by Sumith Gunawardane, Kanchana Kapugama and Vishaka Senevirathne
Case Report
Langerhans cell histiocytosis (LCH) formerly known as histiocytosis X is rare spectrum of disease characterized by a monoclonal proliferation of bone marrow-derived Langerhans cells. LCH involves the head and neck region quite commonly, in particularly the bones of the skull and jaws. This is a case report of 14 years old female, presented with a complaint of intermittent abdominal pain, short stature and delayed puberty, which was subsequently presented with pain and swelling on left side upper premolar region with bleeding gums, which was finally histopathologically diagnosed as Langerhans cell histiocytosis following an incisional biopsy.
American Journal of Medical Case Reports. 2016, 4(9), 328-331. DOI: 10.12691/ajmcr-4-9-10
Pub. Date: October 27, 2016
9025 Views2389 Downloads
by Sumith Gunawardane, Kanchana Kapugama and Vishaka Senevirathne
Case Report
Adenomatoid Odontogenic Tumor (AOT) is a benign odontogenic tumor which is often misdiagnosed as an odontogenic cyst. It presents as a noninvasive lesion of the jaws with a slow but progressive growth. It is predominantly seen in young females, which usually arise in the second or third decade, located frequently associated with unerupted canines in the maxilla. This report describes a rare presentation of AOT in the mandible which occurred in a middle aged male, which was not associated with an impacted tooth.
American Journal of Medical Case Reports. 2016, 4(9), 324-327. DOI: 10.12691/ajmcr-4-9-9
Pub. Date: October 27, 2016
8405 Views1619 Downloads
by Fahidah Alenzi and Abdulrahman Al Arfaj
Case Report
Systemic lupus erythematosus and systemic sclerosis reduce the body ability to fight infections. Although varicella zoster virus (VZV) infections arecommon in these diseases due to poor cellular immunity, VZV-related strokes arerare. When stroke does occur, it may be due to direct infection of the cerebral arteries, leading to a spectrum of both inflammatory and non-inflammatory pathological changes, including thrombosis. This case report is the first from the Middle East to describe a patient who developed stroke associated with herpes zoster ophthalmicus.
American Journal of Medical Case Reports. 2016, 4(9), 321-323. DOI: 10.12691/ajmcr-4-9-8
Pub. Date: October 27, 2016
10705 Views2457 Downloads
by Ines Kechaou, Eya Cherif, Imene Boukhris, Samira Azzabi, Lamia Ben Hassine and Narjes Khalfallah
Case Report
Pyomyositis is a severe infectious complication reported in diabetic patients. A double noncontiguous location of this complication is exceptional. We report a case of a 58-year-old woman, who presented with a painful swelling left thigh and arm. The diagnosis of bifocal pyomyositis in the left vastusintermedius quadriceps and in the triceps muscle of the left arm was made on MRI findings. The causative agent was not isolated because of preceding antibiotic use. In this observation diabetes mellitus constitute the aim predisposing factor revealing pyomyositis by ketoacidosis.
American Journal of Medical Case Reports. 2016, 4(9), 319-320. DOI: 10.12691/ajmcr-4-9-7
Pub. Date: October 27, 2016
12129 Views2828 Downloads1 Likes
by Cesar Gentille, Michael Arriaga and Christopher Peckins
Case Report
Upper extremity (UE) deep venous thrombosis (DVT) is much less common than lower extremity DVT. Primary UE DVT, that which occurs in the absence of known risk factors is quite rare. We present a case of Paget-Schroetter Syndrome (PSS) also known as “Effort Thrombosis,” in a healthy young woman likely brought on by thoracic outlet syndrome (TOS). Our patient developed an UE DVT with minimal symptoms. Ultrasound, and then angiogram demonstrated a dense, long clot in the axillo-subclavian vein. Symptoms improved after catheter-directed thrombolysis although it was only partially successful. A narrowed region of the subclavian vein persists where it exits the thoracic outlet. Clinicians need to be aware of the unusual diagnosis as treatment can improve symptoms and facilitate recovery.
American Journal of Medical Case Reports. 2016, 4(9), 315-318. DOI: 10.12691/ajmcr-4-9-6
Pub. Date: October 20, 2016
12923 Views2623 Downloads1 Likes
by Silvia Quadrelli, Marco Antonio Solis Aramayo, Marcos Hernandez and Manuel Ibarrola
Case Report
A 65 year-old man presented to the Emergency Department (ED) with dyspnoea at rest, peripheral cyanosis, general paleness and a frothy fluid escaping from the nose and mouth. He also showed severe burns in his hands. He had been trying to clean a copper lamp with a 50–70% nitric acid solution at home. He was transferred to the intensive care unit (ICU). Non-invasive mechanical ventilation with PEEP was immediately applied. Treatment was started with 60 mg of furosemide intravenously (IV), and prednisolone 250 mg IV four times daily. As he responded, he was weaned off non-invasive ventilation and administered high-flow oxygen via a facemask (10 L/min). At day 5, he was transferred to the general ward. The patient was discharged from hospital at day 10 without serious pulmonary complications. He was followed-up as an outpatient for three months and respiratory function tests did not show any impairment.
American Journal of Medical Case Reports. 2016, 4(9), 312-314. DOI: 10.12691/ajmcr-4-9-5
Pub. Date: October 17, 2016
12301 Views3051 Downloads
by Liu Qiuling, Chen Hui, Huang Maping, Li Qingqing, Huang Jiebing, Huang Tanghai, Xie Keji and Jiang Chonghe
Original Research
Objective: To evaluate the effect and safety of acupuncture therapy on spinal cord injury patients with neurological detrusor under activity (NDU). Methods: SCI patients with NDU received acupuncture therapy between June 2011 and February 2016. Patients were evaluated at baseline, and week 12. The outcomes including postvoiding residual volume (PVR), maximum flow rate (Qmax), detrusor maximum pressure in voiding phase (Pdetmax), voiding volume, intermittent catheter, and Urogenital Distress Inventory (UDI). Adverse events were recorded. Results: A total of 30 patients were recruited in this trial. Significant differences between baseline and week 12 after treatment with respect to PVR (112.84 ml vs. 81.49 ml, P = 0.014), Qmax (7.94 ml/s vs. 10.41 ml/s, P = 0.023), Pdetmax (19.51 cmH2O vs. 26.33 cmH2O, P = 0.016); voiding volume (146.91 ml vs. 173.68 ml, P = 0.015), intermittent catheter (28 vs. 22, P = 0.038), and UDI (10.63 vs. 13.27, P = 0.017). No patients reported adverse events. Conclusions: Acupuncture is effective and safe for SCI patients with neurological detrusor underactivity.
American Journal of Medical Case Reports. 2016, 4(9), 310-311. DOI: 10.12691/ajmcr-4-9-4
Pub. Date: October 14, 2016
9651 Views2687 Downloads
by Mary Mathews, Abhishek Kumar, Ariel Fromowitz, Brett Simonhoff, Michael Maroules and Amer Akmal
Case Report
Background: Papillary eccrine adenoma (PEA) is a very rare benign cutaneous sweat gland tumor, it usually presents as an isolated well-circumscribed dermal nodule existent for a prolonged duration of time. Objectives: We report a case of PEA in a 74-year-old woman from Mexico who presented with a rare case of papillary eccrine adenoma. Materials and methods: We gathered our information by using PubMed and Scopus portal, in total there have been only 48 cases reported so far in English Literature. We present detailed review of findings of all cases reported so far including our case report. Results: Our results indicated that the median age of presentation was 45 years amongst males and females. The mean size of the tumor is approximately 16 mm amongst males and females with more than double the incidence was noted in females, along with a predominant occurrence noted in the Black population. The most common location for presentation was the lower extremities, followed by the upper extremities, abdomen and face respectively. Conclusion: In summary, PEA is a rare benign cutaneous sweat gland tumor representing intradermal proliferation of sweat gland ducts. It is slow growing in nature, with a greater incidence in women, and predominantly presents on the extremities. Despite its typical histological features, at times it can resemble other cutaneous neoplasms, thus it may present with diagnostic challenges. Moh’s technique has lately been reported to have increased success rates in the management of this tumor.
American Journal of Medical Case Reports. 2016, 4(9), 304-309. DOI: 10.12691/ajmcr-4-9-3
Pub. Date: October 09, 2016
13507 Views2279 Downloads
by Pyong Wha Choi
Case Report
The accidental ingestion of a foreign body is common, and the majority of ingested foreign bodies pass through the gastrointestinal tract without complication. Perforation is one of the rarest complications and commonly occurs in the terminal ileum and recto-sigmoid junction. The sigmoid colon is an extremely rare site of perforation because of its anatomical features of a thick wall, large diameter, and non-angulation. Here, we present a case of sigmoid colon perforation caused by an ingested fish bone. A 56-year-old male patient presented with left lower abdominal pain. The patient had no past medical history and had eaten a steamed cod dish the day before presentation. His abdomen was slightly distended and the left lower abdomen was tender, with no signs of generalized peritoneal irritation. Computed tomography revealed a linear radio-dense foreign body protruding from the sigmoid colon lumen accompanied by infiltration and a small amount of free air. An emergency operation was performed. During the operation, a 4-cm-long fish bone (a portion of a fish head bone) was found protruding from the sigmoid colon. Intraoperative colonic lavage, primary resection, and anastomosis were performed. The postoperative course was uneventful, and the patient was discharged on the ninth postoperative day. The case represents an unusual case of sigmoid colon perforation caused by an ingested fish bone. Because colon perforation by ingested fish bone is extremely rare, and its preoperative diagnosis is difficult, meticulous history taking is crucial for the correct diagnosis and prompt management in the emergency setting.
American Journal of Medical Case Reports. 2016, 4(9), 301-303. DOI: 10.12691/ajmcr-4-9-2
Pub. Date: September 28, 2016
16076 Views4182 Downloads
by Zhen Wang MD, Eugenio Capitle MD, Michael Jaker MD, Smita Mahendrakar MD and Riju Banerjee MD
Case Report
Tumor necrosis factor alpha (TNF-α) antagonist has been widely used in the treatment of inflammatory conditions such as rheumatoid arthritis (RA). Recently there have been case reports of the development of sarcoidosis in patients receiving TNF-α antagonists. Agents such as Infliximab, Adalimumab, and Etanercept have all been linked. However, incidents related to Golimumab, another member of the class, has not yet been described. We present the first case of Golimumab induced CNS, Pulmonary, and Cardiac sarcoidosis in a patient who presented with weakness and weight loss and was later found to have multi-organ (lung, brain, heart) sarcoid like involvement. Patient was diagnosed with seropositive (RF and CCP) RA maintained on Golimumab and Methotrexate for 2 years prior to diagnosis. Resolution of symptoms was achieved through the cessation of Golimumab and the use of systemic steroids.
American Journal of Medical Case Reports. 2016, 4(9), 298-300. DOI: 10.12691/ajmcr-4-9-1
Pub. Date: September 23, 2016
13486 Views3766 Downloads