Journal of Medical Case Reports最新文献

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Recurrent Mandibular Ewing sarcoma in an 11-year-old boy: a rare pediatric case and review of the literature. 复发的下颌尤文氏肉瘤在一个11岁男孩:一个罕见的儿科病例和文献回顾。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-08-10 DOI: 10.1186/s13256-026-06456-3
Seyed Mohammad Kazem Nourbakhsh, Mohammad Shirkhoda, Tahereh Jangjoo
{"title":"Recurrent Mandibular Ewing sarcoma in an 11-year-old boy: a rare pediatric case and review of the literature.","authors":"Seyed Mohammad Kazem Nourbakhsh, Mohammad Shirkhoda, Tahereh Jangjoo","doi":"10.1186/s13256-026-06456-3","DOIUrl":"https://doi.org/10.1186/s13256-026-06456-3","url":null,"abstract":"<p><strong>Rationale: </strong>Mandibular Ewing sarcoma is exceptionally rare in children and frequently mimics common odontogenic infections. This overlap leads to delayed diagnosis and potentially rapid tumor progression. Early recognition and appropriate multimodal management are critical for improving outcomes.</p><p><strong>Patient concerns: </strong>An 11.5-year-old Iranian boy of Middle Eastern ethnicity presented with progressive left mandibular swelling and pain for 1 month, unresponsive to antibiotic therapy previously prescribed for presumed dental abscess.</p><p><strong>Diagnosis: </strong>Imaging (CT, MRI) revealed an aggressive destructive mandibular lesion with periosteal reaction. Histopathology showed small round blue cells, and immunohistochemistry demonstrated CD99 and NKX2.2 positivity, confirming Ewing sarcoma. Staging PET-CT showed mandibular involvement without distant metastatic disease.</p><p><strong>Interventions: </strong>The patient received neoadjuvant chemotherapy according to the Euro-EWING99 protocol using alternating vincristine, doxorubicin, and cyclophosphamide (VDC) and ifosfamide/etoposide (IE). Following local recurrence, salvage treatment with nivolumab, temozolomide, and irinotecan was administered, followed by ICE chemotherapy, radiotherapy, and ultimately left hemimandibulectomy with fibular free-flap reconstruction.</p><p><strong>Outcomes: </strong>Despite multiple local recurrences during treatment, the patient ultimately underwent left hemimandibulectomy with fibular free-flap reconstruction. Postoperative PET-CT demonstrated complete metabolic remission, and the patient remained disease-free at the most recent 6-month follow-up.</p><p><strong>Lessons: </strong>This case highlights the importance of early biopsy for atypical mandibular swellings in children and the role of multimodal treatment-including immunotherapy-as a promising option in relapsed Ewing sarcoma. Persistent jaw masses in pediatric patients should raise concern for malignancy, even when clinical presentation mimics infection.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794329","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
Stepwise diagnosis and minimally invasive management of obscure gastrointestinal bleeding secondary to a Meckel's diverticulum: a case report. 梅克尔憩室继发的隐蔽性消化道出血的逐步诊断和微创治疗:1例报告。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-08-08 DOI: 10.1186/s13256-026-06446-5
Junjie He, Wei Liu, Ling Tong, Haiyan Yang, Guangjie Li, Lanhua Chen, Yunhai Liao
{"title":"Stepwise diagnosis and minimally invasive management of obscure gastrointestinal bleeding secondary to a Meckel's diverticulum: a case report.","authors":"Junjie He, Wei Liu, Ling Tong, Haiyan Yang, Guangjie Li, Lanhua Chen, Yunhai Liao","doi":"10.1186/s13256-026-06446-5","DOIUrl":"10.1186/s13256-026-06446-5","url":null,"abstract":"<p><strong>Background: </strong>Obscure gastrointestinal bleeding (OGIB) presents a significant diagnostic challenge for clinicians due to the anatomical characteristics and inaccessibility of the small intestine. Preoperative diagnosis is particularly challenging, and optimal management relies heavily on precise lesion localization. We report the successful diagnosis and minimally invasive resection of a bleeding Meckel's diverticulum using a multidisciplinary stepwise approach.</p><p><strong>Case presentation: </strong>A 25-year-old Chinese man presented to the emergency department with melena that rapidly progressed to recurrent hematochezia. Initial esophagogastroduodenoscopy and an urgent colonoscopy were non-diagnostic due to significant blood retention obscuring the visual field. To non-invasively locate the bleeding source, abdominal computed tomography angiography (CTA) was performed, which identified a diverticular structure with segmental enhancement in the distal ileum. Guided by this structural roadmap, retrograde double-balloon enteroscopy (DBE) was successfully performed, revealing a Meckel's diverticulum accompanied by multiple irregular large ulcers with stigmata of recent bleeding. Endoclips were deployed around the lesion during the DBE procedure for preoperative marking. This endoscopic intervention facilitated a targeted, tissue-sparing laparoscopic segmental small bowel resection in the present case. Postoperatively, an enhanced recovery after surgery (ERAS) protocol was implemented, enabling early enteral nutrition. The patient's recovery was uneventful, and he was discharged on postoperative day 8 without recurrence.</p><p><strong>Conclusions: </strong>For overt OGIB, a stepwise \"CTA-DBE-Laparoscopy\" pathway may be useful in selected patients. Non-invasive CTA provides an essential anatomical compass, while endoscopic marking prior to surgery facilitated targeted resection and reduced surgical trauma in the present case.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697585","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
Delayed diagnosis of spinal tuberculosis mimicking spondyloarthritis: a case report. 模拟脊椎关节炎的脊柱结核的延迟诊断:1例报告。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-31 DOI: 10.1186/s13256-026-06444-7
Yufan Chen, Huafeng Wang
{"title":"Delayed diagnosis of spinal tuberculosis mimicking spondyloarthritis: a case report.","authors":"Yufan Chen, Huafeng Wang","doi":"10.1186/s13256-026-06444-7","DOIUrl":"10.1186/s13256-026-06444-7","url":null,"abstract":"<p><strong>Background: </strong>Spinal tuberculosis (TB) remains a significant health burden in endemic regions. Its diagnosis is frequently delayed due to non-specific early symptoms and radiological findings that can mimic other inflammatory spinal pathologies, leading to severe complications such as kyphosis and neurological deficit.</p><p><strong>Case presentation: </strong>A 71-year-old woman from Southeast China presented with a 1-year history of progressive low back pain, initially misdiagnosed as axial spondyloarthritis. She experienced temporary relief with symptomatic treatment, including secukinumab. One year later, her symptoms recurred severely. Advanced imaging (computed tomography/magnetic resonance images) revealed destruction of the L1 and L2 vertebral bodies with a paravertebral abscess. Microbiological confirmation was obtained via a positive T-SPOT.TB test and metagenomic next-generation sequencing detecting Mycobacterium tuberculosis complex. The patient successfully underwent posterior debridement, spinal canal decompression, fusion, and instrumentation, followed by a standard anti-tuberculosis regimen. Her symptoms significantly improved, and she resumed return to work within 2 months.</p><p><strong>Conclusion: </strong>This case highlights the potential for spinal TB to masquerade as seronegative spondyloarthritis, leading to dangerous diagnostic delays. Clinicians should maintain a high suspicion for TB in endemic areas and employ specific diagnostic tests early. Timely surgical intervention for instability or neurological compromise, combined with appropriate chemotherapy, is crucial for optimal outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812779","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
Successful non-surgical management of locally advanced gastric adenocarcinoma with squamous differentiation and programmed death-ligand 1 combined positive score 75: a case report. 局部进展期胃腺癌伴鳞状分化和程序性死亡-配体1合并阳性评分75的成功非手术治疗1例
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-31 DOI: 10.1186/s13256-026-06440-x
Sandy Ghadeer Jalloul, Joudi Ghadeer Jalloul, Sarah Ghadeer Jalloul
{"title":"Successful non-surgical management of locally advanced gastric adenocarcinoma with squamous differentiation and programmed death-ligand 1 combined positive score 75: a case report.","authors":"Sandy Ghadeer Jalloul, Joudi Ghadeer Jalloul, Sarah Ghadeer Jalloul","doi":"10.1186/s13256-026-06440-x","DOIUrl":"10.1186/s13256-026-06440-x","url":null,"abstract":"<p><strong>Background: </strong>Poorly differentiated gastric adenocarcinoma with squamous differentiation is a rare and aggressive malignancy, with limited representation in the literature. Its biological behaviour remains poorly characterized, and prognosis is generally poor. Here, we present a case that highlights the role of biomarker-driven, non-surgical management in advanced gastric malignancy, particularly in the context of high PD-L1 expression in an elderly patient.</p><p><strong>Case presentation: </strong>A 75-year-old Syrian Arab male presented with anaemia, weight loss and anorexia. Imaging revealed a large ulcerated gastric mass measuring 9 × 11 cm with perigastric lymphadenopathy and local invasion, but no evidence of distant metastasis. Histopathological examination confirmed poorly differentiated adenocarcinoma with squamous differentiation. Immunohistochemistry demonstrated diffuse p40 positivity and focal cytokeratin 7 (CK7) positivity. Notably, programmed death-ligand 1 (PD-L1) expression was strongly positive, with a combined positive score (CPS) of 75. The patient was started on combined chemotherapy (oxaliplatin and 5-fluorouracil) and immunotherapy (nivolumab). Remarkably, follow-up positron emission tomography-computed tomography (PET-CT) at 3 months showed a reduction in tumour size and metabolic activity, with near complete radiological remission by 6 months. At 1-year follow-up, the patient remains clinically well and disease-free without surgical intervention.</p><p><strong>Conclusions: </strong>This case illustrates how high PD-L1 expression may substantially alter the expected clinical course of gastric cancer, even in rare and poorly differentiated subtypes typically associated with poor outcomes. The observed durable clinical complete response underscores the potential of biomarker-guided chemo-immunotherapy and supports consideration of non-surgical approaches in selected patients.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025063","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
Conus medullaris schistosomiasis, presenting as acute conus-cauda equina syndrome in a pediatric patient: a case report. 脊髓锥血吸虫病,表现为急性马尾锥综合征的儿科患者:一个病例报告。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-29 DOI: 10.1186/s13256-026-06015-w
Dumura Jeneral Alfin, Danaan Joseph Shilong, Gyang Markus Bot, Emmanuel Innocent, Philip O Akpa, Nenkimun Dirting Bakwa, Ishaku A Othman
{"title":"Conus medullaris schistosomiasis, presenting as acute conus-cauda equina syndrome in a pediatric patient: a case report.","authors":"Dumura Jeneral Alfin, Danaan Joseph Shilong, Gyang Markus Bot, Emmanuel Innocent, Philip O Akpa, Nenkimun Dirting Bakwa, Ishaku A Othman","doi":"10.1186/s13256-026-06015-w","DOIUrl":"10.1186/s13256-026-06015-w","url":null,"abstract":"<p><strong>Background: </strong>Conus medullaris intramedullary schistosomiasis is a rare disease, and may present acutely with serious neurological consequences. In its early stages, making a prompt diagnosis, and instituting appropriate treatment results in a good outcome. We share our experience of the diagnostic challenge, surgical treatment and outcome of care of this rare disease entity.</p><p><strong>Case description: </strong>A 7-year-old female patient, of Mada ethnicity, presented with 4 days history of bi-sphincteric dysfunction, severe low back pain, and paraparesis. Examination of the patient revealed a bilateral muscle power of 4/5 at L2-3, and 0/5 at L4-S1. Thoracic spine magnetic resonance imaging (MRI) showed a fusiform distension of the conus medullaris, with an intradural, intramedullary (ID, IM) mass; isointense on T1, and hyperintense on T2. She had T12-L1 laminectomy with complete resection of the mass. Histopathological evaluation revealed a granulomatous lesion with Schistosoma haematobium ova. Patient subsequently had praziquantel and steroid therapy postoperatively, with complete resolution of back pain, and regain of full muscle power of 5/5 at L2-L4, and 3/5 at L5-S1, in both limbs.</p><p><strong>Conclusion: </strong>This case demonstrates the need for a high index of suspicion in considering Schistosomiasis as a differential diagnosis of ID, IM tumor of the conus medullaris in pediatric patients. This will result in a prompt diagnosis, and the early institution of appropriate therapy which is often associated with good outcome.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706876","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
Ileorectal fistula after resection of perforated sigmoid tumor and Hartmann's procedure with uterine invasion: a case report. 乙状窦穿孔肿瘤切除术后造回直肠瘘及Hartmann手术合并子宫侵犯1例。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-25 DOI: 10.1186/s13256-026-06407-y
Armin Ahmadi, Jalal Manoochehri, Khaled Rahmani
{"title":"Ileorectal fistula after resection of perforated sigmoid tumor and Hartmann's procedure with uterine invasion: a case report.","authors":"Armin Ahmadi, Jalal Manoochehri, Khaled Rahmani","doi":"10.1186/s13256-026-06407-y","DOIUrl":"https://doi.org/10.1186/s13256-026-06407-y","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal fistulas are rare but serious postoperative complications, particularly when arising between the ileum and rectum. They are typically associated with complex intra-abdominal surgeries, malignancies, or inflammatory conditions. This case report presents a rare instance of ileorectal fistula formation following resection of a perforated sigmoid tumor with uterine invasion and subsequent Hartmann's procedure.</p><p><strong>Case presentation: </strong>A 40-year-old Kurdish woman with a history of diabetes mellitus presented with abdominal pain, weight loss, and diarrhea. Imaging revealed a large pelvic mass suggestive of a perforated sigmoid tumor invading the uterus. Emergency laparotomy confirmed the diagnosis, and Hartmann's procedure was performed. Postoperative recovery included chemotherapy. Months later, the patient returned with defecation per anus despite a colostomy, suggesting a fistula. Imaging confirmed an ileorectal fistula. During reoperation, the recurrent tumor and fistulous tract between the ileum and Hartmann's pouch were excised. Surgical repair included small bowel resection with anastomosis and ureteral reimplantation due to adjacent involvement.</p><p><strong>Conclusion: </strong>This case underscores the complexity of managing advanced colorectal malignancies with pelvic involvement. Ileorectal fistula is a rare but critical complication of Hartmann's procedure, necessitating individualized surgical planning and vigilant postoperative follow-up to optimize outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227783","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}
引用次数: 0
Thyroid nodule treated by herbal food composite formulation: a case report. 中药食品复合制剂治疗甲状腺结节1例。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-25 DOI: 10.1186/s13256-026-06392-2
Yi You, Hui Li
{"title":"Thyroid nodule treated by herbal food composite formulation: a case report.","authors":"Yi You, Hui Li","doi":"10.1186/s13256-026-06392-2","DOIUrl":"https://doi.org/10.1186/s13256-026-06392-2","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are a prevalent endocrine disorder with a global prevalence estimated to range from 5% to 67%. Conventional treatments, including surveillance, levothyroxine suppression therapy, and surgical resection, are often limited by side effects, invasiveness, and variable efficacy. To date, documented instances of spontaneous regression are exceedingly rare.</p><p><strong>Case presentation: </strong>In this case report, we present a 48-year-old Chinese Asian woman with bilateral thyroid nodules who experienced significant nodule regression after a 3.5-month intervention with herbal food composite formulation. The formula, comprising Aronia melanocarpa, Daucus carota, Apium graveolens, Citrus paradisi, and Litchi chinensis, was consumed as juice every other day post-lunch. The patient's ultrasound examination showed multiple mixed echogenic nodules in both thyroid lobes, with the largest nodule measuring 20.7 × 10.4 mm. After treatment, the nodules significantly decreased in size, and a lymph node in the left neck disappeared.</p><p><strong>Conclusions: </strong>This case raises the possibility that the herbal food composite formulation may have potential value to be explored as an auxiliary therapy for thyroid nodules, warranting further investigation in larger patient populations.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227790","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}
引用次数: 0
Superior sagittal sinus thrombosis with intracranial hemorrhage in a patient on infliximab: a case report. 上矢状窦血栓形成合并颅内出血患者英夫利昔单抗:1例报告。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-25 DOI: 10.1186/s13256-026-06355-7
Mohammad Rizwan Alam, Juan Corona-Ruiz, Joseph Cahill, William Goldsmith, Michael Sabra, Maro Issac, Peter Fahim
{"title":"Superior sagittal sinus thrombosis with intracranial hemorrhage in a patient on infliximab: a case report.","authors":"Mohammad Rizwan Alam, Juan Corona-Ruiz, Joseph Cahill, William Goldsmith, Michael Sabra, Maro Issac, Peter Fahim","doi":"10.1186/s13256-026-06355-7","DOIUrl":"https://doi.org/10.1186/s13256-026-06355-7","url":null,"abstract":"<p><strong>Background: </strong>Superior sagittal sinus thrombosis (SSST) is a rare but life-threatening form of cerebral venous thrombosis. Although several prothrombotic and autoimmune conditions are recognized risk factors, SSST occurring in patients with rheumatoid arthritis (RA) receiving tumor necrosis factor-alpha (TNF-α) inhibitor therapy remains exceptionally rare and poorly described in the literature.</p><p><strong>Case presentation: </strong>We present a 59-year-old Caucasian female with RA treated with infliximab who developed extensive superior sagittal sinus thrombosis with concurrent intracranial and subarachnoid hemorrhage. The patient was managed with anticoagulation, blood pressure control, and seizure prophylaxis, with subsequent clinical and radiologic improvement at one-month follow-up. Hypercoagulability evaluation was overall unrevealing, and no other clear provoking etiology was identified.</p><p><strong>Conclusions: </strong>Given the rarity of this presentation, we report this case to raise awareness of a possible association between cerebral venous thrombosis and TNF-α inhibitor therapy in patients with rheumatoid arthritis. This is especially important given the increasing and widespread use of biologic agents in the treatment of autoimmune diseases.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227818","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}
引用次数: 0
Delayed ischemic stroke ten days after aluminum phosphide ingestion in a previously healthy 21-year-old Ethiopian woman: a case report. 摄入磷化铝10天后迟发性缺血性中风1例既往健康的21岁埃塞俄比亚妇女
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-24 DOI: 10.1186/s13256-026-06403-2
Amanuel Mesfin Oljira, Segni Shube Hunduma, Dereje Gurmessa Geleta, Rabira Waktola Gonfa, Dawit Yosef Barkesa, Bisrat Abate Bekele, Eliab Negusse Reda, Dagim Weldegiorgis Fininsa, Aemon Berhane Fissha, Mathewos Tesfaye Yanore
{"title":"Delayed ischemic stroke ten days after aluminum phosphide ingestion in a previously healthy 21-year-old Ethiopian woman: a case report.","authors":"Amanuel Mesfin Oljira, Segni Shube Hunduma, Dereje Gurmessa Geleta, Rabira Waktola Gonfa, Dawit Yosef Barkesa, Bisrat Abate Bekele, Eliab Negusse Reda, Dagim Weldegiorgis Fininsa, Aemon Berhane Fissha, Mathewos Tesfaye Yanore","doi":"10.1186/s13256-026-06403-2","DOIUrl":"10.1186/s13256-026-06403-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Aluminum phosphide poisoning is a highly lethal toxicologic emergency classically dominated by cardiovascular collapse. Delayed ischemic stroke after apparent clinical stabilization is exceptionally rare and mechanistically uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;A 21-year-old previously healthy Ethiopian woman intentionally ingested five aluminum phosphide tablets. After early gastric lavage, she remained hemodynamically stable during the initial 24 hours and was discharged. Ten days after ingestion, she developed sudden right facial weakness, right hemiparesis, and mild dysarthria. On day 11, her National Institutes of Health Stroke Scale score was 11. Contrast-enhanced brain computed tomography demonstrated acute-to-subacute hypodensity in the left lentiform nucleus, caudate head, and anterior limb of the internal capsule. Non-dedicated post-contrast computed tomography showed visual luminal asymmetry/narrowing of the left middle cerebral artery compared with the contralateral side. Evaluation with electrocardiography, 72-hour continuous inpatient telemetry, transthoracic echocardiography with agitated saline study, carotid/vertebral Doppler ultrasonography, cerebrospinal fluid analysis including acid-fast bacilli testing and GeneXpert, human immunodeficiency virus testing, tuberculosis screening, antiphospholipid antibodies repeated at 12 weeks, thrombophilia testing, and autoimmune markers did not identify an alternative cause within the limits of available investigations. Cerebrospinal fluid culture for tuberculosis and other bacteria, computed tomography angiography/magnetic resonance angiography, transcranial Doppler, serial vascular imaging, and prolonged outpatient Holter monitoring were unavailable. She received aspirin, venous thromboembolism prophylaxis, later atorvastatin 80 mg orally once daily, and structured rehabilitation. The modified Rankin Scale score improved from 4 at the 30-day functional assessment to 2 at three and six months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This case describes delayed deep MCA-territory ischemic stroke temporally associated with aluminum phosphide ingestion. The observed computed tomography (CT) luminal asymmetry is hypothesis-generating only and cannot distinguish toxin-associated vasospasm/arteriopathy from reversible cerebral vasoconstriction syndrome, inflammatory vasculopathy, dissection-related disease, or pseudostenosis artifact. Clinicians should maintain vigilance for delayed focal neurologic deficits after aluminum phosphide exposure and pursue neuroimaging and etiologic evaluation, including dedicated vascular studies and follow-up vascular imaging where available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key clinical message: &lt;/strong&gt;Delayed focal ischemic stroke may occur after apparent clinical stabilization following aluminum phosphide ingestion, even without early hemodynamic collapse or structural heart disease. New lateralizing neurologic deficits after phosphide","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865290","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
Correction: Unexplained recurrent oral bleeding in an adolescent suggestive of factitious disorder: a case report. 更正:青少年不明原因复发性口腔出血提示人为障碍:1例报告。
IF 0.8
Journal of Medical Case Reports Pub Date : 2026-07-24 DOI: 10.1186/s13256-026-06350-y
Hassan Mobarak, Taseer F Din, Mohammed H Mahdi, Finza Latif
{"title":"Correction: Unexplained recurrent oral bleeding in an adolescent suggestive of factitious disorder: a case report.","authors":"Hassan Mobarak, Taseer F Din, Mohammed H Mahdi, Finza Latif","doi":"10.1186/s13256-026-06350-y","DOIUrl":"10.1186/s13256-026-06350-y","url":null,"abstract":"","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"20 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584402","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
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