by Vamsidhar Vennamaneni, Rishbha Dua, George Michel, Virendrasinh Ravat and George Yatzkan
Case Report
Uvular Necrosis is a relatively rare and unfortunate postprocedural circumstance that can occur following a traumatic oropharyngeal insertion of medical instruments. These medical instruments cause compression of the uvula decreasing vascular supply and leading to necrosis and subsequently sloughing off of the affected area. We present here possibly the first-ever case reported as a rare complication of oral bronchoscopy with bronchoalveolar lavage (BAL) that leads to uvular necrosis. The patient complained of persistent sore throat, odynophagia, and dysphagia one day after the procedure. Uvular necrosis is more commonly reported during nasopharyngeal endoscopies and traumatic blind intubations but is rarely associated with bronchoscopies. Though the inciting event is unclear on this patient whether it was the BAL or the bronchoscope itself, the uvular necrosis was a certainty. With appropriate management, the patient¡¯s symptoms started resolving and the area of necrosis diminished. While symptoms from uvular necrosis typically self-resolve within two weeks with conservative management, it is important to recognize the concern to the provider of life-threatening oropharyngeal edema that can be a sequel of this event.
American Journal of Medical Case Reports. 2022, 10(11), 295-299. DOI: 10.12691/ajmcr-10-11-4
Pub. Date: November 28, 2022
by Milenis Lopez Leon, Sahar S. Abdelmoneim, Madeleidis Lopez Leon, Sandy Espinosa Hernandez, Manuel De La Cruz Seoane, Kenneth Adam Kilgore, Santiago Pastori and Odalys Frontela
Case Report
Dextromethorphan (DXM) and DXM-containing cough preparations are available over-the-counter (OTC) and are commonly abused for their euphoriant and hallucinogenic properties. These effects occur when DXM is taken in high doses (10-20 times the amount recommended for cough suppression). Awareness of DXM abuse in the primary care setting is warranted due to its prevalent use and potential to result in drug-induced liver injury (DILI). Reaching a diagnosis of DILI involves an extensive workup to exclude other known causes. If a physician is to identify the use of a single drug as the cause of a patient’s liver injury, a high level of suspicion must be held. We herein present a case of an 82-year-old male who was dependent on over-the-counter, DXM-containing products and who used them regularly for three years. This case report highlights DILI as one potential consequence of chronic OTC DXM use, as is evident from our diagnostic workup.
American Journal of Medical Case Reports. 2022, 10(11), 291-294. DOI: 10.12691/ajmcr-10-11-3
Pub. Date: November 22, 2022
by Vamsidhar Vennamaneni, Raul Fernandez, Rishbha Dua, George Michel, Virendrasinh Ravat and George Yatzkan
Case Report
Bronchiolitis Obliterans Organizing Pneumonia (BOOP), also known as Cryptogenic Organizing Pneumonia, is an uncommon disease defined as an inflammation of the bronchioles which resembles pneumonia on imaging but it is in fact non-infectious pneumonia. BOOP associated with Temozolomide has been observed in a few patients and documented very little, hence, internists and oncologists at the frontier of care must be aware of this lung damage. Here we present a case of a 67-year-old patient who presents with bronchiolitis obliterans organizing pneumonia after receiving chemotherapy for Glioblastoma Multiforme with Temozolomide. When discovering the trigger for the illness was Temozolomide, it was promptly discontinued, and treatment with methylprednisolone was promptly initiated, which provided significant improvement.
American Journal of Medical Case Reports. 2022, 10(11), 286-290. DOI: 10.12691/ajmcr-10-11-2
Pub. Date: November 20, 2022
by Fadi Qutishat, Vinod Sudhir and Ehab Abu Marar
Case Report
Vasculitis syndromes rarely co-exist with pregnancy; for example, Eosinophilic Granulomatosis with Polyangiitis (EGPA) ( formerly known as Churg-Struss Syndrome) is even rarer. Vasculitis syndromes often have a poor prognosis, making diagnosis very problematic, and generally, we do not have much literature about the anesthetic management of these rare types of vasculitis. Our study reports a case scenario of a 38- year-old woman who is pregnant and has been diagnosed with EGPA. She completed a successful pregnancy and was subject to emergency category II cesarean section delivery under regional anesthesia at University College Hospital Galway-Ireland. The patient coped well during the pregnancy apart from the reoccurrence of an asthma attack and allergic rhinitis at mid-pregnancy, which responded to an upsurge in steroid dosage. Clinical effects and choice the type of anesthesia and it’s relation to vasculitis are discussed.
American Journal of Medical Case Reports. 2022, 10(11), 283-285. DOI: 10.12691/ajmcr-10-11-1
Pub. Date: November 10, 2022