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Volume 4, Issue 7

Nocardia arthritidis Infection in an Immunocompetent Human in the United States
Case Report
Patients with T-cell defects are at the highest risk for nocardiosis, a potentially life-threatening infection caused by several species of the genus, Nocardia. We report a case of disseminated Nocardia arthritidis in a patient who had no recognizable risk factors for immunodeficiency. A 43-year-old woman was noted to have a left upper lobe cavitary lesion on an outpatient computerized tomography (CT) scan that was performed for evaluation of pelvic congestion syndrome. She subsequently had an image-guided biopsy of the lesion, but the results were still pending when she presented at the emergency department with a transient episode of aphasia. A CT scan of the patient’s head revealed hypodensities in the right frontoparietal and left frontal lobes. A modified acid-fast stain on the lung biopsy specimen demonstrated variable, branching, filamentous bacteria with morphology consistent with Nocardia species. Matrix-Assisted Laser Desorption / Ionization – Time-of-Flight (MALDI-TOF) Mass Spectrometry at a reference laboratory later identified the bacteria as Nocardia arthritidis. This case highlights that disseminated nocardiosis can occur in an apparently healthy population. A more detailed immunologic evaluation that include screening for chronic granulomatous disease, anticytokine autoantibody deficiency and interleukin-12-gamma interferon pathway deficiency may further assist in the diagnosis of patients’ underlying diseases.
American Journal of Medical Case Reports. 2016, 4(7), 251-254. DOI: 10.12691/ajmcr-4-7-10
Pub. Date: August 12, 2016
13723 Views3714 Downloads
Hemorrhage; Unusual Presentation of Adrenal Hemangioma
Case Report
Cavernous hemangioma is a vascular tumor that are usually incidentally discovered during routine radiologic evaluation. Adrenal cavernous hemangioma is extremely rare benign tumor of the adrenal gland. We report a case of a 75 year old female presented to the emergency department with a bleeding adrenal cavernous hemangioma. A review of the literature, multimodality imaging features, and differential diagnosis of adrenal hemangioma is discussed.
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American Journal of Medical Case Reports. 2016, 4(7), 248-250. DOI: 10.12691/ajmcr-4-7-9
Pub. Date: August 08, 2016
11055 Views3076 Downloads
Hyperglycemia Induced Reversible Hemiballismus as the Main Presentation of Newly Diagnosed Diabetes Mellitus
Case Report
Diabetes Mellitus commonly presents as polyuria, polydipsia, fatigue and polyphagia, though patients presenting with acute complications at the time of diagnosis are not uncommon. Stroke and neuropathies are the most common neurological complications of diabetes. Movement disorder like chorea and hemiballismus are very rarely associated with diabetes mellitus. Primary care physicians should be aware of these rare and complicit presentation of diabetes. We present a case of nonketotic hyperglycemic hemiballismus (NHH) with no acute abnormality seen on MRI brain.
American Journal of Medical Case Reports. 2016, 4(7), 245-247. DOI: 10.12691/ajmcr-4-7-8
Pub. Date: August 06, 2016
10144 Views4103 Downloads
An Unusual Tracheal Hemangioma Successfully Treated with Propranolol
Case Report
A 2-month old, otherwise healthy infant male, presented with inspiratory stridor. A CT scan of the neck revealed an isolated decrease of the lumen in the middle third of the trachea. An MRI showed a markedly hyperintense lesion on T2-weighted images producing an obstruction of 80% of the airway lumen. A rigid bronchoscopy presented a submucosal port wine stain-like mass causing 90% obstruction of the airway at the level of the middle trachea and extending 1,5 cm down the airway. The patient was placed on oral propranolol at 2 mg/kg/day and showed a rapid response to the treatment, with regression of stridor and a significant reduction (less than 50%) of the mass in the images. A new bronchoscopy 3 months later revealed no airways obstruction.
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American Journal of Medical Case Reports. 2016, 4(7), 242-244. DOI: 10.12691/ajmcr-4-7-7
Pub. Date: August 02, 2016
11551 Views2139 Downloads
Myelofibrosis with Tuberculosis: A Case Report
Case Study
Myelofibrosis (MF), or fibrosis of the bone marrow, is an uncommon condition. Most cases arise secondary to other disease processes. However, whether tuberculosis can stimulate a secondary fibrotic reaction or develop in patients who have preexisting myeloproliferative disorders is not clear. Here we present a case of a 54-year-old man whose myelofibrosis disappeared completely after administration of antituberculous treatment. The purpose of reporting this case is to reconsider the relationship between tuberculosis and secondary myelofibrosis.
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American Journal of Medical Case Reports. 2016, 4(7), 240-241. DOI: 10.12691/ajmcr-4-7-6
Pub. Date: July 26, 2016
8849 Views2216 Downloads
Vibrio Cholera Diarrohea in Neonate: A Case Report
Case Report
Neonatal cholera is a extremely rare in neonate. Colostrum may offer potent protection among breast fed neonates mediated by specific immunoglobulin IgA. Occurrence of cholera in a new born reflects the poor hygienic condition of the family and bad child rearing practice. As rehydration therapy and antibiotics is the main stay of treatment of this particular condition, the broader perspective is to counsel the population about hazards of prelactal feed, top feeding and good hygienic measures. We report two cases of neonatal cholera with severe dehydration.
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American Journal of Medical Case Reports. 2016, 4(7), 238-239. DOI: 10.12691/ajmcr-4-7-5
Pub. Date: July 26, 2016
8985 Views2602 Downloads
Arteriovenous Fistula and Pseudoaneurysm: A Rare Complication of Central Venous Catheterization
Original Research
Central venous catheterization (CVC) is a commonly performed invasive procedure in pre-operative period and for long-term intravenous access. Image-guided CVC has gained importance as it not only helps in reducing number of attempts but also prevents wrong internal jugular vein (IJV) punctures leading to reduced incidence & severity of CVC complications. Lack of availability of image-guidance related infrastructure and competence are responsible for non-image-guided CVC-related complications in developing countries. This article emphasizes the importance of image-guided CVC by discussing a case of arteriovenous fistula (AVF) between a small branch of external carotid artery and internal jugular vein detected in immediate postoperative period following CVC which was performed without image-guidance.
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American Journal of Medical Case Reports. 2016, 4(7), 236-237. DOI: 10.12691/ajmcr-4-7-4
Pub. Date: July 16, 2016
12762 Views3375 Downloads
Aggressive Angiomyxoma of the Scrotum: A Case Report and Literature Review
Case Report
Aggressive Angiomyxoma is a rare mesenchymal benign myxoid tumor of the pelvis and perineum which occurs almost exclusively in adult females. It rarely occurs in males and involves scrotum, locally infiltrative but nonmetastasizing. The clinical presentation was one of progressing scrotal edema and enlargement with subsequent development of scrotal abscesses. The clinical differential diagnosis at presentation commonly includes inguinal hernia, testicular neoplasm, spermatic cord lipoma, hydrocele, spermatocele, and scrotal filariasis. We report a case of incidentally diagnosed Angiomyxoma of scrotum presenting as scrotal edema. Case Report: A 41 years old male presented with a painless scrotal swelling since 2 years prior to admission that gradually progressed in size. Clinical examination revealed diffuse scrotal swelling measuring about 15×12cm. with a thickened of scrotal skin. Ultrasound examination report was found of fluid collection with debris in the scrotum suspected as scrotal abscess, subcutaneous edema and cutaneous scrotal wall thickening. Result: The patient underwent wide excision and scrotoplasty, the pathology result of the excised scrotal edema was an Angiomyxoma of the scrotum up to tunica vaginalis. Conclusion: Aggressive Angiomyxoma in the scrotal region may present as a scrotal edema and enlargement, often mistaken for an inguinal hernia, testicular neoplasm, spermatic cord lipoma, hydrocele, spermatocele, and scrotal filariasis.
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American Journal of Medical Case Reports. 2016, 4(7), 232-235. DOI: 10.12691/ajmcr-4-7-3
Pub. Date: July 13, 2016
20569 Views3913 Downloads
Tachyarrhythmias in Microscopic Polyangitis Responding Well to Plasmapharesis Treatment
Case Report
Microscopic polyangiitis (MPA) is a form of anti neutrophilic cytoplasmic antibody associated necrotizing vasculitis, which may present with a variety of clinical manifestations. Cardiac involvement in vaculitis is common and the manifestations usually include cardiomyopathy, pericarditis and arrhythmias. Our patient presented with dyspnea, hemoptysis and acute kidney injury. The patient developed frequent episodes of supraventricular tachycardia (SVT) and non-sustained ventricular tachycardia during the course of his stay, which subsequently resolved on treatment with plasmapheresis. Mortality rate is significantly high in patients with pulmonary hemorrhage and renal failure; plasmpheresis has proven to be beneficial in such acute case. Our case not only highlights the therapeutic effects of plasmapheresis on MPA but also stresses the importance of prompt plasmapheresis to mitigate MPA complications like SVT.
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American Journal of Medical Case Reports. 2016, 4(7), 228-231. DOI: 10.12691/ajmcr-4-7-2
Pub. Date: July 09, 2016
13592 Views3889 Downloads
Oral Malignant Melanoma of the Mandibular Gingiva – A Unusal Case Report
Case Report
Oral Malignant Melanoma (OMM) is a rare, aggressive neoplasm of melanocytic origin, which is known to have the worst prognosis than that of cutaneous melanomas. Primary malignant melanoma of the mouth is an extremely rare tumor arising from the uncontrolled growth of melanocytes found in the basal layer of the oral mucous membrane. It has a higher prevalence in blacks, Japanese, and Indians of Asia due to more frequent finding of melanin pigmentation in oral mucosa of these races. Nearly 80% of oral malignant melanomas (OMM) arise in the mucosa of the upper jaws in elderly patients, with the majority occurring on keratinizing mucosa of the palate and alveolar gingivae. The five-year survival reported in the literature for OMM varies from 0 - 45 % whereas the overall survival for head and neck melanomas ranges between 20 and 48%. Maxillary gingiva and palate are commonly affected. Very few cases have been reported in the mandibular gingiva. It can occur at any age with the range of 20 to 80 years, but less common below 30 years. OMM may appear in various forms including pigmented macule, pigmented nodule, or a large pigmented exophytic lesion or an amelanotic variant of any of these three forms Clinically, it is easy to overlying epithelium. Here we are reporting a rare case of large exophytic, multilobulated OMM involving whole of left mandibular gingiva in a 30 year old male patient.
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American Journal of Medical Case Reports. 2016, 4(7), 224-227. DOI: 10.12691/ajmcr-4-7-1
Pub. Date: July 09, 2016
18601 Views3792 Downloads1 Likes