Asian Journal of Case Reports in Medicine and Health
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Myasthenia Gravis- a Disguised Cause of Recurrent Respiratory Failure: A Rare Case Treated Successfully at National Hospital Sri Lanka
No full textMyasthenia gravis is an autoimmune disease, due to the presence of antibodies against the proteins in the post-synaptic muscle membrane, which leads to localized or generalized muscle weakness.
Presentation of myasthenia gravis could vary from patient to patient, while ocular muscle weakness is the most common form.
Here, a case of a young male who presented with recurrent respiratory failure is reported.
He had respiratory failure as the only clinical manifestation of myasthenia gravis. It describes respiratory weakness as a rare isolated initial presentation of this disorder. This case highlights the importance of prompt diagnosis of this condition, considering the variable presentations, to achieve a successful therapeutic outcome
A Very Rare Case of Neuroendocrine Carcinoma of the Bladder with Unusual Revelation "Skin Metastases": A Case Report
No full textNeuroendocrine carcinoma of the bladder is a very rare tumor, accounting for no more than 1% of all bladder tumors. Its main characteristic is its poor prognosis, which is explained by its high metastatic potential. Classical metastatic sites are lymph nodes, liver and lung, but cutaneous localization is exceptional and can take on different non-specific clinical aspects. In our article, we report the case of a 66-year-old patient who was hospitalized for cutaneous nodules revealing very advanced bladder neuroendocrine carcinoma with lymph node, peritoneal and cutaneous metastases. The particularity of our case report is the very rare histological nature of the bladder tumor, as well as its mode of revelation (cutaneous metastases). In this work, we emphasize the importance of an exhaustive etiological assessment of any skin lesion evolving in a context of altered general condition
Late Discovery: Uncovering Tetralogy of Fallot in Adulthood-A Case Report
No full textTetralogy of Fallot (ToF) is considered the most frequent cyanotic congenital heart abnormality with a low adulthood survival rate if kept untreated. The majority of cases are symptomatic during infancy and mandate early treatment. Few instances of survival to asymptomatic middle-age patients have been reported, and they are decreasing due to early detection. We report the case of a 44-year-old trisomic male, with poor socioeconomic conditions, with an illness-free past medical history presented for preoperative cardiac assessment for cholecystistis. Tetralogy of Fallot was fortuitously discovered and the patient underwent total correction of ToF. In the immediate post-operative period; the patient presented a complete atrioventricular block, for which a double chamber pacemaker was implanted. Echocardiographic follow-up showed no residual shunt, no pulmonary insufficiency. Our patient had an excellent post-operative and six-months follow-up profile. Thorough physical examination of newborns and a screening echo in the early life may aid in detecting the disease earlier
Case Report of a Patient with Burkholderia cepacia Urinary Tract Infection with Prostatitis and Prostatic Micro Abscess
No full textThe term urinary tract infection encompasses a variety of clinical entities, including asymptomatic bacteriuria, cystitis, prostatitis, and pyelonephritis. Burkholderia cepacia is an emerging bacterium causing nosocomial infections. It is associated with a wide variety of infections, including pneumonia, bacteraemia, skin and soft tissue infection, genitourinary tract infection secondary to instrumentation / devices. In this case report we highlight a case of Urinary tract infection caused by Burkholderia cepacia in a patient with history of recent invasive urological procedure. Through this case report, we wish to create an awareness of the fact that urinary tract infection secondary to Burkholderia cepacia should be considered especially in the context of Urological procedure
Radiological Diagnosis of a Left Isomerism Heterotaxy Associated to an Esophagogastric Motility Disorder: A Case Report
No full textSitus ambiguous (isomerism) also known as heterotaxy syndrome is an abnormality of lateralization during embryogenesis resulting in atypical anatomy. This is an intermediate configuration between situs inversus and situs solitus with one or more organs in symmetry or even duplicated.
Left isomerism is a splitting of the anatomical configuration of the left side; the right and left sides being identical to the image on the left side, we therefore have polysplenia, an interruption of the inferior vena cava with the azygos/hemiazygos continuation.
We report a case of left isomerism of a twelve -year-old girl diagnosed by CT scan associated with entire colon and complete common mesentery located on the left, small intestine and stomach distended up the iliac region transposed to the right, a midline liver with transposition of the abdominal vessels and gallbladder, and a polysplenia. These anomalies were associated with a megaesophagus probably linked to a motility abnormality.
Since laterality defects are rare, more data on their anatomical variations could help provide better medical care to this patient population in the future. Their associations with other anomalies, particulary digestives and vasculary ones require particular multidisciplinary attention, the role of the radiologist being central in the management of the multiple variation
A Rare Case of Adult Onset IgA Vasculitis
No full textBackground: IgA vasculitis, formerly known as Henoch – Schoenlein Purpura (HSP), is vasculitis of small vessels, which is a rare and life threatening condition in adults. It is a type 3 hypersensitivity reaction which can affect kidney, joints, skin and intestine. It is a rare presentation in adults and more severe than its pediatric counterpart.
Case Presentation: A 26 year old male with no comorbidities presented with complaints of non-resolving macular rashes on bilateral lower limbs and abdominal pain associated with fever and blood stained loose stools. Upper GI Endoscopy showed features of duodenitis and skin biopsy confirmed the diagnosis of IgA Vasculitis. Patient was started on steroids and was discharged as he improved symptomatically.
Conclusion: Clinical suspicion for adult onset IgA vasculitis should increase in the clinical practice. Early detection of the disease and early initiation of appropriate treatment help in improvement of prognosis of complications associated with IgA vasculitis
Steroid-induced Superficial Fungal Infections: A Case of Prednisone-Associated Tinea Corporis and Tinea Cruris
No full textThis case report addresses the complicated relationship between systemic corticosteroid use and the development of opportunistic fungal infections. A 39-year-old female patient, with a history of prednisolone usage, came with tinea corporis and tinea cruris. These illnesses, which are made worse by prednisolone's immunosuppressive effects, are an example of tinea incognito, a condition in which corticosteroid medication changes the clinical appearance of fungal infections. The patient's overall situation was made more difficult by her unreported fever, widespread body aches, and severe pruritus.
The case emphasizes the need for a complete medical history, especially regarding medication, to identify potential iatrogenic symptoms. It highlights the importance of monitoring dermatological side effects in corticosteroid users. The co-diagnosis of generalized anxiety disorder and acid reflux underscores the necessity for a comprehensive care strategy addressing both mental and physical health. The conclusion calls for patient education on corticosteroid risks and the value of multidisciplinary care for complex cases with multiple comorbidities
A Case Report of Pyrazinamide-Induced Hepatitis Complicated by Obstructive Hydrocephalus Secondary to Tubercular Meningitis in Pediatric Patient
No full textThis case report focuses on a pediatric patient with obstructive hydrocephalus secondary to tubercular meningitis, complicated by pyrazinamide-induced hepatitis. The elevated dosages of essential antituberculosis agents for pediatric use, recommended by the World Health Organization, raise concerns about heightened hepatotoxicity risk. Drug-induced liver injury (DILI) from anti-tuberculosis drugs is defined as hepatic injury, due to anti-tuberculosis drugs as suggested by the international DILI Expert Working Group and American Thoracic society and recent evidence questions the safety profile of pyrazinamide compared to earlier perceptions. The main objective of our study was to identify the anti tubercular drug that caused hepatitis. The patient, a 10-month-old with a history of obstructive hydrocephalus due to TB meningitis, was started with anti tubercular therapy for which the baby was presented with yellowish discoloration of both eyes after 15 days of starting anti tubercular therapy. Clinical and diagnostic findings, including head to toe examination, Cerebrospinal fluid (CSF) analysis, neurosonogram, Contrast enhanced magnetic resonance imaging (CEMRI) of the brain, and abdominal ultrasound, were detailed. Laboratory investigations revealed abnormal liver function and increased inflammatory markers. Identification of pyrazinamide as the specific hepatotoxic agent was established through dechallenge and rechallenge assessments. The patient's management plan was modified to incorporate non-tubercular medications. Adjustments to the treatment regimen, including the discontinuation of pyrazinamide, were executed, resulting in an extension of isoniazid and rifampicin therapy for 9 months. The case highlights the need for a multidisciplinary approach, individualized treatment plans, and close monitoring in pediatric tuberculosis cases, particularly considering neurological and hepatic complications. Further research and awareness are crucial for refining treatment guidelines and improving overall care
Thromboembolic Events and Metabolic Hyperhomocysteinemia: Unraveling the Links and Clinical Implications
No full textThromboembolic events, represents one of the major causes of morbidity and mortality worldwide. While traditional risk factors, are well-established, metabolic hyperhomocysteinemia has emerged as a novel and potentially modifiable risk factor. Elevated levels of homocysteine, have been implicated in the pathogenesis of thromboembolic events, highlighting the importance of recognizing hyperhomocysteinemia in clinical practice. This article explores the relationship between thromboembolic events and Hyperhomocysteinemia by first reporting a case of a 20 years old man admitted to the CHU of Casablanca for a pulmonary embolism and in whom an hyperhomocysteinemia was diagnosed, then we will be highlighting the pathophysiology, clinical implications, and management strategies
A Rare Case of Cerebral Venous Thrombosis Revealing a Primary Sjögren's Syndrome
No full textSjögren's syndrome, formerly known as Gougerot-Sjögren syndrome, is an autoimmune disease with a predilection for exocrine glands, earning it the nickname of exocrinopathy or autoimmune epithelitis of the exocrine glands. It is a rare disease that predominantly affects females, with a sex ratio of 9 women to 1 man and an incidence peak around the age of 50 years. Sjögren's syndrome can be primary when isolated, or secondary when associated with another autoimmune disease which the most common is Rheumatoid Arthritis but also Lupus Erythematosus and Scleroderma. The triad defining the disease includes dryness syndrome, pain, and fatigue [1].
Cerebral thrombophlebitis corresponds to the blockage of a vein around the brain by a blood clot, initially causing few symptoms but eventually leading to persistent headaches that worsen progressively, possibly accompanied by vomiting or epileptic seizures [2].
We report the case of a patient who presented with cerebral thrombophlebitis revealing primary Sjögren's syndrome