The American Journal of Case Reports最新文献_第9页

Musical Ear Syndrome in a Patient with Unilateral Hearing Loss: A Case Report. 单侧听力损失患者音乐耳综合征1例报告。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-20 DOI: 10.12659/AJCR.936537

Faten Mane Aldhafeeri

{"title":"Musical Ear Syndrome in a Patient with Unilateral Hearing Loss: A Case Report.","authors":"Faten Mane Aldhafeeri","doi":"10.12659/AJCR.936537","DOIUrl":"https://doi.org/10.12659/AJCR.936537","url":null,"abstract":"BACKGROUND Hearing music that has no source is known as musical ear syndrome, also known as musical hallucinations (MH), and is often associated with hearing impairment. This report is of a 62-year-old man with a 20-year history of unilateral hearing loss and continuous MH. We investigated the neural basis of MH in a subject without any known neurological or psychiatric disorders. CASE REPORT A 62-year-old man had a history of 20 years of symptomatic mild hearing loss accompanied with continuous MH in the form of multiple tones. The MH were unilateral in the left side and much more likely to be experienced as externally located and uncontrollable. He underwent structural and functional magnetic resonance imaging (fMRI). Results indicated increased activity and reduced cortical thickness in multiple cortical areas, such as the prefrontal cortex (PFC) and temporal and limbic regions, indicating complex processing and involvement. CONCLUSIONS The neurological findings indicate differentiated or multiple-area involvement in MH. These morpho-functional changes may represent a neural reorganization causing MH to arise. The altered or activated regions are all related to the processing of emotions and the processing of episodic memory, which has been seen in the MH of schizophrenic patients. This report also highlights that patients with hearing loss may present with continuous MH, and that these patients should not be assumed to have delusions or psychosis, but should be investigated for underlying auditory abnormalities and treated appropriately.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936537"},"PeriodicalIF":1.2,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/df/amjcaserep-23-e936537.PMC9511037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40368618","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

Concurrent Bell's Palsy and Facial Pain Improving with Multimodal Chiropractic Therapy: A Case Report and Literature Review. 多模式捏脊治疗可改善并发贝尔麻痹及面部疼痛:1例报告及文献复习。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-19 DOI: 10.12659/AJCR.937511

Eric Chun-Pu Chu, Robert J Trager, Alan Te-Chang Chen

{"title":"Concurrent Bell's Palsy and Facial Pain Improving with Multimodal Chiropractic Therapy: A Case Report and Literature Review.","authors":"Eric Chun-Pu Chu, Robert J Trager, Alan Te-Chang Chen","doi":"10.12659/AJCR.937511","DOIUrl":"https://doi.org/10.12659/AJCR.937511","url":null,"abstract":"BACKGROUND Bell's palsy, also called facial nerve palsy, occasionally co-occurs with trigeminal neuropathy, which presents as additional facial sensory symptoms and/or neck pain. Bell's palsy has a proposed viral etiology, in particular when occurring after dental manipulation. CASE REPORT A 52-year-old Asian woman presented to a chiropractor with a 3-year history of constant neck pain and left-sided maxillary, eyebrow, and temporomandibular facial pain, paresis, and paresthesia, which began after using a toothpick, causing possible gum trauma. She had previously been treated with antiviral medication and prednisone, Chinese herbal medicine, and acupuncture, but her recovery plateaued at 60% after 1 year. The chiropractor ordered cervical spine magnetic resonance imaging, which demonstrated cervical spondylosis, with no evidence of myelopathy or major pathology. Treatment involved cervical and thoracic spinal manipulation, cervical traction, soft-tissue therapy, and neck exercises. The patient responded positively. At 1-month follow-up, face and neck pain and facial paresis were resolved aside from residual eyelid synkinesis. A literature review identified 12 additional cases in which chiropractic spinal manipulation with multimodal therapies was reported to improve Bell's palsy. Including the current case, 85% of these patients also had pain in the face or neck. CONCLUSIONS This case illustrates improvement of Bell's palsy and concurrent trigeminal neuropathy with multimodal chiropractic care including spinal manipulation. Limited evidence from other similar cases suggests a role of the trigeminal pathway in these positive treatment responses of Bell's palsy with concurrent face/neck pain. These findings should be explored with research designs accounting for the natural history of Bell's palsy.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937511"},"PeriodicalIF":1.2,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/a4/amjcaserep-23-e937511.PMC9501759.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40366651","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: 7

Combined Factor V and VIII Deficiency with LMAN1 Mutation: A Report of 3 Saudi Siblings. 联合因子V和VIII缺乏与LMAN1突变:3个沙特兄弟姐妹的报告。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-18 DOI: 10.12659/AJCR.937312

Shahad Alsheikh, Rizam Alghamdi, Ahlam Alqatari, Abdullah Alfareed, Mona AlSaleh

{"title":"Combined Factor V and VIII Deficiency with LMAN1 Mutation: A Report of 3 Saudi Siblings.","authors":"Shahad Alsheikh, Rizam Alghamdi, Ahlam Alqatari, Abdullah Alfareed, Mona AlSaleh","doi":"10.12659/AJCR.937312","DOIUrl":"https://doi.org/10.12659/AJCR.937312","url":null,"abstract":"BACKGROUND Combined factor V and factor VIII deficiency (F5F8D) is a rare bleeding disorder with an incidence of 1: 1 000 000. The identified mutations were observed in LMAN1 and MCFD2 genes. This case report presents the cases of 3 Saudi siblings with the genetic mutation of LMAN1 causing F5F8D, and highlights the challenges in diagnosis and treatment. CASE REPORT Patient X, a 7-year-old boy, was misdiagnosed with hemophilia A after a history of prolonged circumcision bleeding and epistaxis. He was referred to our clinic for pre-operative assessment. Blood workup showed prolonged PT and aPTT, which were normalized by mixing studies. Since his previous diagnosis could not explain a prolonged PT, further investigations were performed, revealing low levels of FVIII and FV. Genetic testing confirmed a c.822G>A homozygous LMAN1 mutation. The other 2 siblings (patient Y and Z), who were 5- and 12-year-old, respectively, girls, were also assessed. They both had a history of epistaxis. The younger sibling also had an episode of bleeding after tooth extraction, and physical examination of this patient revealed a bruise over her left thigh. The older sibling had menorrhagia. Blood workup of both revealed prolonged PT and aPTT, with complete correction by mixing study, and low levels of FV and FVIII. The patients' backgrounds and lab results were highly suggestive of F5F8D. CONCLUSIONS This case report describes an extremely rare bleeding disorder. More attention should be directed toward this disease, and a careful evaluation of suspicious cases should be performed to better diagnose and manage these patients.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937312"},"PeriodicalIF":1.2,"publicationDate":"2022-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/cb/amjcaserep-23-e937312.PMC9495817.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365281","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: 2

Coronary Artery Stent Dislodgement and Loss in the Bloodstream: A Case Report and Management Options. 冠状动脉支架在血液中的移位和丢失:一个病例报告和处理方案。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-17 DOI: 10.12659/AJCR.937598

Abdallah Khashan, Samer Talib, Mohamed Hamouda, Jonathan Kovacs, Asfandyar Ibrar, Gagandeep Saini, Zaka Ul Haq, Bhavani Anantharamakrishnan, Mahmood Alam

{"title":"Coronary Artery Stent Dislodgement and Loss in the Bloodstream: A Case Report and Management Options.","authors":"Abdallah Khashan, Samer Talib, Mohamed Hamouda, Jonathan Kovacs, Asfandyar Ibrar, Gagandeep Saini, Zaka Ul Haq, Bhavani Anantharamakrishnan, Mahmood Alam","doi":"10.12659/AJCR.937598","DOIUrl":"https://doi.org/10.12659/AJCR.937598","url":null,"abstract":"BACKGROUND Coronary stent dislodgement is rare but carries serious complications like thrombosis, myocardial infarction, disruption of the systemic circulation, and coronary dissection, which can lead to sudden death. Thus, rapid evaluation and intervention are needed to restore blood flow to vital organs. CASE REPORT A 46-year-old woman with no relevant past medical history except for smoking, presented to the Emergency Department (ED) with left-sided chest pain. The physical exam was unremarkable. EKG showed ST segment elevation, and troponin was 4.03. She underwent cardiac catheterization, which showed 100% occlusion of the left anterior descending coronary artery (LAD). A drug-eluting stent (DES) was placed. Later, she had chest pain similar to the initial episode. EKG showed 1-mm elevation at ST segment in leads V1 and V2 and T wave inversion in leads V2, V3, V4, and V5. She underwent a repeat heart catheterization, which revealed a dissection in the middle LAD distal to the initial stent placement. She was treated with another stent overlapping the proximal stent. While attempting to cross the proximal stent, the stent came off the balloon, slipped from the wire, and went down into the descending aorta. CONCLUSIONS Coronary artery stent dislodgement is a rare event that can lead to significant complications during PCI. Patient restlessness and small-sized, severely angulated, and previously stented coronary arteries are associated risk factors. The main treatment option is stent retrieval, either surgically or using other available techniques. If retrieval of the stent is impossible, crushing it against the blood vessel wall could be considered.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937598"},"PeriodicalIF":1.2,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/ee/amjcaserep-23-e937598.PMC9490492.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364125","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: 1

A Pituitary Abscess Caused by Morganella morganii: A Case Report. 摩根氏菌所致垂体脓肿1例。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-16 DOI: 10.12659/AJCR.936743

Fayez M Alelyani, Yahya Ahmad Almutawif, Hamza Mohammad Ali, Raghad Zaid Aljohani, Abdullah Z Almutairi, Waleed R Murshid

{"title":"A Pituitary Abscess Caused by Morganella morganii: A Case Report.","authors":"Fayez M Alelyani, Yahya Ahmad Almutawif, Hamza Mohammad Ali, Raghad Zaid Aljohani, Abdullah Z Almutairi, Waleed R Murshid","doi":"10.12659/AJCR.936743","DOIUrl":"https://doi.org/10.12659/AJCR.936743","url":null,"abstract":"BACKGROUND Pituitary abscess (PA) is a rare pituitary lesion accounting for less than 1% of all pituitary diseases and is associated with high mortality rates. The non-specific clinical symptoms and radiological features preclude accurate diagnosis of the disease. Hence, surgical intervention is still considered the criterion standard method for PA diagnosis. Most PAs occur as a primary disease or due to complications such as surgery, sepsis, and adjacent inflamed lesions. CASE REPORT A 53-year-old man presented to the Emergency Department with a headache associated with nausea, vomiting, and constipation. The patient had no visual disturbances, polyuria, polydipsia, nocturia, or abnormal discharges. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large suprasellar mass. The patient underwent left-side trans-nasal transsphenoidal microscopic surgery for mass removal. An abscess with discharge was noticed and sent for microbiological evaluation, revealing an infection with a commensal enteric bacterium that rarely causes nosocomial infection, known as Morganella morganii. The patient was discharged after completing the intravenous antibiotic course and was given oral antibiotics. CONCLUSIONS Pituitary abscess is a rare pituitary lesion. However, taking the history of recent meningitis, sinusitis, and/or surgery may help to reach an early diagnosis, prompt surgical intervention, and vital therapeutic steps to reduce mortality rates and improve patient's outcomes. PA should always be considered when patients demonstrate signs of pituitary dysfunction associated with signs of infection. Furthermore, antibiotics should be administered immediately once the PA case is confirmed and should last for at least 6 weeks postoperatively.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936743"},"PeriodicalIF":1.2,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/37/amjcaserep-23-e936743.PMC9486448.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40361429","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

Stapedotomy in Congenital Stapes Ankylosis with Mobile Footplate: A Case Report. 镫骨切除术治疗先天性镫骨强直伴活动足板一例。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-15 DOI: 10.12659/AJCR.936466

Marek Porowski, Henryk Skarżyński, Piotr Henryk Skarzynski

{"title":"Stapedotomy in Congenital Stapes Ankylosis with Mobile Footplate: A Case Report.","authors":"Marek Porowski, Henryk Skarżyński, Piotr Henryk Skarzynski","doi":"10.12659/AJCR.936466","DOIUrl":"https://doi.org/10.12659/AJCR.936466","url":null,"abstract":"BACKGROUND This paper presents a case of a 15-year-old child with a rare congenital anomaly of the middle ear in which the stapes was fused to the medial wall of the tympanic cavity. CASE REPORT This defect coexisted with partial malleus fixation in the attic and caused conductive hearing loss at an average level of 35-40 dB. Two exploratory tympanotomies were performed, where excess bone between the stapes and promontory was removed and the head of the malleus was released in the attic. The good effect of these procedures was unstable, mainly due to re-attachment of the stapes to the medial wall of the tympanic cavity. At the next surgery it was decided to perform stapedotomy, despite the mobile stapes footplate. The operation was performed with a small-fenestra stapedotomy technique. Perforation of the footplate was done using a microdrill with a balanced speed. A KURZ prosthesis with a diameter of 0.5 mm was used. The postoperative period passed without any complications. Three and 6 months after the surgery, control pure tone audiometry was performed and showed significant improvement in hearing thresholds. During the follow-up period of more than 6 months, hearing improvement remained stable. CONCLUSIONS We concluded that it was safe to perform stapedotomy in the presence of a mobile stapes footplate when congenital anomaly of the stapes superstructure caused its severe fixation in the middle ear. In our opinion, in a child with congenital ear anomaly, consideration should be given to the multifocal origin of the hearing loss.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936466"},"PeriodicalIF":1.2,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/cc/amjcaserep-23-e936466.PMC9483239.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40357627","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

Percutaneous Left Atrial Appendage Closure with the LAmbre Device Protected by a Cerebral Protection System in a 76-Year-Old Man with Persistent Left Atrial Appendage Thrombus. 脑保护系统保护下LAmbre装置经皮左心耳闭合术治疗76岁男性持续性左心耳血栓。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-14 DOI: 10.12659/AJCR.937063

Sorin Ștefan Popescu, Christian-Hendrik Heeger, Ahmad Keelani, Roland Richard Tilz

{"title":"Percutaneous Left Atrial Appendage Closure with the LAmbre Device Protected by a Cerebral Protection System in a 76-Year-Old Man with Persistent Left Atrial Appendage Thrombus.","authors":"Sorin Ștefan Popescu, Christian-Hendrik Heeger, Ahmad Keelani, Roland Richard Tilz","doi":"10.12659/AJCR.937063","DOIUrl":"https://doi.org/10.12659/AJCR.937063","url":null,"abstract":"BACKGROUND Despite use of optimal oral anticoagulation regimens, left atrial appendage (LAA) thrombus may develop and persist in patients with atrial fibrillation (AF). The therapeutic options in this population are limited. Percutaneous LAA closure (LAAC) is performed to reduce thrombus formation and the risk of thromboembolism. However, this approach is prohibited in patients with LAA thrombus. We report the case of a 76-year-old man with AF and persistent LAA thrombus who underwent percutaneous LAAC with the LAmbre device protected by the SENTINEL Cerebral Protection System (CPS). CASE REPORT A 76-year-old man with history of persistent AF treated with pulmonary veins and LAA isolation developed LAA thrombus resistant to different anticoagulation therapies, including apixaban and Phenprocoumon, with a target international normalized ratio (INR) of 3-3,5. Repeated follow-up transesophageal echocardiography showed a persistent LAA thrombus despite optimal INR values. Thus, we performed a percutaneous LAAC using a double-umbrella-designed appendage occluder and a CPS to minimize the risk of intraprocedural cerebral embolization. The procedure was guided by transesophageal echocardiography and fluoroscopy. No signs of systemic thromboembolism were noted, and the CPS filters showed no evidence of thrombotic material. CONCLUSIONS This report shows that the use of a CPS during percutaneous LAAC may reduce the risk of procedural cerebral embolization and could be used as an alternative therapy for patients with contraindication or lack of effectiveness of oral anticoagulation.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937063"},"PeriodicalIF":1.2,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/fb/amjcaserep-23-e937063.PMC9483240.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40355556","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

A Challenging Case of Streptococcus pneumoniae Meningitis in a 64-Year-Old Woman Who Presented with Symptoms of Cerebellar Hemorrhage. 一个具有挑战性的病例肺炎链球菌脑膜炎在64岁的妇女谁提出了小脑出血的症状。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-13 DOI: 10.12659/AJCR.937139

Akinori Sasaki, Masao Horiuchi, Eiji Hiraoka

{"title":"A Challenging Case of Streptococcus pneumoniae Meningitis in a 64-Year-Old Woman Who Presented with Symptoms of Cerebellar Hemorrhage.","authors":"Akinori Sasaki, Masao Horiuchi, Eiji Hiraoka","doi":"10.12659/AJCR.937139","DOIUrl":"https://doi.org/10.12659/AJCR.937139","url":null,"abstract":"BACKGROUND There is a recognized association between bacterial meningitis and intracranial hemorrhage. However, acute neurological symptoms at presentation, with confirmation of hemorrhage on imaging, may delay further investigations, including blood culture for diagnosing an infection. This report presents a challenging case of Streptococcus pneumoniae meningitis in a 64-year-old woman who presented with symptoms of cerebellar hemorrhage. CASE REPORT This report describes a 64-year-old woman who had a medical history of untreated diabetes mellitus. She was brought to our hospital with headache and impaired consciousness, complicated with fever. Based on the hemorrhage in the left cerebellar hemisphere detected in the head CT findings, the patient was initially diagnosed with cerebellar hemorrhage. However, a positive blood culture after 12 hours of admission made the physician consider a central nervous system infection as the cause of the hemorrhage and perform a lumbar puncture. Therefore, the patient was diagnosed with acute bacterial meningitis caused by Streptococcus pneumoniae, and antibiotic treatment was started immediately. Although her general condition improved after antibiotic treatment, her mental status did not improve completely. CONCLUSIONS This report highlights that the clinicians should be aware that bacterial meningitis may result in intracranial hemorrhage. Patients with symptoms of a hemorrhagic stroke should be thoroughly investigated to avoid a delay in the treatment of infection.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937139"},"PeriodicalIF":1.2,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/85/amjcaserep-23-e937139.PMC9483238.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33464832","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

A 32-Year-Old Man with Persistent Olfactory Dysfunction Following COVID-19 Whose Recovery Was Evaluated by Retronasal Olfactory Testing. 1例32岁男性新冠肺炎后持续性嗅觉功能障碍患者，通过鼻后嗅觉测试评估其恢复情况。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-12 DOI: 10.12659/AJCR.936496

Kojiro Hirano, Yoshihito Tanaka, Sawa Kamimura, Isao Suzaki, Emiko Suzuki, Hitome Kobayashi

{"title":"A 32-Year-Old Man with Persistent Olfactory Dysfunction Following COVID-19 Whose Recovery Was Evaluated by Retronasal Olfactory Testing.","authors":"Kojiro Hirano, Yoshihito Tanaka, Sawa Kamimura, Isao Suzaki, Emiko Suzuki, Hitome Kobayashi","doi":"10.12659/AJCR.936496","DOIUrl":"https://doi.org/10.12659/AJCR.936496","url":null,"abstract":"BACKGROUND Anosmia, which is loss of smell, is a recognized complication of coronavirus disease 2019 (COVID-19) due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may persist after recovery from infection. Retronasal olfactory testing includes both subjective questionnaires and physiological tests that can be used to evaluate recovery of smell. This report presents the case of a 32-year-old man with persistent loss of smell following COVID-19 whose recovery was evaluated by retronasal olfactory testing. CASE REPORT The patient was a 32-year-old man with confirmed SARS-CoV-2 infection. He was aware of his olfactory dysfunction. Using the orthonasal test, a T&T Olfactometer 2 months after disease onset showed an olfactory threshold score of 2.2 points (mild decrease) and olfactory identification result of 3.4 points (moderate decrease). However, the retronasal intravenous olfactory test showed no response, indicating severe olfactory dysfunction. After 3 months of olfactory training and therapy with steroidal nasal drops (Fluticasone Furoate, 27.5 µg/day) and oral vitamins (Mecobalamin, 1500 µg/day), the patient's orthonasal test olfactory threshold score improved to 0.6 points (normal), and his olfactory identification result improved to 1.2 points (mild decrease). Although the retronasal intravenous olfactory test showed a weak response, a reaction did occur. At this time, the patient did not report any improvement in his symptoms. CONCLUSIONS This report has shown that in cases of persistent anosmia following COVID-19, retronasal olfactory testing can be used to evaluate recovery of the sense of smell.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936496"},"PeriodicalIF":1.2,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/ca/amjcaserep-23-e936496.PMC9475494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33458609","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

A Rare Case of Negative Serum Calcitonin in Metastatic Medullary Thyroid Carcinoma: Diagnosis, Treatment, and Follow-Up Strategy. 一例罕见的血清降钙素阴性转移性甲状腺髓样癌:诊断、治疗及随访策略。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-11 DOI: 10.12659/AJCR.935207

Lorena Licata, Cristina A Di Fidio, Marco Vacante, Francesco Basile, Antonio Biondi, Pierina Richiusa, Alessandra Gurrera, Roberto Ciuni

{"title":"A Rare Case of Negative Serum Calcitonin in Metastatic Medullary Thyroid Carcinoma: Diagnosis, Treatment, and Follow-Up Strategy.","authors":"Lorena Licata, Cristina A Di Fidio, Marco Vacante, Francesco Basile, Antonio Biondi, Pierina Richiusa, Alessandra Gurrera, Roberto Ciuni","doi":"10.12659/AJCR.935207","DOIUrl":"https://doi.org/10.12659/AJCR.935207","url":null,"abstract":"BACKGROUND Medullary thyroid carcinoma is a rare tumor and represents less than 5% of all thyroid cancers. Tumor size and the presence of possible metastases are strictly related to serum calcitonin level, which also suggests prognosis. A serum calcitonin level above the normal range is highly suspicious for medullary cancer. This tumor has no characteristic patterns on ultrasound and fine-needle aspiration, so serum calcitonin level is the only significant element for diagnosis. The literature contains 47 cases of serum calcitonin-negative medullary thyroid cancer with heterogeneous behavior, ranging from non-aggressive to aggressive form. CASE REPORT We report a rare case of a young man with negative serum calcitonin but with lateral cervical node metastases from medullary thyroid carcinoma. At the beginning, diagnosis was not achieved due to normal range of serum calcitonin and a negative thyroid ultrasonography for large nodules. Nevertheless, in another medical center he underwent a neck biopsy of the lateral cervical mass. The histologic findings showed metastases of medullary thyroid cancer. Therefore, a total thyroidectomy plus cervical lymphadenectomy was performed. During the follow-up, due to unusefulness of serum markers, and as CEA levels were negative pre- and post-operatively, an ¹⁸F-DOPA PET scan was performed. In 3 years of follow-up, there is still no evidence of disease relapse. CONCLUSIONS Our case shows how a normal serum level of calcitonin cannot exclude medullary thyroid cancer. Early diagnosis is crucial because it influences appropriate surgical therapy and patient outcome. The current lack of an optimal strategy for the diagnosis and postoperative follow-up for patients with negative serum calcitonin tumor presents a diagnostic challenge for physicians.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e935207"},"PeriodicalIF":1.2,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/75/amjcaserep-23-e935207.PMC9475495.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33463676","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: 2