International Medical Case Reports Journal最新文献

{"title":"Transvenous Dual-Chamber Pacemaker Implantation in a Patient with Persistent Left Superior Vena Cava Undergoing Maintenance Hemodialysis.","authors":"Toan Nguyen Duy, Luyen Nguyen Van, Anh Pham Phuong Thao, Binh Pham Thai, Hoang Ta Anh, Lam Pham Son, Thuc Luong Cong","doi":"10.2147/IMCRJ.S509860","DOIUrl":"https://doi.org/10.2147/IMCRJ.S509860","url":null,"abstract":"<p><strong>Background: </strong>Persistent left superior vena cava (PLSVC) is a rare congenital venous anomaly. Permanent pacemaker implantation (PPI) in patients with PLSVC presents challenges in placing both the right ventricular and atrial leads. The article describes a technique for dual-chamber PPI using standard leads in a PLSVC patient with chronic kidney disease on maintenance hemodialysis.</p><p><strong>Case presentation: </strong>A 69-year-old male patient with sick sinus syndrome (SSS), hypertension, moderate mitral regurgitation, dilated left ventricle, diabetes, chronic kidney disease (on hemodialysis), and NYHA III heart failure underwent dual-chamber pacemaker implantation via the left axillary vein. Venography revealed a persistent left superior vena cava, a challenge for the placement of leads. The ventricular lead was positioned in the right ventricular outflow tract using a Biotronik active fixation lead with a \"C\" shaped stylet, and the atrial lead was placed in the right atrial lateral wall. The procedure took 115 minutes with 17.5 minutes of fluoroscopy. After 4 months, the patient showed symptom improvement and stable pacing parameters.</p><p><strong>Conclusion: </strong>Dual chamber pacemaker implantation through PLSVC in a patient undergoing maintenance hemodialysis using a \"C\" shaped stylet technique is feasible, safe, and effective.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"273-279"},"PeriodicalIF":0.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541842","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":"\"Keep HIT in Mind and Take Care\". Multiple Tips From a Single Patient.","authors":"Sergio Bevilacqua, Pierluigi Stefàno, Viola Ranfagni, Bianca Ammannati, Riccardo Codecasa, Anna Maria Gori, Francesca Cesari, Lara Mary Titherington, Stefano Del Pace, Angela Rogolino, Rossella Marcucci","doi":"10.2147/IMCRJ.S500148","DOIUrl":"10.2147/IMCRJ.S500148","url":null,"abstract":"<p><strong>Introduction: </strong>Heparin-induced thrombocytopenia (HIT) is a relatively rare condition burdened by a high rate of complications and mortality. Cardiac surgery is a high risk setting for this condition. But in this area, some particularities can make both diagnosis and treatment difficult. Warfarin is often needed after valvular surgery but may be dangerous if HIT is ongoing. Danaparoid is the only anticoagulant whose mechanism of action has been demonstrated to counteract the pathogenesis of HIT. However, the 24-hour half-life challenges its use after surgery.</p><p><strong>Case presentation: </strong>Here, we present a case in which HIT occurred six days after cardiac surgery. Warfarin was initiated two days after surgery but was stopped five days later, given the high risk of bleeding due to concomitant thrombocytopenia. HIT probability was initially underestimated, because a misleading diagnosis of endocarditis was made. When redo surgery was performed, no infectious masses were found, but a large thrombus was removed from the left atrium. Bivalirudin and danaparoid were used as alternative anticoagulants during the subsequent postoperative course.</p><p><strong>Conclusion: </strong>HIT should always be kept in mind after cardiac surgery, even if a more plausible cause of thrombocytopenia is present. Discontinuation of warfarin could lead to catastrophic consequences if an unrecognized HIT is ongoing, and an alternative anticoagulant is not started. Bivalirudin and danaparoid were used after the diagnosis of HIT, adapting anticoagulant therapy to the needs of recent surgery.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"265-271"},"PeriodicalIF":0.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482903","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":"Idiopathic Acute Exudative Polymorphous Vitelliform Maculopathy: A Case Report.","authors":"Ana Faria Pereira, João Tavares-Ferreira, Renato Santos-Silva, Cláudia Oliveira-Ferreira","doi":"10.2147/IMCRJ.S507569","DOIUrl":"10.2147/IMCRJ.S507569","url":null,"abstract":"<p><strong>Purpose: </strong>Acute exudative polymorphous vitelliform maculopathy (AEPVM) is a rare retinal disorder first described by Gass in 1988. Characterized by multifocal yellow-white lesions at the level of the retinal pigment epithelium (RPE) and associated with serous retinal detachments, AEPVM typically presents with acute visual disturbances and, in some cases, headaches. Despite its rarity, with fewer than 40 cases reported in the literature, its clinical course and etiology remain poorly understood. Patients generally experience gradual recovery of vision, though retinal abnormalities may persist. Various hypotheses suggest infectious, inflammatory, autoimmune, or even paraneoplastic mechanisms, but definitive causes remain elusive. In this report, we describe the clinical course and multimodal imaging findings of a patient diagnosed with AEPVM, contributing to the limited understanding of this condition's progression and management.</p><p><strong>Case presentation: </strong>We report the case of a 40-year-old Caucasian female presenting with blurred vision for two weeks, with a best corrected visual acuity of 20/20 in both eyes, preceded by flu-like symptoms. Initial clinical evaluation, including fundus examination and spectral-domain optical coherence tomography (SD-OCT), revealed multiple small serous retinal detachments bilaterally. Multimodal imaging (fundus autofluorescence, fluorescein angiography, and indocyanine green angiography) appeared normal initially. A comprehensive systemic workup excluded autoimmune, infectious, and neoplastic etiologies. Upon follow-up, yellowish retinal lesions and hyperautofluorescence emerged, leading to the diagnosis of idiopathic AEPVM. The patient continues to be monitored for visual recovery and potential complications.</p><p><strong>Conclusion: </strong>AEPVM is a rare macular disorder that requires comprehensive multimodal evaluation to establish an accurate diagnosis. Ruling out autoimmune, infectious, and especially neoplastic causes, including paraneoplastic syndromes, is critical for confirming its idiopathic nature. While visual recovery is common, the risk of recurrence and complications such as choroidal neovascularization necessitates vigilant long-term monitoring.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"255-263"},"PeriodicalIF":0.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482931","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":"Nevirapine-Induced Stevens-Johnson Syndrome in an HIV-Infected Patient: A Case Report From Uganda.","authors":"Mohamed Jayte, Yahye Mohamed Jama, Lubega Athanus","doi":"10.2147/IMCRJ.S508884","DOIUrl":"10.2147/IMCRJ.S508884","url":null,"abstract":"<p><p>Nevirapine, a non-nucleoside reverse transcriptase inhibitor (NNRTI), is widely prescribed in antiretroviral therapy (ART) for HIV treatment. Although effective, it is associated with rare but severe adverse drug reactions, including Stevens-Johnson syndrome (SJS), a life-threatening mucocutaneous disorder. This case report describes a Middle age HIV-positive man who developed SJS following nevirapine initiation, highlighting the importance of timely recognition, management, and the need for clinician vigilance to prevent adverse outcomes in antiretroviral therapy.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"249-253"},"PeriodicalIF":0.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440895","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":"Stem Cell Transplantation for Ovarian Cancer Patient with Associated Myelodysplasia After Maintenance Therapy with Olaparib: A Case Report.","authors":"Zeyar Linn, Zhongyi Gu, Libing Wang, Shengyun Cai","doi":"10.2147/IMCRJ.S491062","DOIUrl":"10.2147/IMCRJ.S491062","url":null,"abstract":"<p><p>Ovarian cancer remains a significant cause of morbidity and mortality in women worldwide. Olaparib, a poly ADP-ribose polymerase (PARP) inhibitor, has been shown in studies to increase the time that people with cancer do not get worse. However, reports have indicated rare adverse effects, like myelodysplastic syndrome (MDS). In this report, we highlight the case of a 42-year-old female patient who was diagnosed with ovarian endometrioid carcinoma, FIGO Stage IIB. Following surgery and chemotherapy, the patient commenced maintenance therapy with Olaparib. After two years, she experienced abnormal blood test results, which ultimately led to a diagnosis of myelodysplastic syndrome (MDS), confirmed through a bone marrow biopsy. Despite initial obstacles, the patient underwent stem cell transplantation as a treatment for MDS. After undergoing stem cell transplantation, the patient experienced a notable improvement in their condition. Upon reevaluation, the transplantation proved successful as it resolved the abnormalities related to MDS. Furthermore, the ovarian cancer status showed a positive response, with no signs of disease progression during the follow-up period. This particular case emphasizes the importance of being vigilant for uncommon adverse effects, such as MDS, in ovarian cancer patients undergoing Olaparib maintenance therapy. Early diagnosis and treatment, which may include stem cell transplantation, can lead to favorable results, not only in managing MDS but also in possibly slowing down the progression of ovarian cancer that is causing it. Additional research is necessary to understand the risk factors and the most effective management approaches for these complications in this specific group of patients.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"241-248"},"PeriodicalIF":0.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433039","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":"Efficacy of Intravenous Tenecteplase Bridge Thrombectomy for Recurrent Ischemic Stroke Within 3 Months: A Case Report.","authors":"Cuicui Liu, Junyan Liu, Huiling Ren, Yuzhu Xu, Wanhu Liu","doi":"10.2147/IMCRJ.S497458","DOIUrl":"10.2147/IMCRJ.S497458","url":null,"abstract":"<p><p>In the previous guideline recommendations, patients who have had a stroke within 3 months are excluded from intravenous thrombolysis (IVT) regimens. Some studies have suggested that IVT with alteplase (rt-PA) may be effective and safe in such patients, but evidence supporting the use of tenecteplase (TNK) is not sufficient. This paper includes an 80-year-old male patient readmitted for recurrence of ischaemic stroke (IS) after 48 days, who received TNK IVT as a bridging therapy prior to thrombectomy, with favourable results at 8-week follow-up. This case highlights that TNK alone or IVT as a bridging therapy prior to thrombectomy can also benefit patients with recurrent stroke within 3 months.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"235-239"},"PeriodicalIF":0.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433033","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":"Presumed Pediatric Isolated Oculomotor Nerve Schwannoma - A Case Report.","authors":"Shadi Boqaaiya, Aman Raed, Aviv Vidan, Karine Beiruti Wiegler, Yuval Cohen, Otzem Chassid","doi":"10.2147/IMCRJ.S506448","DOIUrl":"10.2147/IMCRJ.S506448","url":null,"abstract":"<p><p>This report presents a healthy 2.5-year-old child exhibiting headache, ptosis, exotropia, and left mydriasis. Initial neuroimaging, including computed tomography (CT), computed tomography angiography (CTA), and standardized magnetic resonance imaging (MRI), failed to identify any lesions; however, high-resolution MRI revealed an ovoid mass adjacent to the left proximal oculomotor nerve within the superior cavernous sinus. This case underscores the necessity for advanced imaging techniques and a thorough diagnostic approach to enhance understanding of this rare pediatric condition. Moreover, it highlights the limited documentation of pediatric oculomotor schwannomas, leading to an inadequate understanding of their diagnosis and management, and emphasizes the need for enhanced awareness and research to establish effective diagnostic protocols, particularly utilizing advanced neuroimaging techniques.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"229-234"},"PeriodicalIF":0.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390442","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":"Viable Ileosigmoid Knotting, A Very Phenomenon Finding and Rare Cause of Intestinal Obstruction: A Case Report and Literature Review.","authors":"Sintayehu Asrat Beyene, Nahom Tadesse Bogale, Mahad Mohammed Abdinasir, Addisu Zegeye Desalegne, Megdelawit Ayalew Wossen","doi":"10.2147/IMCRJ.S502430","DOIUrl":"10.2147/IMCRJ.S502430","url":null,"abstract":"<p><strong>Introduction: </strong>Ileosigmoid knotting is the wrapping of an active component of either the ileum or the sigmoid colon over each other. It is an unusual cause of intestinal obstruction, accounting for 1-2% of cases of all mechanical obstruction in the majority published literatures. A viable knot is a unique phenomenon of this seldom cause of bowel obstruction.</p><p><strong>Case presentation: </strong>A sixteen-year-old female patient presents with a complaint of central abdominal distension and obstipation of 12-hour duration. Later, she also developed abdominal cramps and vomiting of ingested matter. Her vital signs were all in the normal range, and the abdominal examination was positive for a grossly distended abdomen with mild upper and central abdominal tenderness. The ileosigmoid knotting was clearly visible on the computed tomography. Emergency exploratory laparotomy was performed, and a viable ileosigmoid knot was identified. Unknotting, derotation, and decompression of the sigmoid colon were performed. The postoperative course was uneventful.</p><p><strong>Discussion: </strong>Ileosigmoid knotting is a rare, life-threatening cause of intestinal obstruction with rapid progression to intestinal vascular compromise and gangrene. It is a hyperactive segment of ileum that winds around the pedicle of the redundant sigmoid colon, resulting in a closed-loop obstruction. There are different classification schemes of ileosigmoid knotting depending on the active component of the knot and based on the viability of the bowel and physiology of the patient. Preoperative diagnosis of this condition is often challenging and usually confirmed intraoperative.</p><p><strong>Conclusion: </strong>A high index of suspicion and prompt surgical exploration are crucial for the best outcome of the patient. Despite being a rare cause of intestinal obstruction, ileosigmoid knotting poses a significant morbidity and mortality to the patient. Management of a patient with viable ileosigmoid knotting is controversial, as some scholars suggest non-resective options and others recommend resective treatment as a recurrence preventive measure.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"223-228"},"PeriodicalIF":0.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381252","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":"Isotretinoin - Induced AGEP: A Case Report.","authors":"Hend M Alotaibi, Sultan AlNasser, Abdulelah Aldossari, Abdulrahman Alluhaybi, Reem Alsergani, Waleed Alrajban","doi":"10.2147/IMCRJ.S488180","DOIUrl":"10.2147/IMCRJ.S488180","url":null,"abstract":"<p><p>Acute Generalized Exanthematous Pustulosis (AGEP) is a relatively rare but severe dermatological adverse reaction characterized by the rapid onset of generalized erythema, coupled with numerous sterile nonfollicular pustules. Agents commonly implicated in triggering AGEP include antibiotics, antifungals, antimalarials, and diltiazem. We present a case of a isotretinoin induced AGEP in a young female patient known to have guttate psoriasis, inverse and scalp psoriasis. She was started on Isotretinoin as she had inflammatory acne as well. Three days later, she developed pruritic, erythematous lesions, some vesicles with a yellowish exudate over the armpits, upper chest, upper arms, and legs. A skin biopsy was performed, which, in conjunction with the clinical presentation, was suggestive of AGEP. In 2010, Filho et al described the first case of isotretinoin-induced AGEP in a female patient diagnosed with Hidradenitis Suppurativa. The EuroSCAR tool was utilized to assess the lesion morphology, clinical course, and histological outcomes, which validated the diagnosis. Using the same criteria, our patient was categorized as \"definite AGEP\", further supporting the isotretinoin-induced AGEP hypothesis. This report highlights isotretinoin as a possible trigger for AGEP, emphasizing the crucial role of a thorough history and vigilant clinical assessment in early identification and management of such reactions.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"211-215"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255659","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":"Omadacycline for the Treatment of Severe <i>Legionella</i> Pneumonia Complicated with Multiple Organ Failure: A Case Report.","authors":"Limin Xu, Ying Xiong, Changquan Fang","doi":"10.2147/IMCRJ.S498539","DOIUrl":"10.2147/IMCRJ.S498539","url":null,"abstract":"<p><strong>Background: </strong>Fluoroquinolones and macrolides are the preferred antibiotics for treating Legionnaires' disease. However, the limited utility of these antibiotics in cases of organ dysfunction is a major problem. Omadacycline is a novel tetracycline antibiotic with a good safety profile and in vitro antibacterial activity against <i>Legionella</i>, but it lacks validation by clinical data.</p><p><strong>Case description: </strong>Here, we report a case of severe pneumonia caused by <i>Legionella</i> infection. The patient was empirically treated with antibiotics, after admission but had a poor clinical outcome with severe hepatic and renal insufficiency. After <i>Legionella</i> infection was confirmed by metagenomic next-generation sequencing, the patient was switched to omadacycline antibiotic therapy and eventually discharged after recovery.</p><p><strong>Conclusion: </strong><i>Th</i>e results of this study suggest that metagenomic next-generation sequencing can facilitate early diagnosis of Legionnaires' disease, and omadacycline can be an alternative antibiotic treatment for severe Legionnaires' disease, especially in patients experiencing multiple organ failure.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"217-222"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364865","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}