Archive of clinical cases最新文献_第7页

'Patience is a virtue' - Post-traumatic Axillary Web Syndrome - resolution without intervention. “耐心是一种美德”——创伤后腋窝网综合征——无需干预即可解决。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.38.1001.10233

Jaleel Mohammed, Catherine Ash, Jayanti Rai

{"title":"'Patience is a virtue' - Post-traumatic Axillary Web Syndrome - resolution without intervention.","authors":"Jaleel Mohammed, Catherine Ash, Jayanti Rai","doi":"10.22551/2023.38.1001.10233","DOIUrl":"https://doi.org/10.22551/2023.38.1001.10233","url":null,"abstract":"The current case report showcases an atypical symptomatic post-traumatic Axillary Web Syndrome in a 63-year-old Caucasian male patient with complete resolution of symptoms with no intervention. Axillary web syndrome is a condition where the skin area under the axilla becomes taut and on palpation there is a cord-like feeling similar to a guitar string, usually bound together as spider web appearance. The case report highlights the importance of appropriate physical examination and also the need for Community Diagnostic Centres and Point of Care Ultrasound services to help provide patients with timely diagnosis, reduce patient anxiety, and enhance patient experience and outcomes. The current case study is specifically useful for healthcare professionals working in primary care, especially in the National Health Service, where resources are already stretched to avoid unnecessary referrals, interventions and investigations. The case report is atypical since axillary web syndrome is typically and largely seen in cancer patients, specifically post breast cancer surgery in females and very rarely seen as a post traumatic presentation in acute setting.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 1","pages":"18-20"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/19/acc-10-01-18.PMC9940285.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823557","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

Effectiveness of levosimendan and role of cardiac magnetic resonance in cardiogenic shock due to COVID-19 related lymphocytic myocarditis in the course of viral sepsis. 左西孟旦在病毒性败血症过程中COVID-19相关淋巴细胞性心肌炎心源性休克中的疗效及心脏磁共振的作用

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.38.1001.10236

Francesco Mangini, Elvira Bruno, Remo Caramia, Roberto Flora, Eluisa Muscogiuri, Antonio Medico, Grazia Casavecchia, Robert W W Biederman, Rinaldo Giaccari

{"title":"Effectiveness of levosimendan and role of cardiac magnetic resonance in cardiogenic shock due to COVID-19 related lymphocytic myocarditis in the course of viral sepsis.","authors":"Francesco Mangini, Elvira Bruno, Remo Caramia, Roberto Flora, Eluisa Muscogiuri, Antonio Medico, Grazia Casavecchia, Robert W W Biederman, Rinaldo Giaccari","doi":"10.22551/2023.38.1001.10236","DOIUrl":"https://doi.org/10.22551/2023.38.1001.10236","url":null,"abstract":"COVID-19 and sepsis pose great challenges to clinicians and growing evidence is demonstrating links between the two conditions. Both can be complicated by acute heart failure. The use of levosimendan in patients with ventricular dysfunction during COVID-19 infection and sepsis has very little evidence. A 46-year-old, hypertensive and obese patient was admitted for severe left ventricular failure and shock during sepsis following a COVID-19 infection. The patient was treated first with norepinephrine, which was partially effective, then with the addition of levosimendan as a continuous 24 hours infusion. Vital signs and echocardiographic systolic performance indices, such as FE, SVi, CI, dP/dT, TAPSE, and tricuspid S-wave velocity, as well as diastolic function, were recorded at access, 12 and 24 hours. After initiation of levosimendan, a rapid improvement in vital signs and systolic and diastolic performance indices was observed, not depending on changes in preload, afterload, and inflammatory status. Blood cultures were negative for the presence of bacteria, thus defining the picture of likely viral sepsis. Cardiac magnetic resonance was determinant, showing a picture of myocarditis sustained by immune processes rather than direct viral injury, which was confirmed by endomyocardial biopsy. In conclusion, this case highlights the efficacy of levosimendan in acute heart failure complicated by shock due to COVID-19-related myocarditis and concomitant sepsis and confirms cardiac magnetic resonance as the gold standard for the diagnosis of myocardial inflammatory disease. To the best of our knowledge, this is the first documented case of effective use of levosimendan in this context.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 1","pages":"32-38"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/a3/acc-10-01-32.PMC10012167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9133108","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

Acute Aortic Syndrome in a patient with COVID-19. COVID-19患者的急性主动脉综合征

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.38.1001.10239

João Campos Cunha, António José Cruz, Beatriz Madureira, Yolanda Martins, Gonçalo Sarmento

{"title":"Acute Aortic Syndrome in a patient with COVID-19.","authors":"João Campos Cunha, António José Cruz, Beatriz Madureira, Yolanda Martins, Gonçalo Sarmento","doi":"10.22551/2023.38.1001.10239","DOIUrl":"https://doi.org/10.22551/2023.38.1001.10239","url":null,"abstract":"The global effects of the COVID-19 pandemic make it of the utmost importance to comprehend its mechanisms and define strategies for the most effective approach possible. The SARS-CoV-2 virus can be responsible for the induction of a hypercoagulable state, which can trigger vascular phenomena of venous etiology, specifically deep venous thrombosis or pulmonary embolism. Arterial thrombotic events associated with COVID-19 have also been described in the medical literature, although less frequently. In this paper the authors report the case of a 66-year-old man who was diagnosed with an Acute Aortic Syndrome, specifically an intramural thrombus on the aortic arch, while he was still infected with the virus. Anticoagulation with low weight molecular heparin was initiated and the patient was admitted at the Internal Medicine ward for a conservative therapeutic approach. The thrombus remained stable on a serial imaging evaluation; therefore, the patient was discharged with oral anticoagulation with subsequent follow-up in the outpatient clinic. This case describes a rare and potentially serious complication of COVID-19, which highlights how broad its clinical spectrum can be, affecting systems other than the pulmonary.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 1","pages":"47-49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/f7/acc-10-01-47.PMC10088050.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9305488","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

Lithium-induced parkinsonism associated with vocal cord paralysis: an atypical presentation. 锂诱发的帕金森病伴声带麻痹:一个不典型的表现。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.39.1002.10252

Accursio Raia, Clara Montalbano, Valerio Caruso, Bruno Pacciardi, Stefano Pini

引用次数: 0

Non-islet cell tumor hypoglycemia associated with Gastrointestinal Stromal Tumor: Case report and review of the literature. 非胰岛细胞肿瘤低血糖与胃肠道间质瘤:病例报告及文献复习。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.38.1001.10240

Vikash Kumar, Dhir Gala, Carson Wonders, Sabrin Marowa, Arnold Forlemu, Vijay Gayam, Madhavi Reddy

引用次数: 0

Synchronous anal mucinous adenocarcinoma and anal tuberculosis presenting as chronic anal fistula: Challenging management. 同步肛门粘液腺癌和肛门结核表现为慢性肛瘘:具有挑战性的管理。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.39.1002.10245

Sarah Benammi, Youness Bakali, Mouna Alaoui, Farid Sabbah, Mohamed Raiss, Abdelmalek Hrora

{"title":"Synchronous anal mucinous adenocarcinoma and anal tuberculosis presenting as chronic anal fistula: Challenging management.","authors":"Sarah Benammi, Youness Bakali, Mouna Alaoui, Farid Sabbah, Mohamed Raiss, Abdelmalek Hrora","doi":"10.22551/2023.39.1002.10245","DOIUrl":"https://doi.org/10.22551/2023.39.1002.10245","url":null,"abstract":"Metachronous anal tuberculosis to an anal adenocarcinoma is an exceptional condition. The aim of our study was to report management of the first case of synchronized anal canal adenocarcinoma and anal canal tuberculosis and report our multidisciplinary approach. A 71-year-old man was admitted for non-healing anal fistula. Rectal examination at supine position showed an ulcerative growth at the medio-superior quadrant on a radius of 2cm from the anal verge. Digital rectal examination assessed no tumor in the anorectum. Biopsy of fistulae confirmed diagnosis of anal mucinous adenocarcinoma with coexisting anal tuberculosis. Further exploration confirmed diagnosis with no distal metastasis, no active pulmonary tuberculosis and no immunodepression. Adjuvant anti-bacillary chemotherapy was initiated 1 month prior to adjuvant radio-chemotherapy. Patient was re-admitted at the 6th week following the last dose of radio-chemotherapy for surgery. On long-term evaluation at 10 months, the patient reported absence of symptoms with weight gain. Association of both entities is rare. Chronic inflammatory damage may possibly initiate a sequence of metaplasia and dysplasia, resulting in neoplastic transformation. Anal canal adenocarcinoma treatment follows same guidelines as rectal cancer. Extra-pulmonary tuberculosis treatment follows anti-bacillary protocol with consequent side effects. Therefore, our case is a unique clinical challenge for physicians. Management decision was multidisciplinary process. Their pathophysiology relationship is yet to be understood. Moreover, each entity has defined and individual therapeutic protocols and indications. All this taken into consideration, such case presents a clinical and therapeutic challenge for physicians.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 2","pages":"74-77"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/1d/acc-10-10245.PMC10246597.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9610394","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

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.39.1002.10246

Elissavet Symeonidou, Androniki Dimitriadou, Antonios Morsi-Yeroyannis, Maria S Sidiropoulou, Ioannis Gkoutziotis, Panagiotis Petras, Konstantinos Mpallas

{"title":"COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period.","authors":"Elissavet Symeonidou, Androniki Dimitriadou, Antonios Morsi-Yeroyannis, Maria S Sidiropoulou, Ioannis Gkoutziotis, Panagiotis Petras, Konstantinos Mpallas","doi":"10.22551/2023.39.1002.10246","DOIUrl":"https://doi.org/10.22551/2023.39.1002.10246","url":null,"abstract":"Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esophagectomy due to gastroesophageal junction cancer. In the early postoperative period, the patient developed persistent fever accompanied by acute quadriplegia, impaired consciousness, and no signs of respiratory distress. Imaging with Computed Tomography and Magnetic Resonance revealed multiple bilateral lesions both in gray and white matter, as well as pulmonary embolism. Covid-19 infection was added to the differential diagnosis three weeks later, after other possible causes were excluded. The molecular test obtained at that time for coronavirus was negative. However, the high clinical suspicion index led to Covid-19 antibody testing (IgG and IgA), which confirmed the diagnosis. The patient was treated with corticosteroids with noticeable clinical improvement. She was discharged to a rehabilitation center. Six months later, the patient was in good general condition, although a neurological deficit was still present. This case indicates the significance of a high clinical suspicion index, based on a combination of clinical manifestations and neuroimaging, and the confirmation of the diagnosis with molecular and antibody testing. Constant awareness of a possible Covid-19 infection among hospitalized patients is mandatory.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 2","pages":"78-85"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/9f/acc-10-10246.PMC10246599.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9610389","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

IgA Vasculitis with scrotal involvement - a rare presentation in adults. IgA血管炎伴阴囊受累-一种罕见的成人表现。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.38.1001.10229

Ana Filipa Viegas, Andreia Lopes, Sofia Pereira, Catarina Cardoso Almeida, Maria Lima Costa, João Pedro Tavares

{"title":"IgA Vasculitis with scrotal involvement - a rare presentation in adults.","authors":"Ana Filipa Viegas, Andreia Lopes, Sofia Pereira, Catarina Cardoso Almeida, Maria Lima Costa, João Pedro Tavares","doi":"10.22551/2023.38.1001.10229","DOIUrl":"https://doi.org/10.22551/2023.38.1001.10229","url":null,"abstract":"IgA vasculitis (IgAV) is a small-vessel vasculitis common in children but rare in adults. It is usually an auto-limited disease in children but has a more severe course and worse prognosis in adults. The classical manifestations are non-thrombocytopenic purpura, arthralgias, gastrointestinal involvement and renal involvement. Herein we report a case of a 39-year-old man with a rash of the lower limbs associated with testicular and lower abdominal pain. The initial study revealed increased inflammatory biomarkers and enlarged left testis with bilateral ischemic areas on doppler ultrasound. A cutaneous biopsy later revealed leukocytoclastic vasculitis, confirming the diagnosis of IgAV with scrotal involvement. The patient started prednisolone, with improvement in the first week and sustained remission after two years of follow-up. This case report describes an adult with IgAV and scrotal involvement, which is rarely reported in adults and appears to be different from the one in children. The prevalence of scrotal involvement is presumably underestimated. In all men with IgAV, a scrotal examination should be performed and ultrasonography accordingly since it affects the treatment and follow-up. Recommendations for IgAV diagnosis and treatment in adults are still lacking and more research is needed.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/3f/acc-10-01-1.PMC9940281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9288672","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 cardiotoxicity in a fluoropyrimidine treated cancer patient - case report and practical recommendations. 氟嘧啶治疗癌症患者复发性心脏毒性的病例报告及实用建议。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.39.1002.10241

Andrada Larisa Deac, Raluca Maria Pop, Cristina Florina Crisan, Claudia Cristina Burz, Anca Dana Buzoianu

引用次数: 0

A late spontaneous peripherally inserted central catheter migration: two cases series. 晚期自发性外周置管中心移位2例。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.39.1002.10242

Remo Caramia, Nicola Recchia, Silvia Santoro, Lorenzo Ammirabile, Pietro Fedele

{"title":"A late spontaneous peripherally inserted central catheter migration: two cases series.","authors":"Remo Caramia, Nicola Recchia, Silvia Santoro, Lorenzo Ammirabile, Pietro Fedele","doi":"10.22551/2023.39.1002.10242","DOIUrl":"https://doi.org/10.22551/2023.39.1002.10242","url":null,"abstract":"A central venous catheter is a flexible catheter that is inserted into a vein and ends close to the superior vena cava. It may be inserted through a vein in the neck, chest, or arm. It's also called a central venous line or central line. Peripherally inserted central venous catheters (PICCs) are usually implanted in arm veins such as the basilic vein, the brachial veins or in some cases in the cephalic vein. PICCs can remain in place for up to six months or more. If properly managed, they last even more than a year. PICCs offer the advantage of greater safety for infusion of vesicants/irritants and hyperosmolar solutions and enable the administration of antibiotics, prolonged parenteral nutrition, and chemotherapy agents. They are however, associated with some adverse events such as spontaneous late migration. The reasons for these complications are not yet fully understood. There are now established causes and in some cases hypotheses to explain these phenomena. We describe two clinical cases in which apparently correctly positioned PICCs migrated spontaneously from their original position. The identification of the migration of the vascular catheter was accidental in the two patients, and they did not developed complications. One of the two patients had a pacemaker. The remote migration of a PICC is an event that can occur, and the causes are not definitively clarified in all cases.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 2","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/62/acc-10-10242.PMC10194171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9569484","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