Clinical Medicine Insights. Case Reports最新文献

{"title":"Chilaiditi's Sign: A Rare Finding in a Patient with Concurrent Liver Cirrhosis and Chronic Lymphocytic Leukemia.","authors":"Prosper Adjei, Prince Henry Asamoah, Dominic Asante Ohene, Augustina Amoakohene-Yeboah, Stanley Anenyemele Asasu","doi":"10.1177/11795476241278973","DOIUrl":"https://doi.org/10.1177/11795476241278973","url":null,"abstract":"<p><p>Chilaiditi's sign is a rare radiological finding characterized by colonic interposition between the liver and the right hemidiaphragm. It is a cause of pseudopneumoperitoneum which is often mistaken for true pneumoperitoneum. In this article, we present the case of a 73-year-old female with a previous history of pulmonary tuberculosis, who reported to our hospital with progressive abdominal distension associated with early satiety, bipedal swelling, generalized weakness, worsening fatigue, and weight loss. Following evaluation, she was diagnosed with liver cirrhosis and chronic lymphocytic leukemia. Her chest radiograph also incidentally showed air under the right hemidiaphragm with haustral folds consistent with Chilaiditi's sign. Since she did not have signs of peritonitis, she was eventually treated for liver cirrhosis and chronic lymphocytic leukemia without undergoing any surgical intervention. This case report seeks to create awareness among clinicians about this rare radiological sign in order to prevent misdiagnosis leading to unnecessary surgical procedures.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241278973"},"PeriodicalIF":0.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcifying Odontogenic Cyst Associated with Complex Odontoma: Report of a Rare Case.","authors":"Ikram Attouchi, Lamia Oualha, Raouaa Belkacem Chebil, Souha Ben Youssef","doi":"10.1177/11795476241277660","DOIUrl":"10.1177/11795476241277660","url":null,"abstract":"<p><p>Calcifying odontogenic cyst, also known as Gorlin cyst is a rare benign cystic lesion primarily found in the jawbones, accounting less than 1% of odontogenic cysts. It can be associated with odontogenic tumors such as odontomas. We report a rare case of COC associated with complex odontoma in a young patient and discuss its clinical features, diagnosis, and treatment options. An 18-year-old female patient presented with a painless radiopaque lesion of the right mandibular bone at Oral Medicine and Oral Surgery department. Radiographs revealed irregular tooth-like structures in the canine-premolar area. The lesion was surgically removed, and histopathology confirmed COC with a complex odontoma. As of the World Health Organization's 2022 definition, COC is a developmental odontogenic cyst characterized by calcified ghost cells. It typically affects individuals during their second and third decades of life, with no gender preference, almost equally in the maxilla and the mandible. The main treatment is total enucleation, with a generally favorable prognosis. Histopathology is essential for diagnosis due to its mimicry of other jaw conditions. Long-term follow-up is needed to prevent recurrences.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241277660"},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rosuvastatin-Induced Rhabdomyolysis as a Result of Drug Interaction With Sitagliptin: A Case Report.","authors":"Abdolamir Atapour, Mahnaz Momenzadeh, Mahsa Panahishokouh, Shirinsadat Badri","doi":"10.1177/11795476241274162","DOIUrl":"10.1177/11795476241274162","url":null,"abstract":"<p><p>Rhabdomyolysis was not reported in clinical trials with Sitagliptin alone. However, several reports in the literature on rhabdomyolysis resulted from the interaction between statins and Sitagliptin. In patients with type 2 diabetes and hyperlipidemia, it is expected to co-prescribe statins and Sitagliptin. Herein, we report the case of a 64-year-old woman with rhabdomyolysis should be caused by a drug-drug interaction between Rosuvastatin and Sitagliptin. The patient denied any history of weakness or myalgia during past medical assessments.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241274162"},"PeriodicalIF":0.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemorrhagic Shock Caused by Spontaneous Bleeding from Early Gastric Cancer Was Successfully Cured by Emergency Endoscopic Submucosal Dissection: A Case Report.","authors":"PengFei Wang, Hui Zhang, ShaoCe Xu, YanNing Zhang, HuiMing Ma, Jie Feng, Xiang Wang, DeKui Zhang","doi":"10.1177/11795476241271552","DOIUrl":"10.1177/11795476241271552","url":null,"abstract":"<p><p>Cases and studies of protruding early gastric cancer (EGC) combined with spontaneous bleeding are relatively rare. The current study present a female patient aged 70 to 75 years old with hemorrhagic shock caused by spontaneous bleeding from EGC type 0-Isp, which was successfully cured by rapid emergency endoscopic submucosal dissection (ESD).</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241271552"},"PeriodicalIF":0.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Pulmonic Valve Endocarditis: A Rare Clinical Entity.","authors":"Abera Wondie Gizaw, Abilo Tadesse, Hailemaryam Alemu, Abebe Worku, Samuel Dereje Chanie, Getasew Muluken","doi":"10.1177/11795476241277329","DOIUrl":"10.1177/11795476241277329","url":null,"abstract":"<p><strong>Background: </strong>Isolated pulmonic valve endocarditis is a rare heart valve infection, and constitutes about 1% to 2% of all infective endocarditis cases. Modified Duke's criteria were used to diagnose culture negative pulmonic valve endocarditis.</p><p><strong>Case presentation: </strong>A 52-year-old male patient presented with generalized body swelling of 1 month duration associated with prolonged fever, malaise, fatigue, and lassitude. He had productive cough, dyspnea on mild exertion, and reddish discoloration of urine. Upon physical examination, blood pressure (BP) = 140/90 mmHg, pulse rate (PR) = 104 beats per minute, respiratory rate (RR) = 26 breaths per minute, temperature (T⁰) = 38.3°C, and Sp0₂ = 90% at ambient air. He had signs of bilateral pleural effusion. Cardiovascular examination revealed tachycardia, raised jugular venous pressure, murmurs of pulmonic regurgitation, and tricuspid regurgitation. There was grade 2 ascites and bilateral leg edema. On laboratory investigation, there were normochromic, normocytic anemia; raised ESR; positive Rheumatoid factor, elevated serum creatinine; and active urinary sediments on urinalysis. Two sets of blood culture were negative on days 1, 5, and 7. Chest-X-ray showed cardiomegaly with bilateral pleural effusion. ECG revealed sinus tachycardia with regular P-waves and QRS complexes. 2D Transthoracic echo showed vegetation on pulmonic valves, pulmonary valve lesions, dilated right atrium and right ventricle, and elevated right ventricular systolic pressure. Abdominal ultrasound revealed enlarged and echogenic kidneys, and ascites. Definitive diagnosis of PVE was made using modified Duke's criteria which was evidenced by 1 major (echo-proven vegetation on pulmonic valve), and 3 minors (suspected congenital pulmonic stenosis, fever, and immunologic phenomena [acute glomerulonephritis, positive rheumatoid factor]). The patient's clinical condition markedly improved after 2 weeks of intravenous antibiotics and loop diuretics, and discharged home after completing 6 weeks of parenteral antibiotics.</p><p><strong>Conclusion: </strong>Modified Duke's criteria could play a major role in the management decision about diagnosis and empiric treatment of infective endocarditis in the absence of positive bacterial cultures.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241277329"},"PeriodicalIF":0.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Ordinary: Paeniclostridium sordellii Osteomyelitis in a Young Male Patient From Pakistan.","authors":"Moiz Ahmed Khan, Syeda Samiya Kamal, Summaiya Zafar","doi":"10.1177/11795476241275440","DOIUrl":"10.1177/11795476241275440","url":null,"abstract":"<p><p><i>Paeniclostridium sordellii</i>, a spore-forming anaerobic Gram-positive rod commonly found in soil samples, is rarely associated with human disease. The authors report a rare case of <i>P. sordelli</i> osteomyelitis of the left distal femur in a young male patient, which is the first reported case of <i>P. sordelli</i> from Pakistan. A 21-year-old male, laborer by profession, presented with low-grade fever, fatigue and lethargy since more than a month, which progressed in severity over the last 2 weeks. On CT scan, abnormal thickening of the cortical bone along with encroachment of the medullary cavity was observed in the left distal femur. A diagnosis of acute osteomyelitis was made and surgical intervention was performed to remove infected bone and soft tissue, which were sent for culture to the Microbiology laboratory. Bone and soft tissue cultures yielded no growth after 72 hours of aerobic incubation. However, bacterial growth was observed after anaerobic incubation, in bone culture, which was identified as <i>P. sordellii</i> using Vitek^® 2 automated system. Penicillin, piperacillin-tazobactam, meropenem, vancomycin and metronidazole were susceptible whereas, clindamycin was resistant in the isolate. The patient was started on metronidazole and after he remained stable with a clean surgical wound and symptomatic management, was discharged on regular follow-up as an out-patient. Since, <i>P. sordelli</i> is rare and highly fatal in most cases, prompt reporting and insights from treated infections could pave the way for successful management.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241275440"},"PeriodicalIF":0.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urethral Calculus as an Uncommon Cause of Acute Urinary Retention in Women Diagnosis and Management: A Case Report.","authors":"Ghassane El Omri, Anas Taghouan, Hamza Rais, Houry Younes, Moussaab Rachid, Abdeljalil Heddat","doi":"10.1177/11795476241274690","DOIUrl":"10.1177/11795476241274690","url":null,"abstract":"<p><strong>Background: </strong>Urethral calculi causing acute urinary retention is a highly uncommon condition in women, which poses distinctive difficulties in diagnosis and treatment. This report presents the case of a 52-year-old woman who experienced acute urinary retention caused by a urethral stone. It emphasizes the effective use of minimally invasive methods and underscores the importance of comprehensive multidisciplinary treatment.</p><p><strong>Case presentation: </strong>A 52-year-old woman patient arrived with acute urinary retention symptoms that lasted 6 hours. She complained of pain in the perineal and periurethral regions. She struggled with poorly managed type 2 diabetes, metabolic syndrome, and frequent cystitis. The examination showed the presence of a 2-cm stone in the urethra. The treatment utilised retrograde propulsion and laser fragmentation. Postoperative magnetic resonance imaging results were normal, and follow-up care involved managing diabetes and adopting lifestyle changes to prevent the recurrence of cystitis and stones for 6 months.</p><p><strong>Conclusion: </strong>Urethral calculi exceptionally cause acute urinary retention in women. To achieve successful outcomes and prevent recurrence, it is crucial to prioritize prompt, minimally invasive treatment, and comprehensive management.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241274690"},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microangiopathic Hemolytic Anemia as a Paraneoplastic Syndrome in a Patient with Metastatic Gastric Cancer.","authors":"Shahd T Natsheh, Tuqa Abu Ihlayel, Rawda Qasrawi, Qusai A Alsalah, Ahmad G Hammouri, Amer Zughayyer, Hasan Arafat","doi":"10.1177/11795476241271534","DOIUrl":"10.1177/11795476241271534","url":null,"abstract":"<p><p>Cancer-associated microangiopathic hemolytic anemia (CA-MAHA) is a rare paraneoplastic syndrome. The most effective approach to treating CA-MAHA is to address the underlying malignancy. Documented cases of CA-MAHA are limited to fewer than 50 patients in the literature. Herein, we present a 51-year-old female patient who developed CA-MAHA as a complication of gastric adenocarcinoma. Despite receiving neoadjuvant and adjuvant chemotherapy for gastric cancer, the patient experienced disease progression with metastatic lesions in the liver, pancreas, and other sites. This report highlights the challenges in diagnosing and distinguishing CA-MAHA from other similar conditions such as disseminated intravascular coagulation (DIC), hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), and rheumatological paraneoplastic syndromes. Additionally, it concludes that CA-MAHA is associated with a poor prognosis and limited clinical benefit from treatment, emphasizing the need for early diagnosis and effective management strategies.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241271534"},"PeriodicalIF":0.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141986712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritonitis Secondary to Ruptured Hydatid Liver Cyst in a Young Postpartum Woman: A Rare Case Report.","authors":"Messaoud Ola, Horache Kenza, Jidal Manal, Cherraqi Amine, El Aoufir Omar, Laamrani Fatima Zahra, Jroundi Laila","doi":"10.1177/11795476241271561","DOIUrl":"10.1177/11795476241271561","url":null,"abstract":"<p><p>Hydatid disease, caused primarily by Echinococcus granulosus, is prevalent in regions where livestock farming is common. Although typically considered benign, ruptured hydatid cysts into the abdominal cavity present a rare but severe complication requiring urgent surgical intervention. We hydatid liver cyst, emphasizing the unprecedented nature of this occurrence, as it has never been reported in the literature before. The case underscores the role of computed tomography (CT) imaging in diagnosis and multidisciplinary management involving emergency physicians, radiologists, anesthetists, and surgeons. Key points highlighted include the rarity of postpartum hydatid cyst rupture, the diagnostic utility of CT scans, and the necessity of immediate surgical intervention. Surgical strategies include conservative techniques and intraoperative lavage with hypertonic saline solution to prevent recurrence. Postoperative albendazole therapy and regular follow-up aid in preventing recurrence and early detection of complications. This case underscores the importance of suspecting ruptured hydatid cysts in postpartum women with underlying hepatic hydatid cyst and features of peritonitis, necessitating prompt recognition and management of complications in hydatid disease.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241271561"},"PeriodicalIF":0.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the 'Triangle of Death': A Multidisciplinary Approach in Severe Multi-Trauma Management.","authors":"Yushan Zhang, Fuxia Jian, Liang Wang, Hao Chen, Zhengbin Wu, Shili Zhong","doi":"10.1177/11795476241271544","DOIUrl":"10.1177/11795476241271544","url":null,"abstract":"<p><p>This case report details the challenging management of a 45-year-old male construction worker who suffered severe multiple injuries after a fall and subsequent collision with cement mixers. The patient presented with extensive injuries, including amputation, fractures and internal bleeding, leading to a state known as the 'triangle of death'. Despite the initial grim prognosis, evidenced by an ISS score of 28 and a mortality risk coefficient of 89.56%, the patient was successfully resuscitated and managed through a multidisciplinary approach. This included damage control resuscitation, emergency vascular interventions and targeted temperature management for brain protection. The patient's recovery highlights the effectiveness of comprehensive trauma management and the critical role of coordinated care in severe multi-trauma cases.</p>","PeriodicalId":10357,"journal":{"name":"Clinical Medicine Insights. Case Reports","volume":"17 ","pages":"11795476241271544"},"PeriodicalIF":0.8,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}