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Combined chest wall perforator flap and synchronous fat grafting for partial breast reconstruction.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262439
Shweta Aggarwal, Michael Faheem
{"title":"Combined chest wall perforator flap and synchronous fat grafting for partial breast reconstruction.","authors":"Shweta Aggarwal, Michael Faheem","doi":"10.1136/bcr-2024-262439","DOIUrl":"https://doi.org/10.1136/bcr-2024-262439","url":null,"abstract":"<p><p>Chest wall perforator flaps (CWPFs) have been a well-recognised surgical option for volume replacement following breast conservation surgery (BCS). However, the flap volume can sometimes be limited, which may adversely affect the aesthetic outcome or even disqualify the patient from having BCS. We report the first case of hybrid partial breast reconstruction using immediate autologous fat injection into CWPF.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852640","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
Methaemoglobinaemia in neonates with acute gastroenteritis: lethal, but curable.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262479
Arjun Morishetty, Umamaheswari Balakrishnan, Prakash Amboiram, Saishree Pradhan
{"title":"Methaemoglobinaemia in neonates with acute gastroenteritis: lethal, but curable.","authors":"Arjun Morishetty, Umamaheswari Balakrishnan, Prakash Amboiram, Saishree Pradhan","doi":"10.1136/bcr-2024-262479","DOIUrl":"https://doi.org/10.1136/bcr-2024-262479","url":null,"abstract":"<p><p>Methaemoglobinaemia is a rare factor that can lead to cyanosis. The predominant cause of acquired methaemoglobinaemia is commonly attributed to anaesthetic agents. This case series presents three instances of acquired methaemoglobinaemia resulting from acute gastroenteritis caused by formula feeds. While uncommon, it is important to consider the potential occurrence of acquired methaemoglobinaemia because of acute gastroenteritis in newborns. This case series highlights the significance of promptly identifying and addressing the issue. The presence of metabolic acidosis and methaemoglobinaemia was detected and promptly treated by administering methylene blue and normal fluid therapy. Following that, the newborns have been discharged on exclusive breastfeeds. Despite being infrequent, the initial manifestation of these instances exhibited characteristics that deviated from the norm for a differential diagnosis in an infant experiencing hypoxia, metabolic acidosis and diarrhoea. It is crucial to promptly identify and administer methylene blue treatment to potentially rescue the life of the neonate.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852652","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
Chronic lymphocytic leukaemia or mantle cell lymphoma?
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-263395
Radu Chiriac, Sophie Gazzo, Lucile Baseggio, Camille Golfier
{"title":"Chronic lymphocytic leukaemia or mantle cell lymphoma?","authors":"Radu Chiriac, Sophie Gazzo, Lucile Baseggio, Camille Golfier","doi":"10.1136/bcr-2024-263395","DOIUrl":"https://doi.org/10.1136/bcr-2024-263395","url":null,"abstract":"","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852638","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
Minocycline-induced lupus.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262755
Shinya Hasegawa, Steven M Craig, Hiroyuki Suzuki
{"title":"Minocycline-induced lupus.","authors":"Shinya Hasegawa, Steven M Craig, Hiroyuki Suzuki","doi":"10.1136/bcr-2024-262755","DOIUrl":"https://doi.org/10.1136/bcr-2024-262755","url":null,"abstract":"<p><p>Antibiotics are indicated for inappropriately prolonged durations not only for infectious diseases but also for non-infectious dermatologic conditions such as acne vulgaris, but inappropriate use is not uncommon. Inappropriate antibiotic prescription can contribute to the emergence of multidrug-resistant organisms, patient harm such as adverse drug events and increased healthcare costs. We experienced a case involving a late adolescent with acne vulgaris who had been treated with minocycline for more than 2 years, leading to the development of drug-induced lupus, attributed to minocycline. This resulted in multiple clinic and emergency department visits and extensive and expensive workups, including an invasive procedure. A collaboration between antibiotic stewardship activities and patient-centred medication reviews, followed by personalised deprescribing, could effectively mitigate inappropriate antibiotic prescriptions for non-infectious dermatologic conditions.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852661","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
Torticollis as an early manifestation of basilar invagination in a paediatric patient.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262625
Nehal Shata, Jumanah Ali, Nouf ALNosani, Ramsay MacNay
{"title":"Torticollis as an early manifestation of basilar invagination in a paediatric patient.","authors":"Nehal Shata, Jumanah Ali, Nouf ALNosani, Ramsay MacNay","doi":"10.1136/bcr-2024-262625","DOIUrl":"10.1136/bcr-2024-262625","url":null,"abstract":"<p><p>This case report describes the clinical journey of a male patient in early childhood with developmental delay, failure to thrive, worsening right-sided head tilt torticollis and regression of motor skills with spasticity of the lower limbs. The case was complex due to the early onset and gradually worsening symptoms, including a decline in established motor milestones. Genetic testing to investigate the delayed neurodevelopment revealed a <i>FRA10AC1</i> variant that did not fully explain the patient's phenotype. Investigations were delayed due to the coronavirus disease 2019 pandemic and other factors related to the patient. Eventually, MRI revealed basilar invagination with cord compression and cord oedema at the C1-C2 junction. Treatment included foramen magnum decompression and management of symptoms using a multidisciplinary approach. Treatment resulted in a remarkable recovery. The patient regained some motor abilities and reached the 50th weight percentile.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852669","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
Hypermucoviscous Klebsiella pneumoniae presenting as sternocleidomastoid pyomyositis with subsequent lower extremity necrotising fasciitis.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262362
Julia Margaret Dambly, Emily R Hunter, Alec M Giakas, Joseph B Glowacki
{"title":"Hypermucoviscous <i>Klebsiella pneumoniae</i> presenting as sternocleidomastoid pyomyositis with subsequent lower extremity necrotising fasciitis.","authors":"Julia Margaret Dambly, Emily R Hunter, Alec M Giakas, Joseph B Glowacki","doi":"10.1136/bcr-2024-262362","DOIUrl":"https://doi.org/10.1136/bcr-2024-262362","url":null,"abstract":"<p><p>Necrotising fasciitis (NF) is a severe, rapidly progressing infection of the muscular fascia and subcutaneous tissue. Monomicrobial NF from hypermucoviscous <i>Klebsiella pneumoniae</i> (hvKP-NF) is rare but highly virulent, most common in East Asia. This report reviews a unique case of hvKP-NF in a US male in his 40s with undiagnosed diabetes mellitus, presenting with severe sepsis, neck swelling and calf pain. Imaging revealed pyomyositis in the sternocleidomastoid, and debridement cultures confirmed hvKP. Despite unremarkable examination findings, persistent pain led to a diagnosis of necrotising fasciitis after initial imaging misinterpretations. The patient was treated with multiple surgical debridements and tailored antibiotics. This case underscores the importance of maintaining a high index of suspicion for necrotising fasciitis despite atypical risk factors and symptomatology, awareness of hvKP in the Western Hemisphere, prompt consideration of advanced imaging modalities when initial evaluations are inconclusive and the critical role of multidisciplinary care in managing severe infections.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852645","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
Right upper quadrant pain after previous blunt abdominal trauma: undiagnosed traumatic diaphragmatic hernia with strangulated right colon.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262178
Robert Young, Rajarshi Mukherjee
{"title":"Right upper quadrant pain after previous blunt abdominal trauma: undiagnosed traumatic diaphragmatic hernia with strangulated right colon.","authors":"Robert Young, Rajarshi Mukherjee","doi":"10.1136/bcr-2024-262178","DOIUrl":"https://doi.org/10.1136/bcr-2024-262178","url":null,"abstract":"<p><p>A woman in her 40s self-presented to an emergency department in a major trauma centre with severe right-sided abdominal pain, a tender right upper quadrant mass and chest pain. Diagnostic imaging showed a previously undiagnosed diaphragmatic hernia containing strangulated right colon. The patient had been the victim of a high-energy road traffic accident 18 months earlier, but at that time had not presented to hospital or undergone any outpatient investigation. This emergency presentation necessitated an emergency laparotomy, right colectomy, suture repair of diaphragmatic hernia and formation of ileo-colostomy. While a small number of similar cases have been documented, right-sided traumatic diaphragmatic herniae (TDH), where abdominal viscera bypass the liver and subsequently strangulate, are exceedingly rare. The evidence on delayed diagnosis of TDH is discussed and a system of follow-up for patients who suffer blunt abdominal trauma which is managed non-operatively is suggested.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852667","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
Enterococcus necrotising fasciitis of the face after minor trauma presenting as periorbital cellulitis.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262567
Rekha Ramesh Mudhol, Sneha Lingamaneni, Shruti Sheelin, Aniketan Vallabha
{"title":"<i>Enterococcus</i> necrotising fasciitis of the face after minor trauma presenting as periorbital cellulitis.","authors":"Rekha Ramesh Mudhol, Sneha Lingamaneni, Shruti Sheelin, Aniketan Vallabha","doi":"10.1136/bcr-2024-262567","DOIUrl":"https://doi.org/10.1136/bcr-2024-262567","url":null,"abstract":"<p><p>Necrotising fasciitis (NF), commonly referred to as 'flesh-eating disease', is a rare but life-threatening infection. It rapidly affects subcutaneous tissue, leading to necrosis of the overlying skin. Though primarily seen in the abdomen, perineum and lower limbs, periorbital involvement is rare. This case report presents an elderly male with periorbital NF following a minor head injury. The patient presented with bilateral periorbital swelling, purulent discharge and necrotic tissue. Microbiological analysis revealed a rare <i>Enterococcus</i> species as the causative pathogen. MRI and microbiological analysis confirmed the diagnosis. Treatment included intravenous antibiotics, surgical debridement and skin grafting. The patient showed significant improvement post-treatment. This case underscores the importance of prompt diagnosis and treatment to prevent severe complications.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852636","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
Idiopathic hypoparathyroidism presenting as fatigue.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-261135
Ravishankar Gaddehosur Mylaraiah, Soumya Kanakatte Sathyanarayan
{"title":"Idiopathic hypoparathyroidism presenting as fatigue.","authors":"Ravishankar Gaddehosur Mylaraiah, Soumya Kanakatte Sathyanarayan","doi":"10.1136/bcr-2024-261135","DOIUrl":"https://doi.org/10.1136/bcr-2024-261135","url":null,"abstract":"<p><p>Fatigue is a common symptom encountered in clinical practice, often posing a diagnostic challenge due to its myriad underlying causes. A comprehensive clinical history can serve as a valuable guide in such diagnostic dilemmas. A man in his 30s presented with a history of intermittent fatigue. The history of premature cataract surgery prompted an investigation for hypocalcaemia. Subsequent evaluation revealed hypocalcaemia, hyperphosphatemia and low serum parathyroid hormone. Additionally, elevated creatine kinase and lactate dehydrogenase levels were noted. Treatment with calcium and alfacalcidol yielded a favourable response. This case underscores the significance of revisiting clinical history and considering hypocalcaemia as a potential aetiology in cases of unexplained fatigue. It also emphasises the potential for overlooking the diagnosis due to the inconspicuous nature of hypocalcaemic myopathy in idiopathic hypoparathyroidism.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852646","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
Mondor disease.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-261801
Nandakumar B M, Bharati Hiremath, Harshinie Vinaya Kumar
{"title":"Mondor disease.","authors":"Nandakumar B M, Bharati Hiremath, Harshinie Vinaya Kumar","doi":"10.1136/bcr-2024-261801","DOIUrl":"https://doi.org/10.1136/bcr-2024-261801","url":null,"abstract":"<p><p>Mondor disease (MD) is a benign inflammatory disorder of the veins over the thoracoabdominal wall. Although the disease has been described for a century, very few descriptions in literature are available. This is due to a lack of awareness among treating physicians about the disease entity as well as the self-limiting course of the disease. Patients usually present with a painful lesion in the lateral thoracic wall or as a palpable cord in the late resolving stages. The disease usually resolves with non-steroidal anti-inflammatory drugs and supportive therapy. Few patients with symptomatic tender cords require surgical excision or release. Recent studies have noted association with breast cancer, and an increase in incidence was noted in the COVID-19 pandemic. We report a woman in her 40s who presented with a band in her right lateral chest wall for 6 months and was diagnosed with MD. She underwent an excision and is currently symptom free.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852662","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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