Journal of Medical Case Reports最新文献

{"title":"A structured rehabilitation program for functional recovery in Guillain-Barré syndrome: a case report.","authors":"Neda M Yousef, Daniel Kayode Adejumo, Animesh Hazari, Praveen Kumar Kandakurti","doi":"10.1186/s13256-025-05545-z","DOIUrl":"10.1186/s13256-025-05545-z","url":null,"abstract":"<p><strong>Introduction: </strong>Guillain-Barré syndrome is a rare disorder characterized by progressive generalized muscle weakness commonly arising from proximal leg muscles and developing in an ascending pattern toward the upper limb, facial muscles, and cranial nerves.</p><p><strong>Case report: </strong>A 40-year-old Emirati female patient diagnosed with Guillain-Barré syndrome had paralysis of her upper and lower limbs, with certain muscle groups exhibiting tightness. On the basis of the patient's examination findings and goals, the rehabilitation program focused on inhibiting tightness, activating weak muscles, improving range of motion and proprioception, and developing trunk control for advanced functional training.</p><p><strong>Discussion: </strong>The results of the structured program revealed the effectiveness of an intensive intervention in improving the patient's physical abilities over 4 months. Our program was based on a study that reported that extensive training showed significant improvement in patient functional outcome.</p><p><strong>Conclusion: </strong>The findings of our study suggest that a structured rehabilitation program consisting of progressive resistance training and functional training could be very effective in improving physical function among Guillain-Barré syndrome patients.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"450"},"PeriodicalIF":0.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175987","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":"Appendiceal abscess presenting with meralgia paresthetica: a case report and review of literature.","authors":"Wassie Almaw Yigzaw, Werkneh Demissie, Meron Kiros, Helina Dagnachew, Tazebew Tilahun, Walelign Worku, Samuel Negash","doi":"10.1186/s13256-025-05316-w","DOIUrl":"10.1186/s13256-025-05316-w","url":null,"abstract":"<p><strong>Background: </strong>Meralgia paresthetica is a sensory neuropathy resulting from the entrapment or injury of the lateral femoral cutaneous nerve. It presents with sensory symptoms such as numbness, paresthesia, and chronic pain in the anterolateral thigh above the knee. Although it is typically idiopathic, meralgia paresthetica can occasionally occur as a complication of an appendiceal abscess, as observed in our patient.</p><p><strong>Case presentation: </strong>A 12-year-old Black African male patient presented with abdominal pain lasting for 1 week. The pain initially occurred in the periumbilical area and later localized to the right lower quadrant, accompanied by anorexia, fever, and three episodes of vomiting. He reported numbness in his right thigh during the 3 days preceding his hospital visit. On physical examination, he had a firm, tender, palpable mass in the right lower abdomen. Pain and touch sensations were diminished over the right anterolateral thigh. His white blood cell count was 16,000 per microliter, with a neutrophil percentage of 89%, and ultrasound revealed perforated appendicitis with a sizeable appendicular abscess extending to the right psoas muscle. Given the impression of an appendiceal abscess, under general anesthesia, the patient was explored through a right lower quadrant transverse incision. Intraoperatively, a mass formed between the ileum, cecum, lateral abdominal wall, and omentum that contained approximately 200 cc of thick, intense pus, and extensive necrotic tissue was noted over the psoas bed. The cavity was dismantled, the abscess was drained, and the necrotic tissue was debrided. He had a smooth postoperative course and was discharged in stable condition after a 5-day hospital stay. His sensory symptoms persisted during the postoperative period, although improvement was noted during his second referral clinic visit.</p><p><strong>Conclusion: </strong>Although meralgia paresthetica typically has iatrogenic causes in surgical patients, it may also arise from primary intra-abdominal or pelvic pathology. Self-limiting lateral femoral cutaneous neuropathy can occur in patients with appendiceal abscess; hence, a high index of suspicion and a thorough examination are essential to identify this uncommon complication of appendiceal abscess. His sensory symptoms began in the preoperative period, which makes iatrogenic causes unlikely.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"455"},"PeriodicalIF":0.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175974","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":"Polyneuropathy and noncompressive cauda equina syndrome as manifestation of systemic lupus erythematosus: a case report.","authors":"Ahmad Tirmizi Jobli, Sharifah Aishah Wan, Cheng Lay Teh, Yaw Kiet Cheong, Cindy Hui San Kueh","doi":"10.1186/s13256-025-05536-0","DOIUrl":"10.1186/s13256-025-05536-0","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric systemic lupus erythematosus covers a wide range of central nervous system and peripheral nervous system conditions. We report a rare case of a man with progressive muscle weakness and cauda equina syndrome.</p><p><strong>Case presentation: </strong>A 32-year-old man of Chinese ethnicity presented with a 2-month history of progressive muscle weakness of the upper and lower limbs, associated with inflammatory joint pains, and rashes over the upper and lower limbs. Examination showed post-inflammatory hyperpigmentation over the upper and lower limbs and weakness in the proximal muscles of the upper and lower limbs. Laboratory investigations showed anemia, leukopenia, lymphopenia, positive antinuclear antibodies, positive anti-double-stranded deoxyribonucleic acid antibodies, positive anti-Smith antibodies, and positive anti-ribosomal P protein antibodies. He later developed acute urinary incontinence and weak anal tone. Magnetic resonance imaging of the spine showed leptomeningeal enhancement of the cauda equina. He was diagnosed with neuropsychiatric lupus with peripheral polyneuropathy and cauda equina syndrome. His condition was complicated with an infection and pulmonary embolism, but he eventually recovered with treatment. He was treated with high-dose steroids, hydroxychloroquine, intravenous immunoglobulin, anticoagulation, cyclophosphamide, and subsequently, mycophenolate mofetil.</p><p><strong>Conclusion: </strong>This case highlights the rarity of peripheral neuropathy and noncompressive cauda equina syndrome in systemic lupus erythematosus. A collaborative effort by clinicians in multiple fields is required to achieve a diagnosis and satisfactory treatment in this patient.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"449"},"PeriodicalIF":0.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176021","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":"Bilateral eyelid masses and enophthalmos as the initial manifestation of diffuse large B-cell lymphoma: a case report.","authors":"Tasnim Ibrahim, Basem Zaino, Maria Bader, Saleem Terkmany, Rabab Salloum","doi":"10.1186/s13256-025-05528-0","DOIUrl":"10.1186/s13256-025-05528-0","url":null,"abstract":"<p><strong>Background: </strong>Ocular adnexal lymphoma is considered an uncommon disease, but it is among the most common malignancies affecting the ocular adnexa. While diffuse large B-cell lymphoma constitutes 10% of ocular adnexal lymphomas, the initial presentation with bilateral eyelid swelling is quite rare and can be diagnostically challenging.</p><p><strong>Case presentation: </strong>Here, we report a case of a 64-year-old Middle Eastern male patient with no prior history of malignancy who presented with a 5-month history of bilateral upper eyelid swelling, mild enophthalmos, and ptosis. The patient had no systemic symptoms. The masses were surgically resected, and histopathological examination confirmed the diagnosis of diffuse large B-cell lymphoma. Following surgical resection, the patient developed submandibular and parotid gland enlargements. Subsequent contrast-enhanced computed tomography scan revealed an enhancing mass posterior to the descending aorta. The patient received six cycles of rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone regimen. Despite the aggressive nature of diffuse large B-cell lymphoma, clinical remission has been achieved. Follow-up positron emission tomography revealed no residual disease.</p><p><strong>Conclusion: </strong>Bilateral eyelid swelling is a rare initial sign of aggressive lymphoma, such as diffuse large B-cell lymphoma, even in the absence of systemic symptoms. Clinicians should consider malignancy in such atypical presentations to ensure early diagnosis and treatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"444"},"PeriodicalIF":0.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176029","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":"Emphysematous pyelonephritis in a diabetic child: a case report and review of the literature.","authors":"Behnaz Bazargani, Mastaneh Moghtaderi, Hassan Esfandiary, Fatemeh Ghanbarian, Noosha Samieefar","doi":"10.1186/s13256-025-05537-z","DOIUrl":"10.1186/s13256-025-05537-z","url":null,"abstract":"<p><strong>Introduction: </strong>Emphysematous pyelonephritis is a life-threatening condition characterized by gas accumulation within the kidney and the surrounding tissues, often resulting in tissue necrosis. Although frequently reported in adults, emphysematous pyelonephritis is an extremely rare condition in children, with only a few documented cases in the literature. We present the case of a child with insulin-dependent diabetes mellitus who had initially been admitted with a diagnosis of diabetic ketoacidosis that was later revealed to be emphysematous pyelonephritis.</p><p><strong>Case presentation: </strong>An Iranian 11-year-old girl with poorly controlled type 1 diabetes was referred to the Children's Medical Center with a computed tomography scan confirming emphysematous pyelonephritis (stage 4). The patient initially presented with abdominal and flank pain, fever, and fatigue, and the initial diagnosis was diabetic ketoacidosis. Despite undergoing management for diabetic ketoacidosis, the patient continued to exhibit signs of fever and illness. Further evaluation ruled out diabetic ketoacidosis, and active urine analysis indicated a kidney pathology. Imaging investigations confirmed the presence of gas within the pyelocaliceal system. In our center, the patient was treated with intravenous meropenem and vancomycin for 7 days and was discharged with improved health and normal kidney function.</p><p><strong>Conclusion: </strong>This case underscores the significance of considering emphysematous pyelonephritis in children, particularly those with underlying conditions such as diabetes, even when initial presentations suggest other diagnoses such as diabetic ketoacidosis.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"454"},"PeriodicalIF":0.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176051","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":"Twin interstitial ectopic pregnancy following ipsilateral tubal pregnancy: a case report.","authors":"Maria Inês Sousa, Ana Andrade, Sara Sereno, Rafael Brás, Sandra Soares, Rosa Macedo, Luís Guedes-Martins","doi":"10.1186/s13256-025-05543-1","DOIUrl":"10.1186/s13256-025-05543-1","url":null,"abstract":"<p><strong>Background: </strong>Interstitial pregnancy has an estimated maternal mortality rate seven times greater than the mortality rate for ectopic pregnancies in general. For this reason, early diagnosis is the key to successful treatment and favorable outcomes in patients with this type of ectopic pregnancy. We report the rare case of a Portuguese white woman with a spontaneous twin interstitial pregnancy with embryonic cardiac activity, its diagnosis, and surgical management, as well as a literature review on the specificities of this scenario.</p><p><strong>Case presentation: </strong>A Portuguese white woman in her early forties presented at our hospital for early pregnancy assessment 3 months after having got a salpingectomy for a tubal pregnancy. Transvaginal ultrasound revealed an empty uterine cavity and an eccentric gestational sac within the uterine serosa, containing two yolk sacs and two embryonic poles with cardiac activity. These findings were suggestive of a twin interstitial pregnancy. A cornuostomy was performed, using proximal uterine artery clipping and a purse-string suture around the cornual area as hemostatic measures. No surgical or postoperative complications occurred.</p><p><strong>Conclusions: </strong>Twin tubal pregnancy is a rare occurrence, particularly in spontaneous gestations. Although interstitial pregnancies are more common after ipsilateral salpingectomy, early diagnosis is challenging. The best therapeutic approach is yet to be determined, but surgery, when indicated, offers a definitive treatment. Cornuostomy presents the advantage of removing the ectopic pregnancy while preserving uterine architecture and maintaining fertility. This case report states the relevance of early pregnancy assessment in women with risk factors for ectopic pregnancy. If performing surgery as treatment, it is advisable to adopt less invasive approaches such as cornuostomy. Also, one cannot forget the importance of maintaining a good hemostasis, considering the bleeding potential associated with this type of pregnancy.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"448"},"PeriodicalIF":0.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176054","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":"Incarcerated obturator hernia complicated by lower limb venous thrombosis: a case report.","authors":"Siqi Zhu, Guosong Zha, Weiqiang Gong, Chunfa Cheng","doi":"10.1186/s13256-025-05521-7","DOIUrl":"10.1186/s13256-025-05521-7","url":null,"abstract":"<p><strong>Introduction: </strong>Obturator hernia is a rare type of abdominal wall hernia, predominantly seen in elderly women. It often presents with symptoms of intestinal obstruction, which require emergency medical attention. Computed tomography scanning is a crucial diagnostic tool for this condition.</p><p><strong>Case presentation: </strong>This article reports the case of an 80-year-old Chinese female patient with a left-sided incarcerated obturator hernia complicated by ipsilateral intermuscular venous thrombosis in the lower limb. Emergency laparoscopic exploration revealed the simultaneous presence of an ipsilateral inguinal and femoral hernia, along with a contralateral obturator and femoral hernia. After balancing treatment urgency with systemic risk control, the patient underwent the laparoscopic transabdominal preperitoneal repair to address the left-sided incarcerated obturator hernia, femoral hernia, and inguinal hernia. Postoperatively, the patient recovered well, with significant relief of left leg pain and no progression of the thrombosis.</p><p><strong>Conclusion: </strong>This case highlights the complexity of diagnosing and managing incarcerated obturator hernias. Successful management relies on vigilance for atypical symptoms, precise imaging evaluation, a multidisciplinary decision-making approach prioritizing emergencies and risk stratification, and the integration of minimally invasive techniques with damage control principles.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"443"},"PeriodicalIF":0.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149310","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":"High-grade endometrial stromal sarcoma presenting with multiple brain metastases: a case report.","authors":"Hina Kono, Masafumi Toyoshima, Ai Ikki, Haruki Shimada, Shunji Suzuki","doi":"10.1186/s13256-025-05448-z","DOIUrl":"10.1186/s13256-025-05448-z","url":null,"abstract":"<p><strong>Background: </strong>High-grade endometrial stromal sarcoma is a rare and aggressive subtype of uterine sarcoma, characterized by a poor prognosis. While typical initial manifestations include gynecological symptoms such as abnormal vaginal bleeding (for example, postmenopausal bleeding, intermenstrual bleeding, or menorrhagia), abdominal pain, and abdominal distension, an initial presentation involving distant metastases, particularly to the brain, is exceptionally uncommon. This case highlights a highly atypical initial presentation of this rare and challenging disease.</p><p><strong>Case presentation: </strong>This report details a unique clinical scenario of high-grade endometrial stromal sarcoma in a 58-year-old Japanese woman. She presented with left hemiparesis and unexplained weight loss, leading to the discovery of multiple brain tumors on cranial computed tomography. Following craniotomy and tumor resection, pathology suggested metastatic sarcoma. Positron emission tomography-computed tomography subsequently identified the uterus as the most probable primary site. Despite initial negative endometrial biopsy results, a targeted transabdominal computed tomography-guided biopsy ultimately confirmed the diagnosis of high-grade endometrial stromal sarcoma. Furthermore, detailed imaging and pathological findings raised the intriguing possibility that the high-grade endometrial stromal sarcoma may have originated from pre-existing adenomyosis. Despite initial chemotherapy and Gamma Knife radiosurgery for brain metastases, the patient's condition rapidly deteriorated, leading to her death approximately 4 months after initial presentation, highlighting the aggressive nature and poor prognosis of this disease.</p><p><strong>Conclusion: </strong>The inherent rarity of high-grade endometrial stromal sarcoma, combined with its highly unusual initial presentation as neurological symptoms, significantly contributed to the diagnostic delay in this case. This report critically underscores the vital importance for clinicians to maintain a high index of suspicion for high-grade endometrial stromal sarcoma in the differential diagnosis of patients presenting with brain metastases, even when typical gynecological complaints are absent.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"442"},"PeriodicalIF":0.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149112","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: Successful treatment of meglumine antimoniate in patient with cutaneous leishmaniasis with end-stage renal failure undergoing hemodialysis: a case report.","authors":"Hazem Arab, Yousef Alsaffaf, Ahmed Aldolly, Abdullah Dukhan, Thaer Douri","doi":"10.1186/s13256-025-05490-x","DOIUrl":"10.1186/s13256-025-05490-x","url":null,"abstract":"","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"441"},"PeriodicalIF":0.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092140","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":"Challenges in the use of the CytoSorb^® adsorber in an intensive care patient with liver dysfunction of unknown origin: a case report.","authors":"Caroline Gräfe, Michael Paal, Michael Irlbeck, Uwe Liebchen, Christina Scharf, Helen Graf","doi":"10.1186/s13256-025-05503-9","DOIUrl":"10.1186/s13256-025-05503-9","url":null,"abstract":"<p><strong>Background: </strong>The treatment of critically ill patients in intensive care units is becoming increasingly complex. For example, organ transplants are regularly carried out, the recipients are seriously ill, and the postoperative course can be complicated. This is why organ replacement and hemadsorption procedures are becoming increasingly important. Adsorption processes are used for specific indications, such as hyperinflammation, hepatic dysfunction, or rhabdomyolysis, in critically ill patients. Nevertheless, there is still a knowledge gap in terms of safety, interactions, and application. This case report provides an example of the thought process that went into deciding whether to apply an adsorption process, as well as other necessary treatment modifications resulting from the application.</p><p><strong>Case presentation: </strong>We present the case of a 26-year-old Italian man with a complicated postoperative period after lung transplant with the need of organ support systems and hemadsorption therapy. Besides operative difficulties of the transplant and massive bleeding, the patient developed a severe liver failure of unknown origin with highly elevated bile acids, which indicated the use of the CytoSorb^® cytokine adsorber. Since there are indications that undesired drug elimination may occur and that saturation kinetics have not yet been comprehensively investigated, there were a number of aspects to consider during application. For example, the patient received additional vancomycin dosing and vancomycin blood levels were monitored. Further, to avoid premature saturation of the adsorber, the cartridge was changed every 8 hours. These adjustments resulted in a continuous reduction in bile acids while maintaining stable vancomycin blood levels, which is critical in immunosuppressed patients.</p><p><strong>Conclusion: </strong>The report focuses on two main aspects regarding a safe and sufficient usage of CytoSorb^® in the intensive care medicine. First, shortened changing periods increase the elimination rate of the adsorber, which is quickly saturated by bigger molecules, for example, bile acids. Second, additional vancomycin dosing during CytoSorb^® application avoids under dosing since CytoSorb^® eliminates vancomycin.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"440"},"PeriodicalIF":0.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029979","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}