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

Innovative Combination of Tetracycline Rinse and CO₂ Laser Ablation for Treating White Sponge Nevus in Adolescents: A Case Study. 四环素冲洗和 CO₂ 激光消融治疗青少年白色海绵痣的创新组合：病例研究。

IF 1

American Journal of Case Reports Pub Date : 2024-11-20 DOI: 10.12659/AJCR.944795

Karolina Spodzieja, Piotr Sobiech, Dorota Olczak-Kowalczyk

{"title":"Innovative Combination of Tetracycline Rinse and CO₂ Laser Ablation for Treating White Sponge Nevus in Adolescents: A Case Study.","authors":"Karolina Spodzieja, Piotr Sobiech, Dorota Olczak-Kowalczyk","doi":"10.12659/AJCR.944795","DOIUrl":"10.12659/AJCR.944795","url":null,"abstract":"BACKGROUND White sponge nevus (WSN) is rare, hereditary oral mucosa disorder. This condition usually presents as asymptomatic white coatings on mucous membranes that vary in intensity and thickness. Changes are usually observed on the oral cavity mucosa, and other mucosal sites of involvement include nasal, esophageal, and anogenital. In most cases this condition is considered benign since the plaques cause no pain, with no risk of malignant transformation. Thorough clinical and histopathological examination is indicated to exclude other similar conditions and to avoid unnecessary treatment. CASE REPORT We present a new case of white sponge nevus in a 13-year-old Polish girl with history of familial involvement. The patient had been treated with low-dosage tetracycline rinse (0.25%) for 3 months, and slight reduction in lesions was observed. Laser, ablation was performed with a CO₂ laser, the lesions recurred after half a year. It is the first published case report of WSN lesions on the oral mucosa treated with CO₂ laser. The patient remains under observation. CONCLUSIONS Because therapeutic options recommended in the literature provide only partial improvement or are unsuccessful, further research is still needed to develop treatment methods for patients with WSN. CO₂ laser ablation, although promising, cannot be regarded as an effective treatment method for white sponge nevus.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944795"},"PeriodicalIF":1.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677131","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

Real-Time Depiction of Intrahepatic Biliary Anatomy During Recipient Surgery with Contrast-Enhanced Ultrasonography in Living-Donor Liver Transplantation. 在活体供肝肝移植手术中使用对比增强超声造影实时描绘受体手术过程中的肝内胆道解剖。

IF 1

American Journal of Case Reports Pub Date : 2024-11-19 DOI: 10.12659/AJCR.945859

Baglan Askeyev, Akihiko Soyama, Hajime Matsushima, Takanobu Hara, Kantoku Nagakawa, Hajime Imamura, Mampei Yamashita, Tomohiko Adachi, Susumu Eguchi

{"title":"Real-Time Depiction of Intrahepatic Biliary Anatomy During Recipient Surgery with Contrast-Enhanced Ultrasonography in Living-Donor Liver Transplantation.","authors":"Baglan Askeyev, Akihiko Soyama, Hajime Matsushima, Takanobu Hara, Kantoku Nagakawa, Hajime Imamura, Mampei Yamashita, Tomohiko Adachi, Susumu Eguchi","doi":"10.12659/AJCR.945859","DOIUrl":"10.12659/AJCR.945859","url":null,"abstract":"BACKGROUND In living-donor liver transplantation, biliary complications are considered an Achilles' heel. Consequently, various attempts have been made to reduce their incidence, and multiple innovations in surgical techniques have been reported. We herein report a case involving an intraoperative ultrasound cholangiogram in the recipient's abdominal cavity after reperfusion of the graft. CASE REPORT A 39-year-old male patient with decompensated alcoholic liver cirrhosis was admitted to our hospital for living-donor liver transplantation. The donor was his younger brother. Preoperative magnetic resonance cholangiopancreatography revealed no evidence of biliary anatomical variance; this could have been problematic when donating the left lobe graft. Intraoperative cholangiography showed that the left hepatic duct was sufficiently long for division, guaranteeing donor safety. Back-table observation of the bile duct revealed 3 orifices; of these, the central orifice was very small, and the corresponding bile duct was not evident on intraoperative cholangiography in donor surgery. After an injection of perfluorobutane microbubbles (Sonazoid) diluted 1000-fold into the small central orifice, the bile duct of segment 4 (B4) was clearly visualized with an intraoperative ultrasound cholangiogram. The off-label use of Sonazoid was approved by Nagasaki University Hospital. Based on this finding, we determined that all 3 openings required reconstruction and reconstructed them using a telescope reconstruction method. CONCLUSIONS We verified that intraoperative ultrasound cholangiogram is useful as a tool to confirm the anatomy of the bile duct when it is not revealed through other evaluation techniques; hence, it is a method that transplant surgeons should be familiar with.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945859"},"PeriodicalIF":1.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669503","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

Chronic Gallstone Ileus Presenting as Acute Small Bowel Obstruction: A Case Study. 慢性胆石性回肠炎表现为急性小肠梗阻：病例研究。

IF 1

American Journal of Case Reports Pub Date : 2024-11-18 DOI: 10.12659/AJCR.945343

Jordyn N Becker, Emily A Ginn, Bradley Bandera, Mitzi Miller

{"title":"Chronic Gallstone Ileus Presenting as Acute Small Bowel Obstruction: A Case Study.","authors":"Jordyn N Becker, Emily A Ginn, Bradley Bandera, Mitzi Miller","doi":"10.12659/AJCR.945343","DOIUrl":"10.12659/AJCR.945343","url":null,"abstract":"BACKGROUND Gallstone ileus is an uncommon cause of intestinal obstruction. Rigler's classic triad for a gallstone ileus includes the following: small bowel obstruction, air in the biliary tract, and an obstructing gallstone. This triad, however, is not always observed. We present an unusual case of a gallstone present in the small bowel for several years prior to presenting with an acute obstruction. CASE REPORT A 71-year-old man presented with 3 days of lower abdominal pain, constipation, and abdominal distension, with his last reported bowel movement 3 days prior. The patient's vitals were stable, with a white blood cell count of 11.47×10⁹/L and no lactic acidosis. Abdominal exam was significant for bilateral lower-quadrant tenderness and mild distension. Findings on abdominal computed tomography revealed a large foreign body in the distal small bowel, with evidence of proximal small bowel obstruction. Review of imaging from 4 years prior incidentally revealed the foreign body more proximally in the jejunum. Laparoscopy and enterotomy were performed with removal of a 4×4 cm gallstone encased in fecal material. The patient recovered well from surgery and had no complications. CONCLUSIONS A 71-year-old man presented with lower abdominal pain and distension. Work-up revealed a small bowel obstruction secondary to a presumed foreign body, later found to be a gallstone. We present a highly unusual presentation of a gallstone ileus, with radiographic evidence of an enteric gallstone present 4 years prior, with no evidence of pneumobilia or biliary-enteric fistula in current or previous computed tomography scans.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945343"},"PeriodicalIF":1.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649206","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

Multimodality Imaging Uncovers Giant Coronary Artery Aneurysm Mimicking Cardiac Tumor. 多模态成像发现模仿心脏肿瘤的巨大冠状动脉动脉瘤

IF 1

American Journal of Case Reports Pub Date : 2024-11-17 DOI: 10.12659/AJCR.945434

Karoline Bjerg Dam-Huus, Hans Gustav Hørsted Thyregod, Redi Pecini, Morten Holdgaard Smerup, Ekim Seven, Ida Arentz Taraldsen, Jesper James Linde

{"title":"Multimodality Imaging Uncovers Giant Coronary Artery Aneurysm Mimicking Cardiac Tumor.","authors":"Karoline Bjerg Dam-Huus, Hans Gustav Hørsted Thyregod, Redi Pecini, Morten Holdgaard Smerup, Ekim Seven, Ida Arentz Taraldsen, Jesper James Linde","doi":"10.12659/AJCR.945434","DOIUrl":"10.12659/AJCR.945434","url":null,"abstract":"BACKGROUND Giant coronary artery aneurysms (CAA) are extremely rare and can mimic cardiac tumors. Therefore, an unidentified mass in the heart requires a multimodality imaging approach for accurate diagnosis and guidance of further management, which for CAAs often include surgical intervention to prevent complications such as thrombosis or rupture. CASE REPORT A 37-year-old man presented with non-specific symptoms. A CT scan revealed multiple bilateral pulmonary embolisms and an indeterminate mass in the right atrium. Transthoracic echocardiography (TTE) showed a suspected cardiac tumor, and further imaging with transesophageal echocardiography (TEE), magnetic resonance imaging (MRI), and position emission tomography (PET) indicated a local inhomogeneous mass with arterial perfusion. A preoperative cardiac CT found the mass to be a giant thrombosed CAA in the proximal right coronary artery compressing the tricuspid annulus. The patient underwent successful surgical excision of the CAA along with coronary artery bypass grafting. Postoperative management included lifelong administration of acetylsalicylic acid and a 3-month course of anticoagulant therapy. Histopathology excluded systemic vasculitis, indicating a congenital etiology for the CAA. CONCLUSIONS This case illustrates the indispensable role of coronary CT angiography in accurately diagnosing and managing complex cardiac conditions. Due to the complex and diverse nature of suspected cardiac tumors, cardiac CT should always be added in the diagnostic workup to describe the coronary anatomy in relation to the tumor and to identify a differential diagnosis such as a giant coronary aneurysm.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945434"},"PeriodicalIF":1.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644673","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

Diagnostic Challenges of Multiple Sporotrichoid Skin Lesions Caused by Mycobacterium marinum. 海洋分枝杆菌引起的多发性孢子丝菌皮肤病的诊断难题。

IF 1

American Journal of Case Reports Pub Date : 2024-11-16 DOI: 10.12659/AJCR.945992

Kazuhiro Ishikawa, Minori Otake, Kyoko Tsumura, Satoru Arai, Kayo Okumura, Nobuyoshi Mori

{"title":"Diagnostic Challenges of Multiple Sporotrichoid Skin Lesions Caused by Mycobacterium marinum.","authors":"Kazuhiro Ishikawa, Minori Otake, Kyoko Tsumura, Satoru Arai, Kayo Okumura, Nobuyoshi Mori","doi":"10.12659/AJCR.945992","DOIUrl":"10.12659/AJCR.945992","url":null,"abstract":"BACKGROUND Mycobacterium marinum is a slow-growing non-tuberculous mycobacterium that is known to cause skin and soft tissue infections, even in healthy patients, and is commonly associated with fish and aquatic environments. CASE REPORT A 23-year-old man working in aquarium management presented with a chronic progression of multiple skin nodules on his right forearm and thumb. The patient was referred from the Dermatology Department to the Outpatient Clinic due to suspected skin tuberculosis, as indicated by a positive T-SPOT.TB test. A second excisional biopsy tested positive for M. marinum via PCR sequencing by the National Institute of Infectious Diseases, confirming the diagnosis. The initial treatment consisted of rifabutin at 300 mg/day and clarithromycin at 800 mg/day. However, due to liver dysfunction, the regimen was changed to moxifloxacin at 400 mg/day and rifabutin. Moxifloxacin was discontinued due to nausea. Finally, the treatment was adjusted to linezolid at 1200 mg/day and clarithromycin. The patient's skin condition improved, with the nodular lesions showing a trend toward resolution. Culturing is time-consuming, and the sensitivity can be reduced when using N-acetyl-l-cysteine-sodium hydroxide in the pre-treatment process; therefore, caution with its use is necessary. Pathological examination can initially show inflammatory changes, and granulomatous lesions with caseous necrosis are not always present. Antibiotics such as rifampicin, rifabutin, moxifloxacin, and clarithromycin are used, but there is scant evidence for treatment regimens, often resulting in prolonged monotherapy or combination therapy. CONCLUSIONS In cases presenting chronic lesions resembling multiple sporotrichoid forms, repeated biopsies are crucial due to the challenges associated with culturing.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945992"},"PeriodicalIF":1.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644656","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

Pregnancy Management and Outcomes in a Small Bowel, Pancreas, and Liver Transplant Recipient: A Case Report and Literature Review. 小肠、胰腺和肝脏移植受者的妊娠管理和结果：病例报告与文献综述。

IF 1

American Journal of Case Reports Pub Date : 2024-11-15 DOI: 10.12659/AJCR.945914

Mohammed Abusuliman, Abdullah Olimy, Moataz Aboeldahb, Amr Abusuliman, Sanad Dawod, Sheema Rehman, Ahmed E Salem, Sarah Meribout, Khalid Aloum, Syed-Mohammed Jafri

{"title":"Pregnancy Management and Outcomes in a Small Bowel, Pancreas, and Liver Transplant Recipient: A Case Report and Literature Review.","authors":"Mohammed Abusuliman, Abdullah Olimy, Moataz Aboeldahb, Amr Abusuliman, Sanad Dawod, Sheema Rehman, Ahmed E Salem, Sarah Meribout, Khalid Aloum, Syed-Mohammed Jafri","doi":"10.12659/AJCR.945914","DOIUrl":"10.12659/AJCR.945914","url":null,"abstract":"BACKGROUND Small bowel transplantation (SBT) is a rare but life-saving surgery. However, successful full-term pregnancies in individuals with SBT are exceedingly rare due to the nutritional and immunosuppression challenges this transplant poses for pregnancy. Therefore, clear guidelines for treating pregnant SBT recipients are unavailable. Here, we report the second case of a successful pregnancy in an individual with a triple organ transplant, including SBT, highlighting the need for careful immunosuppressive management and multidisciplinary care. CASE REPORT A 20-year-old woman in the third trimester of pregnancy with a history of small bowel, liver, and pancreas transplantation at age 1 year presented with elevated liver function test results. She had been taking tacrolimus, sirolimus, and prednisone before pregnancy, with no signs of organ rejection. While sirolimus and prednisone was discontinued upon conception, laboratory test results at presentation revealed low serum tacrolimus levels. The patient had an acute kidney injury and pulmonary edema during her hospitalization and received a diagnosis of preeclampsia. She underwent a successful cesarean delivery, due to labor induction complications; however, about 1 month after hospital discharge, the patient experienced elevated liver enzymes, which was treated with high-dose steroids and adjusted tacrolimus. Sirolimus was restarted, and the patient's liver enzymes have been normalized to date. CONCLUSIONS Comprehensive multidisciplinary care, as well as monitoring and optimizing immunosuppression, are essential for pregnant SBT recipients throughout the prenatal, perinatal, and postpartum periods to mitigate risks, prevent graft rejection, and ensure positive maternal and fetal health outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945914"},"PeriodicalIF":1.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630092","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 Acute and Chronic Hypercapnic Respiratory Failure in Severe Obesity-Hypoventilation Syndrome: A Case Study of Multi-Modal Therapy and Long-Term Weight Loss. 严重肥胖-通气不足综合征急性和慢性高碳酸血症呼吸衰竭的治疗：多模式疗法与长期减肥的案例研究》。

IF 1

American Journal of Case Reports Pub Date : 2024-11-14 DOI: 10.12659/AJCR.945448

Miori Kitamura, Hajime Kasai, Jiro Terada, Ken Koshikawa, Kenichi Suzuki, Takuji Suzuki

{"title":"Management of Acute and Chronic Hypercapnic Respiratory Failure in Severe Obesity-Hypoventilation Syndrome: A Case Study of Multi-Modal Therapy and Long-Term Weight Loss.","authors":"Miori Kitamura, Hajime Kasai, Jiro Terada, Ken Koshikawa, Kenichi Suzuki, Takuji Suzuki","doi":"10.12659/AJCR.945448","DOIUrl":"10.12659/AJCR.945448","url":null,"abstract":"BACKGROUND Obesity-hypoventilation syndrome (OHS), also known as Pickwickian syndrome, is a respiratory consequence of morbid obesity, usually treated with non-invasive positive airway pressure (PAP) therapies and weight loss. This study reports a 53-year-old woman with a body mass index of 49 kg/m² who experienced acute hypercapnic respiratory failure due to OHS. Her treatment involved mechanical ventilation, home oxygen therapy, and long-term weight loss of >30 kg. CASE REPORT A 53-year-old woman (109 kg) presented with acute hypercapnic respiratory failure due to OHS, which improved with mechanical ventilation and diuretics. After discharge from the hospital, she was treated with nocturnal non-invasive positive-pressure ventilation (NPPV) and home oxygen therapy. Over a 5-year period, following loss of >30 kg, she was re-evaluated for the discontinuation of NPPV and oxygen therapy. She was evaluated with various NPPV settings and oxygen doses, monitored by transcutaneous pressure of carbon dioxide (PtcCO₂). On NPPV, PtcCO₂ levels ≥55 mmHg were maintained within 10 min, indicating that the durations of PtcCO₂ ≥50 mmHg were too prolonged for her to be switched to continuous PAP therapy. Nonetheless, oxygen therapy was discontinued because the duration of peripheral blood oxygen saturation <90% was brief. CONCLUSIONS For patients with OHS treated with NPPV and oxygen therapy, weight loss alone may not improve hypoventilation and wean the patient from NPPV. Besides obesity, various factors influence respiratory compromise in OHS; hence, a comprehensive assessment of hypoventilation, including PtcCO₂ monitoring, is essential to determine whether NPPV withdrawal is possible after body weight loss.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945448"},"PeriodicalIF":1.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630083","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

Ultrasound-Guided Needle Aspiration and Antibiotic Injection for Subperiosteal Orbital Abscess: A Case Study and 3-Year Follow-Up. 超声引导下针头抽吸和抗生素注射治疗骨膜下眼眶脓肿：病例研究与 3 年随访。

IF 1

American Journal of Case Reports Pub Date : 2024-11-13 DOI: 10.12659/AJCR.944844

Yan Zhang, Na Li, Lei Yu

{"title":"Ultrasound-Guided Needle Aspiration and Antibiotic Injection for Subperiosteal Orbital Abscess: A Case Study and 3-Year Follow-Up.","authors":"Yan Zhang, Na Li, Lei Yu","doi":"10.12659/AJCR.944844","DOIUrl":"10.12659/AJCR.944844","url":null,"abstract":"BACKGROUND Orbital abscess is a severe infectious condition of the eye that can result in significant complications, including vision loss or fatality. Timely and accurate diagnosis and treatment of this condition are crucial. CASE REPORT A 45-year-old man with exophthalmos, diplopia, and decreased vision was admitted to our hospital. He had a history of chronic sinusitis. Ultrasonography showed a dark fluid area above the superior rectus muscle of the right eye, measuring approximately 5.7 ml. Orbital MRI revealed short T1 and long T2 signal shadows outside the upper muscle cone of the right orbit, with a size of about 13.2 ml. The right eyeball was compressed and moved forward, and the superior rectus muscle was also compressed. Long T2 signal shadows were observed in the right frontal sinus, maxillary sinus, and bilateral ethmoid sinuses, leading to a diagnosis of orbital subperiosteal abscess and sinusitis. We performed a fine-needle puncture and injection of antibiotics into the abscess cavity using a 5-ml syringe under the guidance of B-ultrasound. On the 7th day after surgery, the patient showed clinical improvement with decreased symptoms. His visual acuity improved from 20/40 to 20/20, and diplopia resolved. His sinusitis was treated with medication, and no recurrence of ocular symptoms was observed during the 3-year follow-up. CONCLUSIONS This report highlights the use of ultrasound-guided fine-needle puncture and injection of antibiotics into the abscess cavity for the treatment of an upper-quadrant orbital subperiosteal abscess. Timely surgical drainage and effective antibiotic therapy can help reduce the complications associated with orbital abscesses.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944844"},"PeriodicalIF":1.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628486","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

High-Dose Oxygen Therapy and Acute Hypercapnia in Elderly Patients: A Case Series Analysis. 大剂量氧疗与老年患者急性高碳酸血症：病例系列分析。

IF 1

American Journal of Case Reports Pub Date : 2024-11-12 DOI: 10.12659/AJCR.945044

John Patrick Seery

{"title":"High-Dose Oxygen Therapy and Acute Hypercapnia in Elderly Patients: A Case Series Analysis.","authors":"John Patrick Seery","doi":"10.12659/AJCR.945044","DOIUrl":"10.12659/AJCR.945044","url":null,"abstract":"BACKGROUND Detection of episodes of desaturation on pulse oximetry in elderly people in community settings is now a common occurrence. Transfer of such patients to hospital by ambulance has led to a greatly increased exposure to high-dose (FiO₂ > 50%) inhaled oxygen therapy in this group. Current British Thoracic Society (BTS) guidelines recommend administration of oxygen, 15 L/min via a non-rebreather mask (NRB) to acutely hypoxemic patients with an SpO₂ below 85% on room air. In some elderly subjects, such high-dose oxygen therapy induces significant hypercapnia in the absence of an identifiable risk factor for oxygen-induced CO₂ retention. CASE REPORT This case series describes 3 very elderly (>85 years old) female patients developing acute hypercapnia shortly after initiation of high-dose inhaled oxygen therapy. In each of these cases, hypercapnia developed in the absence of an accepted risk factor for oxygen-induced CO₂ retention. In 2 cases, CO₂ narcosis resolved within hours of the establishment of controlled oxygen therapy on bi-level positive airway pressure (BPAP). The possibility of oxygen-induced CO2 retention was not considered by the treating physicians in the acute setting. CONCLUSIONS The possibility of oxygen-induced CO₂ retention should be considered in all elderly patients developing acute type II respiratory failure in the setting of high-dose oxygen therapy. Failure to recognize oxygen-induced CO₂ retention has significant implications for patient outcome and resource utilization.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945044"},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630075","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

Recurrent Syncope as a Rare Initial Manifestation of Diffuse Large B-Cell Lymphoma in the Cervical Region. 复发性晕厥是宫颈区域弥漫性大 B 细胞淋巴瘤的一种罕见初始表现。

IF 1

American Journal of Case Reports Pub Date : 2024-11-11 DOI: 10.12659/AJCR.945393

Mustafa Nuaimi, Sara Ubosy, Brian Shaw, Ryan Shaw, Alex Rico, Mario Madruga, Stephen J Carlan

{"title":"Recurrent Syncope as a Rare Initial Manifestation of Diffuse Large B-Cell Lymphoma in the Cervical Region.","authors":"Mustafa Nuaimi, Sara Ubosy, Brian Shaw, Ryan Shaw, Alex Rico, Mario Madruga, Stephen J Carlan","doi":"10.12659/AJCR.945393","DOIUrl":"10.12659/AJCR.945393","url":null,"abstract":"BACKGROUND Diffuse large B-cell lymphoma is the most prevalent form of non-Hodgkin lymphoma, representing around a quarter of newly diagnosed cases of B-cell non-Hodgkin lymphoma. Diffuse large B-cell lymphoma is a disease that affects mostly older persons, with a median presentation in the 7th decade of life. Clinically, it has a variety of presentations, ranging from constitutional symptoms to local or systemic pressure effects caused by a rapidly growing mass. Only rarely do head and neck lymphomas present as syncopal events. Although diffuse large B-cell lymphoma frequently involves the cervical region, syncope from the condition without cardiac involvement has only been documented in a few cases to date. CASE REPORT A 66-year-old man experienced a sudden onset of recurrent syncopal episodes triggered by neck movement that had been ongoing for 2 weeks before his presentation. A rapidly enlarging left neck mass was first noticed 6 weeks earlier and he was treated with antibiotics. During a workup of the syncope, a diffuse large B-cell lymphoma was discovered to be encasing his left internal carotid artery without obstructing blood flow. Chemotherapy was initiated and resulted in complete neck mass and related syncope resolution. Follow-up positron emission tomography scan after 3 months of chemotherapy revealed an excellent response. CONCLUSIONS Sudden onset of syncopal episodes may be the first or only indication of a neck or head malignancy. As a result, we should be aware of the possibility of an underlying malignancy in individuals with unexplained syncope.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945393"},"PeriodicalIF":1.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628089","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