Case Reports in Critical Care最新文献_第5页

Recurrent Autoimmune Encephalitis in a Patient With Autoimmune Polyendocrine Syndrome Type 1. 1型自身免疫性多内分泌综合征患者复发性自身免疫性脑炎

Case Reports in Critical Care Pub Date : 2026-05-18 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/6086023

Jason T Stemple, Kamal Abulebda, Grace F Ryan, Nadine G Haddad, Alden F Dewey, Jennah C Foltz, Laurence E Walsh, Riad Lutfi

{"title":"Recurrent Autoimmune Encephalitis in a Patient With Autoimmune Polyendocrine Syndrome Type 1.","authors":"Jason T Stemple, Kamal Abulebda, Grace F Ryan, Nadine G Haddad, Alden F Dewey, Jennah C Foltz, Laurence E Walsh, Riad Lutfi","doi":"10.1155/crcc/6086023","DOIUrl":"10.1155/crcc/6086023","url":null,"abstract":"Autoimmune polyendocrine syndrome Type 1, also known as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APS-1/APECED), is a rare monogenic autoimmune disorder with increasing recognition of neurologic manifestations. We report a critically ill adolescent female with APS-1 and a prior history of autoimmune encephalitis who presented with acute encephalopathy and seizures. Electroencephalography demonstrated focal seizures superimposed on ictal-interictal continuum activity, and brain MRI revealed cytotoxic lesions of the corpus callosum. High-titer glutamic acid Decarboxylase 65 (GAD65) antibodies supported a relapse of autoimmune encephalitis after other potential etiologies were excluded. The patient demonstrated marked clinical improvement following aggressive immunotherapy, including plasma exchange, high-dose corticosteroids, and rituximab. This case highlights the diagnostic and management challenges of autoimmune encephalitis in patients with APS-1, and to our knowledge, represents the first reported case of recurrent autoimmune encephalitis in this population with a favorable response to early immunomodulatory therapy.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"6086023"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977134","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

Two Doses to ICU or When Lactate Equals Glucose: Life-Threatening Lactic Acidosis due to Metformin After Initiation of Semaglutide. 两剂量ICU或当乳酸等于葡萄糖：Semaglutide开始后二甲双胍引起的危及生命的乳酸酸中毒。

Case Reports in Critical Care Pub Date : 2026-05-16 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/3478800

Zhanna Albany, David Roe, Daniel Gutteridge, Hanna Webb, Areeba Kara

引用次数: 0

Mixed Shock due to Sepsis and Anaphylactic Reaction With Kounis Syndrome Secondary to Dipyrone (Metamizole): Case Report. 双吡喹酮继发于Kounis综合征的脓毒症及过敏反应混合性休克1例。

Case Reports in Critical Care Pub Date : 2026-05-14 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/2519508

Anthony Pellon

{"title":"Mixed Shock due to Sepsis and Anaphylactic Reaction With Kounis Syndrome Secondary to Dipyrone (Metamizole): Case Report.","authors":"Anthony Pellon","doi":"10.1155/crcc/2519508","DOIUrl":"10.1155/crcc/2519508","url":null,"abstract":"Kounis syndrome (KS) is a rare condition that combines acute coronary syndrome (ACS) with an allergic or anaphylactic reaction; in this case, it also occurred alongside sepsis, a coexistence not previously reported in scientific literature. The case of a 65-year-old man is presented with a history of allergy to penicillin and metamizole, admitted for persistent fever. Following intravenous metamizole administration, he developed hypotension, chest pain, bradycardia, dynamic electrocardiographic changes, and elevated troponin levels, in the context of pneumonia and hematologic dysfunction suggestive of sepsis. The final diagnosis was mixed shock (anaphylactic and septic) with Type I KS. Intramuscular epinephrine, antiallergic therapy, antibiotics, and ACS management were administered, with favorable evolution. This case underscores the importance of recognizing KS, an underdiagnosed entity, even in scenarios of critical comorbidity, as well as the need to maintain a broad differential diagnosis in the emergency department to prevent potentially serious diagnostic delays and errors.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"2519508"},"PeriodicalIF":0.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965446","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-Dependency Care Without Mechanical Ventilation for Severe Guillain-Barré Syndrome in a Rural Low-Income Setting. 农村低收入地区重症格林-巴罗综合征的无机械通气高依赖护理

Case Reports in Critical Care Pub Date : 2026-05-12 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/1700879

Lesley Notghi, Louise Little, Joel Chin

{"title":"High-Dependency Care Without Mechanical Ventilation for Severe Guillain-Barré Syndrome in a Rural Low-Income Setting.","authors":"Lesley Notghi, Louise Little, Joel Chin","doi":"10.1155/crcc/1700879","DOIUrl":"10.1155/crcc/1700879","url":null,"abstract":"Guillain-Barré syndrome (GBS) is a major cause of neuromuscular respiratory failure globally. In many low-income settings, access to mechanical ventilation and disease-modifying therapy is limited. We describe the management of a young woman with rapidly progressive GBS and bulbar weakness in a mission hospital in northern Madagascar without access to intensive care facilities, invasive ventilation or immunotherapy. Respiratory failure was managed using a structured high-dependencyunit (HDU) framework combining noninvasive respiratory support with intensive nursing care, physiotherapy, regular repositioning and close nurse-led observation. The patient survived the acute phase, regained swallow and speech by Day 8 and was discharged from HDU on Day 15. At 1-year follow-up, she had recovered full upper limb strength with residual lower limb weakness. This case highlights the potential for structured supportive care in an HDU to sustain life in clinically significant neuromuscular respiratory failure when definitive critical care resources are unavailable.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"1700879"},"PeriodicalIF":0.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13162226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935313","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

Capnocytophaga canimorsus Septicaemia Presenting With Multiorgan Dysfunction Syndrome (MODS) and Disseminated Intravascular Coagulation (DIC) in an Immunocompetent Individual. 免疫功能正常个体中出现多器官功能障碍综合征（MODS）和弥散性血管内凝血（DIC）的斑痣吞噬败血症

Case Reports in Critical Care Pub Date : 2026-05-06 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/1505682

Kadison Michel, Prashant Pruthi, Charlie Corke

{"title":"Capnocytophaga canimorsus Septicaemia Presenting With Multiorgan Dysfunction Syndrome (MODS) and Disseminated Intravascular Coagulation (DIC) in an Immunocompetent Individual.","authors":"Kadison Michel, Prashant Pruthi, Charlie Corke","doi":"10.1155/crcc/1505682","DOIUrl":"10.1155/crcc/1505682","url":null,"abstract":"We present a rare case of fulminant Capnocytophaga canimorsus septicaemia in a previously well 52-year-old immunocompetent woman, following a minor dog-related forehead abrasion. Despite a recent course of amoxicillin/clavulanate prescribed by her general practitioner, the patient developed profound sepsis characterised by disseminated intravascular coagulation (DIC), multiorgan dysfunction syndrome (MODS) and severe metabolic derangements. Initial symptoms included confusion, diarrhoea and nausea, rapidly progressing to circulatory shock and acute renal failure requiring intubation and continuous renal replacement therapy. Blood cultures later confirmed C. canimorsus, and antimicrobial therapy was rationalised accordingly. Radiological evidence revealed bilateral renal cortical necrosis, ultimately resulting in end-stage renal disease and ongoing dialysis dependency. This case is notable as one of the few documented instances of renal cortical necrosis due to Capnocytophaga infection and the only known case in which the patient survived. It highlights the diagnostic and therapeutic challenges of managing rare zoonotic infections, especially in patients without traditional risk factors. Clinicians should maintain a high index of suspicion for Capnocytophaga spp. in cases of sepsis of unclear origin, particularly with any history of animal exposure, and involve infectious disease specialists early during care.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"1505682"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846128","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 Management of Status Asthmaticus via Veno-Venous ECMO: Extubation Prior to Decannulation-A Case Report. 静脉-静脉ECMO对哮喘状态的成功治疗：拔管前拔管1例报告。

Case Reports in Critical Care Pub Date : 2026-04-29 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/7781487

Sheryl S Ang

{"title":"Successful Management of Status Asthmaticus via Veno-Venous ECMO: Extubation Prior to Decannulation-A Case Report.","authors":"Sheryl S Ang","doi":"10.1155/crcc/7781487","DOIUrl":"10.1155/crcc/7781487","url":null,"abstract":"Background: The use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has risen exponentially since the COVID pandemic. VV-ECMO has been utilized successfully to manage patients in status asthmaticus who have failed to respond adequately to conventional therapeutic interventions and mechanical ventilatory support. However, clear guidelines on the management of mechanical ventilation for these patients while on VV-ECMO support appear to be lacking.Case presentation: A 52-year-old male was placed on emergent VV-ECMO for status asthmaticus after developing worsening hypercarbic respiratory failure despite mechanical ventilation and aggressive bronchodilator therapy. Once he was stabilized on VV-ECMO, there was a dilemma in management priorities-extubate the patient while keeping full VV-ECMO support versus working to aggressively wean VV-ECMO support while the patient is intubated. Ultimately, the decision was made to extubate the patient about 60 h postcannulation. Postexubation, however, he was in respiratory distress with stridor and worsening bronchospasm and required maximum sweep on the VV-ECMO in addition to increased respiratory support via noninvasive ventilation (NIV). Ultimately, he turned the corner, made progressive improvement, was weaned from VV-ECMO support, and was decannulated 7 days after cannulation.Conclusion: Extubating a patient placed on VV-ECMO for status asthmaticus is not a straightforward decision. One needs to consider the management priorities, anticipate the potential problems, and understand the implications of early extubation.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"7781487"},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823284","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

The Hidden Vulnerability: How Underlying SMA Stenosis Turns Routine Intra-Aortic Balloon Pump Support Into Fatal Mesenteric Ischemia. 隐藏的弱点：潜在的SMA狭窄如何将常规的主动脉内球囊泵支持变成致命的肠系膜缺血。

Case Reports in Critical Care Pub Date : 2026-03-13 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/4613711

Nitya Panyala, Bhavneet Singh, Tanya Britto Muthunayagam, Rajeev Mehta

{"title":"The Hidden Vulnerability: How Underlying SMA Stenosis Turns Routine Intra-Aortic Balloon Pump Support Into Fatal Mesenteric Ischemia.","authors":"Nitya Panyala, Bhavneet Singh, Tanya Britto Muthunayagam, Rajeev Mehta","doi":"10.1155/crcc/4613711","DOIUrl":"10.1155/crcc/4613711","url":null,"abstract":"Intra-aortic balloon pump (IABP) therapy is a widely used mechanical circulatory support device for patients with cardiogenic shock. Although generally safe, IABP insertion can lead to serious complications, including the rare but potentially fatal development of mesenteric ischemia. We report a 58-year-old female smoker who presented with ST-elevation myocardial infarction complicated by cardiogenic shock requiring emergent cardiac catheterization and IABP insertion. Following IABP placement, the patient developed progressive abdominal pain, fever, tachycardia, and bloody bowel movements. CT imaging revealed extensive pneumatosis intestinalis and mural hypoenhancement consistent with small bowel ischemia, along with severe stenosis at the origin of the superior mesenteric artery (SMA). Despite emergent exploratory laparotomy with extensive small bowel resection, the patient developed multiorgan failure and died. This case demonstrates that mesenteric ischemia can occur even when IABP placement appears anatomically appropriate, particularly in patients with underlying visceral vascular disease. The patient's pre-existing high-grade SMA stenosis created a compromised perfusion state where reductions in diastolic blood flow from balloon counterpulsation precipitated catastrophic intestinal ischemia. Clinicians must maintain high clinical suspicion for mesenteric ischemia in patients who develop abdominal symptoms while on IABP support, especially those with visceral atherosclerosis. Early recognition is critical, as delayed diagnosis is almost universally fatal.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"4613711"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989948","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

Left Ventricular Sarcoma Causing Dynamic Outflow Tract Obstruction and Cardiogenic Shock: A Case Report. 左心室肉瘤引起动态流出道阻塞和心源性休克1例报告。

Case Reports in Critical Care Pub Date : 2026-01-07 eCollection Date: 2026-01-01 DOI: 10.1155/crcc/9317389

Tomás de la Barra, Mariana Navarro, Pablo Regueira, Aníbal Zamorano, Marlon Ponce, Mario Portilla, Pablo Salazar, Tomas Regueira

{"title":"Left Ventricular Sarcoma Causing Dynamic Outflow Tract Obstruction and Cardiogenic Shock: A Case Report.","authors":"Tomás de la Barra, Mariana Navarro, Pablo Regueira, Aníbal Zamorano, Marlon Ponce, Mario Portilla, Pablo Salazar, Tomas Regueira","doi":"10.1155/crcc/9317389","DOIUrl":"10.1155/crcc/9317389","url":null,"abstract":"Background: Primary cardiac sarcomas are rare and aggressive tumors that often present with nonspecific symptoms, typically diagnosed at advanced stages. Obstruction of the left ventricular outflow tract (LVOT) due to these tumors is an exceptionally rare and life-threatening complication.Case presentation: We describe the case of a previously healthy 33-year-old male who presented with progressive exertional dyspnea, orthopnea, and hemoptysis. Upon admission, he quickly developed hemodynamic instability and respiratory failure. Point-of-care transthoracic echocardiography revealed a large intracardiac mass causing dynamic LVOT obstruction. During intubation, the patient experienced cardiac arrest, necessitating advanced cardiopulmonary resuscitation. Urgent surgical intervention confirmed the presence of an infiltrative cardiac sarcoma with positive margins. The postoperative recovery was favorable, enabling extubation and withdrawal of vasoactive agents within 24 h.Discussion: Cardiac sarcomas often mimic other cardiovascular conditions, complicating early diagnosis. Imaging techniques such as echocardiography and cardiac MRI are essential for detection and characterization. The prognosis for patients with cardiac sarcomas remains poor due to the tumors' infiltrative nature and high rates of recurrence; however, complete surgical resection is the cornerstone of treatment.Conclusion: This case underscores the necessity for clinical vigilance in patients presenting with unexplained cardiopulmonary symptoms. The early application of bedside echocardiography facilitated prompt diagnosis and timely surgical intervention, proving life-saving in this instance of obstructive shock due to a primary cardiac sarcoma.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2026 ","pages":"9317389"},"PeriodicalIF":0.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12776001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935650","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 Vanishing Clot: The Disappearance of a Free-Floating Right Atrial Thrombus Just Before Urgent Surgical Thrombectomy. 一个消失的血栓：一个自由漂浮的右心房血栓在紧急手术取栓前消失。

Case Reports in Critical Care Pub Date : 2025-12-29 eCollection Date: 2025-01-01 DOI: 10.1155/crcc/9997423

Emanuel Heil, Jan Matthias Kruse, Daniel Zickler, Christoph Starck, Petar Petrov, Julius Valentin Kunz

引用次数: 0

Case Report: Extracorporeal Carbon Dioxide Removal in a Severely Brain-Injured Patient With Acute Respiratory Distress Syndrome. 病例报告：体外二氧化碳清除严重脑损伤患者急性呼吸窘迫综合征。

Case Reports in Critical Care Pub Date : 2025-12-19 eCollection Date: 2025-01-01 DOI: 10.1155/crcc/5404072

Sébastien Gibot, Lionel Nace, Aurélie Cravoisy

{"title":"Case Report: Extracorporeal Carbon Dioxide Removal in a Severely Brain-Injured Patient With Acute Respiratory Distress Syndrome.","authors":"Sébastien Gibot, Lionel Nace, Aurélie Cravoisy","doi":"10.1155/crcc/5404072","DOIUrl":"10.1155/crcc/5404072","url":null,"abstract":"The management of acute respiratory distress syndrome (ARDS) in a patient suffering from a severe brain injury may be difficult, especially when hypercapnia occurs. The rise of PaCO2 may compromise cerebral hemodynamics and increase intracerebral pressure (ICP). We describe herein a case of a 41-year-old man with a severe subarachnoid haemorrhage who develops a severe ARDS consequent to an inhalation pneumonia. Despite optimisation of mechanical ventilation, respiratory mechanics worsened and led to a major hypercapnic acidosis associated with an ICP rise. Because of concomitant ICP elevation and hemodynamic instability, prone positioning was considered too high-risk. We therefore opted for an extracorporeal carbon dioxide removal (ECCO2R) technique first. PaCO2 rapidly decreased, as well as ICP, and the patient could finally be proned while in ECCO2R. ECCO2R was kept for a total of 77 h with no complications. Thereafter, the patient progressively improved and could be weaned from the ventilator after 27 days. He was evaluated 3 months later during an outpatient visit. He was doing well with no sequelae and has resumed previous activities. While the use of extracorporeal decarboxylation techniques is being studied in ARDS, specific investigation in severely brain-injured patients deserves to be conducted.","PeriodicalId":52357,"journal":{"name":"Case Reports in Critical Care","volume":"2025 ","pages":"5404072"},"PeriodicalIF":0.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806276","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