by Ohanube GAK, Obeta MU, Ikeagwulonu RC and Jwanse IR
Original Research
The effects of the Coronavirus Disease 2019 (COVID-19) have culminated in a pandemic of great magnitude, with no specific cure in view. Efforts are ongoing by Alternative medicine practitioners to use an existing or new line of herbal products to manage this novel virus. This study reveals that garlic, ginger, and lime when blended, boiled in water, and allowed to cool before drinking, healed the patient with typical signs and symptoms related to COVID-19. Healing was evident in 3 days as observed in our case study who lives in Abuja, Nigeria after this herbal mixture was taken alongside vitamin C (Ascorbic acid). His family was also advised to be on Ascorbic acid for prophylaxis with none of them isolated; yet, they were not infected. Hence, we posit that herbs with a high content of vitamin C be utilized in the management of cases presenting with typical symptoms of COVID-19.
American Journal of Medical Case Reports. 2020, 8(11), 435-437. DOI: 10.12691/ajmcr-8-11-16
Pub. Date: August 07, 2020
2911 Views421 Downloads
by Nazish Malik, Munawwar Hussain and Cyril Nathanial
Case Report
Acute pericarditis is common and often mimics acute coronary syndrome (ACS) in clinical as well as electrographic presentation. It is essential to differentiate between these two conditions, as treatment is different. A rare form of acute pericarditis, regional pericarditis, can be elusive, especially when it presents on EKG as an acute ST-segment elevation MI of a particular wall. We present a case of localized (regional) pericarditis in a 66-year-old female with a history of rheumatoid arthritis who presented to the emergency department with localized left-sided chest pain. Her arrival EKG showed acute anterolateral wall ST-segment elevation. The patient received diagnostic cardiac catheterization, treatment with colchicine and steroid, which produced resolution of symptoms and EKG changes.
American Journal of Medical Case Reports. 2020, 8(11), 433-434. DOI: 10.12691/ajmcr-8-11-15
Pub. Date: August 04, 2020
3319 Views438 Downloads
by Kashini Andrew, Mohd Bakar and Mivanyi Kadala
Case Report
In December 2019 reports from Wuhan showed the emergence of a form of acute respiratory illness caused by a new strain of coronavirus subsequently named Severe acute respiratory distress syndrome coronavirus 2 (SARS CoV-2, 2019-nCoV) due to its close homology (80%) to SARS COV, responsible for a series of Acute Respiratory Distress syndrome between 2002-2003. Since the onset of the pandemic there has been an interest in the cutaneous manifestations of the viral infection. A 35 year old staff nurse presented with fever, dry cough, malaise and myalgia. She tested positive for SARS CoV2. She developed an urticarial rash which was red, itchy and macular affecting both forearms sparing the hands on day 10 of the onset of symptoms. The rash lasted for 72 hours and resolved spontaneously. She had not been started on any new medications prior to the onset of illness. She made a good recovery after three weeks of symptoms with itching controlled by chlorphenamine maleate. Physicians should remember that even though SARS-CoV2 presents with mainly respiratory symptoms which could become life threatening, cutaneous manifestations do occur and can vary in distribution and morphology.
American Journal of Medical Case Reports. 2020, 8(11), 431-432. DOI: 10.12691/ajmcr-8-11-14
Pub. Date: August 03, 2020
4394 Views608 Downloads
by Mousa Suhail Abu Ghoush, Mahfoud El. Bashari, Amani Alzaabi and Mohammed Aboelnaga
Case Report
Coronavirus disease 2019 (COVID-19) is a viral infection caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), it spreads from person to person rapidly and presents with multi systemic manifestations namely respiratory symptoms, similar to prior SARS viruses. Neurologic manifestations of COVID-19 are uncommon; those include encephalopathy, strokes, and polyneuropathy. Here we report a unique neurologic complication of COVID-19 in a patient who had extensive cerebral small-vessel ischemic lesions resembling those of cerebral vasculitis. This case report supports the fact that neurologic complications from CVOID 19 could be more debilitating than the respiratory illness itself, especially for those patients who were eventually able to survive the complicated course of being on mechanical ventilation but unfortunately end up with this extensive CNS insult.
American Journal of Medical Case Reports. 2020, 8(11), 428-430. DOI: 10.12691/ajmcr-8-11-13
Pub. Date: July 31, 2020
3201 Views547 Downloads
by Gin Den William Chang, Christabel Nyange, Sana Ahmad, Prateek Baghel, Elizabeth Brown, Sandrine Lebrun and Nicholas Skipitaris
Case Report
Brugada syndrome is a known electrophysiological phenomenon associated with high risk of sudden cardiac death. However, there are a number of published case reports showing a Brugada pattern in patients due to an underlying agent or cause. This case provides the nearly ideal clinical setup for a patient presenting with electrocardiographic findings of Brugada due to multiple factors requiring treatment of the underlying causes without need for further long term interventions.
American Journal of Medical Case Reports. 2020, 8(11), 424-427. DOI: 10.12691/ajmcr-8-11-12
Pub. Date: July 31, 2020
3496 Views441 Downloads
by Saya Ikegami, Kei Jitsuiki, Ken-ichi Muramatsu, Hiroki Nagasawa, Ikuto Takeuchi and Youichi Yanagawa
Case Report
An 80-year-old man was extremely skinny and developed a left leg phlegmon. He was admitted and underwent an infusion of cefazolin. On the third day, he suddenly collapsed, and advanced cardiac life support resulted in a return of his circulation. He showed vasopressor-resistant hypotension and therefore received an infusion of steroids and multiple supportive therapies. A blood culture later showed Pseudomonas aeruginosa. While his blood pressure increased, he showed peripheral and labile cyanotic changes, even though his peripheral arteries were palpable. On the third day after the collapse, he showed blisters at purpura sites and labile, resulting in the formation of erosions. On the fourth day, massive effusion was drained from the erosive lesions. He temporarily showed a return of consciousness, but his extremities became necrotic, and he ultimately died due to a secondary infection at the erosive lesions. The present fatal case of acute infectious purpura fulminans might have been induced by a P. aeruginosa infection due to complications with multiple blisters, similar to Stevens-Johnson syndrome/toxic epidermal necrolysis. Early aggressive surgical amputation or debridement might be required to obtain a survival outcome when encountering such cases.
American Journal of Medical Case Reports. 2020, 8(11), 421-423. DOI: 10.12691/ajmcr-8-11-11
Pub. Date: July 30, 2020
3199 Views460 Downloads
by Ken-ichi Muramatsu, Kazuhiko Omori and Youichi Yanagawa
Case Report
The patient was a 72-year-old woman who had started to feel left buttock pain 10 days prior to admission to our hospital. She visited a local clinic, where a pain killer was prescribed. However, her pain deteriorated, expanding to her back and left leg, and she became unable to walk. Thus, she was transported to our hospital. She had diabetes mellitus, dyslipidemia, chronic heart failure, and lumbar spinal canal stenosis. She was initially diagnosed with sciatic neuralgia due to lumbar spondylosis and treated with acetaminophen and returned home. The next day, however, she developed bilateral leg paralysis and difficulty speaking. When the emergency medical technicians checked her, she was in cardiac arrest. On arrival at our hospital, she obtained spontaneous circulation but ultimately died. Whole-body computed tomography revealed gas deep in the left buttock, the bilateral psoas muscles and spinal canal. A blood culture later revealed Escherichia coliinfection. Physicians should pay attention when patients with a high pain threshold, including those who are elderly, female or who have diabetes mellitus, complain of refractory buttock pain.
American Journal of Medical Case Reports. 2020, 8(11), 418-420. DOI: 10.12691/ajmcr-8-11-10
Pub. Date: July 30, 2020
3156 Views450 Downloads
by Mousa Suhail Abu Ghoush, Abdulla Alhassani, Alaa Alkhazraji and Syed Hussaini
Case Report
Background: Eosinophilic gastroenteritis is a rare disease of the gastrointestinal tract that may involve some or all of its layers.It may have a varied presentation and is characterized by eosinophilic infiltration. The diagnosis is typically confirmed by biopsy, which should reveal 20-25 eosinophils per high-power field on microscopic examination. Case Presentation: We report a 25 years old man who presented with acute abdominal pain and diarrhea. He was found to have moderate ascites on abdominal US. The investigations revealed peripheral eosinophilia with markedly elevated eosinophils (96%) in the ascitic fluid. The imaging studies showed diffuse concentric bowel wall thickening involving the entire small bowel and Colon. The diagnosis was confirmed by biopsy from the duodenum, terminal ileum and colon. The patient was managed with steroids. Conclusions: This case report highlights a rare entity of Eosinophilic gastritis, which is eosinophilic gastroenterocolitis, diagnosis is confirmed via histopathology along with clinical presentation and exclusion of other causes of tissue eosinophilia.
American Journal of Medical Case Reports. 2020, 8(11), 413-417. DOI: 10.12691/ajmcr-8-11-9
Pub. Date: July 26, 2020
4204 Views569 Downloads
by Rohit Jacob and Manjiri Naik
Case Report
A 60 year old female presented with a 1 day history of altered sensorium. Her imaging findings were suggestive of Viral Encephalitis, for which she was empirically treated with Acyclovir. However, due to the rising incidence of COVID 19 all over the globe, her nasopharyngeal swab was sent for RT PCR, suspecting COVID 19. The report tested positive and she was simultaneously started on Favipravir and vitamin and mineral supplements. After 4 days of initiating treatment, she developed bilateral Crepitations and the Chest XRay was suggestive of Bilateral midzonal haziness. Eventually she was started on Methylprednisolone following which she showed signs of improvement. She eventually regained her orientation and completely recovered from Encephalitis and COVID 19 pneumonia after 15 days of initiating treatment. This case is reported to suggest one of the rarest non - respiratory manifestation of COVID 19.
American Journal of Medical Case Reports. 2020, 8(11), 409-412. DOI: 10.12691/ajmcr-8-11-8
Pub. Date: July 26, 2020
3242 Views289 Downloads2 Likes
by Gil Hevroni, Andrii Maryniak, Diego Cepeda-Mora, Moro O. Salifu and Samy I. McFarlane
Case Report
Rates of implantation of prosthetic valves and cardiac devices have increased significantly in the last thirty years, accounting, at least in-part, for the growing incidence of infective endocarditis cases. Prosthetic valve endocarditis (PVE) is an endovascular, microbial infection occurring on parts of a valve prosthesis or on reconstructed native heart valves. We present a case of a 63-year-old man with multiple comorbidities including extensive cardiovascular disease, who recently underwent bioprosthetic aortic valve replacement. Patient presented to the emergency department with exertional chest pain, dyspnea, fever, melena and lethargy. Blood cultures grew Streptococcus salivarius and transesophageal echocardiography confirmed PVE with an aortic paravalvular abscess. The patient was treated with appropriate antimicrobial therapy based on culture sensitivity and subsequently referred to cardiothoracic surgery for urgent evaluation. This case highlights several important points which include but are not limited to: investigation into the pathogen Streptococcus salivarius and its relationship to other known pathogens, understanding of the complications associated with PVE, and the importance of early identification of PVE and initiation of medical and surgical therapy with respect to prognosis.
American Journal of Medical Case Reports. 2020, 8(11), 405-408. DOI: 10.12691/ajmcr-8-11-7
Pub. Date: July 23, 2020
3868 Views564 Downloads
by Benjamin Ramalanjaona, Gil Hevroni, Samantha Cham, Cameron Page, Moro O. Salifu and Samy I. McFarlane
Original Research
Methotrexate (MTX) toxicity can affect multiple organ systems, manifesting as nephrotoxicity, myelosuppression, hepatotoxicity, mucositis, and gastrointestinal upset. Serious adverse events are rare in patients prescribed low-dose methotrexate. We present a case of an 86-year-old female on a weekly dose of oral MTX 12.5 mg for rheumatoid arthritis presenting with painful gingiva and oral bleeding during outpatient antimicrobial therapy (OPAT) for osteomyelitis with vancomycin and piperacillin-tazobactam. She had acute kidney injury (AKI), elevated serum MTX levels, thrombocytopenia, neutropenia, and a vancomycin level three times therapeutic concentration. MTX toxicity was suspected to have been triggered by vancomycin and piperacillin-tazobactam causing AKI and impaired renal clearance of MTX which itself is nephrotoxic. The patient was managed with leucovorin, alkalinized intravenous fluids, and filgrastim injections over a 2-week period. Her renal function continued to be reduced at 5-week outpatient follow-up, far after other markers of toxicity normalized. This case demonstrates the importance of considering potential drug-drug interactions and the need for robust monitoring for OPAT in select groups.
American Journal of Medical Case Reports. 2020, 8(11), 400-404. DOI: 10.12691/ajmcr-8-11-6
Pub. Date: July 23, 2020
4022 Views614 Downloads
by Mark Ashamalla, Hira Chaudhary, Gil Hevroni, Moro O. Salifu and Samy I. McFarlane
Case Report
Coronavirus disease 2019 (COVID-19) is a pandemic that started in Wuhan city, Hubei province in China in December 2019 and is associated with high morbidity and mortality. This pandemic has overwhelmed health care systems in the USA, Europe and many other countries around the globe. Several health care institutions, including ours, SUNY-Downstate Health Science University in Brooklyn, New York, were designated as COVID-only hospitals. At the same time, patients with other serious illnesses refrained from seeking medical care because of the fear of contracting the virus at the health care facilities. In this report, we present a case of an octogenarian woman with breast cancer who was treated initially with radical mastectomy and chemotherapy, who then developed back pain in mid-March 2020, that later progressed to bilateral lower extremity weakness secondary to cord compression, which was diagnosed nearly 4 weeks after her initial symptoms started. The patient had refrained from seeking medical care citing fear of contracting COVID-19 in the hospital. This case illustrates the dire need to establish mechanisms within our health care system to manage oncologic (and other life or limb threatening) emergencies during times such as the COVID-19 pandemic.
American Journal of Medical Case Reports. 2020, 8(11), 397-399. DOI: 10.12691/ajmcr-8-11-5
Pub. Date: July 23, 2020
3944 Views475 Downloads
by Arturs Balodis, Davis Simanis Putrins, Julija Dolgopolova, Inese Briede, Renars Putnins and Ginta Balode
Original Research
A 65-year-old male patient was referred to a university hospital with a skull mass and previous history of left lung carcinoma, although a left sided pneumonectomy had been performed two years ago. The large solitary extra-axial, intra- and extra-osseous skull mass exhibited uncharacteristic radiologic features that were atypical for all of the proposed differential diagnoses, which included metastasis, atypical meningioma, and osteosarcoma. An incomplete patient history also made the radiologic diagnosis more difficult. In the end a tumour excision was performed and the tissue morphology and immunohistochemical properties examined, and the diagnosis of a metastatic lung carcinoma to the skull was confirmed.
American Journal of Medical Case Reports. 2020, 8(11), 394-396. DOI: 10.12691/ajmcr-8-11-4
Pub. Date: July 22, 2020
3927 Views620 Downloads
by Paul Madaj, Lu Chen, Yuvraj Singh Choudhury, Robert M Donnino and Cristina A Mitre
Case Report
The novel coronavirus disease 2019 (COVID-19) has changed our lives and reshaped our approach to management of various cardiovascular diseases. Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia, most often seen in patients with structural heart disease. If underlying ischemia is suspected, coronary angiography is usually performed on a non-elective basis. In patients with active COVID-19, additional risks of the procedure must be considered for patients and for operators. This case illustrates the management of suspected ischemic VT and discusses the dilemma physicians must face in the ongoing COVID-19 pandemic.
American Journal of Medical Case Reports. 2020, 8(11), 389-393. DOI: 10.12691/ajmcr-8-11-3
Pub. Date: July 22, 2020
3949 Views536 Downloads
by Mousa Suhail Abu Ghoush
Case Report
Background: Hereditary neuropathy with liability to pressure palsies (HNPP) is an uncommon diagnosis that should be considered in patients with multiple compressive neuropathies. This case reports highlights a relatively rare neuropathy with genetic and occupational predisposition, probably first to be reported in the united arab emirates. Case Presentation: We present the case of a 41 years old male who presented with right hand numbness and weakness. Electrodiagnostic testing revealed multifocal neuropathy. Subsequent genetic testing identified heterogeneous deletion of the PMP22 gene to confirm the diagnosis of HNPP. Conclusions: Hereditary neuropathy with liability to pressure palsies can present as a multifocal neuropathy. Occupational history along with genetic testing plays a pivotal role to make the diagnosis.
American Journal of Medical Case Reports. 2020, 8(11), 386-388. DOI: 10.12691/ajmcr-8-11-2
Pub. Date: July 16, 2020
3245 Views473 Downloads
by Chukwuemeka A. Umeh and Ankit Dubey
Original Research
Coronary artery ectasia (CAE) or aneurismal coronary artery disease is a rare dilatation of a segment of the coronary artery to more than 1.5 times of the normal adjacent segments. CAE is mainly caused by atherosclerotic disease and is usually asymptomatic. The authors present an 88 year-old-male with underlying coronary artery disease and repaired abdominal aortic aneurysm (AAA) who presents with recurrent angina and was diagnosed with CAE by coronary angiography. Patient was managed medically with aspirin, statin, beta blocker and anticoagulant.
American Journal of Medical Case Reports. 2020, 8(11), 383-385. DOI: 10.12691/ajmcr-8-11-1
Pub. Date: July 14, 2020
2884 Views482 Downloads