Journal of Medical Case Reports最新文献

{"title":"Post-colonoscopic splenic rupture and hemorrhage: diagnostic challenges and successful transcatheter embolization-a case report.","authors":"XiaoMeng Wu, ChengHong Zhang, JianQing Wu, YaoBin Hu, JianBo Wang","doi":"10.1186/s13256-026-06335-x","DOIUrl":"https://doi.org/10.1186/s13256-026-06335-x","url":null,"abstract":"<p><strong>Background: </strong>Post-colonoscopic splenic rupture with hemorrhage is a rare but fatal complication. Insidious onset and atypical symptoms hinder early diagnosis; we report one case to improve clinical vigilance.</p><p><strong>Case presentation: </strong>A 67-year-old Han Chinese female underwent a screening colonoscopy under general anesthesia. The procedure was technically uneventful, and no polyps were resected or other therapeutic interventions were performed. Postoperatively, the patient developed progressive left upper quadrant pain radiating to the left shoulder. Physical examination revealed abdominal tenderness and guarding, and a decline in hemoglobin level suggested hemorrhage. Contrast-enhanced computed tomography (CT) confirmed splenic rupture with hemoperitoneum. Emergency splenic artery angiography and embolization were performed and successfully controlled the bleeding. The patient recovered uneventfully and was discharged on postoperative day 7.</p><p><strong>Conclusion: </strong>Latrogenic splenic rupture is a rare complication associated with colonoscopy. In patients presenting with post-procedural pain in the left upper abdomen or pain radiating to the left shoulder, with or without hemodynamic changes, splenic injury should be strongly suspected. A favorable prognosis depends on rapid diagnosis and prompt management, in which endovascular interventions such as embolization play a critical role.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed, deep Corynebacterium surgical site infection following scoliosis corrective surgery in a patient with osteogenesis imperfecta: a case report.","authors":"Hani Aljohani, Abdulrahman H Alashkar, Mohamed Ghazala","doi":"10.1186/s13256-026-06357-5","DOIUrl":"10.1186/s13256-026-06357-5","url":null,"abstract":"<p><strong>Background: </strong>Scoliosis is a common spine deformity. Most cases are idiopathic. However, it can be predisposed by certain congenital and neuromuscular conditions, such as osteogenesis imperfecta (OI). Surgical site infection (SSI) is a possible complication of scoliosis surgery. Corynebacterium jeikeium (C. jeikeium) is a rod-shaped, Gram-positive bacterium. It is part of the normal skin flora and has been implicated in various infections, especially in the immunocompromised. To date, only one case of SSI following scoliosis surgery has been reported to be secondary to C. jeikeium. In this report, we present a patient with OI who developed delayed SSI following scoliosis surgery secondary to C. jeikeium.</p><p><strong>Case presentation: </strong>A 16-year-old male patient with OI underwent corrective surgery for his thoracolumbar scoliosis. Five months later, he presented with surgical site swelling with associated fever and pain following minor blunt trauma to his back. Further work-up confirmed the presence of deep SSI, and pus culturing yielded multidrug-resistant C. jeikeium. He was initially treated with surgical wound debridement and antibiotic therapy. However, the infection persisted, and he was managed with implant removal followed by a prolonged course of antibiotic therapy.</p><p><strong>Conclusions: </strong>Our case represents the second reported case of SSI secondary to C. jeikeium following scoliosis surgery. C. jeikeium is a rare cause of SSI in the immunocompetent. It can cause indolent, yet persistent infections. Also, this case discusses how minor trauma could have led to this complication in an OI patient.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447700","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":"Molecular and clinical characterization of a pedigree with factor XI deficiency, including a novel missense variant (p.Cys200Phe): a case report.","authors":"Ruimin Cai, Yi Li, Ping Liu, Yeke Tan, Fei Li, Wenyang Wang, Qiang Feng","doi":"10.1186/s13256-026-06308-0","DOIUrl":"10.1186/s13256-026-06308-0","url":null,"abstract":"<p><strong>Introduction: </strong>Coagulation factor XI (FXI) deficiency is a rare bleeding disorder, we aimed to identify potential variants of F11 gene in a pedigree with hereditary FXI deficiency and explore the molecular pathogenesis.</p><p><strong>Case presentation: </strong>A pedigree with FXI deficiency was included in this study. The proband was an 80-year-old Asian woman who showed a significantly prolonged activated partial thromboplastin time (APTT), along with markedly decreased FXI activity and antigen levels. Direct DNA sequencing of all F11 gene exons identified compound heterozygous variants (p.Trp246* and p.Cys200Phe) in the proband. The daughter was heterozygous for p.Cys200Phe, who had an FXI coagulant activity (FXI: C) of 41.0% and FXI antigen level (FXI: Ag) of 48.0%. Her son and elder granddaughter were heterozygous for p.Trp246*, presenting FXI: C of 35.0% and 34.2%, and FXI: Ag of 43.3% and 53.0%, respectively. Bioinformatics analysis and protein modeling demonstrated that both variants were likely pathogenic, impairing the structure and function of the FXI protein and contributing to FXI deficiency in this pedigree.</p><p><strong>Conclusion: </strong>In summary, we identified compound heterozygous variants (p.Trp246* and p.Cys200Phe) as the likely genetic cause of FXI deficiency in this family. The missense variant p.Cys200Phe has not been reported previously. This study expands the genotypic spectrum of the F11 gene, which is beneficial for enhancing the accuracy of molecular diagnosis, optimizing clinical risk assessment, and facilitating individualized clinical management and genetic counseling for patients with FXI deficiency.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447705","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":"Totally extraperitoneal repair of inguinal hernia containing Mullerian remnants in a patient with Mayer-Rokitansky-Küster-Hauser syndrome: a case report.","authors":"Li Sha, Hao Zhang, Xiancheng Kong, Gang Liu, Lei Du, Xiwei Zhang","doi":"10.1186/s13256-026-06376-2","DOIUrl":"10.1186/s13256-026-06376-2","url":null,"abstract":"<p><strong>Background: </strong>Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by aplasia of the uterus and upper part of the vagina in females with normal secondary sex characteristics. Inguinal hernia containing ovaries, fallopian tubes and uterus occurs rarely in adult females and its association with MRKH syndrome is even more rare and probably unreported.</p><p><strong>Case presentation: </strong>A 43-year-old female who had already undergone a vaginoplasty 20 years ago presented to our clinic with left groin swelling and pain for 3 weeks. Physical examinations revealed a 3-cm palpable mass in the left inguinal region that was difficult to reduce into the abdominal cavity. The diagnosis of MRKH syndrome was considered along with inguinal hernia according to the intraoperative findings within the hernia sac. Although most of the MRKH patients with inguinal hernia underwent open surgery, totally extraperitoneal repair (TEP) operation and mesh placement was performed on this patient and the resected specimen proved to be rudimentary uterus and left oviduct. The patient was discharged 2 days after surgery and free of any complications at 6 months of follow-up.</p><p><strong>Conclusion: </strong>MRKH syndrome may remain undiagnosed until incidentally discovered during surgery for unrelated conditions. TEP approach offers excellent visualization, avoids intraperitoneal adhesions, safe resection of Mullerian remnants and preserves peritoneal integrity for future fertility options.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe angioinvasive pulmonary mucormycosis in an immunocompetent patient with poorly controlled diabetes: a case report.","authors":"Nawwar Fallouh, Mohammad Alaa Aldakak, Raneem Ahmad, Bassel Ibrahim, Bassam Darwish","doi":"10.1186/s13256-026-06366-4","DOIUrl":"10.1186/s13256-026-06366-4","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucormycosis is a rare, life-threatening angioinvasive fungal infection that predominantly affects immunocompromised hosts but can also occur in patients with poorly controlled diabetes mellitus. Its nonspecific presentation may delay diagnosis and treatment.</p><p><strong>Case presentation: </strong>We report the case of a 63-year-old Syrian male with a 25-year history of poorly controlled type 2 diabetes mellitus and heavy smoking, who presented with pleuritic chest pain, productive brownish sputum, fatigue, anorexia, and progressive dyspnea. Empirical antibacterial therapy for presumed community-acquired pneumonia failed to achieve clinical or radiological resolution. Chest computed tomography revealed a left upper-lobe cavitary lesion with surrounding consolidation and necrotic changes. CT-guided transthoracic biopsy showed broad, ribbon-like, nonseptate hyphae with right-angle branching, confirming pulmonary mucormycosis. Because fungal culture did not yield a viable isolate, susceptibility testing could not be performed. The patient received intravenous liposomal amphotericin B for 40 days, followed by left upper lobectomy with lingulectomy. His postoperative course was uneventful, with marked symptomatic improvement.</p><p><strong>Discussion: </strong>This case emphasizes the need to consider pulmonary mucormycosis in diabetic patients with atypical, cavitary, or nonresolving pneumonia despite antibacterial therapy. Imaging may support clinical suspicion, but histopathological confirmation remains essential.</p><p><strong>Conclusion: </strong>Early suspicion, prompt tissue diagnosis, liposomal amphotericin B therapy, metabolic risk-factor control, and surgical resection when disease is localized may be life-saving.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447673","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":"Longitudinal dream-content shift and void-like dissociative phenomenology around outpatient ketamine infusions in chronic low back pain: a case report.","authors":"Kei Torii, Ryo Nishitani","doi":"10.1186/s13256-026-06175-9","DOIUrl":"10.1186/s13256-026-06175-9","url":null,"abstract":"<p><strong>Background: </strong>Altered-state phenomenology around ketamine may relate to longer-term changes in imaginal processes, but observations across routine care are scarce. We report an educational case focusing on pre-defined dream motifs over time, without making treatment efficacy claims.</p><p><strong>Case presentation: </strong>A 48-year-old Japanese man with severe chronic primary low back pain reported dreams during insight-oriented psychotherapy from 2009 to 2025; over 360 narratives were contemporaneously documented. In 2014, he received five low-dose outpatient intravenous ketamine infusions (15 mg; 0.23 mg/kg; first 20 min, then 30 min; no premedication) and described a void-like dissociative state during the first session. Using a pre-specified codebook, two raters (treating clinician and external psychiatrist) independently coded an ID-based, period-stratified random subset of 50 dreams after re-ordering and masking of period labels for three primary motifs (obstruction, fear, anger) plus a descriptive social-interaction/role-completion motif. Obstruction decreased from pre- to post-ketamine periods in both raters (treating clinician: 6/9 vs 4/30; external psychiatrist: 6/9 vs 7/30). In the double-labelled subset, the social-interaction/role-completion motif was labelled more often post- than pre-ketamine by both raters (2/9 pre; 10/30 and 11/30 post).</p><p><strong>Conclusions: </strong>Across the observation window that included outpatient ketamine infusions in 2014, dream content shifted from recurrent obstruction toward imagery of movement, interpersonal engagement, and everyday role completion (illustrated by selected de-identified dream narratives; Table 5). These single-patient, hypothesis-generating observations describe ketamine-associated void-like phenomenology and longitudinal dream-content change without making efficacy claims. In insight-oriented outpatient ketamine care, clinicians may prepare patients for possible dissociative/dream-like experiences, invite brief narrative documentation, and offer post-session integration while maintaining standard physiological monitoring.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437057","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":"Coral reef aorta in a child: a case report.","authors":"Ma Yanling, Zhu Hongtao, Qu Ning","doi":"10.1186/s13256-026-06245-y","DOIUrl":"10.1186/s13256-026-06245-y","url":null,"abstract":"<p><strong>Background: </strong>Hypertension in children is predominantly secondary in nature. When conventional antihypertensive therapy proves ineffective, rare vascular conditions such as Coral Reef Aorta (CRA) should be considered. These disorders are extremely uncommon in pediatric practice and are often overlooked.</p><p><strong>Case presentation: </strong>A 12-year-old Uyghur patient presented with intermittent headaches and severe hypertension. Computed tomography (CT) angiography of the aorta revealed multiple calcified plaques in the descending thoracic aorta, which demonstrated a coral reef-like appearance, as well as renal artery stenosis. Following renal artery balloon angioplasty and antihypertensive medication, the patient's blood pressure was successfully controlled. At the 18-month follow-up, there was no recurrence of hypertension.</p><p><strong>Conclusion: </strong>This case confirms that rare vascular diseases such as CRA must be included in the differential diagnosis of refractory hypertension of unknown cause in children. Early completion of aortic CT angiography is crucial for establishing a definitive diagnosis, guiding treatment, and preventing long-term complications.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437062","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":"Sporadic Creutzfeldt-jakob disease: a case report.","authors":"Li Xie, Yanhong Dong, Guoen Yao, Junling Ge, Miao Li, Xiangdong Jia","doi":"10.1186/s13256-026-06364-6","DOIUrl":"10.1186/s13256-026-06364-6","url":null,"abstract":"<p><strong>Background: </strong>Creutzfeldt-Jakob disease is a rare, transmissible, and fatal degenerative disorder of the central nervous system. As the most common human prion disease, it typically presents with progressive dementia, visual impairment, cerebellar ataxia, pyramidal or extrapyramidal signs, myoclonus, and akinetic mutism. Although dizziness is a prevalent clinical symptom, it is an uncommon initial manifestation of Creutzfeldt-Jakob disease.</p><p><strong>Case presentation: </strong>We report the case of a 71-year-old Chinese woman who presented to our hospital with dizziness. Brain magnetic resonance imaging revealed extensive cortical hyperintensity on diffusion-weighted imaging. Cerebrospinal fluid analysis was positive for the 14-3-3 protein. Collectively, these findings, along with additional supportive investigations, led to the diagnosis of possible sporadic Creutzfeldt-Jakob disease.</p><p><strong>Conclusions: </strong>This case illustrates that Creutzfeldt-Jakob disease can manifest with atypical symptoms like dizziness, highlighting the essential role of brain magnetic resonance imaging in securing the diagnosis. In light of the disease's rarity and clinical heterogeneity, detailed reporting of such cases provides valuable clinical insights that deepen physicians' understanding of this condition.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437055","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":"Correction: Overcoming oral medication allergy and cervical stenosis in an anovulatory in vitro fertilization patient: a case report.","authors":"Romana Dmitrovic, Kristina Belak, Boban Janevski, Karlo Tomicic, Karolina Poljak Panic","doi":"10.1186/s13256-026-06349-5","DOIUrl":"10.1186/s13256-026-06349-5","url":null,"abstract":"","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437040","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":"Chromogenic factor X-guided warfarin monitoring in lupus anticoagulant-positive primary antiphospholipid syndrome with adrenal hemorrhage and progressive deep vein thrombosis: a case report.","authors":"Han-Sheng Fang, Xu-Yang Zhang, Xin-Yue Liu, Hai-Dan Chen, Hui-Li Cai","doi":"10.1186/s13256-026-06200-x","DOIUrl":"10.1186/s13256-026-06200-x","url":null,"abstract":"<p><strong>Background: </strong>Antiphospholipid syndrome (APS) is a thrombotic autoimmune disorder; adrenal hemorrhage is uncommon. Treating progressive thrombosis with concurrent major bleeding is challenging, especially when lupus anticoagulant (LA) may compromise international normalized ratio (INR)-based warfarin monitoring.</p><p><strong>Case presentation: </strong>A 32-year-old Chinese man had isolated marked activated partial thromboplastin time prolongation detected preoperatively 4 years earlier. He showed persistent LA positivity and high-titer anticardiolipin and anti-β2-glycoprotein I antibodies, but no thrombosis was documented and he was lost to follow-up. One year before the current admission, he developed extensive lower-limb deep vein thrombosis (DVT) after a left ankle sprain, followed days later by right-sided lower back/flank pain. Computed tomography showed right adrenal hemorrhage with adjacent perirenal extension. Anticoagulation was withheld because of bleeding, and an inferior vena cava filter was placed. He was readmitted 2 days later with worsening pain, progressive bilateral DVT, thrombocytopenia, markedly elevated D-dimer, and persistent triple-positive antiphospholipid antibodies. After multidisciplinary review, endovascular embolization was performed for local hemostatic control. Anticoagulation was then escalated from reduced-dose enoxaparin to therapeutic-dose enoxaparin, approximately 1 mg/kg every 12 h, and warfarin was initiated. Because LA raised concern regarding INR reliability, chromogenic factor X (CFX) activity was used to guide warfarin monitoring, with a target range of 20%-40%. At 6 months, imaging showed near-complete hematoma absorption and venous recanalization, without recurrent major bleeding or new thrombosis.</p><p><strong>Conclusions: </strong>In selected LA-positive APS patients with competing risks of thrombosis and adrenal hemorrhage, endovascular hemostasis followed by cautious anticoagulation escalation and CFX-guided warfarin monitoring may be feasible when INR monitoring is potentially unreliable.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}