by Asad Ullah, Zeeshan Khakwani and Muzammil Khan
Case Report
A young lady was brought to the emergency department after she was found unconscious sitting in her restroom for several hours. She was found to have decreased sensations below her neck and was unable to move any extremity. Multilevel imaging studies were obtained that revealed extensive areas of cervical spinal cord hemorrhagic infarction, postulated to be due to hyperflexion of her neck resulting in vascular compromise, which were inoperable and rendered her quadriplegic. She required intensive physical rehabilitation and was transferred to a specialist center for further treatment.
American Journal of Medical Case Reports. 2018, 6(6), 121-123. DOI: 10.12691/ajmcr-6-6-6
Pub. Date: July 26, 2018
4426 Views1941 Downloads
by Daniel C. Sacher
Original Research
Torsades de pointes is a form of polymorphic ventricular tachycardia due to prolonged ventricular repolarization represented by a prolonged QT interval on electrocardiogram. Common causes of QT prolongation are usually considered in the clinical setting, such as electrolyte imbalances, medication side effects, congenital syndromes. As recent research has proposed, long-term excessive alcohol use may also be a contributing factor. The effects of alcohol on the heart have been studied extensively, showing that chronic exposure leads to cellular events and structural changes in the heart that may ultimately result in adverse clinical events. This case report presents a patient with a history of chronic alcoholism that experienced torsades de pointes and sudden cardiac death during hospitalization for a severe chronic obstructive pulmonary disease exacerbation. She was given macrolide antibiotics despite a prolonged QTc on electrocardiogram with a history of prior syncopal events. While macrolide antibiotics are known to cause QTc prolongation, chronic alcohol use has also been shown to be associated with QT prolongation. Moreover, QT prolongation may be a predictor of sudden cardiac death in alcoholics. In addition to common medication class side effects, the effects of commonly abused and readily accessible substances such as alcohol, should also be taken into consideration.
American Journal of Medical Case Reports. 2018, 6(6), 117-120. DOI: 10.12691/ajmcr-6-6-5
Pub. Date: July 24, 2018
8520 Views2022 Downloads
by A. LAGDID, M. Boufettal, RA. Bassir, M. KHARMAZ, MO Lamrani, M. Ouadghiri, A. El Bardouni, M. MAHFOUD and M.S. BERRADA
Case Report
Our study reports a case of a multipartite patella that was initially diagnosed as a patellar fracture in a traumatic context but in view of the smooth, regular and dense appearance of the fracture traits, a comparative radiological evaluation of the other knee was necessary, which precluded the diagnosis of fracture in favor of a multipartite patella with knee sprain treated by immobilization and treatment anti-inflammatory with a good evolution, hence the interests of performing a comparative radiological assessment of the contralateral knee in front of any patellar fracture. The multipartite patella is recognized as a developmental anomaly of ossification. Most of them are asymptomatic and are discovered incidentally. The multipartite patella is sometimes misdiagnosed as a patellar fracture, because the x-ray images of both these conditions may appear very similar.
American Journal of Medical Case Reports. 2018, 6(6), 114-116. DOI: 10.12691/ajmcr-6-6-4
Pub. Date: July 21, 2018
7959 Views1113 Downloads
by Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Ronald Pedalino, Sudhanva Hegde, Jonathan D. Marmur, Aarti Shenoy, Michael Ashamalla, Justina Ray and Samy I. McFarlane
Case Report
Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) infection is a matter of public health concern. The incidence of community acquired Staphylococcus aureus (CA-MRSA) is rising. To date only 12 cases of CA-MRSA pericarditis and seven cases of esophageal cancer related purulent pericarditis have been reported. We here present a 54 year old woman who presented with cardiac tamponade that was noted to be purulent and in whom esophagopericardial fistula secondary to squamous cell esophageal cancer was discovered subsequently. Purulent pericardial fluid subsequently grew MRSA. Patient succumbed despite appropriate management with antibiotics.
American Journal of Medical Case Reports. 2018, 6(6), 109-113. DOI: 10.12691/ajmcr-6-6-3
Pub. Date: July 10, 2018
15437 Views3207 Downloads
by Asad Ullah, Zeeshan Khakwani, Asghar Marwat and Samuel Massoud
Case Report
A 38 years old lady presented to her local hospital with acute abdominal pain. To evaluate the cause of her abdominal pain, she had a computed tomography (CT) scan of her abdomen that showed thickening of the distal portion of the transverse colon. For further evaluation, patient underwent colonoscopy that revealed a circumferential colonic mass in the distal portion of the colon that was suspicious for colon cancer. The colonic mass was biopsied and tissue pathology reported adenocarcinoma. Subsequently, magnetic resonance imaging (MRI) scan of her abdomen was obtained that showed the presence of numerous lesions throughout the liver. She underwent laparoscopic hemicolectomy and subsequently chemotherapy with significant improvement of her symptoms and disease burden.
American Journal of Medical Case Reports. 2018, 6(6), 106-108. DOI: 10.12691/ajmcr-6-6-2
Pub. Date: July 09, 2018
9439 Views2743 Downloads
by Benjamin Bluen, Lukasz Kiljanek, Larry Krevolin, Kyle Krevolin and Hans P. Schlecht
Case Report
Peritoneal dialysis catheter-related peritonitis is typically related to catheter insertion or hygiene. Organisms usually manifest as gram positive organisms typically Staphylococci or gram negative bacilli that typically colonize aqueous environments such as Pseudomonas spp. as well as other unusual mycobacterial or fungal pathogens. The authors present a unique case of peritoneal dialysis catheter-related peritonitis manifesting after the patient’s cat bit the proximal aspect of the catheter attachment tubing. After failure to clinically improve after outpatient treatment of Staphylococcus hemolyticus and Staphylococcus capitis catheter related-peritonitis with intraperitoneal Vancomycin and empiric Gentamicin, repeat peritoneal cultures were sent that demonstrated growth of Rhizobium radiobacter. The patient was admitted inpatient and treatment was tailored to intraperitoneal Cefepime with clearance of peritoneal cultures and rapid improvement in peritoneal white blood cell count and the patient’s clinical condition. The patient was subsequently discharged on oral Ciprofloxacin with complete recovery and catheter salvage.
American Journal of Medical Case Reports. 2018, 6(6), 103-105. DOI: 10.12691/ajmcr-6-6-1
Pub. Date: July 03, 2018
10408 Views2340 Downloads