Case Reports in Medicine最新文献_第4页

Choroidal Osteoma: Case Series. 脉络膜骨瘤：病例系列。

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Case Reports in Medicine Pub Date : 2026-07-18 eCollection Date: 2026-01-01 DOI: 10.1155/carm/8005092

Alua Aubakirova, Kamilya Sarsembekova, Zaure Jumatayeva, Zauresh Utelbayeva, Zhanerke Serikova, Dinara Berlibek

{"title":"Choroidal Osteoma: Case Series.","authors":"Alua Aubakirova, Kamilya Sarsembekova, Zaure Jumatayeva, Zauresh Utelbayeva, Zhanerke Serikova, Dinara Berlibek","doi":"10.1155/carm/8005092","DOIUrl":"10.1155/carm/8005092","url":null,"abstract":"Purpose: To describe the clinical presentation, multimodal imaging findings, and management of patients with choroidal osteoma observed at a tertiary ophthalmic center.Methods: A retrospective case series of three patients (four affected eyes) diagnosed with choroidal osteoma at the Kazakh Eye Research Institute, Almaty, Kazakhstan. All patients underwent a comprehensive ophthalmic examination, including best-corrected visual acuity assessment, fundus photography, B-scan ultrasonography, optical coherence tomography (OCT), fluorescein angiography (FA), OCT angiography, and computed tomography (CT).Results: The patients presented with decreased vision, progressive visual impairment, or vitreous floaters. Choroidal osteoma was identified as a yellowish-white or orange peripapillary subretinal lesion with well-defined borders. Multimodal imaging demonstrated characteristic calcified choroidal lesions with high acoustic reflectivity on ultrasonography, hyperdense plaques on CT, and hyperreflective heterogeneous structures on OCT corresponding to cancellous bone architecture. None of the patients demonstrated active choroidal neovascularization at presentation. Associated systemic or inflammatory conditions included systemic lupus erythematosus, retinal vasculitis, and chronic infectious exposure. All patients were managed conservatively with regular follow-up because of the absence of severe complications requiring intervention.Conclusions: Choroidal osteoma is a rare benign ossifying tumor that predominantly affects young individuals and may be associated with inflammatory or immune-mediated conditions. Multimodal imaging is essential for accurate diagnosis and monitoring. Although tumor progression is usually slow, long-term surveillance is necessary because of the risk of decalcification, retinal pigment epithelium atrophy, serous retinal detachment, and choroidal neovascularization.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"8005092"},"PeriodicalIF":1.0,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497240","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

Premature Ovarian Insufficiency in a Patient With Vogt-Koyanagi-Harada Syndrome: An Unusual Association-A Case Report. Vogt-Koyanagi-Harada综合征患者卵巢功能不全：一个不寻常的关联病例报告。

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Case Reports in Medicine Pub Date : 2026-07-16 eCollection Date: 2026-01-01 DOI: 10.1155/carm/2727070

Ruan Barboza Rocha, Denise Corrêa Benzaquem, Paloma de Sousa Passos, Evellyn Karine Cruz da Silva, Jadiele Barbosa Mendonça, Paula Rita Leite da Silva, Jorge Frank Braga Ferreira, Cleiton Fantin

{"title":"Premature Ovarian Insufficiency in a Patient With Vogt-Koyanagi-Harada Syndrome: An Unusual Association-A Case Report.","authors":"Ruan Barboza Rocha, Denise Corrêa Benzaquem, Paloma de Sousa Passos, Evellyn Karine Cruz da Silva, Jadiele Barbosa Mendonça, Paula Rita Leite da Silva, Jorge Frank Braga Ferreira, Cleiton Fantin","doi":"10.1155/carm/2727070","DOIUrl":"10.1155/carm/2727070","url":null,"abstract":"Premature ovarian insufficiency (POI) is a clinical syndrome characterized by ovarian failure in women of reproductive age before the age of 40 years. Its main manifestations include menstrual cycle disturbances, such as oligomenorrhea or amenorrhea. The etiology of POI is highly heterogeneous, with a particular emphasis on genetic and immunological factors. In addition, the condition may be associated with other rare diseases, such as Vogt-Koyanagi-Harada (VKH) syndrome. Our study aimed to describe a rare clinical case of a patient from Manaus, Amazonas, Brazil, who was simultaneously diagnosed with two rare conditions: POI and VKH syndrome, with a specific focus on their etiological characteristics, clinical manifestations, and laboratory findings. Clinical data were collected from the patient's medical record, as registered in the outpatient clinic database at Araújo Lima Hospital. Case description: The case involves a 38-year-old, nulliparous, mixed-race, married female patient diagnosed with POI and VKH syndrome. The understanding of these rare syndromes and the search for an integrated approach are fundamental to ensure better clinical outcomes, quality of life, and reproductive planning for affected patients. This report provides relevant information on the association between two rare syndromes, with the aim of contributing to medical decision-making and diagnostic clarification, as well as providing guidance on appropriate multidisciplinary follow-up. Thus, early diagnosis and appropriate treatment are essential steps in promoting this patient's health.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"2727070"},"PeriodicalIF":1.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469143","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

Severe Rhabdomyolysis Without Electrolyte Abnormalities or Renal Failure and With Disproportionately Low AST. 严重横纹肌溶解，无电解质异常或肾功能衰竭和不成比例的低AST。

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Case Reports in Medicine Pub Date : 2026-07-16 eCollection Date: 2026-01-01 DOI: 10.1155/carm/9601669

Sarah Baig, Michelle Troendle

{"title":"Severe Rhabdomyolysis Without Electrolyte Abnormalities or Renal Failure and With Disproportionately Low AST.","authors":"Sarah Baig, Michelle Troendle","doi":"10.1155/carm/9601669","DOIUrl":"10.1155/carm/9601669","url":null,"abstract":"Rhabdomyolysis is a condition in which damaged muscle tissue breaks down and typically presents with muscle pain, weakness, and dark-colored urine, along with markedly elevated serum creatine kinase (CK) levels. Common lab findings include hyperkalemia, hyperphosphatemia, hypocalcemia, elevated lactate dehydrogenase (LDH), acute kidney injury (AKI), and elevated aspartate aminotransferase (AST), with a typical CK:AST ratio of approximately 20:1. This report describes a 26-year-old man with no prior medical history who developed dark urine and lower back pain after a high-intensity functional training (HIFT) session following a prolonged period of inactivity. Laboratory evaluation revealed an extraordinarily high CK of 260,100 U/L, AST of 2049 U/L, and ALT of 208 U/L, yielding a CK:AST ratio of approximately 127:1. Urinalysis showed myoglobinuria, while renal function and electrolytes remained normal throughout hospitalization. He was managed with intravenous fluids for 36 h, transitioned to oral hydration, and discharged on Day 6 with declining CK and AST levels. This case underscores that severe rhabdomyolysis may occur in the absence of renal dysfunction or electrolyte abnormalities and highlights the importance of prompt recognition and treatment even when traditional laboratory abnormalities are absent. The strikingly abnormal CK:AST ratio challenges reliance on expected lab patterns. Recognizing these atypical presentations is crucial for timely diagnosis and management. Early fluid resuscitation and close monitoring remain essential, even when routine findings appear normal.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"9601669"},"PeriodicalIF":1.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577072","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

Secondary Aortopulmonary Fistula After Thoracic Endovascular Aortic Repair: Case Report. 胸主动脉血管内修复术后继发主动脉肺瘘1例。

IF 1

Case Reports in Medicine Pub Date : 2026-07-06 eCollection Date: 2026-01-01 DOI: 10.1155/carm/9207891

María Del Mar Conde-Crespo, Miguel Zuñiga, Mauricio Velasquez, Liliana Fernández-Trujillo

{"title":"Secondary Aortopulmonary Fistula After Thoracic Endovascular Aortic Repair: Case Report.","authors":"María Del Mar Conde-Crespo, Miguel Zuñiga, Mauricio Velasquez, Liliana Fernández-Trujillo","doi":"10.1155/carm/9207891","DOIUrl":"10.1155/carm/9207891","url":null,"abstract":"Aortopulmonary fistula is a rare but serious condition associated with high mortality, primarily observed in specific patient groups, including those with prior placement of aortic endografts. Its incidence has risen with the adoption of endovascular techniques like thoracic endovascular aortic repair, which, despite its benefits, may lead to complications such as aortobronchial and aortopulmonary fistula formation. However, the current literature offers limited insight into the understanding and management of this condition. Here, we describe the case of a male patient in his late 50s with a history of endovascular repair of chronic Type B dissection of the thoracic aorta, who subsequently developed a complicated aortopulmonary fistula manifesting with recurrent hemoptysis and chest pain. Following extensive evaluations and treatments, the patient underwent open thoracotomy for surgical repair, resulting in a favorable postoperative outcome. Aortopulmonary fistula represents a rare yet significant complication of endovascular procedures. Timely diagnosis and surgical intervention are paramount for enhancing clinical outcomes, although additional research is warranted to enhance our understanding of its pathophysiology and to develop more effective therapeutic approaches. Multidisciplinary collaboration and ongoing follow-up are imperative for managing this complex clinical condition.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"9207891"},"PeriodicalIF":1.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435243","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

Delayed-Onset Cefepime Neurotoxicity in a Patient With Epilepsy and ESRD. 迟发性头孢吡肟对癫痫和终末期肾病患者的神经毒性。

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Case Reports in Medicine Pub Date : 2026-07-03 eCollection Date: 2026-01-01 DOI: 10.1155/carm/5491008

Oluwadamilola Omojola, Sara Siddiqui, Veronica Zheng, Shannon Mccabe, Niti Girish Patel, Toluwalase Awoyemi, David Liebovitz

{"title":"Delayed-Onset Cefepime Neurotoxicity in a Patient With Epilepsy and ESRD.","authors":"Oluwadamilola Omojola, Sara Siddiqui, Veronica Zheng, Shannon Mccabe, Niti Girish Patel, Toluwalase Awoyemi, David Liebovitz","doi":"10.1155/carm/5491008","DOIUrl":"10.1155/carm/5491008","url":null,"abstract":"Cefepime is associated with central nervous system toxicity, particularly in patients with renal impairment. Cefepime-induced neurotoxicity (CIN) can manifest as seizures, encephalopathy, and other neurologic disturbances, often mimicking other conditions in complex patients. In this case report, we report a 42-year-old woman with end-stage renal disease on hemodialysis, systemic lupus erythematosus, and epilepsy who presented with recurrent seizures after four months of indefinite cefepime therapy for chronic Pseudomonas aeruginosa catheter-related bacteremia. Despite therapeutic clobazam levels and stable metabolic parameters, she experienced multiple seizure episodes during a dialysis session. Further investigation revealed characteristic electroencephalography (EEG) for cefepime neurotoxicity as well as elevated serum cefepime level. Following immediate cefepime discontinuation and transition to ceftazidime with optimization of antiepileptic therapy, the patient remained seizure-free for the remainder of hospitalization. This case highlights the diagnostic challenge of cefepime neurotoxicity in patients with multiple comorbidities, particularly those with baseline seizure disorders and renal dysfunction. Clinicians should maintain a high suspicion for CIN in patients with renal impairment presenting with new or worsening seizures, utilize EEG findings and therapeutic drug monitoring when available, and promptly discontinue cefepime when toxicity is suspected.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"5491008"},"PeriodicalIF":1.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390019","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 Right Ventricular Failure Triggered by Excessive Fluid Resuscitation in Septic Shock. 脓毒性休克中过量液体复苏引发的急性右心室衰竭。

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Case Reports in Medicine Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.1155/carm/4817187

Mohamed Achref Boubaker

引用次数: 0

Fatal Rhinocerebral Mucormycosis and Aspergillus flavus Coinfection Complicated by Internal Carotid Artery Arteritis: A Case Report. 致死性鼻脑毛霉病和黄曲霉合并感染并发颈内动脉炎1例。

IF 1

Case Reports in Medicine Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.1155/carm/9945781

Mukhtar Ansari, Talal Alhumaidi Alshammari, Majed Mamdouh Alshammari, Yasser Alhabeeb, Nada Nasser Almansour, Razan Abdullah Alshammari, Alya Khaled Alshayia

{"title":"Fatal Rhinocerebral Mucormycosis and Aspergillus flavus Coinfection Complicated by Internal Carotid Artery Arteritis: A Case Report.","authors":"Mukhtar Ansari, Talal Alhumaidi Alshammari, Majed Mamdouh Alshammari, Yasser Alhabeeb, Nada Nasser Almansour, Razan Abdullah Alshammari, Alya Khaled Alshayia","doi":"10.1155/carm/9945781","DOIUrl":"10.1155/carm/9945781","url":null,"abstract":"This case report describes a fatal case of rhinocerebral mucormycosis and Aspergillus flavus coinfection in a 63-year-old Saudi male with poorly controlled Type II diabetes and hypertension. The patient presented with a 2-day history of rapid right-sided facial swelling, blurred vision, and proptosis. Clinical examination revealed necrotic nasal mucosa and ophthalmoplegia, while laboratory tests showed critical hyperglycemia (RBS 500 mg/dL) and severe leukocytosis. CT and MRI imaging confirmed extensive invasive fungal sinusitis with spread into the right cavernous sinus and involvement of the internal carotid artery (ICA). This angioinvasive progression resulted in infectious ICA arteritis and multiple acute cerebral infarcts. Management involved high-dose liposomal amphotericin B (escalated to 7.5 mg/kg), functional endoscopic sinus debridement, and initially voriconazole, which was discontinued due to hemodynamic instability. Despite these aggressive interventions and histopathological confirmation of the mixed fungal infection, the patient's neurological status deteriorated, leading to mechanical ventilation and, ultimately, death. This case illustrates the lethal nature of rhinocerebral mucormycosis, particularly when complicated by vascular invasion and coinfection. In regions like Saudi Arabia, where diabetes prevalence is high, a high index of clinical suspicion and immediate metabolic and surgical intervention are vital, as prognosis remains exceptionally poor once the infection reaches the cavernous sinus.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"9945781"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367140","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

Paroxysmal Atrial Tachycardia With Atrioventricular Block: A Report of Two Cases. 阵发性房性心动过速伴房室传导阻滞2例报告。

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Case Reports in Medicine Pub Date : 2026-06-29 eCollection Date: 2026-01-01 DOI: 10.1155/carm/2977958

Nika Kuridze, Kakhaber Etsadashvili, Saba Tchanturia, Salome Betsuashvili, Tinatin Kavtaradze

{"title":"Paroxysmal Atrial Tachycardia With Atrioventricular Block: A Report of Two Cases.","authors":"Nika Kuridze, Kakhaber Etsadashvili, Saba Tchanturia, Salome Betsuashvili, Tinatin Kavtaradze","doi":"10.1155/carm/2977958","DOIUrl":"10.1155/carm/2977958","url":null,"abstract":"Paroxysmal atrial tachycardia (PAT) with atrioventricular (AV) block is a rare arrhythmia that can be easily misdiagnosed, yet correct identification is crucial for effective management. This report presents two cases illustrating different etiologies. The first patient, a 78-year-old man on digoxin for heart failure, presented with symptoms including tachycardia and dizziness, with elevated digoxin levels confirming toxicity. Following the withdrawal of digoxin and supportive treatment, sinus rhythm was restored without further intervention. The second case involves a 52-year-old man with hypertension who developed PAT with AV block and hypokalemia following excessive alcohol intake. Treatment with intravenous potassium normalized his rhythm, and he remained arrhythmia-free at follow-up. These cases highlight the importance of identifying underlying causes, such as digitalis toxicity and hypokalemia, in managing PAT with AV block. Accurate diagnosis and individualized therapy are essential for preventing complications and achieving optimal patient outcomes.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"2977958"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350909","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

A Case of Strabismus in a Patient With Psoriasis. 银屑病患者斜视1例。

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Case Reports in Medicine Pub Date : 2026-06-29 eCollection Date: 2026-01-01 DOI: 10.1155/carm/2348907

Karen Cravero, Emma Scott, Matthew Calestino, Nausheen Khuddus

引用次数: 0

Tourniquet-Induced Atypical Lower Back Pain Under Spinal Anesthesia: A Case Report and Mechanistic Exploration of Referred Pain. 脊柱麻醉下止血带引起的非典型腰痛：一例报告及牵涉性疼痛的机制探讨。

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Case Reports in Medicine Pub Date : 2026-06-29 eCollection Date: 2026-01-01 DOI: 10.1155/carm/5531848

Zhifu Zhao, Zhongjun Liu, Yakang Wang, Candida

{"title":"Tourniquet-Induced Atypical Lower Back Pain Under Spinal Anesthesia: A Case Report and Mechanistic Exploration of Referred Pain.","authors":"Zhifu Zhao, Zhongjun Liu, Yakang Wang, Candida","doi":"10.1155/carm/5531848","DOIUrl":"10.1155/carm/5531848","url":null,"abstract":"Tourniquet-associated complications typically manifest as localized limb symptoms or systemic reactions. Here, we report a rare case of acute, severe lower back pain directly induced by a tourniquet during lower limb surgery under spinal anesthesia. A 32-year-old male developed intense lower back pain (VAS: 4-10) approximately 1.5 h after tourniquet application to the right thigh, accompanied by elevated blood pressure and agitation, while bilateral lower limb sensorimotor blockade remained intact (T11-S5 level). Intravenous analgesics provided only transient and limited relief. Crucially, within approximately two minutes of pausing the procedure and releasing the tourniquet, the patient's pain completely resolved (VAS: 0) without additional analgesia, and the anesthetic level was unchanged. This case provides the first clear documentation of tourniquet pain presenting as isolated truncal pain entirely remote from the ischemic region. We propose that this phenomenon arises because spinal anesthesia blocks somatic sensory input from the lower limbs, leading to nociceptive signals from ischemic muscle being transmitted via incompletely blocked visceral or sympathetic afferent pathways to the spinal cord. According to the convergence-projection theory, these signals are then misinterpreted by the brain as originating from the lower back (T10-L2 dermatomes). This finding reveals how regional anesthesia can fundamentally alter the clinical presentation of tourniquet pain, addresses a critical gap in the current understanding of this complication, and alerts clinicians to include atypical referred pain in their differential diagnosis to prevent misdiagnosis and excessive medical intervention.","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"5531848"},"PeriodicalIF":1.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350958","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