Journal of Medical Case Reports最新文献

{"title":"Late presentation of an anomalous left coronary artery originating from the pulmonary artery (ALCAPA) in a 70-year-old male: a case report.","authors":"Seyedeh Zeinab Seyedi, Ali Abedi, Bita Mollashahi, Mohammad Namazinia, Seyed Javad Davari-Sani","doi":"10.1186/s13256-026-06367-3","DOIUrl":"10.1186/s13256-026-06367-3","url":null,"abstract":"<p><strong>Background: </strong>Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare congenital anomaly with an estimated incidence of approximately 1 in 300,000 live births. More than 90% of untreated patients die within the first year of life, and survival into late adulthood is exceptionally uncommon, with only a few cases reported beyond the sixth decade. Such late presentations are clinically important, because they demonstrate the role of extensive collateral circulation in survival and pose unique diagnostic and therapeutic challenges.</p><p><strong>Case presentation: </strong>We report the case of a 70-year-old Iranian man who presented with acute chest pain lasting 12 hours. On admission, his vital signs were stable, and electrocardiography revealed sinus rhythm with ST-segment depression in multiple leads. Serial troponin measurements were negative, and transthoracic echocardiography showed no abnormalities. Owing to persistent clinical suspicion, coronary computed tomography angiography was performed, which revealed anomalous origin of the left coronary artery from the pulmonary artery, with a markedly dilated right coronary artery supplying collaterals to the left coronary system. The patient underwent successful surgical reimplantation of the left main coronary artery into the aorta and was discharged in stable condition.</p><p><strong>Conclusions: </strong>This case represents one of the oldest reported diagnoses of ALCAPA, underscoring the importance of maintaining a high index of suspicion for congenital anomalies even in elderly patients with atypical acute coronary presentations. It contributes to the limited literature on late survival without prior intervention and emphasizes the pivotal role of coronary computed tomography angiography (CCTA) in noninvasive diagnosis and surgical planning.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471225","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":"NTRK fusion in metastatic castration-resistant prostate cancer treated with entrectinib: a case report.","authors":"Shuichi Tatarano, Akihiko Mitsuke, Yoichi Osako, Takashi Sakaguchi, Satoru Inoguchi, Ryosuke Matsushita, Hirofumi Yoshino, Yasutoshi Yamada, Hideki Enokida","doi":"10.1186/s13256-026-06332-0","DOIUrl":"10.1186/s13256-026-06332-0","url":null,"abstract":"<p><strong>Background: </strong>The tropomyosin receptor kinase (TRK) inhibitors have demonstrated substantial efficacy in solid tumors harboring neurotrophic tyrosine receptor kinase (NTRK) gene fusions. Although NTRK fusions have been sporadically reported in prostate cancer, their clinical significance and the therapeutic efficacy of TRK inhibitors in this disease remain unclear. We report a case of NTRK fusion-positive metastatic castration-resistant prostate cancer treated with the TRK inhibitor entrectinib.</p><p><strong>Case presentation: </strong>A 68-year-old Japanese male with metastatic castration-resistant prostate cancer (mCRPC) experienced disease progression after androgen deprivation therapy, enzalutamide, abiraterone, and docetaxel. Because sufficient tumor tissue was unavailable for comprehensive genomic profiling, circulating cell-free DNA (cfDNA) analysis using FoundationOne^® Liquid was performed, and a PBX1-NTRK1 fusion was identified. Based on this result, treatment with the TRK inhibitor, entrectinib, at a daily dose of 600 mg was initiated. Despite two months of therapy, prostate-specific antigen levels increased from 22.7 ng/mL to 70.2 ng/mL, and bone scintigraphy demonstrated radiographic disease progression with new metastatic lesions. Although the patient reported transient improvement in bone pain, entrectinib was ultimately ineffective. No severe adverse events were observed.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first reported case of NTRK fusion-positive mCRPC treated with entrectinib. This case highlights the potential limitations of cfDNA-based detection of NTRK fusions in prostate cancer and suggests that NTRK fusions detected in cfDNA without tissue validation may not reliably predict clinical benefit from TRK inhibitors in mCRPC. Further studies are required to clarify the biological relevance of NTRK fusions and optimal patient selection for TRK inhibitors in prostate cancer.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471171","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":"Osimertinib-induced acute decompensated heart failure: a case report and review of the literature.","authors":"Hou-Chen Lee, Meng-Heng Hsieh, Horng-Chyuan Lin","doi":"10.1186/s13256-026-06378-0","DOIUrl":"10.1186/s13256-026-06378-0","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC), which is one of the most common cancer types, has caused lots of deaths to patients worldwide. Aside from the surgical treatment or chemotherapy, the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), Osimertinib, is used as a treatment for patients with non-small cell lung cancer. However, the cardiotoxicity related to Osimertinib, which is rarely reported, is still a controversial issue to be discussed.</p><p><strong>Case presentation: </strong>A 70-year-old Taiwanese female diagnosed with lung adenocarcinoma had been with Osimertinib treatment for two years. During admission for a routine lung cancer staging workup, she developed acute-onset dyspnea with pulmonary edema. She did not present with any infection-related symptoms. The echocardiography revealed global hypokinesis, while a thallium scan showed no evidence of myocardial infarction. Her symptoms resolved gradually following the withdraw of Osimertinib.</p><p><strong>Conclusion: </strong>We report a case of acute decompensated heart failure in a patient with lung cancer who had been receiving Osimertinib therapy for two years. To the best of our knowledge, this represents the longest the interval reported between initiation of Osimertinib and the onset of cardiotoxicity. The diagnosis of Osimertinib-related heart failure was made by exclusion of the other etiologies, and the patient's clinical symptoms recovered after cessation of Osimertinib for one week. Although the cause of Osimertinib-related cardiotoxicity is still unclear, regular cardiac examination of the patients should be considered.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470851","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":"Spinal muscular atrophy type 2 with severe kyphoscoliosis: a case report.","authors":"Weifan Ren, Bo Jin, Yungen Hu, Lei Han, Renfu Quan, Zhenfei Xiong","doi":"10.1186/s13256-026-06336-w","DOIUrl":"10.1186/s13256-026-06336-w","url":null,"abstract":"<p><strong>Background: </strong>Spinal muscular atrophy (SMA) is a rare autosomal recessive neuromuscular disorder caused by homozygous deletion or mutation of the SMN1 gene. Scoliosis is a common complication in patients with SMA type 2, often leading to impaired sitting balance, reduced respiratory function, and poor quality of life. We report a case of SMA type 2 with severe kyphoscoliosis successfully treated with posterior spinal fusion.</p><p><strong>Case presentation: </strong>A 16-year-old Chinese male presented with progressive spinal deformity and a 14-year history of lower limb weakness. He had never walked independently and was wheelchair bound. Clinical examination revealed hypotonia, areflexia, and a severe thoracolumbar kyphoscoliosis. Genetic testing demonstrated homozygous deletion of SMN1 exon 7, three copies of SMN2, and one copy of NAIP, confirming SMA type 2. Preoperative supine radiography showed a Cobb angle of 83°. The patient underwent posterior spinal fusion with pedicle screw instrumentation from T1 to S2 using S2 alar-iliac screws (S2AIS) for distal fixation. No spinal osteotomy was performed, and deformity correction was achieved by concave distraction and convex compression. Interlaminar artificial bone grafting combined with bone morphogenetic protein (BMP) was used for fusion. Postoperatively, the Cobb angle was corrected to 42°, and he was able to sit upright independently. At 1-year follow-up, the correction was well-maintained and his quality of life was markedly improved. Longer follow-up is needed to confirm the durability of the results.</p><p><strong>Conclusions: </strong>Posterior spinal fusion with S2AIS fixation achieved satisfactory deformity correction and improved quality of life in this skeletally mature SMA type 2 patient with severe kyphoscoliosis. Early diagnosis and multidisciplinary management are critical, and larger studies are needed to confirm long-term outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470947","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":"Signet ring cell carcinoma of colonic origin in a 13-year-old child from remote setting: a case report.","authors":"Dawit Admasu Woldesenbet, Adugnaw Atnafu Atalay, Atsede Birhanu Worku, Gebre Hailu Dejen, Zeru Seyoum Wondimagegn, Zenebe Daniel Getachew, Abayneh Tunta Boye","doi":"10.1186/s13256-026-06286-3","DOIUrl":"https://doi.org/10.1186/s13256-026-06286-3","url":null,"abstract":"<p><strong>Introduction: </strong>Signet ring cell carcinoma (SRCC) is a distinct and aggressive subtype of adenocarcinoma that can arise throughout the tubular gastrointestinal tract, with particularly rare occurrence in the colon, especially in the pediatric population.</p><p><strong>Case presentation: </strong>A 13-year-old girl from the Amhara region of Ethiopia presented with a long standing history of intermittent, crampy abdominal pain, accompanied by loss of appetite, unquantified weight loss, and easy fatigability. Two months prior to admission, her symptoms worsened, and over the course of two days, the pain became persistent and was accompanied by frequent bilious vomiting and failure to pass feces and flatus. On physical examination the patient was restless, tachycardic and in pain. Her abdomen was grossly distended and tympanic on percussion. DRE revealed an empty rectum. With the presumptive diagnosis of ileocolic intussusception the patient underwent further investigations. CBC revealed WBC count of 12,100/µL with neutrophil predominance (76%), hemoglobin 14.2 g/dl, and a platelet count of 442 × 10³/µL. An erect abdominal X-ray showed centrally located dilated bowl loops with multiple air-fluid levels. Abdominal ultrasound revealed a concentric bowel wall thickening involving the cecum and ascending colon, measuring approximately 12 mm in thickness, along with multiple adjacent enlarged paracolic and mesenteric lymph nodes. After preoperative optimization, administration of prophylactic antibiotics, and obtaining informed consent, the patient underwent exploratory laparotomy. Intraoperatively, a circumferentially thickened cecal mass causing luminal obstruction was identified, with marked proximal small bowel dilatation and multiple mesenteric lymphadenopathies.</p><p><strong>Discussion: </strong>Colorectal cancer accounts for approximately 10% of all cancer cases worldwide and remains a leading cause of cancer-related mortality. SRCC of the colon is a rare and aggressive histological subtype characterized by poor prognosis and distinct biological behavior.</p><p><strong>Conclusion: </strong>Colorectal carcinoma in pediatric age group, although rare, may present with nonspecific and atypical symptoms, leading to delayed diagnosis. Therefore, colonic malignancy should be considered in the differential diagnosis of children presenting with chronic, unexplained abdominal pain and bowel obstruction symptoms, as early detection and management of the disease have a pivotal role in the prognosis.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470932","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":"Human granulocytic anaplasmosis-associated myopericarditis: a case report and literature review of a treatable cause of myopericarditis.","authors":"Steve Nwokeocha, Amod Rayamajhi, Abolfazl Ahmady, Roudabeh Kiani, Rupa Pudasaini, Dikshya Khatiwada, Charles Hyman","doi":"10.1186/s13256-026-06385-1","DOIUrl":"https://doi.org/10.1186/s13256-026-06385-1","url":null,"abstract":"<p><strong>Background: </strong>Anaplasmosis is not routinely considered as a cause of myopericarditis. With the increasing incidence of anaplasmosis, uncommon and life-threatening complications are likely to be more frequently encountered.</p><p><strong>Case presentation: </strong>Herein we present a case of an otherwise healthy 28-year-old man who presented with chest pain and ventricular arrhythmias, and was diagnosed with myopericarditis during an acute anaplasmosis infection. Treatment with doxycycline led to complete resolution. We review the 7 other cases of anaplasmosis-related myopericarditis described in the medical literature.</p><p><strong>Conclusion: </strong>Given the increasing incidence of anaplasmosis in many parts of the USA and the world, we suggest that this infection should be included in the differential diagnosis of myocarditis, especially because it has a specific treatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455929","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":"Aneurysmal bone cyst of the calcaneus: a case report and review of the literature.","authors":"Yasutaka Takagi, Hiroshi Yamada, Hidehumi Ebara, Hiroyuki Hayashi, Koji Todate, Ryohei Annen, Koichiro Ae, Tomohiro Aoyama, Aki Nakanami, Tetsutaro Yahata, Satoru Demura, Hiroyuki Tsuchiya","doi":"10.1186/s13256-026-06371-7","DOIUrl":"10.1186/s13256-026-06371-7","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts (ABCs) are locally destructive, blood-filled benign bone lesions traditionally regarded as reactive rather than true neoplastic lesions. ABCs typically affect the proximal humerus, distal femur, proximal tibia, and spine. Involvement of the calcaneus is rare, representing approximately 1.6% of reported cases. A PubMed search identified nine publications describing 22 cases of calcaneal ABCs. Here, we report a rare case of ABC arising in the calcaneus and review the relevant literature.</p><p><strong>Case presentation: </strong>A 17-year-old Japanese male with no relevant medical history presented with left calcaneal pain and gait disturbance. The patient underwent curettage with phenol-ethanol ablation and artificial bone packing (β-tricalcium phosphate [β-TCP], AFFINOS®, KURARAY Co., Tokyo, Japan). No local tumor recurrence was observed at the 36-month follow-up.</p><p><strong>Conclusions: </strong>This case highlights a rare ABC arising in the left calcaneus of a 17-year-old Japanese male, with no recurrence after 36 months. Although adjuvant therapy was performed in this case, additional cases are required to clarify its necessity in the management of calcaneal ABC.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456012","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 diagnosis for vape induced lung injury: a case report.","authors":"Lars Ingmar Veldhuis, Julien van Oosten, Hendrik Endeman","doi":"10.1186/s13256-026-06345-9","DOIUrl":"10.1186/s13256-026-06345-9","url":null,"abstract":"<p><strong>Background: </strong>Vaping can result in acute and severe respiratory distress, a condition known as e-cigarette or vaping-associated lung injury (EVALI). The inhalation temperature of e-cigarettes can reach up to 315-400 °C (600-750 °F). EVALI is characterized by a range of clinical and pathological findings, including pulmonary infiltrates, diffuse alveolar damage, but mainly ground-glass opacities. This case report presents a case of severe lung injury needing extracorporeal membrane oxygenation (ECMO) as a result of vaping, but not with the standard presentation or clinical findings or the standard diagnosis.</p><p><strong>Case presentation: </strong>A 17-year-old Dutch woman with a history of asthma, presented to the emergency department with respiratory distress after vaping up to 600 inhalations daily for several days. The evening prior to admission, the patient experienced three episodes of acute breathlessness accompanied by wheezing and coughing, preceded by 4-5 days of headache and cold symptoms. Though there was initial improvement at the hospital, her condition rapidly deteriorated with silent chest, tachypnea at 70/min, increased respiratory effort with nasal flaring, and muscle retractions. Despite receiving mechanical ventilation and the treatment for a possible status asthmaticus her condition continued to deteriorate. Due to the severeness of the respiratory distress, she was transferred to the Erasmus Medical Center (EMC) for ECMO. Imaging studies at the EMC, including chest CT, revealed severe subcutaneous emphysema and pneumomediastinum without a pneumothorax, as well as severe central and peripheral mucus plugs. Bronchoscopy confirmed severe bronchial obstruction with epithelial shedding with easy bleeding epithelial. After 17 days of ECMO support, the patient showed signs of improvement and was successfully weaned off ECMO. However, she experienced muscle weakness, necessitating prolonged mechanical ventilation and tracheostomy placement. After a total of 26 days in the ICU, she was transferred to the general ward without supplemental oxygen.</p><p><strong>Conclusions: </strong>This case suggests a severe vaping-associated lung injury with features of inhalation injury, rather than classical EVALI. Adequate and critical evaluation of patients with respiratory distress after vaping should be performed.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455938","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":"Incidental detection of adrenal schwannoma: a case report.","authors":"Ensiyeh Bahadoran, Freidoon Solhjoo, Samin Khoei, Afsaneh Yakhforoshha, Fatemeh SamieeRad","doi":"10.1186/s13256-026-06368-2","DOIUrl":"10.1186/s13256-026-06368-2","url":null,"abstract":"<p><strong>Background: </strong>Adrenal schwannomas (AS) are rare benign peripheral nerve sheath tumors that originate from Schwann cells. They are often asymptomatic and discovered incidentally on imaging for unrelated conditions. Owing to its rarity and nonspecific clinical presentation, AS can be misdiagnosed as other adrenal neoplasms, necessitating radiological and histopathological evaluation for accurate diagnosis.</p><p><strong>Case presentation: </strong>We report the case of a 53-year-old Iranian man with a history of hypertension and fatty liver disease, who presented with mild abdominal pain. Imaging studies revealed a large, well-circumscribed, heterogeneous adrenal lesion with cystic changes and calcifications, raising suspicion of an adrenal neoplasm. Laboratory investigations ruled out functional adrenal tumors. The patient underwent laparotomy and left adrenalectomy, and histopathological examination revealed a well-encapsulated tumor with spindle cell proliferation, nuclear palisading (Verocay bodies), and hyalinized blood vessels. To further confirm the diagnosis, immunohistochemical (IHC) staining was performed, which demonstrated positivity for S-100 protein, consistent with AS.</p><p><strong>Conclusions: </strong>This case highlights the importance of considering AS in the differential diagnosis of adrenal masses. Histopathological and IHC remain the gold standard for definitive diagnosis. Complete surgical resection is considered curative, and the long-term prognosis is excellent.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455922","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":"Neuroleptic malignant syndrome precipitated by chlorpromazine: a case report.","authors":"Abdirahman Abdikadir Osman, Hussein Mahdi Ahmed, Mustafa Abdulrahman Ali, Abdisalam Ismail Hassan, Mustafa Yusuf Ahmed, Ahmed Muhammad Bashir, Mohamed Farah Osman Hidig, Marian Muse Osman","doi":"10.1186/s13256-026-06373-5","DOIUrl":"10.1186/s13256-026-06373-5","url":null,"abstract":"<p><strong>Background: </strong>Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal reaction to dopamine-blocking agents. Although most commonly associated with prolonged or high-dose antipsychotic use, it can also occur after a single therapeutic dose.</p><p><strong>Case presentation: </strong>A 56-year-old Somali man developed acute NMS within hours of receiving a single intramuscular dose of chlorpromazine for agitation, presenting with hyperthermia, severe rigidity, altered mental status, autonomic instability, and markedly elevated creatine kinase levels. Alternative diagnoses were excluded, and prompt discontinuation of chlorpromazine with supportive care and bromocriptine resulted in rapid clinical and biochemical recovery.</p><p><strong>Conclusion: </strong>This case highlights that NMS may occur rapidly following a single lowtherapeutic dose of chlorpromazine. Early recognition and timely management are essential for favorable outcomes. To our knowledge, this is the first reported case of chlorpromazine-induced NMS from Somalia.</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/PMC13647888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447658","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}