American Journal of Case Reports最新文献_第3页

Advancing Preoperative Diagnosis: Case Report and Imaging Analysis of Cervical Spine Tenosynovial Giant Cell Tumor.

IF 1

American Journal of Case Reports Pub Date : 2025-03-29 DOI: 10.12659/AJCR.946427

Wei Kong, Yahong Shi, Xin Zhao, Guoping Fang, Chenglei Liu

{"title":"Advancing Preoperative Diagnosis: Case Report and Imaging Analysis of Cervical Spine Tenosynovial Giant Cell Tumor.","authors":"Wei Kong, Yahong Shi, Xin Zhao, Guoping Fang, Chenglei Liu","doi":"10.12659/AJCR.946427","DOIUrl":"10.12659/AJCR.946427","url":null,"abstract":"BACKGROUND Tenosynovial giant cell tumor (TGCT) is a rare, benign, yet aggressive, lesion, usually involving a bursa or the tendon sheath. Spinal TGCT is quite rare. Its appearance on imaging can mimic other aggressive diseases, including giant cell tumor of bone, metastatic disease, and osteoblastoma, thus posing a diagnostic dilemma. We present a new pathologically confirmed case of localized TGCT arising from the cervical spine facet joint and describe its computed tomography (CT) and magnetic resonance imaging (MRI) findings to enhance awareness and improve the accuracy of preoperative diagnosis. CASE REPORT A 33-year-old man experienced neck pain radiating to the right upper limb for 1 year. The pain had subsequently progressed for 1 month. There was no weakness of the lower limbs or limitation in the cervical spine range of motion (ROM). The cervical CT revealed an osteolytic, expansive destructive lesion concentered in the C5-6 right vertebral lamina and spinal process. MRI demonstrated a lobulated mass with heterogeneous isointensity on T1-weighted images and low signal on T2-weighted images. After contrast enhancement, obvious heterogeneous enhancement was identified, and the time-intensity curve (TIC) was of type II (rapid enhancement with low washout curve). Subsequently, a single-stage combined anterior and posterior en-bloc resection was performed. Stabilization was achieved by C5-6 interbody fusion and posterior internal fixation. Histology and immunohistochemistry were suggestive of localized TGCT. The patient's symptoms improved considerably, and there was no sign of a recurrence during the 2-year follow-up. CONCLUSIONS Our case suggested an osteolytic lesion involving the posterior elements of vertebral facet joints. With low signal intensity on T2-weighted image and type II TIC, the possibility of spinal TGCT should be considered.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946427"},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743840","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

Castration-Resistant Prostate Cancer Presenting as Bulky Lymphadenopathy: A Case without Bone Metastasis.

IF 1

American Journal of Case Reports Pub Date : 2025-03-28 DOI: 10.12659/AJCR.946869

Ruchi Yadav, Shengmin Huang, Ifeanyi Uche, Akriti Pokhrel, Umar Zahid, Unni Mooppan, Jen Chin Wang

{"title":"Castration-Resistant Prostate Cancer Presenting as Bulky Lymphadenopathy: A Case without Bone Metastasis.","authors":"Ruchi Yadav, Shengmin Huang, Ifeanyi Uche, Akriti Pokhrel, Umar Zahid, Unni Mooppan, Jen Chin Wang","doi":"10.12659/AJCR.946869","DOIUrl":"10.12659/AJCR.946869","url":null,"abstract":"BACKGROUND Prostate cancer (PCa) tends to spread most often to the regional lymph nodes and then to the skeleton. The prevalence of bone metastases is more than 80% in patients with metastatic PCa. Non-regional lymph node (NRLN) metastasis is defined as cancer cells spreading to lymph nodes distant from the primary tumor and often signals a more advanced stage of cancer. We are reporting such a rare case of NRLN without skeletal metastasis in PCa. CASE REPORT We report a rare case of persistently elevated PSA >20 ng/mL after the treatment of localized PCa in the past. A workup by PSA positron emission tomography (PSMA-PET) scan showed the presence of bulky retroperitoneal massive lymphadenopathy, a type of NRLN metastasis, in the absence of bone metastasis. The patient was then treated with abiraterone plus docetaxel, leading to a decrease in PSA levels from 21 ng/mL to 2.42 ng/mL. The PSMA-PET scan also showed significant shrinkage of lymphadenopathy, marking a favorable response. CONCLUSIONS Castration-resistant PCa typically metastasizes to bone, but our case presents a rare occurrence of bulky NRLN metastasis without skeletal involvement. The use of PSMA-PET imaging and genetic testing can help identify this atypical metastatic pattern. Early recognition is crucial, as it enables more accurate diagnosis and prompt treatment decisions and improves outcomes through timely intervention and personalized therapeutic strategies.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946869"},"PeriodicalIF":1.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732192","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

Hoarseness as a Rare Symptom of Idiopathic Pulmonary Arterial Hypertension Due to Ortner Syndrome: A Case Report. 声音嘶哑是奥特纳综合征引起的特发性肺动脉高压的罕见症状：病例报告。

IF 1

American Journal of Case Reports Pub Date : 2025-03-28 DOI: 10.12659/AJCR.947011

Karolina Jaxa-Kwiatkowska, Magdalena Janus, Mateusz Maciej Graczyk, Katarzyna Szabatowska, Weronika Gościniak, Filip Sawczak, Jerzy Paluszkiewicz, Patrycja Woźniak, Anna Smukowska-Gorynia, Tatiana Mularek-Kubzdela

{"title":"Hoarseness as a Rare Symptom of Idiopathic Pulmonary Arterial Hypertension Due to Ortner Syndrome: A Case Report.","authors":"Karolina Jaxa-Kwiatkowska, Magdalena Janus, Mateusz Maciej Graczyk, Katarzyna Szabatowska, Weronika Gościniak, Filip Sawczak, Jerzy Paluszkiewicz, Patrycja Woźniak, Anna Smukowska-Gorynia, Tatiana Mularek-Kubzdela","doi":"10.12659/AJCR.947011","DOIUrl":"10.12659/AJCR.947011","url":null,"abstract":"BACKGROUND Idiopathic pulmonary arterial hypertension (IPAH) is the most common type of pulmonary arterial hypertension, affecting about 48 to 55 per million adults. Common symptoms include easy fatigability, dyspnea, chest pain, and syncope. Although hoarseness is a rare symptom, several, but limited, cases have been reported to be associated with IPAH due to Ortner syndrome, which is caused by paralysis of the left laryngeal nerve due to enlarged cardiovascular structures. CASE REPORT A 32-year-old man was admitted to the Cardiology Department with suspicion of pulmonary arterial hypertension. Paralysis of the left vocal fold was diagnosed, probably due to compression of the left laryngeal nerve, caused by cardiopulmonary structure (Ortner syndrome). Echocardiography revealed a high probability of pulmonary hypertension with dilatation of the pulmonary artery. Right heart catheterization indicated pre-capillary pulmonary hypertension. Then, several additional tests were performed to clear the causes of pulmonary hypertension, and a diagnosis of IPAH was made. Combined therapy with sildenafil, bosentan, and treprostinil was performed. After several months of therapy, the patient reported improvement in exercise tolerance and hoarseness remission, which seems to be a permanent effect, with no recurrence to date. CONCLUSIONS This case report highlights the role of broad differential diagnosis of hoarseness, emphasizing rare cardiovascular diseases, such as IPAH. Hoarseness caused by the left recurrent laryngeal nerve palsy, resulting from pulmonary artery dilation, one of the most common Ortner syndrome causes, can be treated effectively with appropriate IPAH treatment, by reducing the diameter of the pulmonary trunk.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947011"},"PeriodicalIF":1.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736136","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

Ileo-Cecal Lipomatosis Mimicking Acute Appendicitis Complicated with Appendicular Abscess: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-03-27 DOI: 10.12659/AJCR.946215

Eman Ibrahim Abdalla Osman, Mohammed Latif Elsayed, Premila Samuel, Khadija Ben Amor, Turki Faheem Alshammari

{"title":"Ileo-Cecal Lipomatosis Mimicking Acute Appendicitis Complicated with Appendicular Abscess: A Case Report.","authors":"Eman Ibrahim Abdalla Osman, Mohammed Latif Elsayed, Premila Samuel, Khadija Ben Amor, Turki Faheem Alshammari","doi":"10.12659/AJCR.946215","DOIUrl":"10.12659/AJCR.946215","url":null,"abstract":"BACKGROUND Ileo-cecal lipomatosis is a rare, benign condition characterized by diffuse submucosal adipose tissue infiltration in the intestinal wall. While usually asymptomatic, it occasionally presents with complications such as bowel obstruction, perforation, or mimicry of acute appendicitis, often leading to diagnostic challenges. CASE REPORT A 29-year-old obese woman presented to the Emergency Department with acute abdominal pain, nausea, vomiting, and fever, clinically suggestive of acute appendicitis. Examination revealed right iliac fossa tenderness, and laboratory findings showed elevated white blood cell counts. Computed tomography (CT) imaging indicated an inflammatory mass in the ileo-cecal region, raising suspicion for appendicitis with possible abscess formation. During emergency laparotomy, diffuse thickening and lipomatous infiltration of the ileo-cecal junction were identified rather than a ruptured appendix. Ileo-cecal resection was performed, and histopathological analysis confirmed diffuse submucosal lipomatosis without malignancy or evidence of true inflammatory appendicitis. CONCLUSIONS This case emphasizes the importance of considering rare conditions like intestinal lipomatosis in the differential diagnosis of acute abdominal pain, particularly in atypical presentations. While radiological findings may suggest common conditions like appendicitis, they may be inconclusive, necessitating surgical exploration. Early recognition of ileo-cecal lipomatosis is essential for timely and appropriate management, reducing the risk of unnecessary procedures or complications. Increasing awareness of this rare entity among clinicians can improve diagnostic accuracy and patient outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946215"},"PeriodicalIF":1.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732199","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

Cesarean Delivery in Fetal Triploidy: Clinical Considerations and Case Study Insights.

IF 1

American Journal of Case Reports Pub Date : 2025-03-27 DOI: 10.12659/AJCR.946933

Allison Bautista, Teresa Bernardes, Christine C Greves, Michael Stroup, Stephen J Carlan

{"title":"Cesarean Delivery in Fetal Triploidy: Clinical Considerations and Case Study Insights.","authors":"Allison Bautista, Teresa Bernardes, Christine C Greves, Michael Stroup, Stephen J Carlan","doi":"10.12659/AJCR.946933","DOIUrl":"10.12659/AJCR.946933","url":null,"abstract":"BACKGROUND Fetal triploidy is a rare, lethal disorder characterized by an extra set of haploid chromosomes resulting in 69 chromosomes (69, XXX; 69, XXY; or 69, XYY). Fetal anomalies and occasionally maternal complications such as hypertension result in a high fetal loss rate during gestation. It is estimated to be present in 1: 250 000 pregnancies at 20 weeks, and very few survive to term. Diagnosis is suspected by antepartum ultrasound and confirmed by invasive testing of fetal cells by karyotype. Management includes pregnancy termination or pregnancy continuation based on the patient's choice. Whether a cesarean delivery should be performed for a nonmaternal indication in a triploid pregnancy is controversial. CASE REPORT A 17-year-old primagravida presented at 33 weeks post-last menstrual period with several weeks of lower abdominal pain and nausea. She had received prenatal care at an outside facility and had a second-trimester ultrasound. She declined amniocentesis for definitive fetal karyotyping. On arrival at our hospital, an ultrasound revealed multiple fetal anatomic anomalies. She developed nonreassuring fetal surveillance and underwent cesarean delivery at 37 weeks. The infant died on day 20 of life. CONCLUSIONS Triploidy is a condition that results in ultrasound-detectable anomalies early in the first half of pregnancy. Noninvasive prenatal screens are unreliable for definitive triploid detection. Confirmation of a fetal chromosomal disorder requires an invasive test such as an amniocentesis. Knowing that the fetus has a lethal disorder allows 2 important options: first, a pregnancy termination; second, declining a cesarean delivery. This case illustrates that refusing the amniocentesis changes the entire course of the pregnancy management.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946933"},"PeriodicalIF":1.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721762","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

Neuropsychological Insights Into Child Survival: Possible Protective Dissociation During Prolonged Entrapment After a Turkish Earthquake.

IF 1

American Journal of Case Reports Pub Date : 2025-03-26 DOI: 10.12659/AJCR.946755

Einav Levy, Moshe Uirel Farchi, Chen Hanna Ryder, Michael L Alkan, Yori Gidron

{"title":"Neuropsychological Insights Into Child Survival: Possible Protective Dissociation During Prolonged Entrapment After a Turkish Earthquake.","authors":"Einav Levy, Moshe Uirel Farchi, Chen Hanna Ryder, Michael L Alkan, Yori Gidron","doi":"10.12659/AJCR.946755","DOIUrl":"10.12659/AJCR.946755","url":null,"abstract":"BACKGROUND Earthquakes and other catastrophic events can lead to conditions of being trapped under the rubble, which can cause minor-major health consequences. One of the most challenging issues in entrapment is the need to rescue people as fast as possible. A related issue for rescue forces is how long to continue searching survivors. Indeed, sometimes victims survive longer than expected. The cases described below led us to postulate that certain adverse psychological effects of being trapped under the rubble may be beneficial for survival in such extreme situations. CASE REPORT In this article, we report two cases of children who were rescued from under the rubble following the earthquake in Turkey in February 2023. The children were rescued approximately one week after the earthquake, exhibiting symptoms that could be understood as dissociation. We bring converging neuropsychological and neurophysiological scientific evidence which enables us to propose that dissociation-related imagination together with excessive sleep may have increased vagal nerve activity. Vagal activity in turn may have helped to reduce risk of infections and inflammation, and possibly increased the chance of survival. CONCLUSIONS Though impossible to measure and prove in such extreme contexts, we propose a plausible psychobiological mechanism for those children’s symptoms and relatively long survival under entrapment. While only a speculation, dissociation might have been protective in such conditions. We discuss the limitations of these reports and the speculative mechanisms, and provide further implications for policy.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946755"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711512","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

Choledochoscope-Guided Necrosectomy for Retroperitoneal and Posterior Rectal Post-Pancreatitis Necrosis.

IF 1

American Journal of Case Reports Pub Date : 2025-03-26 DOI: 10.12659/AJCR.946452

Xin Li, Guang Zhao, Cong-Yu Wang, Gen Zhang, Xiang-Lan Feng, Fei He, Shu-Lei Lei, Yun-Feng Cui

{"title":"Choledochoscope-Guided Necrosectomy for Retroperitoneal and Posterior Rectal Post-Pancreatitis Necrosis.","authors":"Xin Li, Guang Zhao, Cong-Yu Wang, Gen Zhang, Xiang-Lan Feng, Fei He, Shu-Lei Lei, Yun-Feng Cui","doi":"10.12659/AJCR.946452","DOIUrl":"10.12659/AJCR.946452","url":null,"abstract":"BACKGROUND Severe acute pancreatitis is a severe acute abdominal disease. Signs and symptoms classically vary from abdominal pain to fever, vomiting, and abdominal distension. Severe complications, such as infected pancreatic necrosis and multiple organ dysfunction syndrome, can occur. The various treatment strategies in acute necrotizing pancreatitis include percutaneous drainage, laparoscopic necrosectomy, endoscopic necrosectomy, and minimally invasive or more hazardous open surgery. In the presently described case, the effect of puncture drainage was not significant, and then choledochoscope-assisted pancreatic necrosectomy was performed. CASE REPORT In this case, a 41-year-old Chinese man developed extensive retroperitoneal necrosis extending into the posterior rectum following severe acute pancreatitis. The treatment of secondary infection of pancreatic necrotic tissue remains a major challenge. The drainage catheter for the abdominal puncture was inserted, but it was not effective enough. On the 45th day of admission, choledochoscope-assisted pancreatic necrosectomy was performed. After the operation, the patient was given continuous saline flushing through the drain and low continuous suction was applied to the lumen sump drain. We consider this to be a valuable case in which a patient improved in response to placement of a drain intraoperatively in the posterior rectum. CONCLUSIONS We report a patient who developed extensive retroperitoneal necrosis extending into the posterior rectum following severe acute pancreatitis. We decided to perform choledochoscope-assisted pancreatic necrosectomy; the necrotic tissue around the posterior rectum was removed and a triple lumen sump drain was placed in the posterior rectum. This is the first case of infection of the posterior rectal space after severe acute pancreatitis treated by choledochoscope-assisted pancreatic necrosectomy.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946452"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732195","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

V-Y Advancement Flap in Mid-Temporal Defect Reconstruction After Mohs Surgery.

IF 1

American Journal of Case Reports Pub Date : 2025-03-25 DOI: 10.12659/AJCR.948113

Shireen S Sachdeva, Faraz Yousefian, Gabriella Vasile, Josh A Hammel

{"title":"V-Y Advancement Flap in Mid-Temporal Defect Reconstruction After Mohs Surgery.","authors":"Shireen S Sachdeva, Faraz Yousefian, Gabriella Vasile, Josh A Hammel","doi":"10.12659/AJCR.948113","DOIUrl":"10.12659/AJCR.948113","url":null,"abstract":"BACKGROUND Overcoming the unique anatomical challenges posed by mid-temporal defects due to Mohs micrographic surgery treatment of various skin cancers can be difficult. Additionally, the decision-making process in selecting the most appropriate approach to achieve functional and aesthetic outcomes can require analytical reasoning. The vulnerability of the temporal branch of the facial nerve becomes relevant when surgical procedures are conducted in proximity to its most superficial region, just over the zygomatic arch. For small defects, second intention and primary closure methods are applicable. However, in terms of large temporal defects, Mohs micrographic surgery can provide the optimal result for patients. CASE REPORT We report a 68-year-old man who presented with a 4.2-cm invasive, well-differentiated squamous cell carcinoma with rapid growth and poorly defined borders in the left mid-temporal region. This tumor was treated with Mohs micrographic surgery and cleared in 5 stages. The local flaps reconstructive technique was used to optimize patient outcomes. CONCLUSIONS For large temporal defects, primary closure may not be feasible, due to the limited elasticity of skin in this region. As such, reconstructive techniques, including local flaps, skin grafts, or a combination of these approaches can be considered. A V-Y advancement flap is a reconstructive technique that can be used for a large mid-temporal defect, while preserving functional and aesthetic elements for patients. The success of this technique depends on the maintenance of flap viability through careful flap planning, anatomical landmarks, dissection, and vascular pedicle preservation.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948113"},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701826","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

Unexpected Deltoid Abscess from BCG Vaccination in a Healthy Adult: A Case Report.

IF 1

American Journal of Case Reports Pub Date : 2025-03-25 DOI: 10.12659/AJCR.946723

Ahmad Abdalla, Ahmed Samir Elbakri, Cinderella Ali Almatrooshi, Nouf Bader AlNaqeeb, Nabeel Umer Hussain, Waqar Haider Gaba, Farhan Fazal

{"title":"Unexpected Deltoid Abscess from BCG Vaccination in a Healthy Adult: A Case Report.","authors":"Ahmad Abdalla, Ahmed Samir Elbakri, Cinderella Ali Almatrooshi, Nouf Bader AlNaqeeb, Nabeel Umer Hussain, Waqar Haider Gaba, Farhan Fazal","doi":"10.12659/AJCR.946723","DOIUrl":"10.12659/AJCR.946723","url":null,"abstract":"BACKGROUND The Bacillus Calmette-Guerin (BCG) vaccine is used to prevent tuberculosis in countries with high rates of tuberculosis. Although the vaccine is generally low risk, there are reports of minor local adverse effects. Rare complications such as abscess formation have been reported in immunocompromised and pediatric patients. However, reports of inoculation-site abscesses are exceedingly rare in the immunocompetent adult population, and there is no clear management plan that has been agreed upon for these cases. We present a case of a 30-year-old immunocompetent woman who developed a Mycobacterium tuberculosis complex abscess following intramuscular injection of the BCG vaccine. CASE REPORT A healthy 30-year-old woman came in for a MMR vaccination but mistakenly received the BCG vaccine intramuscularly in her left deltoid. One week later, she developed pain and swelling at the injection site. A MRI of her shoulder a week later revealed an intramuscular pseudo-lesion. An ultrasound done another 2 weeks later demonstrated an abscess. An acid-fast bacilli smear and culture were done using aspirated fluid and were negative. Pus began to drain from her shoulder days later, which returned positive on a smear and culture for pan-sensitive Mycobacterium tuberculosis complex. She recovered fully following 6 months of anti-tuberculosis medications (rifampicin, isoniazid, pyrazinamide, ethambutol). CONCLUSIONS Development of an abscess secondary to a vaccine should still be considered as a differential diagnosis for vaccine injection-site swelling in immunocompetent adult patients. Healthcare professionals should always confirm the correct type of vaccination and mode of administration before injection to avoid preventable vaccination complications.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946723"},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711523","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

Medical Thoracoscopy in Diagnosis and Management of Silicotuberculosis with Pneumothorax: A Report of a Rare Case.

IF 1

American Journal of Case Reports Pub Date : 2025-03-24 DOI: 10.12659/AJCR.946204

Shandy Billy Riyanto, Isnin Anang Marhana, Helmia Hasan

{"title":"Medical Thoracoscopy in Diagnosis and Management of Silicotuberculosis with Pneumothorax: A Report of a Rare Case.","authors":"Shandy Billy Riyanto, Isnin Anang Marhana, Helmia Hasan","doi":"10.12659/AJCR.946204","DOIUrl":"10.12659/AJCR.946204","url":null,"abstract":"BACKGROUND The diagnosis of silicotuberculosis is rarely reported, even in high-burden countries for tuberculosis like Indonesia. The requirement for an advanced method to diagnose silicosis makes this disease underdiagnosed. Silica detection is a mandatory examination, but not all centers in developing countries can perform it. Once the diagnosis is confirmed, the treatment is also challenging. Patients usually come to the hospital with complications that can be life-threatening. CASE REPORT A 45-year-old Indonesian man with a history of unprotected quarry work and heavy smoking presented with worsening respiratory symptoms during tuberculosis treatment. The chest X-ray in the emergency room showed a left pneumothorax. His discomfort decreased after a chest tube was inserted. A pneumothorax was detected in the right hemithorax, necessitating the insertion of a chest tube. A high-resolution computed tomography examination of the thorax was performed and showed bronchopleural fistulas. Medical thoracoscopy confirmed multiple bronchopleural fistulae. A lung biopsy from thoracoscopy was performed, confirming the presence of silica. After a few days of treatment, the right chest tube was successfully removed. Meanwhile, due to the persistent air leak in the left pleura caused by multiple bronchopleural fistulae, the left chest tube was eventually connected to a dry seal drain, and the patient was scheduled for discharge. CONCLUSIONS This case highlights the successful diagnosis of silicotuberculosis using medical thoracoscopy.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946204"},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701823","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