Journal of Medical Case Reports最新文献

{"title":"Renal failure due to rectal neoplastic polyp: McKittrick-Wheelock syndrome-a case report.","authors":"Ivan Valentinov Dimitrov, Theophil Angelov Sedloev, Ivan Petrov Vasilev, Slavyana Slavcheva Usheva, Yavor Asenov Nikolov, Nikolay Metodiev Penkov, Plamen Ivanov Penchev, Maria-Elena Boyadzhieva, Georgi Chavdarov Jelev","doi":"10.1186/s13256-024-05013-0","DOIUrl":"https://doi.org/10.1186/s13256-024-05013-0","url":null,"abstract":"<p><strong>Background: </strong>McKittrick-Wheelock syndrome is an uncommon and severe disorder caused by large hypersecretory tumors located in the distal colorectal area. Excessive secretion from adenomas is an unusual clinical manifestation that leads to severe electrolyte and fluid depletion, subsequently resulting in kidney injury. Successful treatment relies on quick and cooperative decision-making for timely intervention.</p><p><strong>Case presentation: </strong>A 79-year-old Bulgarian male patient was admitted to the emergency department with syncope resulting from severe electrolyte depletion and renal failure caused by excessive secretion from a rectal polyp. The initial diagnostic and treatment journey included computed tomography, rectoscopy, biopsy, and an attempt at piecemeal removal, ultimately leading to abdominoperineal resection. Despite the permanent colostomy, the patient experienced a smooth recovery and significant improvement in his quality of life.</p><p><strong>Conclusion: </strong>McKittrick-Wheelock syndrome begins with nonspecific initial symptoms in the first extended latent phase, mainly diarrhea, followed by a brief deterioration phase and decompensation phase. However, the key to restoring renal function and correcting electrolyte imbalances lies in surgically removing the tumor, making early detection crucial. Employing a multidisciplinary strategy that includes prompt recognition, timely intervention, and thorough preoperative stabilization is crucial for achieving successful outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"3"},"PeriodicalIF":0.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950241","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":"Antithrombin III deficiency and idiopathic intracranial hypertension: a case report.","authors":"Mansoureh Togha, Yousef Mokary, Elham Jafari","doi":"10.1186/s13256-024-04997-z","DOIUrl":"10.1186/s13256-024-04997-z","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic intracranial hypertension (IIH) is a condition where the pressure of the cerebrospinal fluid in the brain increases without a known cause. It typically affects adults but can also occur in adolescents and children, although it is less common. Numerous elements, including coagulopathy, have been documented in previous cases as potential etiological factors of IIH. Nonetheless, our objective was to present the insufficiency of a coagulation factor as an additional contributing factor to IIH, a notion that has not been previously reported.</p><p><strong>Case presentation: </strong>In this case, a 34-year-old West Asian female patient presented with a subacute generalized headache, bilateral blurred vision, and papilledema. The patient's brain magnetic resonance imaging showed flattening of the posterior globe and empty sella, but no other abnormalities were detected. The results of magnetic resonance venography and cerebrospinal fluid analysis were also normal, except for an opening cerebrospinal fluid pressure of 600 mm H₂O during the lumbar puncture. Rheumatologic and endocrine disorders were ruled out on the basis of clinical assessment and laboratory tests. The patient was started on acetazolamide (1 g/day, increased to 2 g/day) and furosemide (20 mg/twice a day) and was encouraged to lose weight. These treatments led to some improvement for about 1 year, but her symptoms then worsened without an obvious cause. Given the prolonged duration of the disease and the lack of expected response to treatment, the patient was reevaluated for endocrinopathy and collagen vascular disease, which were negative. An additional workup revealed an antithrombin III (AT III) deficiency, for which the patient was prescribed acetylsalicylic acid (80 mg/day) in addition to the previous medications. As a result, the patient's papilledema, macular thickness, and nerve fiber layer edema decreased, as observed by fundoscopy and optical coherence tomography. Clinical examination and imaging also showed improvement in the patient's symptoms.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering coagulopathy in cases of IIH and suggests that antiplatelet therapy with acetylsalicylic acid may be beneficial for such patients.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"2"},"PeriodicalIF":0.9,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927386","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":"Adenoid cystic carcinoma of the breast, from diagnosis to management: a case report.","authors":"Mendoza-Urbano Diana Marcela, Cañon Diana, Palazuelos Gloria Ines, Torres Fabio, Wills Beatriz, Rodriguez-Urrego Paula Andrea","doi":"10.1186/s13256-024-04995-1","DOIUrl":"10.1186/s13256-024-04995-1","url":null,"abstract":"<p><strong>Background: </strong>Adenoid cystic carcinoma of the breast is a rare subtype, constituting less than 3.5% of primary breast carcinomas. Despite being categorized as a type of triple-negative breast cancer, it generally has a favorable prognosis. The primary management approach typically involves breast-conserving surgery. Due to its rarity, diagnosis can be challenging, emphasizing the importance of histopathological confirmation with clinical and imaging correlation. Although this tumor often has a favorable prognosis, additional research is necessary to better understand its clinical, radiological, and pathological features.</p><p><strong>Case presentation: </strong>We present the case of a 54-year-old Colombian woman of Hispanic ethnicity who had a lesion detected by mammography at the junction of the upper quadrants. Breast ultrasound revealed a Breast Imaging Reporting & Data System category 5 solid nodule, 0.8 × 0.7 cm, with irregular borders in the left breast and no axillary abnormalities. A biopsy confirmed infiltrating carcinoma with tubular and cribriform patterns. Immunohistochemistry was consistent with adenoid cystic carcinoma of the breast (triple-negative). Contrast-enhanced breast magnetic resonance imaging showed a primary tumor measuring 18 × 11 × 15 mm at the upper quadrant interface, along with another suspicious mass measuring 50 × 10 mm in the retroareolar region, as well as multiple adjacent enhancing foci suggestive of multicentric tumor involvement with probable ductal extension. Due to potential multifocality, the patient underwent a nipple-sparing mastectomy and sentinel node dissection. Pathology revealed a unifocal retroareolar adenoid cystic carcinoma measuring 2.5 mm, situated less than 1 mm from the deep surgical margin and with a positive anterior margin. There was no evidence of lymphovascular or perineural invasion. The final diagnosis was triple-negative adenoid cystic carcinoma, classic subtype. A multidisciplinary board recommended radiotherapy and imaging follow-up. Postoperative outcomes remained satisfactory during follow-up with the breast surgeon.</p><p><strong>Conclusion: </strong>This case report aims to raise awareness within the medical community regarding this rare cancer, highlighting the importance of accurate clinicopathological recognition and diagnosis. Multidisciplinary management remains crucial as the cornerstone of care, especially for offering therapies tailored to each patient's specific needs.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927375","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":"A case of subcutaneous metastatic malignant melanoma of the left medial ankle: a case report and review of literature.","authors":"Lauren Workman, Lauren Fang, Martina Blazevic, Joanna Chen, Richard Simman","doi":"10.1186/s13256-024-04908-2","DOIUrl":"10.1186/s13256-024-04908-2","url":null,"abstract":"<p><strong>Background: </strong>Although rare, melanoma confined to the dermis or subcutaneous tissue without evidence of a primary cutaneous site should provoke consideration of melanoma of unknown primary. This diagnosis carries a favorable prognosis when compared with cutaneous metastatic melanoma. Several hypotheses have been proposed for how melanoma of unknown primary develops, two of which were considered in our patient case: (1) spontaneous regression of the primary tumor following metastasis or (2) the traumatic implantation of ectopic melanocytic cells in other tissues, such as the subcutaneous tissue. Although not a true example of melanoma of unknown primary, our case is still noteworthy as it represents a unique instance of melanoma presenting subcutaneously from trauma to a preexisting epidermal nevus.</p><p><strong>Case presentation: </strong>We present the case of a 66-year-old non-Hispanic Caucasian male who initially sought evaluation for a nontender lump of the left groin. Ultrasound-guided needle biopsy demonstrated stage III malignant melanoma. Upon further history taking, it was discovered that he had a nevus of the left medial ankle that was subjected to traumatic removal. He later developed a subcutaneous nodule at the same site. Positron emission tomography scan results supported the histopathologic findings which demonstrated invasive melanoma centered in the subcutaneous tissue without an epidermal component. Following left inguinal lymph node dissection, the patient received adjuvant immunotherapy and radiation to the left inguinal area. At 6 months following completion of therapy, metastases were identified in the lungs, vertebra, ribs, and liver. The patient is currently receiving immunotherapy with ipilimumab-nivolumab.</p><p><strong>Conclusion: </strong>As our patient did not have a readily apparent primary epidermal melanoma site at presentation, consideration was given as to whether this case may represent a melanoma of unknown primary, as originally defined by Das Gupta. This case does not meet the proposed criteria, however, as the patient reported a preexisting nevus in the area that was subjected to traumatic removal. Instead, we postulate that this trauma allowed for implantation of melanocytes into the subcutaneous tissue that later resulted in a malignant melanoma.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"647"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909682","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 inverse canine impaction: a case report.","authors":"Tzu-Yuan Weng, Shiuan-Hui Wang, Chih-Cheng Chen, Lih-Jyh Fuh, Ke-Hung Liu, Jui-Ting Hsu","doi":"10.1186/s13256-024-04977-3","DOIUrl":"10.1186/s13256-024-04977-3","url":null,"abstract":"<p><strong>Background: </strong>Maxillary canine impaction can result in malocclusion, temporomandibular joint complications, and esthetic concerns, thus influencing craniofacial development. Although cases of impacted canines are not uncommon in clinical practice, the likelihood of simultaneous bilateral impaction is extremely low; very few reports have documented cases of bilaterally symmetrical, inversely impacted canines.</p><p><strong>Case presentation: </strong>This paper reports a rare case of maxillary canine impaction, a condition characterized by the abnormal eruption of teeth. Potential causes of this condition include genetic, systemic, and localized factors. We analyzed this condition in the skeletal remains of a Taiwanese girl aged 11-14 years. The skeleton, dating 440-598 AD, was recovered from central Taiwan in 2019. Through panoramic X-ray and dental cone-beam computed tomography, we constructed a three-dimensional model of the skull, which exhibited bilateral symmetrical, inversely impacted maxillary canines-a rare clinical observation. On the basis of the current understanding of the dental field, the treatment of maxillary canine impaction is time consuming and labor intensive. Different impacted canine teeth have different difficulty levels of treatment.</p><p><strong>Conclusion: </strong>The archaeological data in this article show that 1500 years ago humans already had the problem of impacted canine teeth in the upper jaw. Moreover, bilaterally symmetrical maxillary canine impaction is very rare in clinical cases.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"617"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907130","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":"Disseminated Mycobacterium abscessus infection with idiopathic CD4+ T-lymphocytopenia: a case report and review of the literature.","authors":"Xianglin Wu, Mingzhu Zhai, Aohong Xu, Yi Zheng","doi":"10.1186/s13256-024-05009-w","DOIUrl":"10.1186/s13256-024-05009-w","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic CD4+ T lymphocytopenia is a rare immune dysfunction disease that is usually found after opportunistic infections. Mycobacterium abscessus is a rapidly growing mycobacterium that can cause pulmonary infections, lymphadenitis, skin and soft tissue infections, disseminated infections, among others, as a conditional pathogenic bacterium.</p><p><strong>Case presentation: </strong>We present the case of a 43-year-old Chinese woman who developed disseminated Mycobacterium abscessus infection due to idiopathic CD4+ T lymphocytopenia. The patient exhibited symptoms including skin infections, lymphadenitis, and bacteremia. A tailored multidrug therapy was initiated, guided by drug susceptibility testing. Within a month of treatment, the patient's fever resolved, and she exhibited a significant recovery and was discharged.</p><p><strong>Conclusions: </strong>Cases of clinical idiopathic CD4+ T lymphocytopenia with Mycobacterium abscessus infection are not common. Clinicians should be vigilant and accurately identify Mycobacterium abscessus as an opportunistic pathogen when dealing with immunocompromised patients, in particular with idiopathic CD4+ T lymphocytopenia.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"645"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909686","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":"Ipsilateral ectopic pregnancy in the distal remaining part of the previously removed Fallopian tube: a case report.","authors":"Bassant Elshatby, Mohamed Mohamed Belal, Mohamed Emad Rezk","doi":"10.1186/s13256-024-04893-6","DOIUrl":"10.1186/s13256-024-04893-6","url":null,"abstract":"<p><strong>Background: </strong>Ectopic pregnancy, occurring outside the uterine cavity, poses a significant health risk, with Fallopian tube involvement being predominant. Recurrent ectopic pregnancy, particularly in the ipsilateral remnant of a previously removed tube, is a rare and poorly understood phenomenon. Here, we present a case of recurrent ectopic pregnancy occurring in the distal remnant of the right fallopian tube following ipsilateral incomplete salpingectomy in a 22-year-old woman.</p><p><strong>Case presentation: </strong>A 22-year-old woman of mixed Arab ancestry and African ethnicity, gravida 4, para 1, with a history of one miscarriage and a previous ectopic pregnancy, presented to Elshatby Maternity Hospital, Alexandria, Egypt, complaining of severe lower abdominal pain with a history of an open right salpingectomy one year prior due to the ectopic pregnancy. She exhibited stable vital signs on admission. Ultrasound revealed a 6-week gestational sac in the right fallopian tube, accompanied by hematoma and mild pelvic collection. Despite analgesic interventions, her symptoms worsened the next day, prompting open surgery. Surprisingly, the distal portion of the right tube, which was supposed to have been removed in the prior salpingectomy, contained the ectopic pregnancy. A laparotomy was performed, involving evacuation of the pelvic hematoma, distal ipsilateral tubal salpingectomy, and peritoneal lavage. Postoperative recovery was uneventful, with improvement demonstrated during follow-up.</p><p><strong>Conclusion: </strong>Caution should be taken when dealing with any woman in the reproductive age group who presents with acute abdomen, especially if she has a previous history of ectopic pregnancy, to exclude the possibility of recurrent ectopic pregnancy. Previous salpingectomy does not exclude the possibility of recurrent ectopic pregnancy on the ipsilateral side, as the inappropriate surgical technique used during salpingectomy can affect the possibility of recurrence. We suggest that careful clinical consideration of the surgical technique used during salpingectomy is essential to minimize the risk of recurrent ectopic pregnancies and prevent serious complications.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"644"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907133","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":"Coinfection of severe acute respiratory syndrome coronavirus 2 and polyomavirus in a patient with coronavirus disease 2019 detected by enrichment next-generation sequencing: a case report.","authors":"Gunadi, Esensi Tarian Geometri, Pramana Adhityo, Ali Zainal Abidin, Marcellus, Dyah Ayu Puspitarani, Fadila Dyah Trie Utami, Kristy Iskandar, Hendra Wibawa, Mohamad Saifudin Hakim","doi":"10.1186/s13256-024-05005-0","DOIUrl":"10.1186/s13256-024-05005-0","url":null,"abstract":"<p><strong>Background: </strong>Severe acute respiratory syndrome coronavirus 2 was found first in Wuhan and declared a pandemic by the World Health Organization. Coinfection with other respiratory viruses may occur, complicating the diagnosis and treatment of coronavirus disease 2019 . Herein, we identified a Karolinska Institute polyomavirus Stockholm 60 present in a nasopharyngeal swab of a patient with severe acute respiratory syndrome coronavirus 2 infection using next-generation sequencing with an enrichment method.</p><p><strong>Case presentation: </strong>A 24-year-old Indonesian woman was admitted to our institution due to a cough, cold, and sore throat. She had no family history of hypertension and diabetes mellitus, and she was well. Her vital signs were as follows: heart rate, 84 beats per minute; respiratory rate, 22 breaths per minute; temperature, 39 °C; and pulse oximetry, 96% on room air. She had runny nose and slightly inflamed pharynx. Her nasopharyngeal swab and real-time polymerase chain reaction were positive for the coronavirus disease 2019 nucleocapsid and open reading frame genes, with cycle threshold values of 32.33 and 33.74, respectively. Whole-genome sequencing of severe acute respiratory syndrome coronavirus 2 was performed using the Nextera DNA Flex for Enrichment using the Respiratory Virus Oligos Panel, Illumina MiSeq instruments, and Illumina MiSeq reagent v3 150 cycles (2 × 75 cycles). The full genomes were aligned to the reference genome (NC_045512.2) by the Burrow-Wheeler aligner algorithm. The whole-genome sequencing showed coinfection of Karolinska Institute polyomavirus Stockholm 60 (NC_009238.1) with an overall coverage of 3561x. The patient was given acetaminophen, vitamin C, vitamin D, and zinc for the treatment and discharged uneventfully from the hospital 4 days after admission. Then, 2 weeks after discharge, she visited the outpatient clinic without any further concerns.</p><p><strong>Conclusion: </strong>This report presents a case of Karolinska Institute polyomavirus and severe acute respiratory syndrome coronavirus 2 coinfection in a patient with nonspecific clinical manifestation. Further studies with a larger sample size are mandatory to clarify the association between severe acute respiratory syndrome coronavirus 2 and Karolinska Institute polyomavirus coinfection, particularly on patient outcomes. Moreover, the results propose the usefulness of enrichment-based next-generation sequencing in detecting viral coinfection in patients with severe acute respiratory syndrome coronavirus 2.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"646"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909683","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":"Survival after aluminum phosphide poisoning with cardiotoxicity: a case report.","authors":"Habtamu Mesele Gebray, Addisu Liknaw Chekol","doi":"10.1186/s13256-024-04988-0","DOIUrl":"10.1186/s13256-024-04988-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Aluminum phosphide is a cheap and commonly used rodenticide that is also an effective solid fumigant and frequently used for grain preservation. The pill contains around 44% inert elements (ammonium carbonate) to avoid disintegration of the tablet, while the rest (about 56%) is aluminum phosphide. Because it is freely available on the market, it is one of the commonly used agents for self-poisoning in different parts of the developing world. Early signs of toxicity are manifested by shock and circulatory failure. Until now, no specific antidote is available. Aggressive supportive management is the key to survival in cases of aluminum phosphide poisoning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;We present a case of successful management of aluminum phosphide poisoning-induced cardiotoxicity with a favorable outcome in a 48-year-old Black African female patient who was taken to a private clinic 6 hours after intentional ingestion of two tablets of aluminum phosphide. She presented with repeated vomiting, restlessness, and confusion. Upon examination, the patient was drowsy, pale, cold, and clammy. She had nonrecordable blood pressure and radial pulsation. Glasgow Coma Scale was 14/15. Routine laboratory investigations and initial electrocardiogram were normal. Six hours after intensive care unit admission, the electrocardiogram showed atrial fibrillation with fast ventricular response, ST segment elevation, and inverted T-waves. Cardiac troponin level was elevated. With the diagnosis of acute aluminum phosphide poisoning with cardiotoxicity (acute myocardial infarction), hospital-based protocol was administered and medical treatment for myocardial infarction was given. She was discharged on the fourth day after full recovery. She came for regular follow-up visits and had normal clinical evaluation, electrocardiogram, and laboratory findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Exposure to phosphine gas released from aluminum phosphide fumigants increases the risk of major morbidity and mortality. The mortality due to aluminum phosphide poisoning is very high and variable. The use of magnesium sulfate to reduce cardiac arrhythmias and mortality is well documented, but there is no uniformity in dose or frequency of its administration worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;One of the limitations of this report is the nature of the case report, being a retrospective design, giving no chance to establish a cause-effect relationship. Arterial blood gas analysis, serum magnesium level, and cardiac computed tomography/magnetic resonance imaging modalities were not available in the town. The recommended gastric lavage with potassium permanganate solution was not used in this case, because potassium permanganate is not available in Ethiopia. The other limitation is that, as it is a case report from a single center, it may not be representative of the general population. These limitations might have a negative impact","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"614"},"PeriodicalIF":0.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903210","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":"An alternative multidrug regimen for multibacillary Hansen's disease: a case report.","authors":"Nazar Akhverdyan, Zachary Cantor, Kellie Hawkins","doi":"10.1186/s13256-024-04971-9","DOIUrl":"10.1186/s13256-024-04971-9","url":null,"abstract":"<p><strong>Background: </strong>Leprosy (Hansen's disease) is an infectious disease most common in resource-limited countries caused by the acid-fast bacilli Mycobacterium leprae and Mycobacterium lepromatosis that frequently affects the skin and peripheral nerves. Prompt diagnosis and treatment with multidrug therapy is crucial to reduce disease transmission and sequelae, which include nerve function impairment, ocular injury, and stigmatizing physical deformities. Traditional treatment of multibacillary leprosy consists of 12-24 months of multidrug therapy with dapsone, rifampin, and clofazimine. However, this regimen is associated with high pill burden and side effects that limit adherence.</p><p><strong>Case presentation: </strong>We report a case of multibacillary leprosy in a previously healthy 30-year-old Hispanic man who recently immigrated to the USA from South America and presented with progressive nodular skin lesions on his face and extremities. He was treated with a monthly regimen of rifampin, moxifloxacin, and minocycline. At follow-up there was significant improvement of his cutaneous lesions without signs of reversal reaction or erythema nodosum leprosum.</p><p><strong>Conclusions: </strong>This case report adds to the growing repertoire of literature supporting the use of rifampin, moxifloxacin, and minocycline. Further studies are needed to assess the efficacy of this antimycobacterial regimen and monitor rates of relapse and delayed immunologic reactions, which may occur 5-10 years after completion of treatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"612"},"PeriodicalIF":0.9,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895356","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}