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Clinical decision-making in gastric taeniasis: risks of endoscopic removal and role of staged therapy. 胃带绦虫病的临床决策：内镜切除的风险和分期治疗的作用。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-21 DOI: 10.1136/bcr-2025-271981
Taned Chitapanarux, Parichat Salee
{"title":"Clinical decision-making in gastric taeniasis: risks of endoscopic removal and role of staged therapy.","authors":"Taned Chitapanarux, Parichat Salee","doi":"10.1136/bcr-2025-271981","DOIUrl":"https://doi.org/10.1136/bcr-2025-271981","url":null,"abstract":"<p><p>This case describes a rare presentation of gastric taeniasis in a young woman with chronic atrophic gastritis and subcutaneous lesions consistent with cysticercosis. Stool microscopy confirmed <i>Taenia</i> spp eggs, though species identification was limited by the absence of morphological or molecular confirmation. While clinical evidence strongly suggested <i>Taenia solium</i>, this limitation is acknowledged. The case underscores the importance of clinical judgement in avoiding endoscopic removal, given risks of incomplete extraction, rupture and anaphylaxis. A staged pharmacologic regimen was employed: niclosamide with purgation achieved intestinal clearance, followed by albendazole for tissue infection. This strategy led to complete symptom resolution and regression of nodules. Corticosteroids were unnecessary, as neurocysticercosis and ocular involvement were excluded. The report emphasises prioritising medical therapy over endoscopic intervention and highlights the relevance of dietary history in endemic regions, where consumption of raw or undercooked pork remains a major exposure risk.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antimicrobial toxic epidermal necrolysis in an ICU patient with multisystem organ failure and sepsis. 抗菌毒性表皮坏死松解合并多系统器官衰竭和脓毒症1例。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-269803
Krystal Phu, Christine Li, Connor Pauplis, Mehrak Moaddab
{"title":"Antimicrobial toxic epidermal necrolysis in an ICU patient with multisystem organ failure and sepsis.","authors":"Krystal Phu, Christine Li, Connor Pauplis, Mehrak Moaddab","doi":"10.1136/bcr-2025-269803","DOIUrl":"10.1136/bcr-2025-269803","url":null,"abstract":"<p><p>Toxic epidermal necrolysis (TEN) is a rare, life-threatening dermatological emergency characterised by blistering and desquamation, often triggered by medications. Early identification and discontinuation of offending agents are critical for improving outcomes.Here, we describe a woman in her 30s with a complex medical history, including systemic lupus erythematosus and common variable immunodeficiency, who developed TEN following antifungal and antibacterial therapy. She initially presented with respiratory distress and was treated for pneumonia. Over the ensuing days, her clinical course rapidly deteriorated as she developed skin desquamation, tachycardia, hyperkalaemia and acute renal failure, and she was diagnosed with TEN. Suspected offending agents were discontinued, and treatment was initiated with intravenous immunoglobulin, corticosteroids and tumour necrosis factor-alpha blockade.This case illustrates the complexity of managing TEN in a patient with multiple comorbidities and ongoing immunosuppression, emphasising the importance of prompt recognition and treatment given the high mortality and morbidity of TEN.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Degenerative peripheral retinoschisis simulating occlusive retinal vasculitis in intermediate uveitis. 中间葡萄膜炎的变性周围视网膜裂模拟闭塞性视网膜血管炎。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-265287
Sawsan Elsheikh, Mohammad O Tallouzi, Andrej Kidess, Georgios Agorogiannis
{"title":"Degenerative peripheral retinoschisis simulating occlusive retinal vasculitis in intermediate uveitis.","authors":"Sawsan Elsheikh, Mohammad O Tallouzi, Andrej Kidess, Georgios Agorogiannis","doi":"10.1136/bcr-2025-265287","DOIUrl":"10.1136/bcr-2025-265287","url":null,"abstract":"<p><p>Retinoschisis, the horizontal splitting of retinal layers, is classified into four types: hereditary (juvenile or X-linked), degenerative (senile, which is more frequently encountered in clinical practice, or acquired), tractional (associated with vitreoretinal interface abnormalities) and exudative (linked to an optic disc pit).Acquired retinoschisis is reported in intermediate uveitis and is hypothesised to result from chronic vascular leakage and subclinical retinal ischaemia, although evidence remains limited.A senior female patient was referred to the uveitis service for management of suspected left occlusive retinal vasculitis secondary to intermediate uveitis. She presented with chronic bilateral floaters for the past 6 years.Ocular examination showed no signs of anterior segment inflammation, but chronic vitreous cells, snowballs, bilateral retinoschisis and inferotemporal retinal haemorrhages accompanied by exudates in the left eye. Multimodal imaging studies, including angiography, revealed bilateral quiescent intermediate uveitis. The findings were consistent with senile degenerative peripheral retinoschisis, likely incidental in a patient with longstanding quiescent intermediate uveitis, although an association with previous inflammatory processes cannot be definitively ruled out.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intracardiac and pulmonary arterial thrombosis as a first presentation of Behçet's disease. 心内和肺动脉血栓形成是behaperet病的首要表现。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-271721
Katie Choi, Iyare Nehikhare, Salamat Ullah, Riyaz Somani
{"title":"Intracardiac and pulmonary arterial thrombosis as a first presentation of Behçet's disease.","authors":"Katie Choi, Iyare Nehikhare, Salamat Ullah, Riyaz Somani","doi":"10.1136/bcr-2025-271721","DOIUrl":"10.1136/bcr-2025-271721","url":null,"abstract":"<p><p>Behçet's disease (BD) is a rare vasculitis characterised by mucocutaneous lesions and ocular, vascular and neurological manifestations. We report a man in his early 20s who presented with dyspnoea, haemoptysis, pulmonary arterial thromboses and a large right ventricular thrombus. Initial investigations for infectious and autoimmune causes were negative, complicating diagnosis. A revisited history and new examination revealed oral and genital aphthosis, fulfilling the international criteria for BD. The patient was treated with anticoagulation and high-dose immunosuppression, resulting in rapid clinical improvement and resolution of the intracardiac thrombus. This case highlights the diagnostic challenge of BD when vascular manifestations precede recognition of the more characteristic features of BD and emphasises the therapeutic challenges of long-term secondary prevention.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lichenoid pseudovesicular papular eruption of the nose (LIPEN): clinicodermoscopic and histopathological correlation. 鼻苔藓样假性水泡丘疹（LIPEN）：临床皮肤镜和组织病理学相关性。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2026-272628
Kartik Saini, Sushantika Sushantika, Prashant Durgapal, Sunil Kumar Gupta
{"title":"Lichenoid pseudovesicular papular eruption of the nose (LIPEN): clinicodermoscopic and histopathological correlation.","authors":"Kartik Saini, Sushantika Sushantika, Prashant Durgapal, Sunil Kumar Gupta","doi":"10.1136/bcr-2026-272628","DOIUrl":"10.1136/bcr-2026-272628","url":null,"abstract":"<p><p>Lichenoid pseudovesicular papular eruption of the nose (LIPEN) is an uncommon and often overlooked facial dermatosis characterised by monomorphic papules with a pseudovesicular appearance, predominantly affecting the nasal dorsum and adjacent centrofacial areas. Owing to its clinical resemblance to several inflammatory and granulomatous dermatoses, it is frequently misdiagnosed, leading to delayed recognition and inappropriate management for a long term. We report a patient presenting with chronic, asymptomatic centrofacial papules unresponsive to conventional therapies. Dermoscopic examination revealed characteristic brown-grey dots and globules with a pseudoreticular pattern. Histopathological evaluation demonstrated features of lichenoid interface dermatitis, confirming the diagnosis of LIPEN. Patient responded to topical calcineurin inhibitors. Recognition of its distinctive clinicodermoscopic and histopathological features is essential to differentiate LIPEN from common mimics and guide appropriate management.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pituitary apoplexy in a macroadenoma with cavernous sinus extension presenting with acute ophthalmoplegia. 垂体大腺瘤伴海绵窦扩张并发急性眼麻痹。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-271096
Cristian Andre Martin-Solis, Paulina Rivera-Bastida, Marisol Gallegos-Guerrero, Ildefonso Rodriguez-Leyva
{"title":"Pituitary apoplexy in a macroadenoma with cavernous sinus extension presenting with acute ophthalmoplegia.","authors":"Cristian Andre Martin-Solis, Paulina Rivera-Bastida, Marisol Gallegos-Guerrero, Ildefonso Rodriguez-Leyva","doi":"10.1136/bcr-2025-271096","DOIUrl":"https://doi.org/10.1136/bcr-2025-271096","url":null,"abstract":"<p><p>A man in his 30s presented with a thunderclap retro-orbital headache, nausea and acute binocular diplopia with right ptosis. This presentation illustrates the 'red flag' combination of thunderclap headache and pupil-involving third-nerve palsy in pituitary apoplexy. A vascular-first, then sellar-focused imaging pathway (CT → MR angiography (MRA) → sellar MRI) expedites diagnosis and protects vision. Brain MRI with sellar protocol revealed a haemorrhagic pituitary macroadenoma with suprasellar extension compressing the optic chiasm and lateral extension abutting the right cavernous sinus. Intracranial aneurysm was excluded on MRA. The initial pituitary panel was unremarkable. Stress-dose steroids were administered, and early endoscopic endonasal trans-sphenoidal decompression was performed. The headache remitted, and oculomotor deficits began to improve within 48 hours. This case highlights the value of immediate endocrine-neurosurgical-neuro-ophthalmology coordination, the superiority of MRI for staging intratumoral haemorrhage, the importance of immediate stress-dose steroid coverage and the role of structured decision tools (eg, Pituitary Adenomas (PAs)/Pituitary Adenoma Genomes/Genetics (PAGs) to individualise surgery versus conservative care.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Closed reduction in the emergency room following traumatic C1-C2 rotary subluxation: a paediatric perspective. 创伤性C1-C2旋转半脱位后急诊室的闭合复位：儿科视角
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-271559
Devika A Shenoy, Raelynn Vigue, Iryna Ivasyk, Emily C Sterrett, Robert K Lark
{"title":"Closed reduction in the emergency room following traumatic C1-C2 rotary subluxation: a paediatric perspective.","authors":"Devika A Shenoy, Raelynn Vigue, Iryna Ivasyk, Emily C Sterrett, Robert K Lark","doi":"10.1136/bcr-2025-271559","DOIUrl":"10.1136/bcr-2025-271559","url":null,"abstract":"<p><p>Atlantoaxial rotatory subluxation (AARS) represents a significant cause of acute torticollis in children involving rotational displacement of C1 on C2. Unlike common idiopathic torticollis, AARS represents a true subluxation that frequently necessitates reduction by an experienced provider to restore alignment. Here, we present the case of a child who developed AARS after falling out of bed. A CT scan confirmed acute C1-C2 rotatory subluxation. The patient was successfully treated with closed reduction under sedation in the emergency department by a paediatric spine surgeon, followed by immobilisation in a cervical collar. At the 2-week follow-up, she had achieved a full clinical and radiographic recovery with a return to normal function. This case underscores the necessity of maintaining a high index of suspicion for AARS in traumatic paediatric torticollis, highlights the role of advanced imaging in reaching a definitive diagnosis and confirms that non-operative management can lead to excellent outcomes.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Triple-negative breast cancer with neurofibromatosis type 1: management challenges. 三阴性乳腺癌伴1型神经纤维瘤病：管理挑战
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-270134
Iraj Fatima, Afrah Jaffarsadiq, Amber E Faquih, Cynthia Hlavacek, Aasim Sehbai
{"title":"Triple-negative breast cancer with neurofibromatosis type 1: management challenges.","authors":"Iraj Fatima, Afrah Jaffarsadiq, Amber E Faquih, Cynthia Hlavacek, Aasim Sehbai","doi":"10.1136/bcr-2025-270134","DOIUrl":"https://doi.org/10.1136/bcr-2025-270134","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1) is an autosomal dominant RASopathy associated with increased risk of early-onset breast cancer, particularly triple-negative breast cancer (TNBC). We report a woman in her early 40s with NF1 who presented for elective cosmetic breast surgery and was incidentally found to have a suspicious right breast lesion on screening mammogram. Biopsy confirmed high-grade ductal carcinoma in situ (DCIS) with invasive ductal carcinoma, immunohistochemically triple-negative. Staging investigations revealed no nodal or distant disease. She underwent bilateral mastectomy with right sentinel lymph node biopsy (SLNB), followed by adjuvant docetaxel-cyclophosphamide chemotherapy. Radiotherapy was avoided given the elevated risk of radiation-induced sarcoma (RIS) in NF1. Postoperative reconstruction was staged and ultimately successful. At more than 3 years of follow-up, she remains disease-free with satisfactory cosmetic outcomes. This case highlights the importance of vigilant breast surveillance in NF1, challenges in balancing oncologic control with treatment-related risks, and the need for individualised multidisciplinary care.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complete hydatidiform mole with a co-existing normal fetus at mid-trimester in a dichorionic diamniotic gestation. 双绒毛膜双羊膜妊娠中期完全葡萄胎与正常胎儿共存。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2025-271801
Catherine Preethi D, Joylene Diana D'Almeida, Shannon Fernandes, Diya Mathen
{"title":"Complete hydatidiform mole with a co-existing normal fetus at mid-trimester in a dichorionic diamniotic gestation.","authors":"Catherine Preethi D, Joylene Diana D'Almeida, Shannon Fernandes, Diya Mathen","doi":"10.1136/bcr-2025-271801","DOIUrl":"10.1136/bcr-2025-271801","url":null,"abstract":"<p><p>We report a spontaneously conceived dichorionic diamniotic twin pregnancy in which a complete hydatidiform mole co-existed with a structurally normal fetus. An early ultrasound scan demonstrated a viable fetus with an adjacent cystic area initially interpreted as subchorionic haemorrhage. A definitive diagnosis was established at 21 weeks' gestation when repeat ultrasound scan revealed a separate sac containing diffuse vesicular placental tissue consistent with a complete molar co-twin.Although serum β-human chorionic gonadotropin (β-hCG) was elevated (236,580 mIU/mL), this value falls within the physiological range described in twin pregnancies. The diagnosis was based primarily on ultrasound scan findings rather than biochemical parameters.After multidisciplinary counselling, medical termination was performed, followed by ultrasound-guided suction evacuation. Recovery was uncomplicated, with rapid regression of β-hCG levels.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tumour lysis syndrome following deliberately dose-reduced chemotherapy in extensive-stage small cell lung cancer with critical airway obstruction. 伴有严重气道阻塞的广泛期小细胞肺癌故意减少剂量化疗后的肿瘤溶解综合征。
IF 0.6
BMJ Case Reports Pub Date : 2026-04-20 DOI: 10.1136/bcr-2026-272527
Sze Kye Teoh, Yen Shen Wong, Suhashini Ganapathy, Audi Adawiah Sulaiman Shah
{"title":"Tumour lysis syndrome following deliberately dose-reduced chemotherapy in extensive-stage small cell lung cancer with critical airway obstruction.","authors":"Sze Kye Teoh, Yen Shen Wong, Suhashini Ganapathy, Audi Adawiah Sulaiman Shah","doi":"10.1136/bcr-2026-272527","DOIUrl":"10.1136/bcr-2026-272527","url":null,"abstract":"<p><p>A man in his late 60s presented with rapidly progressive dyspnoea and inspiratory stridor requiring emergency intubation. Bronchoscopy demonstrated critical bilateral main bronchial compression, and biopsy confirmed small cell lung cancer (SCLC) with bulky mediastinal disease. Deliberately dose-reduced carboplatin and etoposide were initiated. Despite prophylactic hydration and allopurinol, he developed fulminant tumour lysis syndrome (TLS) approximately 72 hours after chemotherapy initiation, meeting Cairo-Bishop criteria and died despite rasburicase and maximal supportive care.TLS is rare in solid tumours, and in SCLC, it is typically reported following spontaneous lysis or full-dose chemotherapy. This case demonstrates that even dose-reduced chemotherapy, when used emergently in bulky, chemosensitive disease, can precipitate catastrophic TLS. It highlights critical airway compromise in SCLC as a high-risk phenotype and highlights the need for heightened vigilance and anticipatory management when balancing urgent airway stabilisation against systemic therapy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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