Archive of clinical cases最新文献_第10页

Hypofibrinogenemia and miscarriage: report of a first successful pregnancy under fibrinogen substitution and short review of the literature. 低纤维蛋白原血症和流产:纤维蛋白原替代下首次成功妊娠的报告和简短的文献回顾。

Archive of clinical cases Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.22551/2022.36.0903.10211

Christoph Sucker, Christof Geisen, Ursula Schmitt, Bartosz Zawislak

引用次数: 0

Septic shock from multiple intra-abdominal Streptococcus constellatus abscesses unamenable to percutaneous drainage. 腹腔内多发星形链球菌脓肿所致感染性休克，不能经皮引流。

Archive of clinical cases Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.22551/2022.36.0903.10215

Faraz Badar, Aqsa Ashraf, Shaheryar Usman, Asma Iftikhar

{"title":"Septic shock from multiple intra-abdominal Streptococcus constellatus abscesses unamenable to percutaneous drainage.","authors":"Faraz Badar, Aqsa Ashraf, Shaheryar Usman, Asma Iftikhar","doi":"10.22551/2022.36.0903.10215","DOIUrl":"https://doi.org/10.22551/2022.36.0903.10215","url":null,"abstract":"Streptococcus constellatus are gram-positive cocci belonging to the Streptococcus milleri group that have a propensity to cause bacteremia and abscesses, especially in immunocompromised patients. Here, we report the case of a 39-year-old male who was initially admitted to the hospital for diabetic ketoacidosis. During the hospitalization, he developed sepsis and blood cultures grew Streptococcus constellatus. CT imaging revealed multiple hepatic abscesses. A periapical abscess of the left mandibular central incisor found on CT Scan of face was identified as the likely source of infection. IR-guided drainage was performed however the patient went on to develop septic shock despite attempted source control and IV antibiotic therapy. Repeat imaging showed persistent hepatic abscesses in addition to new intraperitoneal abscesses necessitating exploratory laparotomy, drainage and abdominal washout. Fluid cultures grew Streptococcus constellatus and common enteric flora. Our report highlights the need for high clinical suspicion in cases of Streptococcus constellatus bacteremia to obtain diagnostic imaging for any abscess formation. Prolonged antibiotic therapy is a must and imaging guided or surgical drainage may be needed.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"117-120"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/63/acc-09-03-117.PMC9512127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384830","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

Abnormal uterine bleeding in a female with Klippel Trenaunay syndrome. 女性Klippel - Trenaunay综合征异常子宫出血1例。

Archive of clinical cases Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.22551/2022.36.0903.10209

Ashiq Pramchand

引用次数: 0

Pituitary hypoplasia and growth hormone deficiency in a patient with Coffin-Siris syndrome and severe short stature: case report and literature review. 1例Coffin-Siris综合征合并严重身材矮小患者的垂体发育不全和生长激素缺乏:病例报告并文献复习。

Archive of clinical cases Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.22551/2022.36.0903.10216

Stefana Catalina Bilha, Laura Teodoriu, Cristian Velicescu, Lavinia Caba

{"title":"Pituitary hypoplasia and growth hormone deficiency in a patient with Coffin-Siris syndrome and severe short stature: case report and literature review.","authors":"Stefana Catalina Bilha, Laura Teodoriu, Cristian Velicescu, Lavinia Caba","doi":"10.22551/2022.36.0903.10216","DOIUrl":"https://doi.org/10.22551/2022.36.0903.10216","url":null,"abstract":"Coffin-Siris syndrome (CSS) is a rare genetic disorder caused by the haploinsufficiency of one of the various genes that are part of the Brahma/BRG1-associated factor (BAF) complex. The BAF complex is one of the chromatin remodeling complexes, involved in embryonic and neural development, and various gene mutations are associated with cognitive impairment. CSS has a highly variable genotype and phenotype expression, thus lacking standardized criteria for diagnosis. It is generally accepted to associate 5th digit/nail hypoplasia, intellectual disability (ID)/developmental delay and specific coarse facial features. CSS patients usually display miscellaneous cardiac, genitourinary and central nervous system (CNS) anomalies. Many patients also associate intrauterine growth restriction, failure to thrive and short stature, with several cases demonstrating growth hormone deficiency (GHD). We report the case of a 4-year-old girl with severe short stature (-3.2 standard deviations) due to pituitary hypoplasia and GHD that associated hypoplastic distal phalanx of the 5th digit in the hands and feet, severe ID, coarse facial features (bushy eyebrows, bulbous nose, flat nasal bridge, dental anomalies, thick lips, dental anomalies, bilateral epicanthal fold) and CNS anomalies (agenesis of the corpus callosum and bilateral hippocampal atrophy), thus meeting clinical criteria for the diagnosis of CSS. Karyotype was 46,XX. The patient was started on GH replacement therapy, with favorable outcomes. Current practical knowledge regarding CSS diagnosis and management from the endocrinological point of view is also reviewed.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/b0/acc-09-03-121.PMC9512126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384829","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: 1

A case report of pyogenic sacroiliitis in a 9-month-old child. 化脓性骶髂炎1例，9个月大。

Archive of clinical cases Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.22551/2022.36.0903.10213

Sarah Thomas, Saira Haque, Trisha Radia

{"title":"A case report of pyogenic sacroiliitis in a 9-month-old child.","authors":"Sarah Thomas, Saira Haque, Trisha Radia","doi":"10.22551/2022.36.0903.10213","DOIUrl":"https://doi.org/10.22551/2022.36.0903.10213","url":null,"abstract":"A very rare condition, pyogenic sacroiliitis is responsible for 1-2% of all osteoarticular infections in children. Diagnosis is often delayed in the pediatric population due to non-specific signs and symptoms during presentation, difficulty in assessing the joint, more common differential diagnosis and low yield diagnostic findings in conventional radiography. A delayed diagnosis of this condition can lead to permanent joint damage. A 9-month-old presented to the emergency department with a history of fever, being unsettled and clingy along with refusal to weight bear over the past few days. On initial assessment, she was found to be tachycardic and afebrile with abnormal posture of her left leg held in external rotation at the hip joint. On examination, she refused to weight bear, presented with alternating tenderness of her left and right hip joints and spinal tenderness at the L5 position. Investigations done showed slightly raised inflammatory counts, normal hip and pelvic radiographs, normal hip ultrasound and blood culture growing staphylococcus aureus and Magnetic Resonance Imaging spine showing right sacroiliitis leading the diagnosis of pyogenic sacroiliitis. This case report highlights the importance of examination of the back and the importance of avoiding fixation error by history. Although rare, clinicians should consider the diagnosis of sacroiliitis in children who present with fever, being unsettled with decreased and painful movements around the pelvic region.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"108-111"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/b3/acc-09-03-108.PMC9512130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40383812","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

Autoimmune myasthenia gravis after COVID-19 in a triple vaccinated patient. 三次接种后患者的自身免疫性重症肌无力

Archive of clinical cases Pub Date : 2022-09-26 eCollection Date: 2022-01-01 DOI: 10.22551/2022.36.0903.10212

Cristina-Georgiana Croitoru, Dan Iulian Cuciureanu, Iulian Prutianu, Petru Cianga

{"title":"Autoimmune myasthenia gravis after COVID-19 in a triple vaccinated patient.","authors":"Cristina-Georgiana Croitoru, Dan Iulian Cuciureanu, Iulian Prutianu, Petru Cianga","doi":"10.22551/2022.36.0903.10212","DOIUrl":"https://doi.org/10.22551/2022.36.0903.10212","url":null,"abstract":"Despite a well characterized mechanism, myasthenia gravis (MG) remains a dilemma in terms of etiology. Several case reports and series of cases suggest a potential cause-effect relation between SARS-CoV-2 infection or vaccination and MG. We present the case of an autoimmune MG occurring post Covid-19 in an elderly male, vaccinated with three doses of the BNT162b2/Pfizer-BioNTech vaccine. The 78-year-old male was admitted in the Neurology Clinic in early November 2021 with double vision, bilateral ptosis, dysphonia and dysphagia, 16 days after receiving a third dose of the BNT162b2/Pfizer-BioNTech SARS-CoV-2 vaccine and 12 days after testing positive for SARS-CoV-2 infection. The symptoms began to emerge at 9 days after COVID-19 diagnosis. Clinical neurological examination included ice-pack test and intramuscular neostigmine, both with positive results. Myasthenia gravis positive diagnosis was confirmed by slow repetitive nerve stimulation and abnormally increased serum levels of antibodies against acetylcholine receptors. Due to patient's refusal of further hospitalization, he was discharged with therapy recommendations. Under treatment with oral pyridostigmine, but no oral corticosteroid due to therapeutic noncompliance, the patient was readmitted two months later with aggravated symptoms. The myasthenic crisis was successfully treated with intravenous immunoglobulins, corticosteroid therapy and oral pyridostigmine. The novelty of the current case resides in the fact that, to the best of our knowledge, appears to be the first case of MG clinically manifested after COVID-19 infection in a fully vaccinated patient.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"104-107"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/c3/acc-09-03-104.PMC9512128.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384828","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: 2

Total hip arthroplasty for an intracapsular femoral neck fracture of high-femoral amputee. 全髋关节置换术治疗高位股骨截肢者股骨颈囊内骨折。

Archive of clinical cases Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI: 10.22551/2022.35.0902.10203

Panagiotis Christidis, Theofanis Kantas, Christos Kalitsis, Sampria Georgia Frechat, Georgios Biniaris, Nikolaos Gougoulias

{"title":"Total hip arthroplasty for an intracapsular femoral neck fracture of high-femoral amputee.","authors":"Panagiotis Christidis, Theofanis Kantas, Christos Kalitsis, Sampria Georgia Frechat, Georgios Biniaris, Nikolaos Gougoulias","doi":"10.22551/2022.35.0902.10203","DOIUrl":"https://doi.org/10.22551/2022.35.0902.10203","url":null,"abstract":"Femoral neck fractures in transfemoral amputees are not common and management is associated with surgical technique and post-operative rehabilitation challenges. A 61-year-old Caucasian, male, above-knee amputee (following mangled extremity trauma 8 months before) who mobilized with a prosthesis presented to the emergency department with a right femoral neck fracture (Garden III). The patient underwent cementless total hip replacement (THR), using the lateral (Hardinge's) approach. No additional instrument was used to manipulate the residual femoral stump. The absence of the distal limb required careful preparation of the femoral canal, taking into consideration the position of the lesser trochanter, in order to appropriately align the femoral prosthesis regarding anteversion. Postoperative recovery was uneventful. Six months later, the patient was ambulating using his prothesis and had almost returned to his pre-injury activity status. Satisfactory results can be obtained after THR in trans-femoral amputees.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/07/acc-09-02-50.PMC9262082.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40581271","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

Dabigatran for intracardiac thrombus, yet another promising role of a direct oral anticoagulant: a case report and short review of literature. 达比加群用于心脏内血栓，又是一种有前途的直接口服抗凝剂:一个病例报告和简短的文献回顾。

Archive of clinical cases Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI: 10.22551/2022.35.0902.10207

Piyush Kumar, M Sudhakar Rao, Kanhai Lalani, Ganesh Paramasivam, Tom Devasia, Pankti Parikh

{"title":"Dabigatran for intracardiac thrombus, yet another promising role of a direct oral anticoagulant: a case report and short review of literature.","authors":"Piyush Kumar, M Sudhakar Rao, Kanhai Lalani, Ganesh Paramasivam, Tom Devasia, Pankti Parikh","doi":"10.22551/2022.35.0902.10207","DOIUrl":"https://doi.org/10.22551/2022.35.0902.10207","url":null,"abstract":"A left ventricular (LV) thrombus is a relatively common and well-known condition associated with significant LV systolic dysfunction. However, LV thrombosis is unusual in the absence of kinetic abnormalities. The elderly gentleman presented with subacute onset of bilateral lower limb discomfort and cold extremities, but no gangrene. With normal LV function, an echocardiogram revealed a massive movable LV apical clot. He was treated with dual antiplatelets and heparin at first. He switched to dabigatran 110 mg twice a day in combination with dual antiplatelets. The thrombus had entirely vanished and leg problems had improved after a 2-week follow-up. For the next six months, he was treated with aspirin and dabigatran and was asymptomatic at follow-up. There are no specific guidelines for treating an intracardiac thrombus. Experts agree that a hypermobile and pedunculated LV thrombus with a high embolic risk should be surgically removed as soon as possible. According to ESC/ACC guidelines, all patients with LV thrombus associated with myocardial infarction should be treated with anticoagulation. Warfarin requires regular International Normalized Ratio (INR) monitoring and has a small therapeutic window; hence a direct oral anticoagulant (DOAC) could be a viable therapeutic solution. However, there are no guideline recommendations to date to guide DOAC therapy for this indication.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/e0/acc-09-02-75.PMC9262080.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40579244","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: 1

Biventricular cardiac metastasis from vulvar squamous cell carcinoma. 外阴鳞状细胞癌的双心室心脏转移。

Archive of clinical cases Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI: 10.22551/2022.35.0902.10205

Ștefan Spînu, Daniel Sur, Andreea Pârv, Călin Căinap, Petruța Stoia, Veronica Creciun, Mădălina Bota, Alina Pop, Ovidiu Bochiș

{"title":"Biventricular cardiac metastasis from vulvar squamous cell carcinoma.","authors":"Ștefan Spînu, Daniel Sur, Andreea Pârv, Călin Căinap, Petruța Stoia, Veronica Creciun, Mădălina Bota, Alina Pop, Ovidiu Bochiș","doi":"10.22551/2022.35.0902.10205","DOIUrl":"https://doi.org/10.22551/2022.35.0902.10205","url":null,"abstract":"Vulvar cancers make up just 3% to 5% of all gynecological cancers, and they are most typically found in postmenopausal women. Vulvar cancer distant metastases are uncommon and usually arise late. Only six cases of vulvar cancer metastasizing to the heart have been reported in the literature, and none of them included both the left and right ventricles. We describe the case of a 68-year-old patient diagnosed with vulvar cancer arising from lichen sclerosus, initially localized, treated with chemotherapy, surgery, and radiation therapy. Less than two months after the end of the treatment sequence, the patient returned to our clinic with bone pain. Imaging investigations have shown multiple disseminated metastases, but not in the heart at that moment. Chemotherapy was initiated, and after two cycles, the patient developed an arrhythmia (atrial fibrillation with rapid ventricular rate), which was later determined to be caused by cardiac metastases discovered by echocardiography and computed tomography. Vulvar cancer metastatic to the heart represents a rare clinical condition, requiring multidisciplinary care. The case's uniqueness is the biventricular metastasis, which resulted in STEMI despite angiographically normal epicardial coronary arteries.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":" ","pages":"62-68"},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/4d/acc-09-02-62.PMC9262084.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40579247","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

Marijuana-induced myocarditis in a 24-year-old man. 一名 24 岁男子因吸食大麻引发心肌炎。

IF 0.8

Archive of clinical cases Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI: 10.22551/2022.35.0902.10206

Toktam Alirezaei, Mohammad Kalateh Agha Mohammadi, Rana Irilouzadian, Hamidreza Zarinparsa

引用次数: 0