European journal of case reports in internal medicine最新文献_第10页

Syphilitic stomatitis: raising awareness on an often-overlooked presentation of secondary syphilis 梅毒性口腔炎：提高对经常被忽视的继发性梅毒表现的认识

European journal of case reports in internal medicine Pub Date : 2024-04-22 DOI: 10.12890/2024_004416

Henrique Atalaia-Barbacena, Catarina Isabel Lopes, Inês Matias Lopes, Patrícia Howell Monteiro

{"title":"Syphilitic stomatitis: raising awareness on an often-overlooked presentation of secondary syphilis","authors":"Henrique Atalaia-Barbacena, Catarina Isabel Lopes, Inês Matias Lopes, Patrícia Howell Monteiro","doi":"10.12890/2024_004416","DOIUrl":"https://doi.org/10.12890/2024_004416","url":null,"abstract":"Syphilis, a disease caused by the bacteria Treponema pallidum, has a multitude of clinical manifestations and is classified into primary syphilis, secondary syphilis and tertiary syphilis, based on clinical presentations and the time elapsed since the primary infection. The secondary stage of the disease can affect multiple organs and systems, and some of these involvements may be general and non-specific, justifying its name as ‘the great imitator’. We present a case of a 30-year-old woman with a history of painful neck lymph nodes with progressive enlargement, persistent headache, weight loss, myalgia and alopecia. During investigations, stomatitis on the dorsal face of the tongue developed. A secondary study showed serum positive for rapid plasma reagin (RPR) and T. pallidum haemagglutination (TPHA), negative RPR in cerebrospinal fluid and normal MRI, thus the diagnosis of secondary syphilis was made. The patient was treated with a single dose of penicillin with complete resolution of symptoms. The case highlights the need for an exhaustive clinical examination, especially in cases presenting with non-specific and general symptoms, and raises awareness for this disease which has increased its prevalence in the last decades.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140675254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of chronic pulmonary aspergillosis due to pulmonary infarction, mimicking cryptogenic organising pneumonia 一例由肺梗塞引起的慢性肺曲霉菌病，模仿隐源性器质性肺炎

European journal of case reports in internal medicine Pub Date : 2024-04-22 DOI: 10.12890/2024_004501

Saki Yanoma, Motoi Ugajin, Hiasanori Kani

引用次数: 0

Cardiac sarcoidosis presenting as sustained ventricular tachycardia 表现为持续性室性心动过速的心脏肉瘤病

European journal of case reports in internal medicine Pub Date : 2024-04-17 DOI: 10.12890/2024_004298

N. Cotrim, Beatriz Vargas Andrade, Sofia Carralas Antunes, Miguel Rodrigues, Sílvia Aguiar Rosa, Marisa Peres, V. Martins

{"title":"Cardiac sarcoidosis presenting as sustained ventricular tachycardia","authors":"N. Cotrim, Beatriz Vargas Andrade, Sofia Carralas Antunes, Miguel Rodrigues, Sílvia Aguiar Rosa, Marisa Peres, V. Martins","doi":"10.12890/2024_004298","DOIUrl":"https://doi.org/10.12890/2024_004298","url":null,"abstract":"Introduction: Sarcoidosis has many possible clinical presentations since it can affect any organ, most commonly the lungs. The hallmark of the disease consists of the formation of non-necrotising granulomas. Pathogenesis is thought to rely on the interplay of genetic, environmental and epigenetic factors. This case highlights the importance of a thorough clinical history and physical examination, and the correlation with imaging findings in the diagnostic work-up of the non-ischaemic cardiomyopathy. Case description: A 57-year-old woman was admitted due to the sudden onset of malaise, dizziness, and chest discomfort. Sustained monomorphic ventricular tachycardia was evidenced and the patient rapidly evolved with haemodynamic instability; she underwent successful electrical cardioversion. The electrocardiogram afterwards showed a high-risk electrocardiographic pattern. Invasive coronary angiography excluded obstructive epicardial coronary lesions. Physical examination revealed skin lesions on the lower limbs which raised suspicion for erythema nodosum and therefore a biopsy was performed. Transthoracic echocardiography and cardiac magnetic resonance imaging revealed features consistent with an inflammatory cardiomyopathy, and an implantable cardioverter-defibrillator was placed. The histologic examination of the cutaneous lesions showed a non-necrotising granulomatous inflammatory process. Radionuclide imaging was inconclusive. The patient underwent an endomyocardial biopsy, which confirmed the diagnosis of systemic sarcoidosis with cardiac involvement. Conclusions: Systemic sarcoidosis with cardiac involvement is a challenging diagnosis. The role of imaging techniques such as transthoracic echocardiography, cardiac magnetic resonance imaging and radionuclide imaging is essential in raising suspicion and diagnosing this pathology. Endomyocardial biopsy is the ‘gold standard’ for its diagnosis; however, it has a low diagnostic yield.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140690667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Should histoplasmosis be screened for before initiation of tumour necrosis factor alpha inhibitors? 在开始使用肿瘤坏死因子α抑制剂之前，是否应筛查组织胞浆菌病？

European journal of case reports in internal medicine Pub Date : 2024-04-16 DOI: 10.12890/2024_004467

Srujan Edupuganti, Yashitha Chirumammilla, Manoj Upadhyay, Danielle Osterholzer

{"title":"Should histoplasmosis be screened for before initiation of tumour necrosis factor alpha inhibitors?","authors":"Srujan Edupuganti, Yashitha Chirumammilla, Manoj Upadhyay, Danielle Osterholzer","doi":"10.12890/2024_004467","DOIUrl":"https://doi.org/10.12890/2024_004467","url":null,"abstract":"Histoplasmosis is a soil based dimorphic fungus endemic to the Midwest and Southeastern United States and is responsible for infection through inhalation of conidia. Infection is usually asymptomatic, as the fungal growth is contained by formation of granulomas. However, dissemination can occur in immunocompromised hosts due to the lack of optimal activity of interferon gamma, tumor necrosis factor-alpha (TNF-alpha) and interleukin-17. There is a significant overlap between the symptomatology of histoplasmosis and granulomatosis with polyangiitis (GPA). We are reporting a case of a 48-year-old female who presented with high grade fever, worsening generalized weakness and tachycardia. She had a previous history of bilateral cavitary lung lesions for which she was evaluated at an outside facility. As her entire infectious work up was negative and found to be positive for antineutrophil cytoplasmic antibody (ANCA), a diagnosis of GPA was made and she was initiated on rituximab infusions 7 weeks prior to her presentation to our facility. Repeat infectious work up at our facility was positive for (1,3) beta-D-glucan test and urine histoplasma antigen. Prompt discontinuation of rituximab and initiation of systemic antifungal therapy led to clinical improvement. Based on this experience we would like to highlight the association of histoplasma with ANCA positivity along with the importance of closely monitoring these patients, for possible clinical worsening after the initiation of immunosuppressive therapy, despite the negative infectious work up. ","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Group B Streptococcus meningitis in an adult woman with type 2 diabetes and ethmoid roof defect. Impact on “frontal” cognitive functions 一名患有 2 型糖尿病和乙状顶缺损的成年女性患 B 群链球菌脑膜炎。对 "前额 "认知功能的影响

European journal of case reports in internal medicine Pub Date : 2024-04-16 DOI: 10.12890/2024_004514

Roberto Vicinanza, Alice Miscetti, Cesare Magistrato, Melina Castiglione, Alessandro Frizza

{"title":"Group B Streptococcus meningitis in an adult woman with type 2 diabetes and ethmoid roof defect. Impact on “frontal” cognitive functions","authors":"Roberto Vicinanza, Alice Miscetti, Cesare Magistrato, Melina Castiglione, Alessandro Frizza","doi":"10.12890/2024_004514","DOIUrl":"https://doi.org/10.12890/2024_004514","url":null,"abstract":"Background: Community-acquired bacterial meningitis in adults represents one of the most severe infectious diseases worldwide with potentially life-threatening medical complications. Several infectious agents can cause acute meningitis. Although group B Streptococcus is more prevalent in newborns, infection can also lead to meningitis in older adults, particularly those with underlying health issues. Case Description: A 53-year-old woman with a body mass index of 28.7 kg/m2, type 2 diabetes mellitus, and dyslipidaemia presented to the emergency department of Santa Maria della Stella Hospital (Orvieto, Italy) with confusion, low-grade fever, echolalia, and hyperglycaemia. Computed tomography scans of the brain revealed a hypodensity in the left anterior frontal lobe and an osteodural defect of the rhinobase. Meningitis was suspected and empiric broad-spectrum antibiotic therapy with corticosteroids and insulin were administered while the results of the cerebrospinal fluid analysis confirmed the diagnosis of group B Streptococcus meningitis. Repeat imaging at 48 hours revealed enlargement of the hypodense lesion. The frontal assessment battery indicated deficits in executive functions. Prompt treatment led to rapid clinical improvement. Following the restoration of euglycemic status and hemodynamic stabilization, a follow-up magnetic resonance imaging confirmed the ischaemic lesion and showed cerebrospinal fluid in the sella turcica. The patient was then transferred to neurorehabilitation. Conclusions: The complex interactions among multiple risk factors resulted in an atypical clinical case of group B Streptococcus meningitis, which was promptly treated with empiric antibiotic therapy to mitigate neurocognitive deficits.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Going back to basics: remembering touch in the digital era 返璞归真：在数字时代记住触摸

European journal of case reports in internal medicine Pub Date : 2024-04-09 DOI: 10.12890/2024_004484

Beatriz R. Sousa, Diogo Faustino, Rita Pocinho

引用次数: 0

Sulfuric acid ingestion: may the severity of the metabolic acidosis be considered as a predictive sign of late damage to the gastrointestinal tract? 摄入硫酸：能否将代谢性酸中毒的严重程度视为胃肠道晚期损伤的预兆？

European journal of case reports in internal medicine Pub Date : 2024-04-09 DOI: 10.12890/2024_004437

Elisa Mastrodicasa

{"title":"Sulfuric acid ingestion: may the severity of the metabolic acidosis be considered as a predictive sign of late damage to the gastrointestinal tract?","authors":"Elisa Mastrodicasa","doi":"10.12890/2024_004437","DOIUrl":"https://doi.org/10.12890/2024_004437","url":null,"abstract":"Introduction: Caustic substances ingestion results in a complex syndrome. The patient characteristics and severity of injury are important prognostic predictors. The monitoring of clinical changes and the multidisciplinary approach are necessary to prevent death in the early stages of the poisoning. Case description: The case report describes the suicide of a woman by ingestion of a large amount of 15% sulfuric acid for suicidal purposes (15–20 ml). The initial conditions were stable, and no changes were found on a CT scan. However, the main sign was a severe metabolic acidosis. After 7 hours, haematemesis and oedema of the larynx appeared, and oro-tracheal intubation and ICU admission were necessary. Consequent progressive haemodynamic deterioration with persistent severe metabolic acidosis, increasing lactates and septic shock appeared. A new CT scan with contrast was performed 22 hours later detecting diffuse perforations and liquid in pleurae and abdomen. A pleural sample showed necrotic liquid. The death was 24 hours after ingestion and no surgical treatment was performed because of the diffuse lesions to the thoracoabdominal districts. Conclusions: Early detection of gastroenteric lesions and the monitoring of clinical changes are mandatory to avoid the death of the patient. Gastroenteric perforations require an immediate radiological evaluation and surgical treatment. The clinical case report states the severity of prognosis was related to high doses of sulfuric acid ingestion. The immediate metabolic acidosis is related to quick subsequent severe systemic pathological lesions of the gastrointestinal tract. The severity of absorption metabolic acidosis, consequently, may be an early and prognostic sign of the late chest and abdominal lesions.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140720995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated melioidosis presenting as sepsis, neurological melioidosis, liver and prostate abscess in United Arab Emirates 阿拉伯联合酋长国表现为败血症、神经性瓜虫病、肝脏和前列腺脓肿的播散性瓜虫病

European journal of case reports in internal medicine Pub Date : 2024-04-09 DOI: 10.12890/2024_004415

Maria Hasani Maria Hasani, Sadia Rounak Shriya Sadia Rounak Shriya, Mariyam Thahira, Saima Haque, Saima Liyakat Khan, Azza Shaloob Azza Shaloob, Sara Osman Sara Osman

{"title":"Disseminated melioidosis presenting as sepsis, neurological melioidosis, liver and prostate abscess in United Arab Emirates","authors":"Maria Hasani Maria Hasani, Sadia Rounak Shriya Sadia Rounak Shriya, Mariyam Thahira, Saima Haque, Saima Liyakat Khan, Azza Shaloob Azza Shaloob, Sara Osman Sara Osman","doi":"10.12890/2024_004415","DOIUrl":"https://doi.org/10.12890/2024_004415","url":null,"abstract":"Background: Melioidosis is an infection caused by Burkholderia pseudomallei, a Gram-negative bacterium. It is a disease endemic to Southeast Asia and northern Australia although its global incidence has been rising. It most commonly infects people with certain identified risk factors such as diabetes, alcoholism, thalassemia, and underlying chronic disease involving lungs, kidney and liver. This bacterium is capable of producing a wide array of clinical manifestations ranging from asymptomatic disease to localised infections such as in the lung, bone or skin to disseminated infection. Case description: This is a case, from United Arab Emirates, of a 40-year-old male recently diagnosed with diabetes who presented with multiple abscesses and was eventually diagnosed with disseminated melioidosis. He was treated successfully with antibiotics and drainage of abscesses. Conclusion: In non-endemic regions, melioidosis can be easily missed in common diagnostic approaches. This gap of awareness could delay the diagnosis and allow further deterioration of the patient due to complications. Thus, case reports like this can enlighten internists about changing incidences and complexity of clinical presentations, thus preparing them to better handle such patients in the future.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140725309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrent intra-stent coronary restenosis in a carrier of non-disease-specific antinuclear antibodies 非疾病特异性抗核抗体携带者复发性支架内冠状动脉再狭窄

European journal of case reports in internal medicine Pub Date : 2024-04-05 DOI: 10.12890/2024_004412

Benedetta Tomberli, Stefano Fumagalli, Tiziana Cristina Minopoli, S. Menale, V. Scheggi, N. Marchionni

{"title":"Recurrent intra-stent coronary restenosis in a carrier of non-disease-specific antinuclear antibodies","authors":"Benedetta Tomberli, Stefano Fumagalli, Tiziana Cristina Minopoli, S. Menale, V. Scheggi, N. Marchionni","doi":"10.12890/2024_004412","DOIUrl":"https://doi.org/10.12890/2024_004412","url":null,"abstract":"Intracoronary in-stent restenosis (ISR) is a phenomenon that generally occurs between 3 and 6 months after stent placement. With the introduction of drug-eluting stents (DES), the incidence of ISR has decreased but not disappeared. We report a case of reiterant in-stent restenosis of an 81-year-old female patient who underwent multiple percutaneous coronary intervention and two coronary artery bypass surgeries. ISR is possibly associated with extra-stent, stent-related and intra-stent factors. Here, we excluded the first two and focused on the intra-stent factors that seem more likely in our case. A challenging diagnostic workup led us to the hypothesis of a coronary vasculitis potentially triggered by some component of the stent in a predisposed patient carrier of non-disease-specific ANA, with an exaggerated immune response. No recurrence of ISR occurred after the introduction of steroids. Biological and intra-stent causes of ISR should be taken into careful consideration to aim for the early detection of the underlying mechanism of restenosis and to embrace the best therapeutic strategy.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140738209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Late tuberculosis reactivation after severe COVID-19 严重 COVID-19 后结核病晚期再活化

European journal of case reports in internal medicine Pub Date : 2024-04-03 DOI: 10.12890/2024_004406

T. Dormans, Eric Zandijk, Frans Stals

{"title":"Late tuberculosis reactivation after severe COVID-19","authors":"T. Dormans, Eric Zandijk, Frans Stals","doi":"10.12890/2024_004406","DOIUrl":"https://doi.org/10.12890/2024_004406","url":null,"abstract":"Background: Although there is no specific therapy for COVID-19, it is recommended that patients with severe SARS-CoV-2 infection are treated with corticosteroids and anti-IL-6 receptor monoclonal antibodies. Both COVID-19 itself and the treatment modalities mentioned above have suppressive effects on the immune system which may lead to an increased susceptibility to other infections. In patients with latent tuberculosis (TB) reactivation of TB infection after recovery from severe COVID-19 has been described. Most of these cases have occurred in parts of the world where tuberculosis is endemic. Case description: The patient is a female in her 70s who was born and raised in Southeast Asia and has lived in the Netherlands for more than 30 years. She was treated for a severe COVID-19 requiring mechanical ventilation for several weeks and pharmaceutical treatment with corticosteroids and anti-IL-6 receptor monoclonal antibodies (Sarilumab). She recovered well. Two years later she was readmitted with symptoms of a serious pulmonary infection and meningitis. Her condition deteriorated in a short time. An active TB infection was diagnosed. Despite adequate antibiotic treatment and supportive therapy her condition worsened and four days after admission to the ICU she deceased. Discussion: Reactivation of latent TB after recovery from a severe COVID-19 has been described several times and may occur several months after the SARS-CoV-2 infection. In this case the reactivation presented two years after COVID-19. This case illustrates that long-term follow-up of patients with latent TB that recover from a severe COVID-19 may be indicated.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140746926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0