Journal of Community Hospital Internal Medicine Perspectives最新文献_第5页

Rare Complications of Chronic Rhinosinusitis Associated With Nasal Polyps and Osseous Metaplasia. 慢性鼻窦炎合并鼻息肉及骨化生的罕见并发症。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1585

Michael Ritz, Alaina Rubenacker-O'Dell, Faith Olson, Ilya Fonarov

{"title":"Rare Complications of Chronic Rhinosinusitis Associated With Nasal Polyps and Osseous Metaplasia.","authors":"Michael Ritz, Alaina Rubenacker-O'Dell, Faith Olson, Ilya Fonarov","doi":"10.55729/2000-9666.1585","DOIUrl":"10.55729/2000-9666.1585","url":null,"abstract":"Chronic rhinosinusitis with nasal polyps (CRSwNP) is typically a benign condition; however, osseous metaplasia (OM), skull base erosion, and intracranial extension are rare complications, especially in young patients. Reporting such cases is important to increase awareness of unusual presentations of CRSwNP and guide management. We report the case of an 18-year-old male with a history of asthma and prior polypectomy who presented with worsening frontal headaches, subtle visual changes, and right eye proptosis. Imaging revealed extensive pansinusitis with complete frontal sinus opacification, bony erosion of the anterior skull base, and evidence of intracranial and orbital extension. The patient underwent endoscopic sinus surgery, which revealed fibrotic polyps, bone expansion, and purulent intracranial collections. Cultures were obtained, and decompression of the frontal sinuses was accomplished through bilateral Draf IIb procedures. Postoperatively, the patient experienced resolution of proptosis and improvement of symptoms. This case highlights an unusual and aggressive course of CRSwNP complicated by features of OM and emphasizes the importance of early recognition, multidisciplinary management, and close follow-up in preventing neurological and ophthalmic sequelae.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"86-89"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793828","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}

引用次数: 0

Cryptococcal and EBV Meningitis in a Postpartum Woman With HIV Despite ART: A Case Challenging the Limits of Immune Reconstitution. 尽管抗逆转录病毒治疗，产后感染艾滋病毒妇女的隐球菌性和EBV性脑膜炎：一个挑战免疫重建极限的病例。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1577

Rouba Isshak, Zhaoqi Li, Aqsa Z Sorathia, Opeyemi Fakayode, Ivan Mercado, Malina Mohtadi, Nader Ghobriel, Mina Gerges, Patrick Michael, Simi Philip

{"title":"Cryptococcal and EBV Meningitis in a Postpartum Woman With HIV Despite ART: A Case Challenging the Limits of Immune Reconstitution.","authors":"Rouba Isshak, Zhaoqi Li, Aqsa Z Sorathia, Opeyemi Fakayode, Ivan Mercado, Malina Mohtadi, Nader Ghobriel, Mina Gerges, Patrick Michael, Simi Philip","doi":"10.55729/2000-9666.1577","DOIUrl":"10.55729/2000-9666.1577","url":null,"abstract":"Cryptococcal meningitis (CM) is a life-threatening opportunistic infection, mainly affecting immunocompromised patients, especially with advanced HIV/AIDS. Unmasking cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) is a severe but relatively rare complication in the United States. Co-infection with other central nervous system (CNS) pathogens further complicates both diagnosis and management. In this case report, we present a rare instance of CM secondary to C-IRIS alongside EBV meningitis in a postpartum, HIV-positive patient on ART. This co-infection highlights the vulnerability of immunocompromised individuals, even on ART, to multifactorial CNS infections. It emphasizes the need for vigilant monitoring, timely intervention, and comprehensive long-term management in high-risk groups such as postpartum patients, while also highlighting the importance of thorough opportunistic infection screening before ART initiation to reduce the risk of IRIS-related complications.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"50-53"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793790","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}

引用次数: 0

Recurrent Pubic Osteomyelitis and Urosymphyseal Fistula in a Prostate Cancer Survivor: A Multidisciplinary Management Challenge. 前列腺癌幸存者复发性耻骨骨髓炎和尿联合瘘：多学科管理挑战。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1591

Peng J Wu, Navin Sampathkumar, Tanmay Singh, Sonal Gandhi

{"title":"Recurrent Pubic Osteomyelitis and Urosymphyseal Fistula in a Prostate Cancer Survivor: A Multidisciplinary Management Challenge.","authors":"Peng J Wu, Navin Sampathkumar, Tanmay Singh, Sonal Gandhi","doi":"10.55729/2000-9666.1591","DOIUrl":"10.55729/2000-9666.1591","url":null,"abstract":"A 67-year-old male with a history of prostate cancer, treated with prostatectomy and subsequent radiation for recurrence, presented with a complex clinical course of recurrent osteomyelitis and a persistent urosymphyseal fistula with associated phlegmon. Following stereotactic body radiation therapy (SBRT) for a T4 vertebral lesion, he developed pelvic osteomyelitis, from which Kocuria species was cultured. The progression of his disease led to a urosymphyseal fistula, necessitating a cystectomy with ileal conduit and pubic bone debridement. Despite this extensive surgical intervention, he presented one year later with recurrent ileal conduit phlegmon and osteomyelitis. This case highlights the significant diagnostic and management challenges of chronic, structurally complicated infections. It emphasizes the necessity for a multidisciplinary approach involving urology, orthopedics, infectious disease, and pain management to balance conservative (prolonged antibiotics) versus aggressive (surgical) interventions, while also considering the patient's quality of life.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"72-75"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793762","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}

引用次数: 0

Refractory Post-transplant Erythrocytosis in a Renal Transplant Recipient: A Case Report. 肾移植受者移植后难治性红细胞增多1例报告。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1574

Ahmed Mustafa, Abbas Gain, Umm E Salma Shabbar Banatwala, Nasim Salimiaghdam, Amir Kamran

{"title":"Refractory Post-transplant Erythrocytosis in a Renal Transplant Recipient: A Case Report.","authors":"Ahmed Mustafa, Abbas Gain, Umm E Salma Shabbar Banatwala, Nasim Salimiaghdam, Amir Kamran","doi":"10.55729/2000-9666.1574","DOIUrl":"10.55729/2000-9666.1574","url":null,"abstract":"Background: Post-transplant erythrocytosis (PTE) is a well-recognized complication occurring in approximately 8-15 % of renal transplant recipients. It is commonly managed with renin-angiotensin system (RAS) inhibitors, including angiotensin receptor blockers (ARBs). However, a subset of patients may be refractory to standard pharmacologic therapy.Case presentation: We report the case of a 57-year-old male kidney transplant recipient who developed persistent erythrocytosis despite treatment with an ARB. The patient remained symptomatic with elevated hematocrit levels, prompting consideration of alternative management strategies.Management and outcome: Given the inadequate response to RAS blockade, therapeutic phlebotomy was initiated. The patient tolerated the procedure well, and phlebotomy was effective in achieving long-term hematocrit control and symptom relief. No significant complications were observed during follow-up.Conclusion: This case underscores the need for individualized management in patients with refractory PTE. It demonstrates the safe and effective use of therapeutic phlebotomy when pharmacologic interventions fail. The variability in treatment response suggests a need for flexible hematocrit targets and emphasizes monitoring of clinical symptoms in addition to laboratory values. Further research is needed to establish optimal treatment strategies and identify predictors of resistance to RAS blockade.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"76-79"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793818","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}

引用次数: 0

An Unexpected Cause of Thrombocytopenia in Pregnancy: A Case of Malaria in a Non-endemic Setting With Unclear Transmission Source. 妊娠期血小板减少的意外原因：一个传播源不明的非地方性疟疾病例。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1578

Jessica Ohemeng-Dapaah, Riham Mohammed, Ikechuwku Eke-Okoro

{"title":"An Unexpected Cause of Thrombocytopenia in Pregnancy: A Case of Malaria in a Non-endemic Setting With Unclear Transmission Source.","authors":"Jessica Ohemeng-Dapaah, Riham Mohammed, Ikechuwku Eke-Okoro","doi":"10.55729/2000-9666.1578","DOIUrl":"10.55729/2000-9666.1578","url":null,"abstract":"Malaria remains a significant global health threat, with increasing concern for imported and locally acquired cases in non-endemic regions. We present the case of a 35-year-old pregnant woman from Sierra Leone, living in Missouri, who despite no recent international travel, was found to have symptomatic Plasmodium falciparum malaria. Her clinical course was notable for fever, severe thrombocytopenia, mild anemia and intraerythrocytic ring forms on her peripheral smear. She had a history of chronic hepatitis B and prior chemotherapy for Hodgkin lymphoma and recent travel to Florida, where local malaria transmission has been documented. The patient responded rapidly to artemisinin-based therapy, with resolution of parasitemia and improvement in hematologic parameters. This case highlights the diagnostic challenges of malaria in pregnancy, particularly in non-endemic settings and draws attention to the evolving epidemiology of malaria and the need for vigilance in regions previously considered malaria-free.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"54-57"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793648","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}

引用次数: 0

Clinical Application of Midline Catheters in an Acute Care Ward: A Single-center Retrospective Observational Study. 中线导管在急症病房的临床应用：一项单中心回顾性观察研究。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1586

Miki Satou, Yusuke Makio, Taku Harada, Kenta Shukuya, Hiroki Taira, Shintaro Kosaka

{"title":"Clinical Application of Midline Catheters in an Acute Care Ward: A Single-center Retrospective Observational Study.","authors":"Miki Satou, Yusuke Makio, Taku Harada, Kenta Shukuya, Hiroki Taira, Shintaro Kosaka","doi":"10.55729/2000-9666.1586","DOIUrl":"10.55729/2000-9666.1586","url":null,"abstract":"Introduction: Midline catheters are a promising alternative to central venous access devices for intermediate-term therapy, with reduced risks of catheter-related bloodstream infections (CRBSI) and deep vein thrombosis (DVT). Their inclusion in the 2024 World Health Organization guidelines reflects increasing global interest. However, their use remains limited to select countries, and real-world clinical data are scarce. This study evaluated the safety and effectiveness of midline catheters in an acute care setting.Methods: We retrospectively analyzed 68 midline catheter insertions in 50 patients between November 2023 and April 2024 in a general internal medicine ward of a 400-bed hospital. Collected data included patient demographics, indications for use, catheter dwell time, number of blood draws, and occurrence of complications. Insertions were ultrasound-guided and performed under sterile precautions. Weekly site disinfection and dressing changes were implemented. Complications were classified as major (CRBSI, symptomatic DVT) or minor (occlusion, poor return, leakage, unintentional removal).Results: Median age was 59.5 years (IQR 70-85.75); 46 % were female. All patients required frequent blood sampling. Common indications included prolonged antibiotic therapy (72 %) and difficult venous access (38 %). Median dwell time was 11 days, with a median of 4 blood draws. No CRBSI or symptomatic DVT occurred. Minor complications included leakage (n = 7), unintentional removal (n = 8), poor return (n = 4), and occlusion (n = 1).Conclusion: Midline catheters demonstrated a favorable safety profile, with no major complications and minor complication rates comparable to international data. Preventive strategies should target vulnerable patients to reduce unintentional catheter removal.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"11-13"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793676","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}

引用次数: 0

When to Continue, Pause, or Stop SGLT-2 Inhibitors in Heart Failure: A Complication-based Clinical Guide. 心衰患者何时继续、暂停或停用SGLT-2抑制剂：基于并发症的临床指南

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1576

Nicole A Tesoro, Jasvin K Manha, Sumanth K Bandaru

{"title":"When to Continue, Pause, or Stop SGLT-2 Inhibitors in Heart Failure: A Complication-based Clinical Guide.","authors":"Nicole A Tesoro, Jasvin K Manha, Sumanth K Bandaru","doi":"10.55729/2000-9666.1576","DOIUrl":"10.55729/2000-9666.1576","url":null,"abstract":"Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become an essential part of guideline-directed medical therapy for heart failure due to their proven ability to reduce hospitalizations and improve survival, independent of diabetes status. Despite these benefits, their use can be complicated by genitourinary side effects such as genital mycotic infections, urinary tract infections, and, rarely, serious complications including urosepsis, Fournier's gangrene, and euglycemic diabetic ketoacidosis. These events often leave clinicians uncertain about whether therapy should be continued, paused, or permanently discontinued. Current guidance remains limited and inconsistent, with most recommendations derived from case reports, expert opinion, or post-marketing surveillance. In this review, we summarize the mechanisms and benefits of SGLT2 inhibitors, outline common and serious adverse events, and propose a practical, case-based approach to guide decisions about continuing, pausing, or discontinuing therapy. Evidence suggests that most mild genitourinary infections can be managed with standard treatment while maintaining therapy, whereas severe, recurrent, or life-threatening events may warrant temporary or permanent discontinuation. A structured, individualized approach that balances risks and benefits allows clinicians to preserve the cardiovascular benefits of SGLT2 inhibitors while minimizing preventable harm.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 2","pages":"38-44"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793770","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}

引用次数: 0

Severe Spontaneous Hematoma in an Elderly Female: A Case of Acquired Hemophilia A. 老年女性严重自发性血肿一例获得性血友病A。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1582

Sandeep Beesabathina, Sara Sartaj, Nabeel Rajeh

引用次数: 0

Unprovoked Extensive Cerebral Venous Sinus Thrombosis in a Heterozygous Prothrombin G20210A Mutation Carrier: A Rare Case Report. 杂合子凝血酶原G20210A突变携带者无端广泛脑静脉窦血栓形成：罕见病例报告。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-03-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1584

Hasan Obeidat, Sandeep Kshetri, Mahyar Toofantabrizi

引用次数: 0

Renal Function Equations and Medication Dosing: The Daily Clinical Dilemma. 肾功能方程式和药物剂量：日常临床困境。