American Journal of Case Reports最新文献_第7页

Cholecystoduodenal Fistula Due to Gallstone Disease Masquerading as a Duodenal Ulcer Bleed: A Case Report. 胆石症导致的胆囊十二指肠瘘伪装成十二指肠溃疡出血：病例报告。

IF 1

American Journal of Case Reports Pub Date : 2025-03-01 DOI: 10.12659/AJCR.946743

Jayati Churiwala, Hemant Sheth, Esam Aboutaleb

{"title":"Cholecystoduodenal Fistula Due to Gallstone Disease Masquerading as a Duodenal Ulcer Bleed: A Case Report.","authors":"Jayati Churiwala, Hemant Sheth, Esam Aboutaleb","doi":"10.12659/AJCR.946743","DOIUrl":"10.12659/AJCR.946743","url":null,"abstract":"BACKGROUND A cholecystoenteric fistula (CEF) is a rare complication of gall stone disease. While a cholecystoduodenal fistula is the most commonly occurring bilioenteric fistulous communication, cholecystocolonic, cholecystogastric and choledochoduodenal fistulas have also been described. CASE REPORT A 73-year-old woman presented with a 1-week history of melena on a background of acid reflux and no abdominal pain. A gastroscopy revealed kissing D1 ulcers with excretion of pus. Following a CT scan of the abdomen, the patient was referred to the surgical team for the management of acute cholecystitis with a cholecystoduodenal fistula. She underwent an open cholecystectomy with fistula take-down and repair of the duodenum in the same admission. Following an uneventful postoperative recovery, she was discharged on an empirical course of H. pylori eradication therapy. Recurrent episodes of acute cholecystitis or chronic cholecystitis can lead to adhesions between the gall bladder and adjacent viscus. Gall stone impaction then can cause pressure necrosis, leading to a fistulation between the gall bladder and the viscus. Rarely, this presents with massive upper-gastrointestinal bleeding. Imaging with ultrasound can reliably diagnose cholelithiasis, cholecystitis, and pneumobilia, but is unlikely to help in the definitive diagnosis of a bilioenteric fistula, which requires cross-sectional imaging. CONCLUSIONS Massive upper-gastrointestinal bleeding is a rare mode of presentation of CEF. Hemodynamic resuscitation and management of upper-GI bleed takes precedence, followed by definitive management of the CEF after establishment of the diagnosis.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946743"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531991","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

Pediatric Crohn Disease Presenting as Isolated Acute Upper-GI Bleed: A Case Report. 儿童克罗恩病表现为孤立的急性上消化道出血1例

IF 1

American Journal of Case Reports Pub Date : 2025-02-28 DOI: 10.12659/AJCR.946099

Logan Norris, Parker Giroux, Traci Jester, David P Galloway, Jeanine Maclin, Stephanie Saaybi, Benjamin Hill, Mariangeles Medina Perez, Chinenye R Dike

{"title":"Pediatric Crohn Disease Presenting as Isolated Acute Upper-GI Bleed: A Case Report.","authors":"Logan Norris, Parker Giroux, Traci Jester, David P Galloway, Jeanine Maclin, Stephanie Saaybi, Benjamin Hill, Mariangeles Medina Perez, Chinenye R Dike","doi":"10.12659/AJCR.946099","DOIUrl":"10.12659/AJCR.946099","url":null,"abstract":"BACKGROUND The incidence of Crohn's disease (CD) has increased worldwide. Although common presenting symptoms of CD in children include abdominal pain, diarrhea, and rectal bleeding, it can also present atypically and can have extraintestinal manifestations. Isolated upper-gastrointestinal bleed as the only manifestation of CD with ileocolonic involvement is rare. CASE REPORT We describe the case of a previously healthy, 9-year-old boy who presented to the emergency department (ED) with isolated, acute-onset hematemesis. He was evaluated in the ED, and found to be hemodynamically stable, and hematemesis had resolved upon arrival to the ED. Therefore, he was placed on a proton pump inhibitor (PPI), and discharged with a close gastrointestinal clinic follow-up, which he missed. He returned to the ED 3 weeks later with another episode of hematemesis with hemodynamic instability requiring resuscitation and intensive care unit stay. He underwent an emergency esophagogastroduodenoscopy (EGD), which revealed a bleeding gastric ulcer in the fundus. Bleeding was controlled with epinephrine injection and application of hemostatic clips. Gastric biopsies revealed granulomas. Therefore, during his hospitalization, ileocolonoscopy was completed to rule out CD. Ileocolonoscopy showed left colonic edema with ulcers and terminal ileal ulcers with exudates. Histopathology revealed granulomas in these areas. Infliximab infusions were started during the hospitalization. He is currently receiving 10 mg/kg of infliximab every 4 weeks. CONCLUSIONS This case highlights the need for increased clinician awareness of atypical presentations of inflammatory bowel disease (IBD) and maintenance of a high index of suspicion when treating children and adolescents with acute GI bleed.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946099"},"PeriodicalIF":1.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523548","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

Management of Post-Stroke Cold Sensations: A Case Study on Sympathetic Nerve Ablation. 脑卒中后冷感的处理：交感神经消融的个案研究。

IF 1

American Journal of Case Reports Pub Date : 2025-02-27 DOI: 10.12659/AJCR.946352

Haojia Li, Dejian Chen, Jiajia Deng, Lu Sun, Jianjun Zhu, Hanrui Fan, Yingjie Hua, Xiaoyan Guo, Ming Yao, Yong Fei

{"title":"Management of Post-Stroke Cold Sensations: A Case Study on Sympathetic Nerve Ablation.","authors":"Haojia Li, Dejian Chen, Jiajia Deng, Lu Sun, Jianjun Zhu, Hanrui Fan, Yingjie Hua, Xiaoyan Guo, Ming Yao, Yong Fei","doi":"10.12659/AJCR.946352","DOIUrl":"10.12659/AJCR.946352","url":null,"abstract":"BACKGROUND Stroke is a leading cause of mortality worldwide and often results in complex sequelae. Peripheral circulation disorders in paralyzed limbs are particularly challenging, presenting as persistent cold sensations and cold-induced pain that severely impair patients' quality of life. This report presents an innovative approach to managing refractory post-stroke limb coldness and pain using computed tomography (CT)-guided sympathetic nerve radiofrequency ablation. CASE REPORT We present the case of a 65-year-old woman with hemiplegia in her left extremities following a cerebral infarction 1 year earlier. Despite standardized treatment, her condition worsened after 6 months, with increased spasticity, cold-induced pain, and a significant drop in temperature in the left limbs. To address these issues, CT-guided radiofrequency ablation of the sympathetic nerve at the fourth thoracic vertebra and the third lumbar vertebral body was performed at 75°C for 3 min. The procedure significantly improved the peripheral perfusion index, increased palm and foot temperature, and reduced pain. Magnetic resonance imaging revealed improved cerebral infarction and enhanced brain function in temperature-related regions. Ethical approval and patient consent for publication were obtained. CONCLUSIONS CT-guided radiofrequency ablation of the thoracic and lumbar sympathetic nerves effectively alleviates post-stroke peripheral circulation disorders, improves limb temperature, and enhances collateral circulation. This report underscores the importance of awareness and early intervention for such post-stroke complications in patients.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946352"},"PeriodicalIF":1.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516832","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

Successful Radiotherapy in Management of Inoperable Trichoblastic Carcinoma: A Case Report. 放疗成功治疗不能手术的毛细胞癌1例报告。

IF 1

American Journal of Case Reports Pub Date : 2025-02-26 DOI: 10.12659/AJCR.945865

Sébastien Colin, Jean-Christophe Faivre, Jean-François Devoti, Florence Granel-Brocard, Sophie Renard

{"title":"Successful Radiotherapy in Management of Inoperable Trichoblastic Carcinoma: A Case Report.","authors":"Sébastien Colin, Jean-Christophe Faivre, Jean-François Devoti, Florence Granel-Brocard, Sophie Renard","doi":"10.12659/AJCR.945865","DOIUrl":"10.12659/AJCR.945865","url":null,"abstract":"BACKGROUND Trichoblastic carcinoma (TC) is a rare adnexal tumor that usually occurs on the scalp and the face. Clinical presentation is nonspecific and can simulate basal cell carcinoma (BCC). Optimal treatment and outcomes remain unclear. Surgery remains the main treatment but can be difficult or impossible in locally-advanced situations. Thus, conservative options must be developed as TC affects elder populations, and radiotherapy may be a good conservative option but its use in TC is poorly documented. CASE REPORT We report a case of an 86-year-old man with an asymptomatic 5-cm tumor of the nose, extending to the right cheek and inner canthus. He was immunodeficient on kidney transplant and was treated by prednisone and tacrolimus. Biopsy confirmed the TC diagnosis. Surgery and brachytherapy were not possible due to clinical extension, advanced age, and comorbidities. External beam radiation with intensity modulated radiotherapy on tomotherapy was attempted. Seventy Gy was delivered in 35 fractions over 2 months 5/7 days. A bolus with ball (Seemed®) was used each treatment day to deliver an adequate dose of radiotherapy to the skin. Clinical examination at 1 month did not reveal any residual lesion and the patient remains in complete remission after 9 months of follow-up. Tolerance was characterized by grade 2 (NCI CTC AE V4) radiodermatitis, mucositis, and conjunctivitis, managed by local medications. CONCLUSIONS We report a rare case of locally-advanced TC, successfully treated by external beam radiation, which may be an acceptable alternative treatment for unresectable tumors.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945865"},"PeriodicalIF":1.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503805","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 40-Year-Old Woman with Inoperable Uterine Fibroids Treated with Combined Uterine Artery Embolization and Relugolix. 子宫动脉栓塞联合瑞路高利治疗40岁不能手术的子宫肌瘤1例。

IF 1

American Journal of Case Reports Pub Date : 2025-02-25 DOI: 10.12659/AJCR.946334

Livio Leo, Raphael Thomasset, Alessio Massaro, Raffaele Tinelli, Bianca Masturzo, Valentino Remorgida, Alessandro Libretti, Massimiliano Natrella

{"title":"A 40-Year-Old Woman with Inoperable Uterine Fibroids Treated with Combined Uterine Artery Embolization and Relugolix.","authors":"Livio Leo, Raphael Thomasset, Alessio Massaro, Raffaele Tinelli, Bianca Masturzo, Valentino Remorgida, Alessandro Libretti, Massimiliano Natrella","doi":"10.12659/AJCR.946334","DOIUrl":"10.12659/AJCR.946334","url":null,"abstract":"BACKGROUND Surgery was once considered the only possible treatment for uterine fibroids. However, a more conservative treatment approach can preserve women's reproductive capacity. In recent years, uterine artery embolization (UAE) and medical treatments have been introduced as a minimally or non-invasive therapeutic option. Relugolix is a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist used to reduce the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This report presents the case of a 40-year-old woman with inoperable uterine fibroids managed with combined uterine artery embolization and Relugolix, a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist. CASE REPORT A woman in her 40s presented with recurrent menometrorrhagia and an 80-mm uterine fibroid causing bleeding and anemia. Due to her medical history and previous surgeries, surgery was deemed risky. Instead, a conservative approach involving UAE followed by Relugolix combination therapy (Relugolix-CT) was pursued before performing minimally invasive surgery. Following bilateral UAE, the ultrasound scan showed there had already been a reduction in the fibroid size. Right after the UAE, the patient was discharged with Relugolix-CT, which reduced the symptoms and helped further reduce the fibroid's size and vascularity. Six months later, a mini-resectoscopic myomectomy was performed under local anaesthesia. CONCLUSIONS This case underscores the effectiveness of UAE and Relugolix-CT as a pre-surgical strategy for large uterine fibroids in patients who are not immediately suitable candidates for major surgery. This new combined approach can lead to improved patient outcomes and reduced surgical risks.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946334"},"PeriodicalIF":1.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494013","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

Severe COVID-19 Pneumonia, Opportunistic Candida krusei Infection, and Acute Respiratory Distress Syndrome with Pulmonary Arterial Hypertension Treated with Bosentan: A Case Report. 波生坦治疗重症COVID-19肺炎、机会性克鲁氏念珠菌感染、急性呼吸窘迫综合征合并肺动脉高压1例

IF 1

American Journal of Case Reports Pub Date : 2025-02-24 DOI: 10.12659/AJCR.946400

Killen H Briones-Claudett, Killen H Briones-Zamora, Jaime Galo Benites Solis, Doménica I Huilcapi Borja, Karelys Nicole Arteaga Ocaña, Maria Antonieta Touriz Bonifaz, Pedro Barberan-Torres, Michelle Grunauer

{"title":"Severe COVID-19 Pneumonia, Opportunistic Candida krusei Infection, and Acute Respiratory Distress Syndrome with Pulmonary Arterial Hypertension Treated with Bosentan: A Case Report.","authors":"Killen H Briones-Claudett, Killen H Briones-Zamora, Jaime Galo Benites Solis, Doménica I Huilcapi Borja, Karelys Nicole Arteaga Ocaña, Maria Antonieta Touriz Bonifaz, Pedro Barberan-Torres, Michelle Grunauer","doi":"10.12659/AJCR.946400","DOIUrl":"10.12659/AJCR.946400","url":null,"abstract":"BACKGROUND Despite global vaccination efforts, COVID-19 still necessitates effective treatments for severe cases that can quickly escalate to life-threatening complications, such as acute respiratory distress syndrome (ARDS) and secondary pulmonary arterial hypertension (PAH). Here, we present the clinical journey of a 73-year-old Ecuadorian man who developed severe COVID-19 pneumonia complicated by an opportunistic Candida krusei infection and ARDS, subsequently progressing to long-term PAH, managed with bosentan, an endothelin 1 (ET-1) antagonist. CASE REPORT The patient, vaccinated with 2 doses of CoronaVac, experienced severe COVID-19 complications, including ARDS and secondary PAH, further complicated by a C. krusei infection. Despite prompt mechanical ventilation and intensive care, his condition rapidly deteriorated. Clinical evaluation confirmed COVID-19-associated ARDS, secondary PAH, and C. krusei infection through bronchoalveolar lavage. The therapeutic approach combined bosentan (125 mg twice daily) with dual antifungal therapy, leading to significant stabilization and eventual discharge. Post-discharge assessments showed persistent cardiopulmonary dysfunction, consistent with post-COVID-19 syndrome. CONCLUSIONS This case highlights critical COVID-19 complications in a vaccinated patient. While vaccination may provide substantial protection, COVID-19 pneumonia treated with corticosteroids can increase the risk of opportunistic infections like C. krusei, and ARDS can lead to pulmonary fibrosis and PAH. This case underscores the need for research on therapeutic strategies for complex COVID-19 cases and emphasizes comprehensive, personalized care for managing COVID-19 complications and sequelae.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946400"},"PeriodicalIF":1.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484257","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

Rare Lacrimal Gland Melanoma: A Case Report and Treatment Insights. 罕见泪腺黑色素瘤：1例报告及治疗见解。

IF 1

American Journal of Case Reports Pub Date : 2025-02-23 DOI: 10.12659/AJCR.946361

Reinhard Told, Ana-Iris Schiefer, Christoph Hoeller, Adrian Reumueller, Judith Kreminger, Roman Dunavoelgyi

{"title":"Rare Lacrimal Gland Melanoma: A Case Report and Treatment Insights.","authors":"Reinhard Told, Ana-Iris Schiefer, Christoph Hoeller, Adrian Reumueller, Judith Kreminger, Roman Dunavoelgyi","doi":"10.12659/AJCR.946361","DOIUrl":"10.12659/AJCR.946361","url":null,"abstract":"BACKGROUND Melanoma is a malignant transformation of melanocytes known for its capacity to metastasize, necessitating early diagnosis and intervention. While over 97% of melanomas are diagnosed with a known primary site, such as the skin, eye, or mucous membranes, rare cases like melanoma of unknown primary (MUP) can present with atypical manifestations, highlighting the need for comprehensive examinations. CASE REPORT In January 2023, a 68-year-old woman presented with a 4-week history of swelling and discoloration in her left upper eyelid, revealing a hard, livid mass indicative of malignancy. Surgery and subsequent histopathology confirmed epithelioid cell melanoma in the lacrimal gland. Although no other primary melanoma sites were found, imaging and biopsy in August 2023 identified metastatic spread to her lungs. Despite proton radiotherapy, progression led to thoracoscopic surgery for metastasis resection in September 2023. Further re-evaluation revealed metastases in both lungs, leading to her enrolment in a trial comparing PD-1 (programmed death ligand 1) antibody plus LAG-3 (lymphocyte activation gene 3) antibody with PD-1 monotherapy. Subsequent progression required treatment with ipilimumab and nivolumab, which resulted in near complete regression of the orbital tumor. Unfortunately, she later developed serious complications, including hypophysitis, lung infection, renal failure, and viral meningitis, which ultimately led to her death in April 2024. CONCLUSIONS This case report highlights the diagnostic challenge in distinguishing between melanoma of known and unknown primary origins. It emphasizes the importance of thorough histological work-up and heightened suspicion for melanoma of the lacrimal gland, despite its rarity, to ensure prompt diagnosis and treatment due to its metastatic potential.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946361"},"PeriodicalIF":1.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484239","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

Rare Presentation of Middle Ear Neuroendocrine Tumor: A Case Report. 罕见的中耳神经内分泌肿瘤：病例报告

IF 1

American Journal of Case Reports Pub Date : 2025-02-22 DOI: 10.12659/AJCR.945602

Nan Zeng, Qiong Yang, Jing Hu, Shang Yan

{"title":"Rare Presentation of Middle Ear Neuroendocrine Tumor: A Case Report.","authors":"Nan Zeng, Qiong Yang, Jing Hu, Shang Yan","doi":"10.12659/AJCR.945602","DOIUrl":"10.12659/AJCR.945602","url":null,"abstract":"BACKGROUND Neuroendocrine tumors (NETs) of the middle ear are exceptionally rare, representing less than 2% of primary ear tumors in adults. These neoplasms originate from neuroendocrine cells within the middle ear cavity, posing significant diagnostic and therapeutic challenges. CASE REPORT We present a 27-year-old man with a 2-month history of left-sided hearing loss, tinnitus, and ear fullness. Comprehensive assessments, including tuning fork tests, pure tone audiometry, computed tomography (CT) scan of the temporal bone, and magnetic resonance imaging (MRI), were conducted. Differential diagnoses, included cholesteatoma and other middle ear masses, but chronic suppurative otitis media was not considered due to the intact tympanic membrane. Intraoperative findings revealed a pale pink mass encasing the ossicular chain, confirmed as a neuroendocrine tumor (CK [+], Syn [+++], CK18 [+], EMA [++], CD56 [-], CgA [+], Ki67 [2%+]) by immunohistochemistry. The tumor was excised via an endoscopic tympanotomy. Postoperative follow-up over 2 years showed no recurrence or metastasis, and the patient reported no significant hearing impairment affecting quality of life. CONCLUSIONS Middle ear neuroendocrine tumors require meticulous diagnostic workup and precise surgical intervention. This case adds to the limited body of evidence supporting that middle ear neuroendocrine tumors, although rare, can be managed effectively with tailored surgical approaches. Continued case reporting will be vital to enhance understanding and to refine treatment guidelines for optimal patient outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945602"},"PeriodicalIF":1.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476975","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

Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case. 后 COVID-19 肺曲霉瘤的治疗：一个临床病例的启示。

IF 1

American Journal of Case Reports Pub Date : 2025-02-21 DOI: 10.12659/AJCR.946456

Atif S Siddiqui

{"title":"Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case.","authors":"Atif S Siddiqui","doi":"10.12659/AJCR.946456","DOIUrl":"10.12659/AJCR.946456","url":null,"abstract":"BACKGROUND This report presents the case of a 49-year-old man with pulmonary aspergilloma 6 months after hospitalization and mechanical ventilation for COVID-19 who was treated with robot-assisted lobectomy. COVID-19-associated pulmonary aspergillosis is a life-threatening complication of SARS-CoV-2 infection. Aspergilloma, a delayed complication of COVID-19, is rare. Major risk factors for pulmonary aspergilloma include neutropenia, solid organ transplantation, prolonged high-dose corticosteroid therapy, hematological malignancy, cytotoxic therapy, acquired immunodeficiency syndrome, and chronic granulomatous disease. Common symptoms include cough, shortness of breath, fatigue, wheezing, weight loss, fever, and chest pain. Hemoptysis is the most severe complication of pulmonary aspergilloma. Treatment options include antifungals, bronchial artery embolization, and surgery. Surgical treatment is considered definitive for patients who do not respond to antifungal medications. CASE REPORT We describe the case of a 49-year-old man with pulmonary aspergilloma who developed a delayed sequela of SARS-CoV-2 infection. He presented to a pulmonary clinic 6 months after a severe COVID-19-related hospitalization, with symptoms of mild hemoptysis, cough, and shortness of breath. A computed tomography scan of the chest revealed a right upper lobe cavitary lesion approximately 9.6×6.1 cm in size. Bronchoalveolar lavage during bronchoscopy revealed Aspergillus fumigatus. The patient did not respond to antifungal treatment and was successfully treated with a robotic-assisted lobectomy. CONCLUSIONS Aspergillus infection should be considered in COVID-19 survivors with pulmonary symptoms. Minimally invasive robotic lobectomy is a feasible option for high-risk patients with post-COVID-19 aspergilloma and hemoptysis who are resistant to medical treatment.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946456"},"PeriodicalIF":1.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469521","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

Vision-Threatening Complications of Juxtapapillary Retinal Capillary Hemangioma: A Case of Retinal Artery Occlusion. 视网膜乳头旁毛细血管瘤危及视力的并发症：视网膜动脉闭塞1例。

IF 1

American Journal of Case Reports Pub Date : 2025-02-20 DOI: 10.12659/AJCR.946514

Jingnan Han, Siyu Wang, Yuedong Hu

{"title":"Vision-Threatening Complications of Juxtapapillary Retinal Capillary Hemangioma: A Case of Retinal Artery Occlusion.","authors":"Jingnan Han, Siyu Wang, Yuedong Hu","doi":"10.12659/AJCR.946514","DOIUrl":"10.12659/AJCR.946514","url":null,"abstract":"BACKGROUND Juxtapapillary retinal capillary hemangioma (JRCH) is a rare vascular hamartoma that, when present, can cause many complications. We report a case of branch retinal artery occlusion (BRAO) in the setting of progressive exophytic JRCH, which, to the best of our knowledge, has not been reported until now. CASE REPORT The patient was 34-year-old woman who presented with visual blurring and visual field defects of the left eye and with no significant medical history. Fundoscopy and other auxiliary examinations revealed a red, elevated mass at the optic disc with surrounding hemorrhage and vascular abnormalities. JRCH was then diagnosed, and she underwent conservative treatment. However, 3 days later, during the follow-up, she developed a worsened best corrected visual acuity (BCVA) and visual field defect. The optical coherence tomography angiography found swelling of the tumor, macular edema, and vascular occlusion of the inferior macula; therefore, secondary BRAO was diagnosed. With emergency treatments, the tumor size reduced during the follow-up; however, the vision field, BCVA, and vascular occlusion were not improved. CONCLUSIONS JRCH are rare benign tumors associated with progressive vision loss due to complications such as macular exudate and retinal detachment. Various treatments, including laser, radiotherapy, and anti-angiogenic intravitreal (anti-VEGF) injections, have been suggested; however, the optimal approach is unclear. JRCH complicated with BRAO has not been reported before. Our report suggests that the tumor was closely related to the retinal arteriovenous system, and BRAO could be a vision-threatening complication of JRCH that deserves more attention.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946514"},"PeriodicalIF":1.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459982","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