Archive of clinical casesPub Date : 2024-06-24eCollection Date: 2024-01-01DOI: 10.22551/2024.43.1102.10287
Shreyas Bellur, Michele Gallo, Brian Ganzel, Praveen Seshabhattar, Siddharth Pahwa
{"title":"Transcatheter prosthetic valve endocarditis of an aortic valve-in-valve bioprosthesis in an elderly male.","authors":"Shreyas Bellur, Michele Gallo, Brian Ganzel, Praveen Seshabhattar, Siddharth Pahwa","doi":"10.22551/2024.43.1102.10287","DOIUrl":"10.22551/2024.43.1102.10287","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) is the percutaneous alternative to traditional surgery. Infective endocarditis is a fatal complication of TAVR, especially in the elderly. A 65-year-old male with a history of valve-in-valve TAVR presented to our emergency room with altered mentation. On examination, he was febrile. Laboratory investigations and echocardiography suggested infective endocarditis. Explantation and surgical aortic valve replacement were planned. The biopsy of the prostheses showed acute inflammation. Transcatheter prosthetic valve endocarditis warrants early diagnosis, particularly in the elderly. Our case emphasizes the importance of the prompt inclusion of endocarditis in the differential and surgical referral.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"11 2","pages":"47-50"},"PeriodicalIF":0.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452308","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}
Archive of clinical casesPub Date : 2024-05-14eCollection Date: 2024-01-01DOI: 10.22551/2024.42.1101.10280
Elamein Yousif, Elamin Dahawi, Sarah Premraj, Wissem Melki
{"title":"Triple whammy in a patient with portal vein thrombosis.","authors":"Elamein Yousif, Elamin Dahawi, Sarah Premraj, Wissem Melki","doi":"10.22551/2024.42.1101.10280","DOIUrl":"10.22551/2024.42.1101.10280","url":null,"abstract":"<p><p>Infection with SARS-CoV-2 has been shown to predispose to thromboembolic events. The risk of such thromboses further increases in those with underlying inherited or acquired prothrombotic states. The authors present a 30-year-old lady who developed acute abdominal pain, three days after recovery from a mild COVID-19 infection. She was also using oral contraceptive pills. Laboratory investigations revealed elevated inflammatory markers, and a contrast-enhanced abdominal CT scan demonstrated portal vein thrombosis (PVT). Due to the unusual site of thrombosis, a thrombophilia screen was performed, which detected a heterozygous Factor V Leiden mutation (FVL). Thus, her PVT was attributed three simultaneous risk factors, namely COVID-19 infection, OCP use and FVL mutation. She was initiated on anti-coagulation, with which she improved significantly. In patients presenting with thromboses at uncommon sites, investigation for evidence of recent Covid-19 infection and screening for inherited and acquired thrombophilia should be considered, while discontinuing any offending medications.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"11 1","pages":"16-18"},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923728","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}
{"title":"Internal hernia as cause of acute abdomen in a preterm neonate: when necrotizing enterocolitis is not the culprit.","authors":"Zoi Lamprinou, Elisavet Kanna, Ioannis Skondras, Rodanthi Sfakiotaki, Jonida Mene, Orthodoxos Achilleos","doi":"10.22551/2024.42.1101.10284","DOIUrl":"10.22551/2024.42.1101.10284","url":null,"abstract":"<p><p>Internal hernias in preterm neonates, although rare, can arise due to various anatomical and physiological factors associated with prematurity. We report a case of a preterm infant with symptoms of suspected necrotizing enterocolitis (NEC) that turned out to be an internal hernia during surgical exploration. Given the overlapping symptoms, it is crucial to maintain a high index of suspicion and utilize the appropriate imaging techniques, such as ultrasound or radiographic studies, to aid in the differentiation between NEC and internal hernia, especially when responding to cases that do not improve with standard NEC management or exhibit atypical features. Early recognition and accurate differentiation are crucial for appropriate management and prevention of complications in affected neonates.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"11 1","pages":"34-36"},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923508","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}
Archive of clinical casesPub Date : 2024-04-30eCollection Date: 2024-01-01DOI: 10.22551/2024.42.1101.10282
Stefano Pini, Accursio Raia, Giulia Amatori, Benedetta Nardi, Barbara Carpita, Antonio Tundo, Liliana Dell'Osso
{"title":"A reevaluation of mixed depressive states from the DSM-5- TR perspective: a series of prototypical cases.","authors":"Stefano Pini, Accursio Raia, Giulia Amatori, Benedetta Nardi, Barbara Carpita, Antonio Tundo, Liliana Dell'Osso","doi":"10.22551/2024.42.1101.10282","DOIUrl":"https://doi.org/10.22551/2024.42.1101.10282","url":null,"abstract":"<p><p>Mixed depressive states are defined by the co-presence of depressive and manic symptoms. They represent extremely variable conditions from the point of view of clinical expressiveness and are difficult to recognize, ranging from clear schizophrenic-like psychoses and pseudodemented pictures to subsyndromal psychopathology. At the basis of the extreme variability of depressive pictures with mixed features are the different combinations that depressive and manic symptoms can assume. Furthermore, the intensity of depressive symptoms and manic symptoms, combined, can be variable, a factor that contributes to making the picture even more variable. Each form of mixed depressive state therefore presents its own specific symptomatic characteristics and specific difficulties in differential diagnosis and each form requires a different therapeutic strategy. In this work we have distinguished four possible specific subtypes of mixed depressive states, describing their specific clinical presentation and the therapeutic options most supported by the literature with the aim of contributing to a better recognition of mixed depressive states, to avoid incorrect diagnoses at patient and treatments that are useless if not worsening.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"11 1","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867744","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}
{"title":"Exploring the severity and early onset of familial type 1 diabetes in Romania: genetic and microbiota insights.","authors":"Amalia Ioana Arhire, Dorian Sorin Ioacara, Teodora Papuc, Gratiela Gradisteanu Parcalibioru, Simona Fica","doi":"10.22551/2024.42.1101.10283","DOIUrl":"https://doi.org/10.22551/2024.42.1101.10283","url":null,"abstract":"<p><p>Type 1 diabetes mellitus (T1DM) is a chronic condition characterized by pancreatic autoimmunity and destruction of the insulin producing beta-cells. The risk of familial type 1 diabetes (FT1DM) is greater in families with paternal T1DM. The children with paternal FT1DM have a more severe form of the disease with diabetic ketoacidosis. Three families with FT1DM, out of which two with paternal diabetes and daughters diagnosed with this disease, and one family with sibling FT1DM were evaluated between 2019-2021 in the Pediatric Diabetes and the Diabetes, Nutrition and Metabolic Departments of a tertiary hospital. Clinical, biological, and genetic evaluations were performed, together with an assessment of the gastrointestinal microbiota. The Romanian children with FT1DM had a more severe onset, a median of age at onset of 9 years old and a genetic predisposition with positive HLA DR3/R4, DQB1*02:01. The protecting allele, DPB1*04:01, was found only in the siblings with FT1DM. A gastrointestinal dysbiosis, characterized by pro-inflammatory bacteria, with high levels of <i>Enterobacteriaceae</i> and <i>Candida</i>, was observed in the gut microbiota. This is the first case series of FT1DM in Romanian patients that shows the presence of genetic determinants but also a pathological microbiota which may determine a more severe and an early-age onset of disease.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"11 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873822","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}
Archive of clinical casesPub Date : 2024-04-30eCollection Date: 2024-01-01DOI: 10.22551/2024.42.1101.10281
Nasreen Noor, Gene Peir, Ásdís Finnsdóttir Wagner, Jay Rilinger, Jenna Miller
{"title":"Recurrent diffuse alveolar hemorrhage and extracorporeal membrane oxygenation utilization in a hematopoietic stem cell transplant patient with Hunter's syndrome.","authors":"Nasreen Noor, Gene Peir, Ásdís Finnsdóttir Wagner, Jay Rilinger, Jenna Miller","doi":"10.22551/2024.42.1101.10281","DOIUrl":"https://doi.org/10.22551/2024.42.1101.10281","url":null,"abstract":"<p><p>We describe the natural history of a three-month-old patient with Hunter Syndrome with hematopoietic stem cell transplant (HSCT) who developed recurrent diffuse alveolar hemorrhage (DAH) requiring extracorporeal membrane oxygenation (ECMO). The patient underwent HSCT with several complications, including veno-occlusive disease and DAH. He was managed with ECMO. Unfortunately, despite initial success he developed recurrent DAH and ultimately died. This is a novel report of this severe adverse event requiring ECMO following the use of HSCT in this rare patient population. We share the clinical strategies employed to address the complications associated with HSCT and the progression of his disease over his hospitalization.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"11 1","pages":"19-21"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856070","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}
Archive of clinical casesPub Date : 2023-12-28eCollection Date: 2023-01-01DOI: 10.22551/2023.41.1004.10276
Clement Tan, Jithmy Perara, Pranav Kumar
{"title":"A unique case of indolent microscopic polyangiitis in an elderly gentleman: a case report and brief review.","authors":"Clement Tan, Jithmy Perara, Pranav Kumar","doi":"10.22551/2023.41.1004.10276","DOIUrl":"10.22551/2023.41.1004.10276","url":null,"abstract":"<p><p>Antineutrophil cytoplasmic autoantibody associated vasculitides has 3 different types: Granulomatosis with polyangiitis, eosinophilic granulomatosis and polyangiitis and microscopic polyangiitis. These vasculitides manifest differently based on which area of small and medium size vessels in our bodies that it affects. In this case report, we discuss a unique case of microscopic polyangiitis diagnosed in a 75-year-old male who was relatively asymptomatic i.e. indolent, apart from nodules present in the lung with the use of the diagnostic criteria outlined by 2022 American College of Rheumatology and European Alliance of Associations for Rheumatology. In addition, we reviewed briefly about vasculitis, its epidemiology and the workup of microscopic polyangiitis.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"205-209"},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139059237","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}
Archive of clinical casesPub Date : 2023-12-28eCollection Date: 2023-01-01DOI: 10.22551/2023.41.1004.10275
Sofija Pejkova, Darko Aleksovski, Sara Hadjitrifon, Sofija Tusheva, Gordana Georgieva, Blagoja Srbov, Oskar C Aszmann
{"title":"Paget-Schroetter syndrome: the importance of early detection and effective surgical intervention.","authors":"Sofija Pejkova, Darko Aleksovski, Sara Hadjitrifon, Sofija Tusheva, Gordana Georgieva, Blagoja Srbov, Oskar C Aszmann","doi":"10.22551/2023.41.1004.10275","DOIUrl":"10.22551/2023.41.1004.10275","url":null,"abstract":"<p><p>Paget-Schroetter syndrome (PSS) is relatively rare condition of thoracic outlet syndrome characterized by thrombosis or blood clot formation in the subclavian vein. Due to the non-specific symptoms and low incidence rate, PSS is frequently missed by medical professionals, and as such it often leads to wrong diagnosis and untreated patients. We present the case of a 30-year-old CrossFit trainer who developed a thrombosis of the subclavian vein. Initially, the patient consulted an internist after experiencing swelling in the right shoulder region and discoloration of the right upper extremity. Angiography revealed occlusion of the subclavian vein and anticoagulant therapy was prescribed. For more than a year, the patient's symptoms remained unchanged, and the subclavian vein occlusion persisted. Venography suspected effort thrombosis of the subclavian vein. The patient underwent surgery for decompression of the subclavian vein. After six months, results from post-operative computed tomography angiography showed that venous flow was fully restored and no pathology of the venous vessel wall could be demonstrated. This report aims to increase awareness of PSS among medical professionals, leading to earlier diagnosis and adequate clinical-surgical management.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"200-204"},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139059239","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}
Archive of clinical casesPub Date : 2023-12-28eCollection Date: 2023-01-01DOI: 10.22551/2023.41.1004.10274
Axler Jean Paul, Rebecca St Louis, Adonai Aly Isaac Julien, Frednel Florvil, Wendell Blaise
{"title":"Bullosis diabeticorum in a morbidly obese woman in Haiti.","authors":"Axler Jean Paul, Rebecca St Louis, Adonai Aly Isaac Julien, Frednel Florvil, Wendell Blaise","doi":"10.22551/2023.41.1004.10274","DOIUrl":"10.22551/2023.41.1004.10274","url":null,"abstract":"<p><p>Bullosis diabeticorum is a rare skin complication of diabetes mellitus, characterized by sudden onset bullous lesions with no history of trauma. It predominantly affects men and has an acral asymmetric presentation. Here, we report a case of bullous disease in a diabetic patient with morbid obesity, the first described in Haiti. A 40-year-old woman, with a strong history of diabetic for five years, poorly controlled and morbidly obese presented to our emergency for bullosis lesions in her limb. She had a prior presentation about two years ago and, approximately a week before this actual presentation, the same symptomatology occurred suddenly without any trauma. After evaluation and screening, the diagnosis of bullosis diabeticorum was kept. She was initially treated with antibiotics due to signs of superinfection. However, as soon as the symptoms improved, antibiotics were discontinued. An antiseptic lotion and topical antibiotic, neomycin, were used along with daily dressings. About a week after, her blood glucose came to control, signs of infection disappeared as did the bullous lesions and surgical evaluation was performed to ensure proper wound evolution. She was educated by a nutritionist, and our team emphasized the importance of regular follow-up at the hospital. Diabetic bullous disease is very rare and easy to confuse with other diabetic skin complications. A good clinical history is essential to make the diagnosis, and management requires good therapeutic education to avoid the burdensome complications of diabetes.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"196-199"},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139059238","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}
Archive of clinical casesPub Date : 2023-12-28eCollection Date: 2023-01-01DOI: 10.22551/2023.41.1004.10267
Daniel Felipe Galindo Cortes, Helen Mejia Efeer, Sandra Caro Perdomo, Nathalie Hernandez Hidalgo
{"title":"Superscan on <sup>68</sup>Ga PSMA PET/CT in patients with metastatic prostate carcinoma: A case series.","authors":"Daniel Felipe Galindo Cortes, Helen Mejia Efeer, Sandra Caro Perdomo, Nathalie Hernandez Hidalgo","doi":"10.22551/2023.41.1004.10267","DOIUrl":"10.22551/2023.41.1004.10267","url":null,"abstract":"<p><p>Prostate cancer is the second most common malignancy in men worldwide, with a good prognosis when is detected and treated in early stages, but, when it presents progression to castration-resistant metastatic prostate cancer, most of the cases will have bone metastasis, decreasing the quality of life and life expectancy. For the evaluation of the disease in the routinary clinical practice, <sup>68</sup>Ga-PSMA PET/CT, among others is a valuable tool for the evaluation of the disease extension. <sup>68</sup>Ga-PSMA PET/CT detects the presence of PSMA receptor in the tumoral tissue, but also has physiologic uptake in certain organs, such as liver, spleen, intestine, kidneys, lacrimal and salivary glands. Total or partial absence of uptake in those organs is rare and may be due to a high metastatic tumor burden, a phenomenon originally described in bone scintigraphy as super scan. We describe a case series of seven patients with prostate cancer from the National Institute of Cancerology in Colombia, in which a super scan pattern was found in the evaluation with <sup>68</sup>Ga-PSMA PET/CT, proposing the suppression of uptake in the intestine, liver, spleen, lacrimal and salivary glands as the main criteria for its definition, and showing that renal uptake persists in most cases, considering that, unlike the super scan in conventional bone scintigraphy, this is not a criterion necessary for its definition in the study with <sup>68</sup>Ga-PSMA.</p>","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"164-170"},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10753930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139059240","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}