Journal of investigative medicine high impact case reports最新文献_第7页

Breast Abscess Secondary to Brucellosis: A Rare Case Report. 继发于布鲁氏菌病的乳房脓肿1例报告。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-06-28 DOI: 10.1177/23247096251347405

Dar Hasan Abeer, Assaf Tasneem, Sharaf Razan, Ghanem Usra, Adwan Rabee

引用次数: 0

Unveiling the Unexpected-Role of Unique Pathogens in Necrotizing Cavitary Pneumonia of Sickle Cell Disease: A Case Report. 揭示独特病原体在镰状细胞病坏死性空洞性肺炎中的意外作用：1例报告。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-04-12 DOI: 10.1177/23247096251334241

Jayalekshmi Jayakumar, Manasa Ginjupalli, Fiqe Khan, Meher Ayyazuddin, Giovannie Isaac Coss, Muhammad Ashar Ali, Asmat Ullah

{"title":"Unveiling the Unexpected-Role of Unique Pathogens in Necrotizing Cavitary Pneumonia of Sickle Cell Disease: A Case Report.","authors":"Jayalekshmi Jayakumar, Manasa Ginjupalli, Fiqe Khan, Meher Ayyazuddin, Giovannie Isaac Coss, Muhammad Ashar Ali, Asmat Ullah","doi":"10.1177/23247096251334241","DOIUrl":"https://doi.org/10.1177/23247096251334241","url":null,"abstract":"Sickle cell disease (SCD), prevalent in African Americans, is associated with numerous complications, including infections and pulmonary manifestations. Necrotizing cavitary pneumonia, a rare but severe complication, poses significant diagnostic challenges in patients with SCD. We report a 27-year-old male with SCD and history of pulmonary infarction from pulmonary embolism who presented with bilateral wrist pain, cough, and chest pain and was found to have necrotizing cavitary pneumonia. Initial imaging revealed significant right upper lobe cavitary consolidation. Despite negative sputum cultures, blood cultures identified Staphylococcus epidermidis and Granulicatella, atypical pathogens in pneumonia cases. Pain crisis treatment and treatment with antibiotics for pneumonia displayed significant improvement in symptoms. Our case highlights the necessity of considering unusual pathogens in SCD patients presenting with pneumonia, particularly those with prior pulmonary complications. Infections remain a leading cause of morbidity and mortality in SCD, underscoring the importance of rapid diagnosis and tailored management. Vigilant monitoring of cavitary lesions and prompt recognition of atypical pathogens can mitigate risks of severe pulmonary complications and improve patient outcomes. Additional research is required to delineate the epidemiology of rare infections in SCD and establish effective treatment protocols.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251334241"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967956","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

Gastroduodenal Artery (GDA) Pseudoaneurysm as a Cause of Massive Upper Gastrointestinal (GI) Bleeding Years After Partial Gastrectomy. 胃十二指肠动脉（GDA）假性动脉瘤是胃部分切除术后大量上消化道出血的原因。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-22 DOI: 10.1177/23247096251323076

Hussam Almasri, Sana Rabeeah, Guneet Sidhu, Arman Qurashi, John Bassett, Bisher Sawaf, Shahem Abbarh

{"title":"Gastroduodenal Artery (GDA) Pseudoaneurysm as a Cause of Massive Upper Gastrointestinal (GI) Bleeding Years After Partial Gastrectomy.","authors":"Hussam Almasri, Sana Rabeeah, Guneet Sidhu, Arman Qurashi, John Bassett, Bisher Sawaf, Shahem Abbarh","doi":"10.1177/23247096251323076","DOIUrl":"10.1177/23247096251323076","url":null,"abstract":"Gastroduodenal artery (GDA) pseudoaneurysm is a rare complication of gastric and pancreatic surgery. The presentation is often severe gastrointestinal (GI) bleeding with up to a 90% mortality rate. Proper identification of past gastrectomy based on history or endoscopic appearance is essential for timely embolization or surgery, given that endoscopic management often fails. Here, we present a 65-year-old man who has a history of gastric ulcer-related surgery without clear documentation and hypertension presented with hematemesis, black stools, and syncope. Upper endoscopy showed signs of gastroenterostomy with stenosis and duodenal ulcer with spurting hemorrhage. Two days after endoscopic therapy, a recurrence of massive GI bleeding was noted. A celiac arteriogram was done by interventional radiology, demonstrating a pseudoaneurysm off the GDA. Successful embolization was performed with helical coils. The GI bleeding stopped, and the patient became stable after that. The GDA pseudoaneurysm-related bleeding should always be suspected in patients who underwent gastrectomy, bypass surgery, or pancreatectomy. Endoscopic interventions are usually temporary and sometimes can only give anatomical correlation before angiogram and embolization offer a definite treatment. Patients with GDA pseudoaneurysm can be entirely asymptomatic for a long time. The most common site of bleeding is the duodenum. Surgical interventions can also be offered if an angiogram is not successful in stopping the bleeding.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251323076"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677038","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

The Perfect Storm: Co-occurrence of Agranulocytosis and Thyroid Storm Successfully Managed with Lithium Therapy. 完美风暴：粒细胞缺乏症和甲状腺风暴的共同发生与锂治疗成功管理。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-04-25 DOI: 10.1177/23247096251336657

Nikhil Vojjala, Omar Fathalla, Mahvish Renzu, Rishab Prabhu, Lakshmi Kattamuri, Geetha Krishnamoorthy, Wael Taha

{"title":"The Perfect Storm: Co-occurrence of Agranulocytosis and Thyroid Storm Successfully Managed with Lithium Therapy.","authors":"Nikhil Vojjala, Omar Fathalla, Mahvish Renzu, Rishab Prabhu, Lakshmi Kattamuri, Geetha Krishnamoorthy, Wael Taha","doi":"10.1177/23247096251336657","DOIUrl":"https://doi.org/10.1177/23247096251336657","url":null,"abstract":"A thyroid storm is a medical emergency that requires high clinical suspicion and emergency treatment. We report an unusual case of thyroid storm and agranulocytosis managed with lithium therapy. The patient is a 32-year-old woman with a history of Graves' disease on methimazole therapy who presented to the emergency department with fever and palpitations. She was diagnosed with COVID-19 infection a week ago. She was febrile and tachycardic with fine tremors on examination. Routine laboratory workup showed agranulocytosis. Serum thyroid-stimulating hormone levels are <0.01 µIU/ml (normal range is 0.45-5.33) with elevated T4 and T3 (10.4 pcg/ml [2.1-4.1 pcg/ml], 4.34 ng/dl [0.61-1.24 ng/dl]). Burch-Wartofsky Point Scale score was 60 points, highly suggestive of thyroid storm. A clinical diagnosis of thyroid storm was made. The precipitating factor in this case was identified as the recent COVID-19 infection. Adding to the conundrum is the co-existent agranulocytosis, precluding the usage of antithyroid medications. She was treated with beta-blockers, intravenous fluids, and steroid therapy to suppress T4 to T3 conversion. Lithium was started, given her neutropenia and thyroid storm. She responded to oral lithium therapy and was discharged. During follow-up, her symptoms were controlled and leucopenia resolved. In conclusion, COVID-19 is a recognized precipitating factor for thyroid storms. It is very rare to see co-existent thyroid storm and agranulocytosis, and lithium can be a useful option in such cases. This case report adds to the minimal literature existing on lithium use in patients with thyroid storm.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251336657"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995960","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

Diabetic Myonecrosis: Lessons in Recognizing and Treating a Rare Complication. 糖尿病性肌坏死：认识和治疗罕见并发症的经验教训。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI: 10.1177/23247096251331890

Brandon Garten, Mark Schwade, Saleh Alkathiri, Lane Perry

{"title":"Diabetic Myonecrosis: Lessons in Recognizing and Treating a Rare Complication.","authors":"Brandon Garten, Mark Schwade, Saleh Alkathiri, Lane Perry","doi":"10.1177/23247096251331890","DOIUrl":"10.1177/23247096251331890","url":null,"abstract":"Diabetic myonecrosis is a rare complication of poorly controlled diabetes that presents as spontaneous limb pain and swelling. It is associated with other microvascular diabetic complications such as nephropathy or retinopathy and is frequently misdiagnosed given its resemblance to infectious and vascular complications. We present a case of a 49-year-old male with poorly controlled type 2 diabetes and a history of recurrent thigh pain. This was initially treated as cellulitis, but the patient experienced persistent severe pain despite multiple rounds of antibiotics. Imaging with MRI ultimately confirmed a diagnosis of diabetic myonecrosis. The patient was successfully managed with a combination of aspirin, insulin therapy, and a multimodal pain regimen, leading to significant clinical improvement. This condition poses a diagnostic challenge due to its rarity and nonspecific presentation, often leading to delays in appropriate treatment. Prompt diagnosis with exclusionary testing and imaging, followed by appropriate management, can prevent severe complications. Additional research is needed to establish a standardized protocol for treating this condition.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251331890"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753033","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 Vasospasm Presenting as Acute Myocardial Infarction. 难治性血管痉挛表现为急性心肌梗死。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-14 DOI: 10.1177/23247096251325426

Nismat Javed, Emamuzo Obaro Otobo, Ankita Gore, Maulin Patel, Nisha Ali, Amandeep Singh, Nassim Krim, Preeti Jadhav

{"title":"Refractory Vasospasm Presenting as Acute Myocardial Infarction.","authors":"Nismat Javed, Emamuzo Obaro Otobo, Ankita Gore, Maulin Patel, Nisha Ali, Amandeep Singh, Nassim Krim, Preeti Jadhav","doi":"10.1177/23247096251325426","DOIUrl":"10.1177/23247096251325426","url":null,"abstract":"Refractory coronary artery spasm is a challenging condition with many complications, including acute myocardial infarction. We present the case of an elderly woman who developed refractory coronary artery vasospasm requiring extensive hemodynamic support. She had an abnormal electrocardiogram. She was diagnosed with severe coronary artery vasospasm that initially responded to intracoronary nitroglycerin. However, the course was complicated by arrhythmias and cardiogenic shock following an additional episode of vasospasm that required higher concentrations of nitroglycerin. Notably, this case is relatively less documented in women and within the South Bronx population. Refractory coronary artery spasm is a critical condition that can lead to life-threatening outcomes. Prompt and effective treatment is essential, especially for high-risk patients, to prevent cardiac ischemia. Given the significant dangers of delayed or insufficient treatment, it is crucial to manage coronary artery spasms proactively to enhance patient outcomes and avoid severe complications. In addition, this diagnosis should be strongly considered in women, with an emphasis on following guidelines for managing cases of acute myocardial infarction.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251325426"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624965","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

Concomitant Polycythemia Vera and Primary Splenic Diffuse Large B-Cell Lymphoma Complicated by Gastrosplenic Fistula: A Case Report. 真性红细胞增多症合并原发性脾弥漫性大b细胞淋巴瘤并发胃脾瘘1例。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-17 DOI: 10.1177/23247096251325409

Bibek Saha, Jenny J Cao, Zachary S Kelm, Allison Reinhardt, Alex Danielson, Victoria Kalinoski-Dubose, William Mundell

{"title":"Concomitant Polycythemia Vera and Primary Splenic Diffuse Large B-Cell Lymphoma Complicated by Gastrosplenic Fistula: A Case Report.","authors":"Bibek Saha, Jenny J Cao, Zachary S Kelm, Allison Reinhardt, Alex Danielson, Victoria Kalinoski-Dubose, William Mundell","doi":"10.1177/23247096251325409","DOIUrl":"10.1177/23247096251325409","url":null,"abstract":"Diffuse large B-cell lymphoma (DLBCL) is the most prevalent and aggressive subtype of non-Hodgkin lymphoma comprising 30% to 40% of cases. While DLBCL frequently arises in the lymph nodes, up to 40% of cases originate in extranodal tissues. Primary splenic DLBCL is extremely rare comprising only ~1% of DLBCL cases and can be complicated by rare entities including gastrosplenic fistula (GSF). In contrast to DLBCL, polycythemia vera (PV) is a myeloproliferative malignancy. Polycythemia vera can transform into other hematologic malignancies including post-polycythemia myelofibrosis, but associations with DLBCL are uncommon. We present the first case of PV with concomitant primary splenic DLBCL complicated by GSF. While the majority of splenic lesions are benign, they have a broad differential diagnosis including malignant etiologies. Cystic or solid morphology, the number of lesions, and vascularity on imaging heavily guide further management. Due to concern for imminent massive upper gastrointestinal bleeding in the setting of GSF, our patient was diagnosed and managed with prompt splenectomy and gastrectomy. Percutaneous splenic biopsy is also a safe and effective diagnostic modality, but was deferred in our case given increased bleeding risk with PV. In conclusion, primary splenic lymphoma should be in the differential for a splenic mass regardless of whether the patient has a prior hematologic malignancy, and management should be prompt especially if complicated by a GSF.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251325409"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649212","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 Xanthogranulomatous Pyelonephritis With Staghorn Calculi and Perinephric Abscess: A Case Report. 重度黄色肉芽肿性肾盂肾炎合并鹿角型结石及肾周脓肿1例。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-05-14 DOI: 10.1177/23247096251342033

Manar Ashour, Ahmed Dheyaa Al-Obaidi, Shahzaib Ahmed, Nizar Alyassin, Mustafa Almusawi, Hashim Talib Hashim

引用次数: 0

A Distinctive Case of Hemophagocytic Lymphohistiocytosis in Chronic Lymphocytic Leukemia. 慢性淋巴细胞白血病中的嗜血细胞淋巴组织细胞增多症独特病例

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-23 DOI: 10.1177/23247096251326465

Jayalekshmi Jayakumar, Manasa Ginjupalli, Fiqe Khan, Meher Ayyazuddin, Muhammad Ashar Ali, Giovannie Isaac Coss, Asmat Ullah

{"title":"A Distinctive Case of Hemophagocytic Lymphohistiocytosis in Chronic Lymphocytic Leukemia.","authors":"Jayalekshmi Jayakumar, Manasa Ginjupalli, Fiqe Khan, Meher Ayyazuddin, Muhammad Ashar Ali, Giovannie Isaac Coss, Asmat Ullah","doi":"10.1177/23247096251326465","DOIUrl":"10.1177/23247096251326465","url":null,"abstract":"Chronic lymphocytic leukemia (CLL) is an indolent malignancy characterized by the accumulation of dysfunctional B-cell lymphocytes. Complications such as hemophagocytic lymphohistiocytosis (HLH) can arise, particularly during disease progression. HLH has been increasingly reported as a complication of CLL, often triggered by factors such as superimposed infections, chemotherapy, Richter transformation, or disease progression. This case explores HLH as an initial presentation of undiagnosed CLL without any identifiable trigger. We present the case of a 65-year-old woman who presented with a high-grade fever, sore throat, and pancytopenia. Despite broad-spectrum antibiotic treatment, her condition deteriorated. Investigations revealed elevated ferritin levels, low natural killer cell activity, and other findings consistent with HLH. Flow cytometry and bone marrow biopsy ultimately confirmed the diagnosis of CLL. HLH is characterized by the hyperactivation of immune cells and is known to be triggered by a variety of factors, including infections and malignancies. In this case, the absence of identifiable triggers raises important questions about the underlying pathophysiology linking HLH with CLL. While previous reports have highlighted HLH as a complication of CLL, typically secondary to infection or treatment, this case is particularly noteworthy due to the unexplained onset of HLH in the absence of such triggers. This case underscores the need for heightened awareness of HLH as a potential manifestation of underlying malignancy, especially in non-septic patients presenting with unexplained fever and pancytopenia. In addition, the simultaneous presentation of normal pressure hydrocephalus emphasizes the complex interplay of inflammatory processes in CLL. Further research is needed to explore the relationship between inflammation and the pathogenesis of CLL.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251326465"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692649","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

Disseminated Histoplasmosis-Associated Cardiac Tamponade in a Patient With Acquired Immunodeficiency Syndrome. 获得性免疫缺陷综合征患者弥散性组织胞浆菌相关性心脏填塞

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-06-13 DOI: 10.1177/23247096251342922

Priya Ramcharan, Arun Katwaroo, Matthew Maharaj, Valmiki Seecheran, Rajeev Seecheran, Lakshmipathi Peram, Stanley Giddings, Naveen Seecheran

引用次数: 0