AME Case Reports最新文献_第2页

Polymicrobial infection presenting as non-clostridial gas gangrene in a patient with an open pelvic ring fracture accompanied by abdominal evisceration: a case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-27 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-128

Kenichi Takeno, Motoki Sugano, Yasuo Kokubo

{"title":"Polymicrobial infection presenting as non-clostridial gas gangrene in a patient with an open pelvic ring fracture accompanied by abdominal evisceration: a case report.","authors":"Kenichi Takeno, Motoki Sugano, Yasuo Kokubo","doi":"10.21037/acr-24-128","DOIUrl":"10.21037/acr-24-128","url":null,"abstract":"Background: Open pelvic fractures are rare but represent a serious clinical problem with high mortality rates. Acute mortality is often associated with hemorrhage, whereas delayed mortality is most often associated with sepsis and multiple organ failure. We report a case of Wang's classification of type II open pelvic ring fracture with hemorrhagic shock and septic shock from gas gangrene.Case description: A healthy 41-year-old man presented with an open pelvic ring fracture and a laceration in the lower abdomen sustained at an ironworks. His hemodynamic status was unstable. Pelvic ring stabilization with an external fixator, ligation of the median sacral and bilateral internal iliac arteries, partial resection of the ileum, appendectomy, and intra-abdominal pelvic packing were performed. Seven days after the injury, he developed a single spike fever of 39.8 ℃ with a significant pus discharge from the open wound around his groin. A computed tomography scan revealed an accumulation of gas around the sacroiliac joint, in the abdominal cavity, and the adductors and gluteus maximus muscles caused by non-clostridial gas gangrene. We performed surgical debridement three times and initiated vancomycin administration. Hyperbaric oxygen therapy was also initiated as an adjunctive therapy. The patient could walk with a cane 5 months after the injury.Conclusions: We described a multidisciplinary case of a patient with a Wang type II open pelvic fracture who required emergent damage control and subsequently developed anaerobic sepsis. Bleeding was controlled by packing gauze into the intraperitoneal cavity and applying external fixation to the pelvic ring. However, it is important to administer prophylactic antibiotics against anaerobic bacteria and to detect subsequent infections early when packing gauze into the intraperitoneal cavity in patients with open pelvic fractures.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"29"},"PeriodicalIF":0.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048159","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

Cryoablation for airway stenosis caused by malignant pulmonary epithelioid hemangioendothelioma: a case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-27 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-106

Li Wang, Yingjun Kong, Yao Zhang, Chuanyong Mu

{"title":"Cryoablation for airway stenosis caused by malignant pulmonary epithelioid hemangioendothelioma: a case report.","authors":"Li Wang, Yingjun Kong, Yao Zhang, Chuanyong Mu","doi":"10.21037/acr-24-106","DOIUrl":"10.21037/acr-24-106","url":null,"abstract":"Background: Pulmonary epithelioid hemangioendothelioma (P-EHE) is a rare vascular tumor derived from mesenchymal cells with an incidence of about 1/1 million. The etiology remains unclear, and there are no established treatment guidelines. The tumor can occur in a variety of organs, among which the liver, lung and bone are the most commonly involved, with different clinical manifestations, mainly depending on the organ involved, but none of them is specific. Most epithelioid hemangioendotheliomas are indolent and can achieve long-term survival even without any treatment. The prognosis of patients with primary liver or lung diseases is poor, and P-EHE has the highest mortality rate. Clinical reports of airway stenosis caused by P-EHE are exceedingly rare.Case description: We report a case of a middle-aged female patient with initial diagnostic difficulties leading to misdiagnosis, which was eventually confirmed as P-EHE by pathology. Despite radiotherapy, chemotherapy, and antiangiogenic therapy, the efficacy was limited, resulting in severe airway stenosis in the advanced stage of the disease, with severe clinical symptoms. After bronchoscopic cryoablation, the oxygenation index of the patient was significantly improved, and the quality of life was significantly improved.Conclusions: This case underscores the complexity of diagnosing and managing P-EHE and illustrates the potential of cryoablation as an effective treatment for severe airway stenosis secondary to this rare tumor.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"28"},"PeriodicalIF":0.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047983","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

Tailgut cyst, management of a rare perianal mass: a case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-27 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-133

Jenna de Crombrugghe, Sorin Cimpean, Laurine Verset, Abdelilah Mehdi

{"title":"Tailgut cyst, management of a rare perianal mass: a case report.","authors":"Jenna de Crombrugghe, Sorin Cimpean, Laurine Verset, Abdelilah Mehdi","doi":"10.21037/acr-24-133","DOIUrl":"10.21037/acr-24-133","url":null,"abstract":"Background: A perianal mass has a wide range of possible diagnoses, including tailgut cysts. Tailgut cysts are congenital, and their development is slow. Because its most common placement is retro-rectal, it is extremely rare to find it on the perianal level only. It is possible to develop neoplastic or infectious problems. Consequently, proper support is required.Case description: We present a case of perianal tailgut cyst in a 59-year-old man who sought help for painless anal discomfort. Nuclear magnetic resonance was used to conduct this assessment. The radiologist thought it was probably benign, but he was not able to find a precise diagnosis. Thus, the cyst was completely removed using a transanal way with the patient in a lithotomy position. Then, the anatomopathological examination had confirmed the diagnosis and the benignity of the cyst. The postoperative follow-up was uneventful. We had planned to see the patient for a clinical follow-up every six months, but he has refused so far.Conclusions: Tailgut cysts are uncommon in the perianal area but should be included in the differential diagnosis of perianal masses and should not be confused with an abscess or a haemorrhoid. The nuclear magnetic resonance appears to be the most appropriate radiological examination for the assessment of these masses. Excision is performed systematically to confirm the diagnosis and exclude a malignant condition thanks to the anatomopathological examination.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"18"},"PeriodicalIF":0.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047799","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

Differential response to immunotherapy in different lesions of MSI-H double primary colorectal cancer: a case report and literature review.

IF 0.7

AME Case Reports Pub Date : 2024-11-25 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-137

Zhigui Guo, Dan Hong, Yaning Wei, Yue Huo, Shenyong Su, Yan Shi, Lin An, Kunjie Wang, Yajing Su, Zhiyu Wang

{"title":"Differential response to immunotherapy in different lesions of MSI-H double primary colorectal cancer: a case report and literature review.","authors":"Zhigui Guo, Dan Hong, Yaning Wei, Yue Huo, Shenyong Su, Yan Shi, Lin An, Kunjie Wang, Yajing Su, Zhiyu Wang","doi":"10.21037/acr-24-137","DOIUrl":"10.21037/acr-24-137","url":null,"abstract":"Background: Mucinous adenocarcinoma is a rare type of colorectal cancer (CRC) associated with poor prognosis, particularly when it includes signet ring cell components. Furthermore, its rate of microsatellite instability-high (MSI-H) is significantly higher compared to non-mucinous adenocarcinoma. Immunotherapy has emerged as the standard treatment for MSI-H metastatic CRC (mCRC). In the KEYNOTE-177 trial, for individuals with advanced CRC exhibiting MSI-H or mismatch repair deficiency (dMMR), treatment with pembrolizumab as a single agent demonstrated a superior outcome compared to standard systemic chemotherapy. The study revealed a notably higher objective response rate (43.8% versus 33.1%) and an extended progression-free survival duration (16.5 versus 8.2 months). These findings imply that pembrolizumab may be regarded as a front-line treatment option for patients with advanced CRC who have MSI-H/dMMR status.Case description: The patient with double primary CRC, both of which were identified as MSI-H through next generation sequencing (NGS). Following a regimen of immunotherapy-based combination therapy, the rectal lesion achieved a complete clinical response (cCR), while the colon lesion displayed continued progression, indicating primary resistance to treatment.Conclusions: Specific histological subtypes of CRC, such as mucinous adenocarcinoma, might adversely affect the efficacy of immunotherapy, resulting in primary treatment resistance. Consequently, in the case of this particular cancer subtype, local surgical resection may be a more appropriate treatment strategy.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"17"},"PeriodicalIF":0.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048012","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

HER2 positive primary breast squamous cell carcinoma with good prognosis: a case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-21 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-138

Yanan Li, Kefeng Wu, Huiying Li, Chun Wu

{"title":"HER2 positive primary breast squamous cell carcinoma with good prognosis: a case report.","authors":"Yanan Li, Kefeng Wu, Huiying Li, Chun Wu","doi":"10.21037/acr-24-138","DOIUrl":"10.21037/acr-24-138","url":null,"abstract":"Background: Primary breast squamous cell carcinoma (PBSCC) is a unique histopathological type of breast cancer. The majority of current case reports of PBSCC are triple-negative tumors with poor prognosis. Due to its heterogeneous clinical course, no unified management is achieved. Here, we report a human epidermal growth factor receptor 2 (HER2) positive case with good clinical outcome, which may contribute to the development of appropriate guidelines and imprecise management of PBSCC.Case description: A 45-year-old female presented with a painless mass in the medial-upper quadrants of right breast and the imaging examination suggested a malignant tumor. She received modified radical mastectomy and axillary sentinel lymph node dissection of the right breast, and the pathological diagnosis was squamous cell carcinoma with HER2 over-expression. Subsequently, she underwent post-operative chemotherapy regimen of doxorubicin, cyclophosphamide, T-docetaxel and trastuzumab (AC-TH) and then received maintenance treatment with trastuzumab and pertuzumab. Clinical follow-up suggests that she had achieved clinical complete remission and has survived for over 4 years.Conclusions: The diagnosis of PBSCC relies on histomorphology, due to non-specific imaging manifestations. Immunohistochemical (IHC) staining helps to clarify the pathological type, hormone receptor status, HER2 amplification and programmed cell death ligand 1 (PD-L1) expression, which is essential for clinical decision-making. HER2-positive PBSCC patients can benefit from AC-TH chemotherapy and 1-year anti-HER2 therapy is necessary to good prognosis. If possible, dual anti-HER2 therapy combined with trastuzumab and pertuzumab is recommended. Finally, positive clinical prognosis of PBSCC may be attributed to early detection, immediate surgery, precise diagnosis and proper adjuvant treatment strategy.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"20"},"PeriodicalIF":0.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048131","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

Electrical storm caused by sertraline overdose: case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-18 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-93

Vraj Patel, Mina Rismani, Fakhra Sultan, Amr Essa, Pascha Schafer

{"title":"Electrical storm caused by sertraline overdose: case report.","authors":"Vraj Patel, Mina Rismani, Fakhra Sultan, Amr Essa, Pascha Schafer","doi":"10.21037/acr-24-93","DOIUrl":"10.21037/acr-24-93","url":null,"abstract":"Background: In cases of electrical storm, identifying the etiology is essential, as patients with reversible causes do not benefit from implantable cardioverter defibrillator (ICD). Given the diversity of pharmacologic and nonpharmacologic management tools available for hemodynamically unstable patients in electrical storm, all must be considered and tailored to each individual patient.Case description: This report describes a 36-year-old female without prior cardiac history who presented in ventricular fibrillation (VF) electrical storm. While she lacked significant electrolyte abnormalities or ischemia to explain etiology of electrical storm, she incidentally had variant coronary anatomy noted on angiography. After thorough consideration of possible etiologies of storm, selective serotonin reuptake inhibitor (SSRI) intoxication was the most highly suspected etiology. Regarding management of her hemodynamically unstable electrical storm, she was treated with lidocaine, amiodarone, as well as mechanical circulatory support devices including extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP). The patient ultimately was decannulated from ECMO, had IABP removal, and achieved recovery of ejection fraction (EF) to baseline. She was not offered ICD as the etiology of her cardiac arrest was reversable. She was discharged with recommendation to discontinue SSRI and follow up with psychiatry regarding SSRI overdose.Conclusions: Identification of electrical storm etiology is crucial as reversible causes do not warrant ICD placement. Selection of appropriate pharmacologic and nonpharmacologic management in the hemodynamically unstable electrical storm patient is important given the wide range of available options.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"22"},"PeriodicalIF":0.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048013","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

Fluoroscopy-guided guidewire-assisted technique for difficult removal of a peripherally inserted central venous catheter (PICC) in children: a report of three cases and literature review.

IF 0.7

AME Case Reports Pub Date : 2024-11-14 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-119

Rongwei Xu, Linna Tang, Minghai Wang, Shiyong Qin, Shuguang Zhang

{"title":"Fluoroscopy-guided guidewire-assisted technique for difficult removal of a peripherally inserted central venous catheter (PICC) in children: a report of three cases and literature review.","authors":"Rongwei Xu, Linna Tang, Minghai Wang, Shiyong Qin, Shuguang Zhang","doi":"10.21037/acr-24-119","DOIUrl":"10.21037/acr-24-119","url":null,"abstract":"Background: In general, it is relatively easy to remove peripherally inserted central venous catheter (PICC) by gentle traction without any complications. However, the removal of PICC can be challenging occasionally. If the standard interventions fail to remove the catheter, there are no clear recommendations about what to do. We presented three cases to explore fluoroscopy-guided guidewire-assisted technique for removal of the firmly adherent PICC.Case description: Three cases of difficult PICC removal were all children with acute lymphoblastic leukemia (ALL). All cases were male, range 3-6 years, mean 5.00±1.73 years, catheter indwelling time 289-433 days, mean 367.33±72.83 days. All three cases underwent PICC intubation via the basilic vein approach and all catheters were 3.0 French (Fr), silicone, single-lumen PICCs (Bard Access Systems, Inc., Salt Lake City, UT, USA). Removal of the PICC at the end of the treatment course was difficult. The pullback of the catheter went smoothly for the first few centimeters, but then resistance was encountered. The catheter did not move backward at that point, although we applied strong continuous traction. Several noninvasive approaches to remove the catheter (e.g., repositioning of the extremity, application of hot compress, and vascular massage) were all with no success. Eventually, the firmly adherent PICC was removed using fluoroscopy-guided guidewire-assisted technique in hybrid operating room safely and successfully.Conclusions: Difficult PICC removal can result after prolonged dwell times. When conventional noninvasive interventions are unsuccessful, fluoroscopy-guided guidewire-assisted technique is a safe and effective method for the removal of adherent PICC.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"21"},"PeriodicalIF":0.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048052","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

Is classic papillary thyroid carcinoma definitely an "indolent cancer"?-a case of locally advanced classic occult papillary thyroid carcinoma: a case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-13 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-81

Qinguo Liu, Deshou Ma, Yufei Wang, Xiaofeng Zhou, Lei Shen, Zhijun Ma

{"title":"Is classic papillary thyroid carcinoma definitely an \"indolent cancer\"?-a case of locally advanced classic occult papillary thyroid carcinoma: a case report.","authors":"Qinguo Liu, Deshou Ma, Yufei Wang, Xiaofeng Zhou, Lei Shen, Zhijun Ma","doi":"10.21037/acr-24-81","DOIUrl":"10.21037/acr-24-81","url":null,"abstract":"Background: Occult papillary thyroid carcinoma (PTC) refers to the PTC accidentally found due to its occult lesions. Classic, as the most common subtype of PTC, is usually considered to have a low degree of malignancy and a favorable prognosis. Currently, the American Thyroid Association Management Guidelines adopted active surveillance (AS) as an alternative to immediate surgery in some low-risk PTC patients with less than 1 cm in diameter.Case description: The patient was admitted to the clinic because of an incidentally detected right neck mass, and neck ultrasonography (US) and computed tomography (CT) showed an enlarged lymph node in right neck, which had an unclear border with the right internal jugular vein and the sternocleidomastoid muscle, whereas no abnormality was detected in thyroid glands; fine-needle aspiration biopsy (FNAB) of the enlarged lymph node showed metastatic carcinoma, and the possibility of follicular epithelial origin from the thyroid was highly considered; then the enlarged lymph node resection + right thyroid lobectomy + freezing + left thyroid lobectomy and isthmus resection + lymph nodes and adipose tissue dissection in II-VI regions in right neck + complete resection of the invaded right sternocleidomastoid muscle and right internal jugular vein were performed; postoperative pathology was classic PTC and lymph node metastasis with blood vessels and striated muscle tissues involved.Conclusions: In this case, lateral cervical lymph node metastasis had already occurred without the preoperative detection of a primary thyroid focus, suggesting that the potential risk of classic PTC <1 cm cannot be ignored. Besides, how to accurately identify the malignant degree of low-risk PTC <1 cm preoperatively is worthy of further study.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"10"},"PeriodicalIF":0.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048139","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

Evaluating the risk of mild serotonin syndrome in primary care: a retrospective case series of patients with treatment-resistant depression.

IF 0.7

AME Case Reports Pub Date : 2024-11-13 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-123

Waseem Jerjes, Rachel Kopunova

{"title":"Evaluating the risk of mild serotonin syndrome in primary care: a retrospective case series of patients with treatment-resistant depression.","authors":"Waseem Jerjes, Rachel Kopunova","doi":"10.21037/acr-24-123","DOIUrl":"10.21037/acr-24-123","url":null,"abstract":"Background: Serotonin syndrome is an adverse drug reaction characterised by the excess of serotonin activity in the central nervous system. It is a condition of great concern in primary care where some patients, usually with treatment-resistant depression, get treatment with multiple serotonergic agents.Case description: This retrospective case series looked at 20 primary care patients with treatment-resistant depression who developed mild serotonin syndrome after starting a second antidepressant. The patients were, on average, 40.4 years old, with 55% being female, and had been in treatment for about 5.3 years. The study also considered other health conditions and medications the patients were using. Interventions included stopping or reducing the dose of the second antidepressant, adjusting medications, and educating the patients. Symptoms occurred 1 to 4 weeks after introduction of the second antidepressant, with duration before presentation to the primary care physician ranging from 2 to 11 weeks. Symptoms resolved between 7-21 days after interventions for all patients, and 85% of cases were resolved in under 2 weeks. The most common intervention was stopping or reducing the dose of serotonergic medications in 70% of cases. All patients had improved, with an excellent response to well-targeted interventions in the primary care setting.Conclusions: This study highlights the need for careful monitoring of serotonin syndrome in patients with treatment-resistant depression, especially in the case of polypharmacy. Early recognition of symptoms by primary care providers and close management ensure patient safety through proper medication management and education.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"34"},"PeriodicalIF":0.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048014","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

Brucellosis in pregnancy: a case report.

IF 0.7

AME Case Reports Pub Date : 2024-11-13 eCollection Date: 2025-01-01 DOI: 10.21037/acr-24-110

Alexis M Dunn, Laura E Coats, Tulip A Jhaveri, Kamir Boodoo, Samantha Williams, Elizabeth A Lutz, Sarah Araji

{"title":"Brucellosis in pregnancy: a case report.","authors":"Alexis M Dunn, Laura E Coats, Tulip A Jhaveri, Kamir Boodoo, Samantha Williams, Elizabeth A Lutz, Sarah Araji","doi":"10.21037/acr-24-110","DOIUrl":"10.21037/acr-24-110","url":null,"abstract":"Background: Brucella spp., a gram-negative bacterium, is one of the most prevalent zoonotic illnesses worldwide and is more commonly seen in animals; however, the disease may be present in humans. Clinical manifestations of brucellosis are variable and can range from asymptomatic to severe disease. In women who are pregnant, potential obstetrics complications are possible. The purpose of this report is to present a case of brucellosis in a pregnant patient and discuss the potential complications and treatment recommendations.Case description: We present a case of a 17-year-old gravida 2, parity 1 (G2P1) at 35 weeks and 2 days (35w2d) with brucellosis after she assisted in the delivery of puppies. All puppies were stillborn and the dog was confirmed positive for B. canis on serological testing. Our patient was also found to have B. canis, which is a particularly rare cause of human brucellosis. She was treated with ceftriaxone, rifampin, and gentamicin before delivery and switched to doxycycline and ceftriaxone postpartum until negative. The patient was instructed not to breastfeed. After treatment, the patient felt well and the baby was healthy.Conclusions: When evaluating patients, it is necessary to obtain a social history including animal exposures to rule in or rule out zoonotic infections such as brucellosis. It is important to establish a suspected brucellosis infection in pregnancy and begin antibiotic treatment as soon as possible to prevent maternal and fetal complications. The treatment regimen we administered was an effective strategy, particularly for pregnancy, when typical treatments are contraindicated.","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"9 ","pages":"9"},"PeriodicalIF":0.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048036","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