by Walid Omer and Nagat Mudabal
Case Report
The Brugada syndrome is an autosomal dominant genetic disorder with variable expression characterized by abnormal findings on the surface electrocardiogram (ECG) in conjunction with an increased risk of ventricular tachyarrhythmias and sudden cardiac death . Typically, the ECG findings consist of a pseudo-right bundle branch block and persistent ST segment elevation in leads V1 to V2. We present a rare case of spontaneous Type I Brugada secondary to drug overdose with cocaine and benzodiazepines in a young male patient who eventually received automated implantable cardioverter defibrillator (AICD).
American Journal of Medical Case Reports. 2024, 12(3), 56-57. DOI: 10.12691/ajmcr-12-3-7
Pub. Date: March 26, 2024
by Kristina Loukeris and Elmira Mostafidi
Case Report
Background: Here, we report a sigmoid mucosal Schwann cell hamartoma as an uncommon entity. Though unexpected, the pathologist should consider this among differential diagnoses and be able to distinguish the microscopic features when examining colorectal biopsies. Finally, we have reviewed the literature for similar cases reported over the past two decades. Case presentation: A 55-year-old woman was found to have a 5 mm sessile polyp during her screening colonoscopy. The microscopic study revealed colonic mucosa with ill-defined proliferation of uniform spindle-shaped cells arranged in a haphazard pattern within the lamina propria. All cells had elongated bland nuclei with eosinophilic cytoplasm and unclear cell borders. Edema and mild lymphoplasmacytic infiltration were noticed in the lamina propria. No nuclear atypia, necrosis, or mitosis was identified. On immunohistochemistry, Schwann cells showed diffuse and strong nuclear and cytoplasmic positivity for S-100 protein. CD117 (C-kit) and desmin were negative. Conclusion: Colorectal MSCH has a benign nature, and the lack of axons and strong immunoreactivity for S-100 protein can help distinguish MSCH from most similar entities.
American Journal of Medical Case Reports. 2024, 12(3), 49-55. DOI: 10.12691/ajmcr-12-3-6
Pub. Date: March 22, 2024
by Yongping Liu, Siyou Tan, Lai Wei and Wenyan Chen
Case Report
This study aimed to investigate the effect of dexmedetomidine (Dex) combined with remote ischemic preconditioning (RIPC) on hepatic ischemia-reperfusion injury (HIRI) in patients undergoing hepatectomy. This study was designed as a prospective trial including ASA I-III patients aged 18 to 65 years scheduled for elective laparoscopic hepatectomy. Patients were randomly divided into two groups with 8 cases in each group: control and Dex combined with RIPC (DR) group. Information was collected regarding gender, age, height, weight, portal triad clamping time, operation time, intraoperative infusion volume, blood loss, and urine volume. Venous blood was collected after reperfusion to detect serum IL-6, ALT, AST, and TBIL. No difference was found in baseline information among the two groups (P > 0.05). Among the two groups, the serum level of ALT and AST in group DR was significantly decreased compared with the controls (p < 0.05), and the differences in postoperative serum IL-6 and TBIL levels between the two groups were not statistically significant (P > 0.05). The study demonstrated that the combined use of Dex and RIPC could alleviate HIRI caused by blocking the hepatic portal during laparoscopic hepatectomy.
American Journal of Medical Case Reports. 2024, 12(3), 46-48. DOI: 10.12691/ajmcr-12-3-5
Pub. Date: March 21, 2024
by Waad Al Saleemi, Amal Al Balushi, Ahmed AlAzri, Mustafa Al Shaaibi, Amina Al-Jardani, Azza Al Rashdi, Khalsa Al Ramadhani, Hala Al Hinai and Nawal Al Kindi
Case Report
Brain abscess represents one of the most serious complication of head and neck infections. While anaerobic bacteria are frequent isolates from brain abscesses, usually in a mixed culture, Eikenella corrodens is rarely isolated from this site. E. corrodens is a fastidious gram-negative bacterium that normally colonizes the oral cavity and upper respiratory tract. We report a case of a 42-year-old immunocompetent lady with a background of Ebstein cardiac anomaly who presented with parietooccipital brain abscess. She underwent awake surgery under navigation guidance, burr hole drainage of the abscess. Abscess culture revealed growth of E. corrodens in addition to anaerobic bacterial growth of Fusobacterium nucleatum and Parvimonas micra. The patient was successfully treated with a six weeks course of intravenous ceftriaxone and metronidazole which resulted in complete resolution of the abscess.
American Journal of Medical Case Reports. 2024, 12(3), 42-45. DOI: 10.12691/ajmcr-12-3-4
Pub. Date: March 17, 2024
by Dr. S. AlKaabi, Dr. R. Ebead, Dr. M. Khames, Dr. M. Amin, Dr. A. Gupta, Dr. E. Marzouk and Dr. S. Ahmed
Case Report
This is a case of 54-years-old critically ill H1N1 ARDS patient with prolonged ventilation and sedation and difficult weaning from sedation and mechanical ventilation. The case gives spotlight on not uncommon cause of delirium and failure of weaning in critically ill patients which is Vitamin B1 deficiency and how it is underestimated and should be put in mind while management those patients. Delirium and the failure to wean patients off sedation and mechanical ventilation in intensive care units (ICUs) are significant challenges that healthcare providers frequently face. This issue became evident in a unique case involving a critically ill H1N1 ARDS patient aged 54, which highlighted the often-ignored cause of these complications - Vitamin B1 deficiency. This critical review aims to delve deeper into the role of Vitamin B1 deficiency in exacerbating the conditions of critically ill patients and argue why it should be a key consideration in patient management.
American Journal of Medical Case Reports. 2024, 12(3), 38-41. DOI: 10.12691/ajmcr-12-3-3
Pub. Date: March 15, 2024
by S. AlKaabi, R. Ebead, M. Khames, M. Amin, S. Ahmed, A. Gupta and E. Marzouk
Case Report
This case study presents the clinical course and management of an 18-year-old male patient diagnosed with very long fatty acid dehydrogenase deficiency (VLCADD). The patient exhibited recurrent episodes of rhabdomyolysis accompanied by acute kidney injury (AKI) and elevated liver enzymes. Presented to us by irritability and restlessness and 3 episodes of seizures. The purpose of this case study is to highlight the challenges in diagnosing and managing this rare metabolic disorder and to emphasize the importance of early recognition and intervention to prevent further complications.
American Journal of Medical Case Reports. 2024, 12(3), 33-37. DOI: 10.12691/ajmcr-12-3-2
Pub. Date: March 10, 2024
by Youichi Yanagawa, Hiroki Nagasawa, Hiroaki Taniguchi, Tatsuro Sakai and Ikuto Takeuchi
Case Report
A 79-year-old male presented with decreased blood pressure, weight loss, and episodes of transient loss of consciousness. Diagnosed with neurocardiogenic syncope and vagal nerve paralysis, he experienced a loss of consciousness. Despite initial treatments, syncope persisted. Repeated imaging revealed swelling of neck lymph nodes, diagnosed as carotid sinus syndrome. Lymph node biopsy confirmed malignant lymphoma, prompting thorough dissection. Following diagnosis, syncope episodes ceased. Steroid therapy and radiation were initiated due to weight loss and swallowing difficulties. This case underscores the importance of considering surgical interventions, even when non-invasive treatments fail, in managing carotid sinus syndrome caused by cervical malignant lymphoma.
American Journal of Medical Case Reports. 2024, 12(3), 29-32. DOI: 10.12691/ajmcr-12-3-1
Pub. Date: March 05, 2024