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Volume 8, Issue 12

Lightning Injury Caused by a Side Flash
Case Report
A 29-year-old male soldier, who was taking part in a military field training exercise during summer, lost consciousness and fell backwards while sheltering at the foot of a tree that was struck by lightning during a thunderstorm. Upon arrival, his vital signs were stable. He had a linear burn at the right brachium with headache. Electrocardiography, cardiac ultrasound and whole body computed tomography revealed no specific findings. Blood biochemistry revealed rhabdomyolysis. The post-admission course was uneventful. This is a rare report of a patient who received a side flash from a tree during a lightning strike. Service members who routinely train and work outdoors should be vigilant in relation to the dangers of lightning.
American Journal of Medical Case Reports. 2020, 8(12), 538-540. DOI: 10.12691/ajmcr-8-12-29
Pub. Date: October 13, 2020
3800 Views256 Downloads
Atypical 'Aspiration Pneumonia: A Rare Case of Co-infection with Mycoplasma Pneumonia and Streptococcus Pneumonia
Case Report
Mycoplasma pneumoniae is known to cause atypical pneumonia, but not aspiration pneumonia, macrolides are still considered the first-line therapy. Typical antimicrobials used to treat aspiration pneumonia does not cover atypical pneumonia, here we report a case of a young, previously healthy female with no significant medical history, who was in her usual state of health before she was brought to the hospital with altered mental sensorium, preceded by benzodiazepine intake that she bought from the street. She had imaging and labs consistent with acute hypoxic respiratory failure due to aspiration pneumonia, was intubated and started on mechanical ventilation. She was found to be co-infected with mycoplasma pneumonia and streptococcus pneumonia, successfully managed with intravenous antibiotics, and eventually liberated from the ventilator and was safely discharged home.
American Journal of Medical Case Reports. 2020, 8(12), 535-537. DOI: 10.12691/ajmcr-8-12-28
Pub. Date: September 29, 2020
2932 Views296 Downloads
Epstein-Barr Virus Associated Myopericarditis Presenting as Generalized Anxiety
Case Report
Background: This case highlights the importance of motivational interviewing in a rare condition with comorbid psychiatric symptomology. Epstein-Barr Virus (EBV) induced myopericarditis has not been described in a healthy young woman. Her anxiety symptoms complicated the diagnosis of this condition. Case presentation: Ms. A is an otherwise healthy 26-year-old female with a history of generalized anxiety disorder. She presented to the emergency department with anxiety and a sense of impending doom. Her family history is positive for hypertension and unspecified mental health issues. She refused workup due to panic symptoms but was persuaded through motivational interviewing. Eventual cardiac MRI revealed viral induced myopericarditis. The outcome was both resolution of her cardiovascular and psychiatric symptomology. Conclusion: The implications of this case report is the value of addressing psychological resistance to pathophysiological workup. Once her concerns were addressed through psychological and psychopharmacological methods, a rare cardiovascular disorder was identified and treated. The lesson for healthcare providers is that nonjudgmental interviewing can lead to the diagnosis of very uncommon diseases.
American Journal of Medical Case Reports. 2020, 8(12), 532-534. DOI: 10.12691/ajmcr-8-12-27
Pub. Date: September 28, 2020
3186 Views214 Downloads
Rare Case of Incarcerated Bilateral Spigelian Hernia in Ghana: A Case Report and Literature Review
Case Report
Spigelian hernia is an uncommon form of abdominal wall hernia. The symptoms can be insidious but the commonest are abdominal pain or a lump on the anterior abdominal wall. Diagnosis can be challenging, but the use of ultrasonography and contrast enhanced CT (CECT) scan is essential to avoid diagnostic delays. In view of a high risk of incarceration and strangulation anticipated, urgent operative intervention is necessary. In this case report, a 42-year old multiparous woman presented with bilateral lumps on the abdominal wall and abdominal pain with no symptoms or signs of obstruction or strangulation. The clinical evaluation was suspicious of bilateral spigelian hernia. This was confirmed by CECT scan of abdomen as ultrasonography was inconclusive. This case report illustrates the diagnostic challenges of spigelian hernia and how early operative intervention is crucial to preventing strangulation.
American Journal of Medical Case Reports. 2020, 8(12), 528-531. DOI: 10.12691/ajmcr-8-12-26
Pub. Date: September 28, 2020
4192 Views431 Downloads
Vulvar Squamous Cell Carcinoma in a Patient with AIDS: A Case Study
Case Study
Vulvar cancer comprises 5% of gynecological cancers with squamous cell carcinoma (SCC) being found in 90% of the cases. Vulvar intraepithelial neoplasia is human papilloma virus (HPV)-driven and is the precursor lesion in nearly 40% of all cases of vulvar SCC. Pruritus is reported as the most common initial manifestation of vulvar SCC which may be of a long duration with pain, discharge, and bleeding been less frequently reported which contributes to the delayed initial presentation of the disease. So far, there are no recommended screening strategies for vulvar cancer and HPV vaccination may be the only effective way for prevention. We present a case of advanced vulvar cancer in an immunocompromised host. We will review pertinent topics for the clinicians on HPV infection prevention, clinical course, staging and the need for strong efforts on patient education.
American Journal of Medical Case Reports. 2020, 8(12), 522-527. DOI: 10.12691/ajmcr-8-12-25
Pub. Date: September 28, 2020
5442 Views385 Downloads
Anomalous Origins of All Three Coronary Arteries from Separate Ostia within the Right Aortic Cusp: A Case Report and Review of the Literature
Case Report
Coronary artery anomalies are congenital defects which are found incidentally or after cardiac events. While these are rare abnormalities with the majority of patients remain asymptomatic and largely undiagnosed, it remains to be a major cause of sudden cardiac death (SCD). Anomalous origin of left coronary artery (ALCA) from the opposite right aortic sinus is extremely rare with less than 100 cases reported to-date. These patients are at increased risk for significant cardiac events, including SCD. In this report, we present a 48-year-old man with hypertension and marijuana use who was admitted initially with multi-lobar pneumonia and acute kidney injury, developed respiratory failure and sustained ST elevation myocardial infarction (STEMI). Coronary angiography demonstrated anomalous origin of all three main coronary arteries arising from right aortic sinus. In this report we also discuss the genesis of this rare and potentially fatal congenital abnormality and we highlight the diagnostic and management strategies available to-date.
American Journal of Medical Case Reports. 2020, 8(12), 518-521. DOI: 10.12691/ajmcr-8-12-24
Pub. Date: September 25, 2020
3297 Views339 Downloads
An Unusual Case of Ruptured Amoebic Liver Abscess into the Pericardium via Hepato Pericardial Fistula
Case Report
Diagnosing a rare disease is challenging but unravelling the rare findings of a common disease is motivating! One such common disease dealt in the case report below is Amoebiasis. Amoebiasis is a major public health problem worldwide. Mortality due to amebiasis is mostly by extra intestinal infections, amebic liver abscess being the most common one. Overall, 10% of the world’s population is infected with Entamoeba histolytica (E. histolytica) but out of this only 1% becomes symptomatic. Nearly 20% of the Indian population show manifestations of the disease. With this background epidemiological prevalence, we present an unusual case of a 30year old male with a ruptured amoebic liver abscess into the pericardium.
American Journal of Medical Case Reports. 2020, 8(12), 515-517. DOI: 10.12691/ajmcr-8-12-23
Pub. Date: September 25, 2020
3648 Views201 Downloads
Pneumomediastinum after Convulsion and Vomiting
Case Report
A 15-year-old woman had a vomiting following 10 minutes of clonic convulsion after intentional overdose of cold remedy. When emergency medical technicians checked her, convulsion had subsided, however, she had a convulsion again during transportation. On arrival, she was coma state but had clear airway. Her head computed tomography (CT) was negative, however, chest roentgen and CT showed spontaneous pneumomediastinum (SPM). Initially, physician on duty did not know that she had had overdose, she just underwent infusion of evetiracetam and tazobactam / piperacillin. Her consciousness became clear on day 2. Post admission course was no eventful and she discharged without sequlae. We present extremely rare case of SPM immediately after a convulsion. As mechanism of such complication is poorly understood, further analysis by accumulation of such cases is necessary.
American Journal of Medical Case Reports. 2020, 8(12), 512-514. DOI: 10.12691/ajmcr-8-12-22
Pub. Date: September 25, 2020
3003 Views284 Downloads
MFSD8 Mutation Causing Neuronal Ceroid Lipofuscinosis Type 7 in a Bangladeshi Patient: A Rare Case Report and Review of Literature
Case Report
The neuronal ceroid lipofuscinoses (NCLs) are a heterogeneous group of inherited neurodegenerative disorders. Their unifying clinical hallmarks are seizures, visual loss, myoclonus, ataxia, cognitive and motor regression which lead to early death. Based on the clinical onset of symptoms NCL-affected individuals have been classified into six categories. Fourteen genetic forms of NCL (CLN1 to CLN14) have been identified so far. The variant late-infantile form of the disease has been linked to CLN5, CLN6, CLN7 (MFSD8) and CLN8 mutations.We report a patient of 9 years from a consanguineous family who presented with progressive visual loss and seizures. Clinical Exome sequencing reveals a homozygous missense mutation in exon 11 of the MFSD8 gene (c.1235C>T, p.Pro412Leu). To our knowledge, this is the first report of MFSD8 gene mutation in a Bangladeshi patient with variant late-infantile NCL. This study also provides information regarding the phenotypic and molecular spectrum of CLN7 disease.
American Journal of Medical Case Reports. 2020, 8(12), 508-511. DOI: 10.12691/ajmcr-8-12-21
Pub. Date: September 25, 2020
3277 Views229 Downloads2 Likes
Anti-N-methyl-d-aspartate Receptor Encephalitis Related Sinus Node Dysfunction and the Lock-Step Phenomenon
Case Report
Described in 2007, anti-N-methyl-d-aspartate receptor encephalitis (ANMDARE) is a rare autoimmune limbic encephalitis affecting young adults (predominantly women of reproductive age) and is a paraneoplastic manifestation of ovarian teratoma in about half of the cases. ANMDARE is characterized by psychiatric changes, neurological changes, autonomic instability and cardiac dysrhythmias. In this report, we present a 36-year-old woman who was 16 weeks pregnant and brought to the hospital with confusion and subsequently had a seizure with Electroencephalography (EEG) demonstrated an extreme delta brush pattern consistent with ANMDARE. Patient developed sinus nodal dysfunction and was also found to have ovarian teratoma, a rather typical presentation for ANMDARE, that is considered a paraneoplastic syndrome for ovarian teratoma. In this report, we highlight the cardiac manifestation of ANMDARE, the pathophysiology associated with autonomic instability, and management strategies of this rare, and largely devastating illness.
American Journal of Medical Case Reports. 2020, 8(12), 503-507. DOI: 10.12691/ajmcr-8-12-20
Pub. Date: September 25, 2020
4284 Views359 Downloads
Myocarditis Associated With COVID-19
Original Research
Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic, with affecting to-date over 23 million people and causing over 800,000 deaths around the globe. The major pathogenetic mechanisms include inflammation, vasoconstriction and thrombogenesis. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically manifests as fever, cough, shortness of breath, and exhibits radiographic evidence of bilateral pneumonic infiltrates. Recent meta-analyses have shown that myocardial injury, including viral myocarditis, is prevalent among infected patients, especially in patients requiring ICU level care. Diagnosis of viral myocarditis is multifactorial and involves detection of elevated cardiac biomarkers and echocardiographic evidence of cardiomyopathy, in the absence of diseased coronary arteries. Endomyocardial biopsy with histopathologic examination provides definitive confirmation. We present a case of a previously healthy 52-year-old male who presented clinically with suspected myocarditis with new-onset dilated cardiomyopathy (DCM) and systolic dysfunction as a sequela of infection with SARS-CoV-2. In this report we highlight the clinical presentation of echocardiographic findings and proposed pathogenetic mechanisms of myocarditis associated with COVID-19 which has a varied presentation, ranging from clinically silent to life-threatening arrhythmias with hemodynamic compromise.
American Journal of Medical Case Reports. 2020, 8(12), 498-502. DOI: 10.12691/ajmcr-8-12-19
Pub. Date: September 25, 2020
4324 Views357 Downloads
A Rare Case of Acute Ischemic Hepatitis Secondary to Hepatic Sequestration Crisis in Sickle Cell Disease
Case Report
Acute Ischemic Hepatitis in sickle cell disease could lead to acute hepatic failure. The term Sickle Cell Hepatopathy encompasses a wide range of hepatic manifestations that occur due to this disease itself or secondary to treatment. Although our patient had a homozygous inheritance for the sickle cell gene but never experienced any hepatic complications of the disease. Our patient experienced an acute hepatic sequestration crisis which otherwise usually occurs in the spleen. This case signifies the importance of early evaluation and management of hepatic involvement in sickle cell disease to prevent overt hepatic failure.
American Journal of Medical Case Reports. 2020, 8(12), 496-497. DOI: 10.12691/ajmcr-8-12-18
Pub. Date: September 23, 2020
2819 Views278 Downloads
Appendicitis: In the Times of COVID-19
Case Report
Coronavirus disease -19 (COVID-19) is a novel contagious infection initially thought to be a respiratory pathogen, but there is increasing evidence of multisystem involvement. Here, we report a 43-year-old male who presented with acute abdominal pain associated with fever and chills and was diagnosed with acute appendicitis. He was tested positive for COVID-19, and because of elevated inflammatory markers, the patient was successfully managed non-operatively with remdesiver and intravenous (IV) antibiotics. Our patient had predominantly abdominal findings, and we believe that that there is a possibility that appendicitis may be associated with COVID-19.
American Journal of Medical Case Reports. 2020, 8(12), 494-495. DOI: 10.12691/ajmcr-8-12-17
Pub. Date: September 17, 2020
2956 Views336 Downloads
A Case of Cardiac Arrest Soon after Receiving a Sting from a Wasp
Case Report
While felling trees along a national roadside in a remote area, a 38-year-old man suddenly cried out that he had been stung by a wasp on his left hand. His colleague came over to him, and he fell unconscious, so his colleague called an ambulance. When emergency technicians found him, he was in cardiopulmonary arrest. His initial rhythm was asystole. He receive advanced cardiac life support but was unable to obtain return of spontaneous circulation, possibly due to his anaphylactic shock and complication with Kounis syndrome resulting in a low cardiac output, as he showed temporal complete bundle branch block with tachycardia PEA, repeated ventricular fibrillation, and elevated cardiac enzymes. The presence of a sting mark may also have been a sign of his severe state and complication of Kounis syndrome. The establishment of a new framework, such as permitting non-medical staff to inject adrenaline into patients with anaphylaxis, might be required.
American Journal of Medical Case Reports. 2020, 8(12), 491-493. DOI: 10.12691/ajmcr-8-12-16
Pub. Date: September 17, 2020
3283 Views339 Downloads
Extensive Peripheral Arterial Thrombosis in a Patient with SARS-CoV-2 Infection
Case Report
Thrombosis is one of the major underlying pathogenetic mechanisms leading to increased morbidity and mortality among COVID-19 patients. Thromboembolic events as well as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are the major causes of death in this continued pandemic. While elevated D-dimer level suggests worse thrombotic outcomes, levels at which benefits of anticoagulation outweigh the bleeding risk is yet to be determined. In this report, we present a case of a 72-year-old man with COVID-19 presented with confusion and subsequently developed acute hypoxic respiratory failure. On hospital day 7, patient developed extensive peripheral arterial thrombosis with acute rise of D-dimer from 800 to 14,899 ng/ml. He was treated with heparin drip and underwent urgent brachial, radial and ulnar embolectomy under general anesthesia. In this report, we also discuss the pathogenetic mechanisms and management of thromboembolism in COVID-19 patients, highlighting the role of early detection and aggressive therapeutic interventions that could be life and / or limb saving strategy.
American Journal of Medical Case Reports. 2020, 8(12), 486-490. DOI: 10.12691/ajmcr-8-12-15
Pub. Date: September 15, 2020
4052 Views394 Downloads
Zosteriform Cutaneous Leishmaniasis of the Elbow
Original Research
Clinical features of cutaneous leishmaniasis (CL) are characterized by a very significant polymorphism making its diagnosis a real challenge for healthcare professionals. Herpes-zoster-like or zosteriform leishmaniasis is exceptional and often misdiagnosed atypical/unusual presentation of CL. Its prevalence is estimated at 0.14-0.17% of all CL and 2.4% of atypical CL, and is often reported as sporadic clinical cases. We present an original case of zosteriform CL at the elbow, in a young immunocompetent Tunisian woman.
American Journal of Medical Case Reports. 2020, 8(12), 483-485. DOI: 10.12691/ajmcr-8-12-14
Pub. Date: September 15, 2020
3868 Views235 Downloads
Occupant Restraint Systems do not Completely Prevent Injury at the Cranio-cervical Junction in a High-energy Accident
Case Report
Advances in automobile crashworthiness have reduced both fatalities and severe injuries with different occupant restraint systems (seatbelts and airbags). However, even the appropriate use of these systems does not always completely prevent injury at the cranio-cervical junction in a high-energy accident. This report presents two such cases. Drivers should be educated not to place too much confidence in the safety provided by occupant restraint systems. In addition, physicians should pay attention to cranio-cervical trauma when a patient experiences cardiac arrest after a motor vehicle accident, even the patient is protected by occupant restraint systems.
American Journal of Medical Case Reports. 2020, 8(12), 481-482. DOI: 10.12691/ajmcr-8-12-13
Pub. Date: September 10, 2020
3421 Views333 Downloads
Pseudoaneurysm of the Mitral-Aortic Fibrosa in the Absence of Valvulitis
Case Report
The mitral-aortic intervalvular fibrosa (MAIVF) is the thin avascular fibrous structure located between the left side of the non-coronary cusp, the left coronary cusp and the anterior mitral leaflet. MAIVF pseudoaneurysm typically results as a complication of endocarditis, aortic valve surgery or chest trauma. We present a case of an incidental MAIF pseudoaneurysm in a 68-year female with a history of rheumatic fever without involvement of the mitral apparatus. We also discuss the presentation, evaluation and management of this rather rare valvular disorder.
American Journal of Medical Case Reports. 2020, 8(12), 478-480. DOI: 10.12691/ajmcr-8-12-12
Pub. Date: September 08, 2020
3348 Views388 Downloads
A Case of Scrub Typhus with Multiple Eschars and New-Onset Atrial Fibrillation
Case Report
We report a case of scrub typhus with multiple eschars and acute myocarditis with a new onset atrial fibrillation in a 53 year-old man. Eschar and cardiovascular complications of scrub typhus were discussed.
American Journal of Medical Case Reports. 2020, 8(12), 474-477. DOI: 10.12691/ajmcr-8-12-11
Pub. Date: September 08, 2020
5923 Views362 Downloads
Early Neurosyphilis in an Immunocompetent Patient: A Case Report
Case Report
While the prevalence of syphilis had seen a significant decrease in the post-antibiotic era, it can still present in immunocompromised patients. While it is rare for immunocompetent patients to present with advanced stages of Syphilis, prompt recognition and diagnosis is imperative to prevent serious complications. We present the case of a 52 year old immunocompetent female who was diagnosed with syphilis 30 years ago who presented with vague symptoms including a rash, blurred vision, and headache and was diagnosed with early neurosyphilis.
American Journal of Medical Case Reports. 2020, 8(12), 471-473. DOI: 10.12691/ajmcr-8-12-10
Pub. Date: September 03, 2020
2877 Views337 Downloads
Invasive Recurrent Meningioma with Extracranial Tissue Involvement: A Case Report
Case Report
Meningioma is a common benign intracranial neoplasm. The incidence of extracranial extension to other sites is rare. Due to the neglected intracranial component, the chances of an under diagnosis or a misdiagnosis of the extracranial component is there, which may adversely affect the management and therefore, the prognosis of the patient.
American Journal of Medical Case Reports. 2020, 8(12), 467-470. DOI: 10.12691/ajmcr-8-12-9
Pub. Date: September 03, 2020
4963 Views315 Downloads
Left Homonymous Hemianopia: An Uncommon, Neuro-ophthalmological Presentation of Hyperglycemic Hyperosmolar State
Case Report
Spectrum of the neurological deficits in non-ketotic hyperglycemia and hyperosmolar hyperglycemic state (HHS) ranges widely among patients and can have any presentation from focal seizures, epilepsia partialis continua, chorea-hemiballismus syndrome, hemiparesis, hemianopia to mental obtundation and coma. Here we report a case of HHS which presented with Left Homonymous Hemianopia as the only initial presentation. Symptoms slowly resolved over the course of two weeks by administration of insulin and normalizing the glucose.
American Journal of Medical Case Reports. 2020, 8(12), 463-466. DOI: 10.12691/ajmcr-8-12-8
Pub. Date: September 03, 2020
3257 Views333 Downloads
Intussusception Presenting as Intestinal Obstruction in Pregnancy: A Case Report from a Tertiary Hospital in Ghana
Case Report
There is paucity of scientific data on intussusception in pregnancy globally which makes it a rare clinical occurrence. The symptoms in pregnancy may mimic obstetric conditions and thus presents a diagnostic dilemma to clinicians. A high index of suspicion is therefore needed in order to establish a preoperative diagnosis. We present a 29-year old woman, gravida 5 para 4, 2 alive and 2 dead (G5P42A+2D) at 23-weeks’ 6 days gestation from northern Ghana, who was referred to Tamale Teaching Hospital (TTH) as a case of acute abdomen. Initial clinical assessment and bedside ultrasonography led to a diagnosis of intussusception. A viable colo-colic intussusception was found on open laparotomy and a left hemicolectomy was performed. This was confirmed by histopathological examination of the resected bowel. There was no identifiable lead point. This case report illustrates how good and prompt initial clinical assessment supported with imaging led to a successful outcome of acute abdomen in pregnancy in a low – middle resource country.
American Journal of Medical Case Reports. 2020, 8(12), 459-462. DOI: 10.12691/ajmcr-8-12-7
Pub. Date: August 31, 2020
3194 Views328 Downloads1 Likes
Symptom Resolution in Acyclovir Treated Hand, Foot, and Mouth Disease
Case Report
Background: Hand, Foot, and Mouth Disease (HFMD) is a highly contagious virus primarily affecting young children, but may also impact older children and adults. Initial symptoms typically manifest as fever, malaise, and pharyngitis, followed by eruption of erythematous, papular lesions on the palms and soles. HFMD is typically treated with supportive care, as there is no current gold standard therapy for HFMD. However, based on previous case studies, acyclovir has demonstrated its potential as a viable treatment for HFMD. Case Presentation: A 37-year-old female patient presented to the clinic with a two-day history of fever, malaise, pharyngitis, and papulovesicular skin lesions on her hands and feet. A clinical diagnosis of HFMD was made, and the patient was promptly started on oral acyclovir 800 mg, three times daily for seven days. Within two days of acyclovir treatment, the patient’s fever subsided, and the skin lesions on the hands and feet were fully resolved. Conclusion: Our case report showcases the benefits of acyclovir therapy in treating HFMD. Acyclovir treatment provided our patient symptomatic relief, resulting in defervescence and complete resolution of skin lesions. Symptom duration and severity were lessened significantly within the first couple days of therapy. Acyclovir therapy has shown promising results for potential HFMD treatment, and we encourage additional studies to further evaluate its efficacy.
American Journal of Medical Case Reports. 2020, 8(12), 456-458. DOI: 10.12691/ajmcr-8-12-6
Pub. Date: August 31, 2020
2902 Views273 Downloads
Schizophrenia: An Observational Study and Demonstration that Alpha-emitting Nanoparticulates Effect Is not Hereditary but Direct in the Brain (Explaining Core Relation with TBI)
Original Research
A case study (with involvement of the author in various observational settings and many subjects) leads to confirmation of the general link between schizophrenia and traumatic brain injury that was already underlined in the existing literature. The effects of the welfare State conceal the core idea that schizophrenia can hence be healed radically because the existence of monetary incomes for people suffering of mental disease triggers an incentive to self-contaminate and maintain the state of dereliction of the brain instead of actually contributing to society. This case study allows to prove that second statement and to confirm as well general demands of French economist Jacques Rueff. The issue of marijuana risks is also discussed, confirming the dangers of marijuana (THC, THCa only) in a situation in which the brain is contaminated.
American Journal of Medical Case Reports. 2020, 8(12), 453-455. DOI: 10.12691/ajmcr-8-12-5
Pub. Date: August 31, 2020
2953 Views369 Downloads
The Traumatic Vacuum Phenomenon at the Anterior Portion of the Spine: A Clue to Extensive Spinal Fracture
Original Research
A sixty-seven-year-old man complained back pain after falling from a ladder. On arrival, he had no neurological deficits in either leg. Emergency truncal computed tomography (CT) demonstrated multiple rib fractures with lung contusion and air density at the anterior portion of the 12th thoracic spine with fracture of the spinous process. Magnetic resonance imaging demonstrated an area of high intensity at the anterior portion of the 10 and 11th thoracic spine with the posterior portion of the 11 and 12th thoracic spine, suggesting extensive unstable lower thoracic fracture. The present case suggested that air density at the anterior portion of the spine on the CT might be an important clue that suggests the existence of rare extensive thoracic spinal fracture.
American Journal of Medical Case Reports. 2020, 8(12), 451-452. DOI: 10.12691/ajmcr-8-12-4
Pub. Date: August 27, 2020
3309 Views378 Downloads
Pericardial Effusion Complicating Refractory Hypothyroidism Secondary to Autoimmune Atrophic Gastritis: A Case Report
Original Research
Hypothyroidism is characterized by a broad clinical spectrum ranging from asymptomatic or subclinical hypothyroidism to overt myxedema and multisystem failure. Pericardial effusion occurs frequently in myxedema but is rare in other stages of hypothyroidism because of the timeliness in which hypothyroidism is nowadays detected and treated. The author reports a case of progressively worsening pericardial effusion from refractory hypothyroidism secondary to autoimmune atrophic gastritis. The approach to managing pericardial effusion complicating refractory hypothyroidism is discussed.
American Journal of Medical Case Reports. 2020, 8(12), 447-450. DOI: 10.12691/ajmcr-8-12-3
Pub. Date: August 20, 2020
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Juvenile Neuronal Ceroid Lipofuscinosis: A Rare Case Report with Literature Review in a Siblings Pair Having Cardiac Involvement
Case Report
Neuronal ceroid lipofuscinosis (NCL) are a group of genetically mediated neurodegenerative disorders affecting children and young adults. They are characterized by progressive vision, cognitive deterioration and epilepsy ultimately resulting in death. Of the various types, late infantile variety is the 2nd most common form of NCL. Here we report a case of an 18-year-old boy along with his elder sister who presented to the neurology clinic with progressive mental and social deterioration since the age of 5-6 years. As the disease progressed, he developed progressive vision loss, cognitive decline, behavioral changes and epilepsy. Skin biopsy from the thigh revealed characteristic curvilinear and fingerprint inclusion bodies suggestive of NCL. This case highlights a rare entity of neurodegenerative disorders with cardiac involvement.
American Journal of Medical Case Reports. 2020, 8(12), 443-446. DOI: 10.12691/ajmcr-8-12-2
Pub. Date: August 18, 2020
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A Rare Case Report of Blastic Plasmacytoid Dendritic Cell Neoplasm
Case Report
Blastic plasmacytoid dendritic cell neoplasm also formerly known as Blastic NK cell lymphoma is a very rare haematological malignancy. WHO defined BPDCN as a neoplasm with features of cutaneous lymphoma and/or leukaemia and designated BPDCN in a separate category under the myeloid class of neoplasms since 2008. Diagnosis of BPDCN requires both morphological evidence of plasmacytoid dendritic blast cells and immunohistochemical positivity for CD123, CD4, CD56 and TLC-1. Unlike other haematological malignancies there are no established optimal chemotherapy regimens for BPCDN although standard chemotherapeutic regimens used for induction treatment of AML, ALL and high grade lymphoma have shown complete remission rates albeit for a short duration, with ALL regimens having a higher remission percentage among both adults and children. Here we present a case of BPDCN without skin involvement.
American Journal of Medical Case Reports. 2020, 8(12), 438-442. DOI: 10.12691/ajmcr-8-12-1
Pub. Date: August 14, 2020
4648 Views622 Downloads