"https://doi.org/10.1155/2022/5603919","url":null,"abstract":"Immune thrombocytopenic purpura (ITP) has been reported following vaccinations such as MMR as well as after viral infections such as hepatitis C and HIV. Few case reports have been reported of ITP after COVID-19 infections and COVID-19 vaccines. Herein, we present a patient who presented with severe ITP with a platelet count of 0 after receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine (also known as the Pfizer BioNTech). She subsequently recovered with a prolonged treatment course.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77715975","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}
Myiasis refers to the infestation of living vertebrae with fly larvae, principally occurring in individuals with a low socioeconomic status and poor personal hygiene. Myiasis is rarely manifested in the urogenital system. Herein, we report a case of urogenital myiasis in a 49-year-old rural woman complaining of maggots in the urine and severe genital itching.
{"title":"A Rare Case of Urogenital Myiasis in a 49-Year-Old Woman","authors":"A. Salehi, E. Jenabi, Maral Salehi","doi":"10.1155/2022/7910176","DOIUrl":"https://doi.org/10.1155/2022/7910176","url":null,"abstract":"Myiasis refers to the infestation of living vertebrae with fly larvae, principally occurring in individuals with a low socioeconomic status and poor personal hygiene. Myiasis is rarely manifested in the urogenital system. Herein, we report a case of urogenital myiasis in a 49-year-old rural woman complaining of maggots in the urine and severe genital itching.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"13 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76338573","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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