Asian Journal of Case Reports in Medicine and Health
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Diffuse Large B-cell Lymphoma of the External Auditory Canal: Case Report
No full textA 68 yr old male presented with hearing loss due to an obstructing mass in his ear canal. A CT scan confirmed a non-erosive mass, which was biopsied. A diagnosis of Diffuse Large B-Cell Lymphoma was made. Following 6 courses of intra-thecal methotrexate the patient is asymptomatic and in remission. Diffuse Large B-Cell Lymphoma (DLBCL) of the EAC (external auditory canal) is extremely unusual with only 8 cases of documented DLBCL in the literature
A Case of Ventilator Associated Pneumonia Caused by Pannonibacter phragmitetus
No full textPannonibacter phragmitetus is an environmental pathogen that can occasionally cause serious infections in humans. While positive cultures for this organism in an otherwise asymptomatic person likely represent contamination, this microbe should not be ignored in patients who show signs of sepsis. This is the first report of a ventilator associated pneumonia caused by this organism
Restrictive Cardiomyopathy or Hypertensive Heart Disease?: A Case Report
No full textCardiomyopathies include a spectrum of intrinsic myocardial diseases without significant inflammation. Out of these, restrictive cardiomyopathy is considered a rare form compared to Hypertrophic and Dilated types. A 67-year-old male with a history of hypertension and diabetes for more than 10 years and a previous echo-cardiographic diagnosis of restrictive cardiomyopathy was admitted with bilateral lower limb swelling, severe dyspnoea and other features of cardiovascular compromise. Despite resuscitative attempts, he died shortly after admission. During the post mortem examination, pink frothy discharge from the mouth and icteric sclerae were noted. Gross pulmonary oedema, gross ascites with 3 liters of straw-colored fluid, nutmeg liver and oedematous kidneys were noted. The spleen was shrunken. Heart was grossly enlarged with a weight of 700 g and increased epicardial fat. Right and Left ventricular thicknesses were 0.8 cm and 2.2 cm respectively showing marked bi-ventricular hypertrophy. All major branches of coronary circulation showed over 60% atherosclerotic narrowing. An organized clot at right auricle was noted with dilated atria. Histological examination revealed pulmonary oedema and congestion, centri-lobular hepatic necrosis, patchy renal tubular necrosis and relatively hypertrophic cardiac myocytes with diffuse interstitial hyaline material. Gross myocyte disarray was not noted specially in sections from the inter-ventricular septum and apex. Special stains did not show evidence of amyloid deposition. Although the clinical picture might have been compatible with diastolic dysfunction due to a restrictive element restricting the diastolic filling, the primary disease/pathology was confirmed at autopsy as hypertrophy with scarring due to hypertensive heart disease. An infiltrative condition leading to restrictive cardiomyopathy had been excluded. Functional restriction to diastolic filling could be attributed to gross ventricular hypertrophy
Pulmonary Tuberculosis and Intercostal Zona Complicating Abusive Corticosteroid Therapy: About a Case
No full textThe present case study describe the pulmonary tuberculosis and intercostal zona complicating abusive corticosteroid therapy. Corticosteroids have changed the history and prognosis of most inflammatory diseases by the effectiveness and speed of their action. Far from being a universal panacea, the abusive and long-term use of these powerful anti-inflammatory agents with immunosuppressive effect, exposes to severe complications, some of which, namely opportunistic infections, are serious. A case showed 59-year-old patient with a history of long-term systemic corticosteroid therapy based on dexamethasone established for an acute orchiepididymitis and with no notion of tuberculous contagion found, who had consulted at the Gloria Medical Union Clinic for chronic cough, vespero-nocturnal fever and painful rashes. The clinical examination found bilateral pulmonary condensation, a vesicular band rash lesion, metameric from front to back and hyperesthesic resting on an erythematous background, located in the lower third disengaging on the right hemithorax on an erythematous background, surmounted by embedded vesicles under the skin and grouped in clusters in places without going beyond the left contralateral hemithorax to the midline. Compliance with the indications and close monitoring of patients on corticosteroid therapy will, as far as possible, avoid them
A Curious Case of Accidental Foreign Body Ingestion with a Mini-review of the Literature
No full textForeign body ingestion is a frequently occurring event. Pediatric patients and mentally handicapped are at high risk of foreign body ingestion than adults. Most patients get away with conservative management only. However, some complicated cases require surgical interventions. We report an interesting case of foreign body ingestion
Persistent Pruritic Plaque Like Rash in Adult-Onset Still’s Disease: A Case Report
No full textAdult-onset Still’s disease (AOSD) is a multi-system, inflammatory disease that presents with acute fevers, arthritis or arthralgia, and a evanescent maculopapular rash, mostly occurring with myalgia, sore throat, splenomegaly, lymphadenopathy, raised C-reactive protein (CRP), serum ferritin, and neutrophilic leukocytosis. This is a case report of a 51-year-old female who came with pruritic plaques on her neck, chest, shoulders, upper arms, thighs, and lower back along with fever and arthritis. Her initial lab work showed borderline low C4, positive antinuclear antibody (ANA), and a CRP of 14 mg/dl (that was later increased to 281 mg/dl), microscopic hematuria with +1 protein on urinalysis with a creatinine of 1.3 mg/dl, WBC of 23.5x109/L mildly elevated liver function tests, brain natriuretic peptide (BNP) of 480 mg/dl, and high troponin of 0.130. In this case, we are highlighting the atypical presentation of rash in Adult-onset Still’s disease
COVID-19 Patient Associated with Rare Pneumatocele Finding: CT Features and Case Report
No full textBackground and Aim: Coronavirus disease-2019 (COVID-19) has become pandemic across the world, especially in Indonesia. One of the rare complications reported due to COVID-19 is pulmonary pneumatocele. We aim to describe the COVID-19 patient case report with pneumatocele in CT-Scan findings.
Case Report: A 41-year-old man referred to our hospital with fever, dyspnea and a productive cough for seven days before admission. His chest X-ray and CT-Scan showed possible bilateral bronchopneumonia due to COVID-19 and confirmed with Polymerase Chain Reaction (PCR) test. In the next two weeks, the second CT-Scan showed the development of pneumothorax dextra and pneumatocele dextra with a diameter of 7,8 cm. On the third follow up, CT-Scan revealed increasing diameter into 9,5 cm and air-fluid levels in pneumatocele. He was diagnosed with infected pneumatocele, and we gave antibiotics. The patient recovered after the twenty-third-day post-admission, then discharged from hospital after twice a negative of nasopharynx swab result and resolution of symptoms.
Conclusion: Pneumatocele is one of the rare abnormality findings in COVID-19 patients. If the clinician suspect pneumatocele finding, the progressivity of disease should be monitored due to the possibility of complicated pneumatocele
Guillain-Barre Syndrome Associated with Acute Hepatitis A Infection: A Case Report
No full textBackground and Aim: Guillain-Barré syndrome (GBS) is considered as an inflammatory postmanifestation of infectious, which acute ascending motor weakness, hyporeflexia or areflexia and sometimes sensory loss are hallmarks of this clinical syndrome. It is an acute polyradiculoneuropathy often provoked by an infectious agent. It is an acute polyradiculoneuropathy often provoked by an infectious agent, but its development following acute hepatitis A has rarely been reported.
Case Presentation: The authors report a 35 years old female of Guillain-Barre syndrome following acute hepatitis A in a young female, that developed symmetrically ascending motor weakness two weeks after the onset of initial symptoms of hepatitis infection. Our case presented with high-grade fever, vomiting and jaundice. The diagnosis of GBS was made according to clinical manifestations and albuminocytologic dissociation in cerebrospinal fluid. The patient was transferred in the ICU, NGT fixed, and plasmapheresis started. Patient’s neurological condition improved after 8 times plasmapheresis every 48 h after seven day in ICU. Treatment outcome was satisfactory and her facial palsy had almost completely improved.
Conclusion: Although GBS due to hepatitis A is very rar, this complication should be kept in mind and the best way to prevent Hepatitis A through vaccination and personal hygiene especially in close contact with an infected household member, beside good environmental sanitation
Povidone-iodine Induced Fixed Bullous Eruption: A Case Report
No full textFixed drug skin eruption to the iodine especially manifesting by bullous lesions is very rare. We present a case of a 73-year-old female who developed multiple blisters on the fingers of both hands with serous or serous-hemorrhagic content after a week of postoperative topical use of Povidone-iodine. Clinically diagnosed bullous eruption resolved in 12 days on the background of offending drug discontinuation and systemic steroid treatment but then it was reappeared at the same site after re-treatment of inflamed wound with the same antiseptic drug. Three months later after the complete resolution of the symptoms, diagnostic examinations such as patch-test and provocation were performed. On the basis of these test results, the diagnosis of a fixed bullous eruption caused by Povidone-iodine was confirmed
Complications of Spinal Cord Injury can Hide Fever and Cough Associated to COVID-19
No full textAim: Coronavirus disease (COVID-19) is a lower respiratory tract infectious disease. This new coronavirus responsible for severe acute respiratory syndrome, higher level of illness and death. Comorbid health conditions are highly important in clinical course of Coronavirus disease. Patient with spinal cord injury (SCI) may have numerous comorbidities like respiratory muscle weakness, tendency to coagulation caused by immobilisation, autonomic dysreflexia accompanied by hypertension, urinary tract infection, SCI-induced immune suppression etc.
Case of Presentation: A 43 year-old male patient is affected by ASIA A, T7 level paraplegia. After the COVID-19 outbreak, he acquired severe dorsal pain with recurrent submaximal fever at night. The patient was considered primarily as a urinary tract infection. He was evaluated covid-19 on the development of dyspnoea and cough in the following periods. Due to SCI complications, it is late in diagnosis and treatment.
Discussion: SCI patients are vulnerable individuals of our society in having respiratory infections. Comorbidities caused by the spinal cord injury lay the ground for this. The importance of this sensitive condition should be emphasized in the COVID-19 pandemic. SCI patients may not come with symptoms such as fever, cough and dyspnoea, which are typical symptoms of covid-19 in initial hospital admissions.
Conclusion: Complications of SCI can cover COVID-19 infections. Evaluating SCI patients in terms of infection, this should be known and cautious. In this way, there is no delay in the treatment of SCI patients and less mortality can be observed