International Medical Case Reports Journal最新文献

{"title":"Electric Heating Pad as an Adjuvant Treatment of Extensive Chromoblastomycosis in Immunocompetent Patient: A Case Report.","authors":"Risa Miliawati Nurul Hidayah, Hendra Gunawan, Nisa Fauziah, Fathia Rianty","doi":"10.2147/IMCRJ.S507453","DOIUrl":"10.2147/IMCRJ.S507453","url":null,"abstract":"<p><p>Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues, caused by melanized fungi. In cases with extensive cutaneous lesions, heat therapy can be used as an adjuvant to systemic antifungal therapy. This case report aimed to demonstrate the efficacy of heat therapy using an electric heating pad as an adjuvant to itraconazole in the treatment of extensive chromoblastomycosis. A 60-year-old immunocompetent male presented with ten-year history of extensive verrucous erythematous plaques with atrophic central lesions located in the right arm. Histology and mycological examination from a direct smear and skin biopsy revealed muriform cells and pathognomonic chromoblastomycosis. Cultures grew dark-pigmented colonies, yielding <i>Fonsecaea spp</i>. A combination therapy of itraconazole 400 mg daily and topical heat therapy using an electric heating pad resulted in clinical improvement during the first month of treatment. Heat therapy can be administered as an adjuvant to systemic antifungal therapy because of its fungistatic and fungicidal effects, and its ability to enhance the patient's immune response. The selection of a suitable heat therapy device is crucial for improving the success of therapy. In this case, the patient demonstrated significant improvement in cutaneous lesions after one month of combination therapy with itraconazole and heat therapy. Electric heating pads are a good choice for topical heat therapy because of their stable temperature, availability, affordability, and ease of use. Heat therapy using electric heating pads is an effective adjuvant to systemic antifungal therapy in the treatment of extensive chromoblastomycosis.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"315-320"},"PeriodicalIF":0.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615549","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":"The Management Modality of Aseptic Loosening for Acetabular Components Along With Femur Prostheses Following Primary Hip Arthroplasty: A Reports of Four Cases.","authors":"Hongxia Zhu, Lei Fu, Yu Xie, Xiao Yuan, Shengtao Chen, Lunli Xie","doi":"10.2147/IMCRJ.S506741","DOIUrl":"10.2147/IMCRJ.S506741","url":null,"abstract":"<p><strong>Purpose: </strong>Aseptic loosening (AL) of prostheses is a complex and multi-factorial consequences characterized by nonspecific hip start-up pain, impaired gait, or ambulation. The AL of acetabular components associated with femur prostheses can lead to challenges in accurate diagnosis and suitable therapy, potentially resulting in disaster consequence. This study reported revision of in four cases with AL of acetabular components associated with or without femur prostheses after underwent primary total hip arthroplasty.</p><p><strong>Case description: </strong>We present four cases with aseptic loosening of prostheses with a medical history of total hip arthroplasty who presented obvious clinical features of recurrent hip pain or \"start-up\" pain, limping gait, and worsening of walking. Basing on preoperative imaging materials, and ruling out prosthetic joint infection, the comprehensive analysis revealed migration and radiolucency line around margin of prosthesis, confirming the diagnosis of prosthetic AL. All patients accepted individual revision surgery and acquired satisfactory results basing on the month telephone follow-up duration.</p><p><strong>Conclusion: </strong>Our case report suggests long femur stem associated with wires cerclage fixation combined with or without bone graft revision for treatment of aseptic loosening of the acetabular components coupled with femur prostheses is a viable technique for achieving reliable fracture healing and satisfactory clinical results. Besides, it is the critical need for individualized approaches to therapeutic method, uniquely intended to address the complexity of this AL after THA.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"307-314"},"PeriodicalIF":0.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605101","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":"Arterialized Venous Free Flap for Hand Defect Reconstruction Due to Ischemic Steal Syndrome.","authors":"Rani Septrina, Putie Hapsari, Irra Rubianti Widarda, Ronny Lesmana, Reno Rudiman, Rizky Abdulah, Amelia Febrina","doi":"10.2147/IMCRJ.S495524","DOIUrl":"10.2147/IMCRJ.S495524","url":null,"abstract":"<p><p>Ischemic steal syndrome (ISS) occurs in hemodialysis patients. Hence, it rarely becomes gangrene or disrupts hand function. We reported a patient with an ISS and radial atherosclerosis that presented with infected ulcer. The patient was treated with arterialized venous free flap from the contralateral forearm. Dialysis access can be used as early as 10 days after the flap. The report also describes the long-term functional follow-up after reconstruction. Although there was superficial flap necrosis, this non-physiologic flap can preserve the patient's hand function.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"301-305"},"PeriodicalIF":0.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596966","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":"Thalidomide as Treatment of Lip's Pyogenic Granuloma.","authors":"Liyan Lai, Jiayao Nie, Dejian Duan, Dan Huang","doi":"10.2147/IMCRJ.S511053","DOIUrl":"10.2147/IMCRJ.S511053","url":null,"abstract":"<p><p>Pyogenic granuloma (PG) is a benign vascular tumor that can be challenging to treat, particularly in aesthetically sensitive areas. We report a case of a 32-year-old man with a PG on the upper lip that did not respond to conventional treatments, including glucocorticoid injections and long-pulse 1064 nm laser therapy. Due to aesthetic concerns and the lack of response to these treatments, the patient was administered oral thalidomide at a nightly dose of 75 mg for 5 months, which resulted in complete regression without recurrence over a 3-year follow-up. This case suggests thalidomide's potential as an effective alternative treatment for PG in sensitive areas.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"295-299"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572844","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":"Porto Sinusoidal Vascular Disorder: A Case Report.","authors":"Naima Mukhtar Abdullahi, Mohammed A M Ahmed, Mohamed Abdulahi Yusuf, Hawa Ali Warsame","doi":"10.2147/IMCRJ.S502206","DOIUrl":"10.2147/IMCRJ.S502206","url":null,"abstract":"<p><strong>Background: </strong>Porto sinusoidal vascular disease (PSVD) is an unusual vascular disorder defined by raised portal venous pressure without cirrhosis or other common causes of liver pathology. The disease pathogenicity is not well understood.</p><p><strong>Case report: </strong>We report a rare case of Porto Sinusoidal Vascular Disorder (PSVD). This patient presented with hematemesis and melena several times, despite having no prior history of chronic disease. An endoscopic evaluation revealed 4 cords of oesophageal varices. The exact cause of portal hypertension was not identified despite the patient undergoing MRI, liver biopsy, abdominal and hepatic sonography, and other required laboratory tests. This patient was performed band ligation and received beta blockers, proton pump inhibitors and whole blood transfusion.</p><p><strong>Conclusion: </strong>This case highlights the complexity of the diagnosing and managing of PSVD. Despite the patient receiving symptomatic treatment, he still has pancytopenia due to splenomegaly and needs close monitoring and flow-up.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"289-293"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566757","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":"Burkitt's Lymphoma of the Uterine Cervix in a Woman with Advanced HIV Disease: A Case Report on Challenges with Its Management in a Low Resource Setting.","authors":"Lisa Erin de Miranda, Bernard Uzabakiriho, Melanie Louw, Nnabuike Chibuoke Ngene","doi":"10.2147/IMCRJ.S500905","DOIUrl":"10.2147/IMCRJ.S500905","url":null,"abstract":"<p><strong>Background: </strong>Burkitt's lymphoma (BL) affecting the female genital tract is rare.</p><p><strong>Objective: </strong>The aim of this paper is to report BL of the cervix in an HIV-positive patient to discuss the fatality of the condition and ways to mitigate it through advocacy for improved health care delivery in resource limited settings.</p><p><strong>Methods: </strong>The patient was a 29-year-old woman, Para 1, with abnormal vaginal bleeding for a month and living with HIV and had a CD4 of 26 cells/μL. The histological examination of the cervical biopsy confirmed an extra-nodal BL. She had International Federation of Gynecology and Obstetrics (FIGO) stage 3B cervical cancer based on presence of hydronephrosis and pelvic wall involvement. The patient was reviewed at the oncology multidisciplinary meeting and required chemoradiation. There was delay in her management due to a long waiting list for chemoradiation at oncology unit in the referral center and the patient demised 43 days after diagnosis and did not receive the treatment.</p><p><strong>Results: </strong>This case suggests that women living with HIV who have BL should be fast-tracked for treatment as HIV viremia may worsen the prognosis of the malignancy. Following the encounter with the index patient an advocacy action plan has been made by the oncology multidisciplinary team to prioritize the treatment of women with aggressive histological types of cervical cancer.</p><p><strong>Conclusion: </strong>A long waiting list for chemoradiation in low resource settings may delay management of advanced BL of the cervix. Inadequate cervical cancer screening and delays in diagnosis are other barriers to the care of women with aggressive cervical cancers in low resource settings. Systemic changes in healthcare delivery are therefore required in many low resource settings. Advocacy for patients particularly those with aggressive diseases using the index case as a point of reference is ideal and should be promoted in resource-limited settings to improve health care delivery.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"281-287"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572843","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":"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}