{"title":"Papillary Muscle Rupture in the Setting of <i>Streptococcus lutetiensis</i> Endocarditis.","authors":"Kristy Leker, Arti Patel, Annam Zahid","doi":"10.1177/23247096241300912","DOIUrl":"10.1177/23247096241300912","url":null,"abstract":"<p><p>Papillary muscle rupture is commonly linked to ischemic events, occurring typically postmyocardial infarction. However, iatrogenic and nonischemic etiologies can play a role in papillary muscle rupture, including infective endocarditis. The case presented herein is an 85-year-old female with a history of heart failure with preserved ejection fraction (HFpEF), who presented with progressive dyspnea despite furosemide therapy, and was discovered to have a flail posterior mitral valve leaflet secondary to papillary muscle rupture associated with <i>Streptococcus lutetiensis</i> endocarditis. Transthoracic echocardiography revealed flail posterior mitral valve leaflet with newly appreciated severe wide-open mitral regurgitation. Emergent mitral valve repair was performed with a successful MitraClip placement. Patient had an atypical presentation without ischemic symptomology or electrocardiogram (EKG) changes indicative of ischemia. Despite transesophageal echocardiography, not revealing vegetations, infective endocarditis was presumed due to presence of <i>Streptococcus lutetiensis</i> bacteremia, osteomyelitis, elevated inflammatory markers, and clinical presentation. Papillary muscle rupture results in severe mitral regurgitation that is a medical emergency that requires prompt diagnosis and management from a multidisciplinary team. Therefore, it is imperative to ensure clinical insight into the multiple etiologies of papillary muscle rupture to provide timely treatment.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241300912"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681892","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}
Dayana Nasr, John Joyce, Vishnu Kumar, Hafiz M Khan, Savio John, Sidhartha Chaudhry
{"title":"A Rare Case of Primary B-Cell Lymphoma of the Pancreas.","authors":"Dayana Nasr, John Joyce, Vishnu Kumar, Hafiz M Khan, Savio John, Sidhartha Chaudhry","doi":"10.1177/23247096241263536","DOIUrl":"10.1177/23247096241263536","url":null,"abstract":"<p><p>Primary pancreatic lymphomas (PPLs) are a subgroup of gastrointestinal (GI) lymphomas. They are an exceedingly rare entity, both in terms of pancreatic malignancies and also extranodal lymphomas. Epidemiological investigations have been challenging to do because of their rarity. This has resulted in a lack of clarity on the clinicopathological characteristics, differential diagnosis, best course of treatment, and prognosis of PPL. Because the clinical signs are frequently non-specific, it can lead to a diagnostic hazard for the unwary physician. Preoperatively, it is imperative to distinguish between adenocarcinoma and PPL, as they present similarly, but have vastly different treatment modalities and prognosis. We herein present a case of an elderly man who presented with obstructive jaundice and was found to have PPL.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241263536"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751872","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}
Kevin Trong Dao, Carlos D'Assumpcao, Rupam Sharma, Arash Heidari
{"title":"<i>Clostridium paraputrificum</i> in a Middle-Aged Male With Liver Disease.","authors":"Kevin Trong Dao, Carlos D'Assumpcao, Rupam Sharma, Arash Heidari","doi":"10.1177/23247096241292213","DOIUrl":"10.1177/23247096241292213","url":null,"abstract":"<p><p><i>Clostridium paraputrificum</i> is a gram-positive anaerobic spore-forming bacillus with a pathological prevalence of <1% among all <i>Clostridium</i> species. However, despite being a rare bacterium, there have been reported cases of <i>C paraputrificum</i> causing a wide range of varying pathologies. Herein presented is a case of cirrhosis secondary to alcoholism complicated by developing <i>C paraputrificum</i> bacteremia suspected due to gastrointestinal mucosal damage. There is literature demonstrating certain comorbid conditions having an impact on the overall prognosis of patients with <i>C paraputrificum</i> bacteremia.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241292213"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467627","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}
Ayah Abu Lehia, Adham Itbaisha, Lila H Abu-Hilal, Abdullah Hamamdah, Adeeb Darras, Abdullatif Shawar
{"title":"Renal Vein Thrombosis as an Initial Presentation for Systemic Lupus Erythematosus in a 32-Year-Old Sudanese Male: A Case Report in Palestine.","authors":"Ayah Abu Lehia, Adham Itbaisha, Lila H Abu-Hilal, Abdullah Hamamdah, Adeeb Darras, Abdullatif Shawar","doi":"10.1177/23247096241291922","DOIUrl":"10.1177/23247096241291922","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a complex autoimmune disease known for its diverse clinical presentations, and one severe complication is lupus nephritis (LN), which significantly contributes to morbidity and mortality. While LN often presents within the first 5 years of SLE diagnosis, renal vein thrombosis (RVT) is a rare vascular complication with a high risk of mortality and morbidity. This case report discusses the rare occurrence of RVT as the initial presentation of SLE in a 32-year-old Sudanese male patient, currently working in Palestine, presenting with flank pain, hematuria, fever, and lower limb edema. The case details the patient's symptoms, examination findings, and extensive laboratory and imaging workup leading to the diagnosis. This report highlights the rare association between RVT and SLE, emphasizing the importance of maintaining a high index of suspicion for SLE in patients with multisystem involvement, especially in males, where the diagnosis may be overlooked due to its lower prevalence. Early recognition can improve patient outcomes and reduce the risk of complications. Further research is needed to better understand the connection between RVT and SLE and to develop more effective treatment strategies.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241291922"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467632","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}
Shengmin Huang, Mustafa Wasifuddin, Amulya Bellamkonda, Po-Shing Lee, M Rashid Chaudhry, Jen C Wang
{"title":"Light-Chain Myeloma Presented as Osseus Tumors: A Case Report.","authors":"Shengmin Huang, Mustafa Wasifuddin, Amulya Bellamkonda, Po-Shing Lee, M Rashid Chaudhry, Jen C Wang","doi":"10.1177/23247096241307445","DOIUrl":"10.1177/23247096241307445","url":null,"abstract":"<p><p>Light-chain multiple myeloma (LCMM) is a rare subtype of plasma cell neoplasm, usually linked to kidney involvement and lytic bone lesions. However, case presents as osseus tumors are very uncommon. A 63-year-old male patient complained of persistent rib pain. Computed tomographic imaging showed an isolated bone tumor in the eighth rib. Further positron emission tomography-computed tomographic scan revealed multiple lytic bone lesions in other areas. Biopsy of the rib lesion confirmed the presence of plasma cells producing kappa light chains. The patient received 4 cycles of daratumumab, bortezomib, lenalidomide, and dexamethasone treatments, resulting in significant improvement. Reviewing literatures, osseus tumor with osteosclerotic lesions has been rarely described in LCMM, underlining the challenge in diagnosis and stressing the importance of considering LCMM in the differential diagnosis of bone tumors.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241307445"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837240","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 Tirzepatide Drop: Beware of Slimmer's Paralysis.","authors":"John M Tucker, Jordan Ritchie","doi":"10.1177/23247096241264635","DOIUrl":"10.1177/23247096241264635","url":null,"abstract":"<p><p>This case series explores the association between tirzepatide-assisted weight loss and the development of foot drop due to peroneal nerve neuropathy, a phenomenon known as slimmer's paralysis. Two cases are presented of patients who experienced rapid weight loss after initiation of tirzepatide therapy and within 6 to 8 months developed bilateral foot drop. As providers, we have more medications than ever to assist patients in their weight loss journeys, but both of these cases are reminders of the risks of rapid weight loss and the need to monitor therapy closely for patients on tirzepatide and similar medications.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241264635"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759208","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}
Niloufar Ebrahimi, Behzad Najafian, Yan Chen Wongworawat, Sayna Norouzi, Amir Abdipour
{"title":"Anti-Tubular Basement Membrane Antibody Nephritis Manifesting in a Patient With Chronic Lymphocytic Leukemia: A Very Rare Case Report.","authors":"Niloufar Ebrahimi, Behzad Najafian, Yan Chen Wongworawat, Sayna Norouzi, Amir Abdipour","doi":"10.1177/23247096241281612","DOIUrl":"10.1177/23247096241281612","url":null,"abstract":"<p><p>Anti-tubular basement membrane (anti-TBM) antibody nephritis is a rare type of tubulointerstitial nephritis associated with progressive decline in kidney function. It is characterized histopathologically by tubular atrophy and dilation, interstitial fibrosis, lymphocyte and macrophage-predominant cellular infiltration, and linear deposition of IgG and complement along the tubular basement membrane. We herein present a case of a 69-year-old male who was recently diagnosed with chronic lymphocytic leukemia (CLL) and was referred for evaluation of kidney failure, ultimately diagnosed as anti-TBM antibody nephritis progressing into end-stage kidney disease (ESKD). This case report highlights the management challenges of anti-TBM antibody nephritis as a rare kidney disorder.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241281612"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307936","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}
Hoang Dinh Canh, Cao Ba Loi, Dao Nguyen Hung, Le Thi Hong Van, Nguyen Thi Nhu Quynh, Do Thi Thuy Dung, Nguyen Ngoc Tuan, Do Ngoc Anh
{"title":"A Vulvovaginal Yeast Infection Caused by <i>Cryptococcus victoriae</i> in Vietnam: A Rare Case Report.","authors":"Hoang Dinh Canh, Cao Ba Loi, Dao Nguyen Hung, Le Thi Hong Van, Nguyen Thi Nhu Quynh, Do Thi Thuy Dung, Nguyen Ngoc Tuan, Do Ngoc Anh","doi":"10.1177/23247096241237756","DOIUrl":"10.1177/23247096241237756","url":null,"abstract":"<p><p>Cases of vulvovaginitis caused by <i>Cryptococcus</i> genus are exceedingly uncommon, with only a handful of instances having been described for this causative species. This report describes a rare case of vulvovaginitis suspected to be caused by <i>Cryptococcus victoriae</i> in a 58-year-old woman residing in an urban area of Hanoi city, Vietnam. The patient with a 10-year history of depression and type 2 diabetes mellitus was admitted to the hospital due to vulvar itching and vaginal discharge. Vaginal swabs confirmed the presence of a yeast infection by direct microscopic examination with 10% KOH and culture on CHROMagar Candida. The yeast was identified as <i>C victoriae</i> using genetic sequencing tools. The patient's treatment plan involved topical clotrimazole and a daily oral dose of 200 mg of itraconazole for 7 days. This comprehensive treatment approach resulted in the patient's full recovery. This is the first reported case of vulvovaginitis attributed to <i>C victoriae</i> in humans worldwide.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241237756"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094204","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":"Gastroduodenal Involvement in AL Amyloidosis: Case Report and Literature Review.","authors":"Rajarajeshwari Ramachandran, Tyler Grantham, Giovannie Isaac-Coss, Denzil Etienne, Madhavi Reddy","doi":"10.1177/23247096241237759","DOIUrl":"10.1177/23247096241237759","url":null,"abstract":"<p><p>Gastrointestinal amyloidosis is a rare condition commonly found in the setting of systemic AL amyloidosis. Amyloid can deposit throughout the gastrointestinal tract and the resulting symptoms vary depending on the site of deposition. Gastrointestinal (GI) manifestations can range from weight loss or abdominal pain, to more serious complications like gastrointestinal bleeding, malabsorption, dysmotility, and obstruction. This case describes a patient with known history of IgG lambda AL amyloidosis, presenting with epigastric pain and unintentional weight loss found to have gastroduodenal amyloidosis. The definitive diagnosis of GI amyloidosis requires endoscopic biopsy with Congo red staining and visualization under polarized light microscopy. There are currently no specific guidelines for the management of GI amyloidosis. Generally, the goal is to treat the underlying cause of the amyloidosis along with symptom management. Our patient is being treated with cyclophosphamide, bortezomib, and dexamethasone (CyBorD) and started on hemodialysis due to progression of renal disease.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241237759"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094205","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}
Lefika Bathobakae, Rammy Bashir, Dhruv Patel, Tyler Wilkinson, Nader Mekheal, Gabriel Melki, Yana Cavanagh, Walid Baddoura
{"title":"A View in the Dark: Two Cases of Acute Esophageal Necrosis in the Setting of Diabetic Ketoacidosis.","authors":"Lefika Bathobakae, Rammy Bashir, Dhruv Patel, Tyler Wilkinson, Nader Mekheal, Gabriel Melki, Yana Cavanagh, Walid Baddoura","doi":"10.1177/23247096241269864","DOIUrl":"10.1177/23247096241269864","url":null,"abstract":"<p><p>Acute esophageal necrosis (AEN), also known as Gurvits syndrome, is a rare and potentially life-threatening condition characterized by necrosis of the esophageal mucosa. Acute esophageal necrosis is often associated with critical conditions, such as myocardial infarction, diabetic ketoacidosis (DKA), coronavirus disease 2019 (COVID-19) infection, or post-surgical complications. Patients typically present with nausea, hematemesis, acute dysphagia, and melena. Given its high mortality rate, prompt detection with upper endoscopy and early initiation of treatment are crucial. Most cases of Gurvits syndrome are managed conservatively using intravenous fluids, proton pump inhibitors, and antibiotics. Herein, we present a case series of AEN in the setting of DKA. Both patients received supportive care and were discharged in a stable condition.</p>","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"12 ","pages":"23247096241269864"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897574","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}