Asian Journal of Case Reports in Medicine and Health
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A Successful Treatment of a Patient Infected with Pan-drug Resistant Acinetobacter baumannii Ventriculitis with Intravenous Sulbactam: A Case Study
No full textThe post neurosurgical ventriculitis caused by Acinetobacter baumannii (A. baumannii) is an important problem disorder in neurosurgical patients that can lead to serious medical complications, or even to death. This is because A. baumannii frequently can develop multi-drug resistance to several classes of antibiotic, rendering conventional treatment method ineffective. In this case study, we report a case where our patient who is infected with post neurosurgical ventriculitis from A. baumannii (pan-drug resistant strain) is successfully treated with 12 grams per day of intravenous sulbactam concurrent with usual dose of intravenous tigecycline and intraventricular colistin. This successful treatment can be another novel adjunctive therapy for the treatment of CNS infection caused by A. baumannii (pan-drug resistant) using intravenous non-colistin base plus intraventricular colistin base regimen in post neurosurgical condition
Bilateral Osgood-Schlatter Disease in an Adolescent Nigerian Male: A Case Report
No full textOsgood-Schlatter disease is a frequent but uncommon cause of knee pain in active adolescent children aged 10-15 years. The incidence is generally unknown. Affected children usually present with a history of pain below the patella at the insertion of the patellar tendon which is usually aggravated by sporting or other activity. Despite its frequent occurrence, late sequelae are rarely observed. We report a 13-year-old male adolescent who presented to the rheumatology clinic with a 1-year history of recurrent bilateral knee joint pain. There was no associated fever, swelling, or limitation of ambulation. The diagnosis was initially missed at first contact at the referring clinic. Plain radiograph of both knees revealed an irregularity of tibial tuberosity; patella tendon edema; osseous density anterior to the tuberosity which suggests Osgood-Schlatter disease. Clinicians need to have a high index of suspicion for prompt diagnosis of Osgood-Schlatter disease especially in adolescents with chronic knee pain
Congenital Agenesia of the Inferior Vena Cava: A Diagnosis to Mention in Front of a Deep Vein Thrombosis
No full textCongenital agenesia of the inferior vena cava (IVC) is an extremely rare morphological anomaly in the general population; found in approximately 0.0005% to 1% [1]. It is a rare cause of deep vein thrombosis (DVT) and could be responsible for less than 5% of thromboses without a contributory factor in subjects under 30 years of age [2].
We present a case of DVT agenesis, demonstrated by a CT angiography, performed as part of the etiologic assessment of extensive, bilateral and recurrent deep venous thrombosis (DVT), in a young 24-year-old man.
We discuss the mechanisms of occurrence of thrombosis associated with IVC agenesis and their possible clinical and therapeutic features
Prostate Cancer Presenting as Left Supraclavicular Lymphadenopathy and a Review of the Literature
No full textAims: Patients presenting with a neck mass are commonly seen by the ENT surgeon. They are also usually related to head and neck tumours. However, cervical node involvement from the prostate is rare, especially as an initial presentation of the disease. We report a case of prostate carcinoma presenting with a left supraclavicular lymph node.
Presentation of Case: A 61-year-old gentleman presented to our clinic with a rapidly growing left sided neck mass. Fine needle aspiration cytology (FNAC) of the neck mass was interpreted as metastatic carcinoma. It was later revealed by the patient that he had been experiencing lower urinary tract symptoms (LUTS). PSA was 1331 ng/ml. He was referred to our urology service and was treated as metastatic prostate cancer.
Discussion: Prostate cancer commonly spreads to the regional lymph nodes, pelvic organs, or the axial skeleton. Distant metastases to the cervical nodes are rare and accounts for 0.3-1% of cases.
Conclusion: In male patients presenting with left supraclavicular mass, it is important for the clinician to keep in mind of the possibility of metastases from prostatic malignancy
Orbital Emphysema: Is it Due to Primary Blast Injury or Nose Blowing? A Case Report
No full textThe authors wish to discuss the possibilities and pathophysiology of orbital emphysema of a live victim of high-explosive blast attack. A 35-year-old male suffered a terrorist blast resulting in shrapnel injuries, flash-burns and bilateral ear drum perforation. Throughout in a conscious and rational state, he was taken to the nearest tertiary-care hospital. Two shrapnels were surgically removed and all external injuries cleaned and dressed. Swollen left eye was examined by the ophthalmologist to reveal unilateral subcutaneous emphysaema and diplopia but no orbital wall fracture was detected. Specialized ENT referral revealed bilateral central eardrum perforation with impaired hearing. Treating clinicians have already attributed all injuries to the effects of the blast, by the time the Forensic Specialists examined the patient for medico-legal purposes. The forensic specialists were reluctant to attribute orbital emphysema to the effects of the initial blast. Detailed history from the examinee revealed an incident of forceful and violent nose-blowing immediately after the blast to relieve the abnormal sensation he felt within his ears. We discuss here the pathophysiology of orbital emphysema and possible mechanisms of its causation. In conclusion, we emphasize the need for careful interpretation of injuries specially in complex situations such as bomb blasts to prevent attribution of erroneous aetiological factors
Methemoglobinemia Precipitated Possibly by Three Prescribed Drugs
No full textMethemoglobinemia is a potentially fatal condition, can be congenital but mainly acquired after intoxication by certain drugs. To this date there are very few cases associated with use of multiple drugs leading to methemoglobinemia. We report a patient who developed methemoglobinemia secondary to multiple drugs. Our patient had diabetes related micro and macro vascular complication along with non-vascular complication i.e. diabetic gastropares is along with UTI. She was treated with multiple drugs which included metoclopramide, nitrates, paracetamol which led to methemoglobinemia. All three of these drugs can precipitate methemoglobinemia either individually or in combination with each other. This patient was successfully treated with iv methylene blue
Minor p190 Fusion Transcript in CML - A Case Report
No full textObjective: Detection of minor (p190) BCR-ABL fusion protein in a CML patients.
Case Report: A 26-year-old female presented with complaints of pain abdomen and episodes of vomiting. On examination her vitals were stable and there was moderate splenomegaly. The peripheral blood and bone marrow cytological features were consistent with myeloproliferative neoplasm. Fluorescent in situ hybridization (FISH) for BCR ABL was positive, with 87% of cells showing fusion transcript. However, Real Time Polymerase chain reaction (RT-PCR) for p210 BCR-ABL was found to be negative. In view of high morphologic index of suspicion for CML, further molecular analysis was carried out for BCR/ABL fusion transcript variants along with JAK2 V617F mutations.
Conclusion: The patient was found to be positive for BCR/ABL p190 e1a2 fusion transcript, while BCR/ABL p210 fusion transcript was negative
Appendiceal Endometriosis: A Case Report
No full textoai:ojs.pkp.sfu.ca:article/1Introduction: Endometriosis is established as the presence of ectopic endometrial tissue, outside the lining of the uterine cavity. Endometriosis of the appendix is uncommon especially in our environment. A definitive diagnosis is customarily established following histo-pathological examination of the appendix. Complications include rupture and haemorrhage.
The Case: A fifty-three years old female was admitted at the Jos University Teaching Hospital emergency unit, complaining of right lower abdominal pain of three days duration and abdominal distension of one week duration. The pain was associated with nausea, vomiting and fever (38.9°C). Abdominal examination showed generalised distension with guarding and tenderness especially at the lower abdomen with positive rebound tenderness. An exploratory laparotomy was done which showed copious pus in the peritoneal cavity. Appendectomy was done, and the peritoneal cavity was copiously lavaged.
Pathomorphology: Grossly, the appendix measured 6.5 by 1.7 by 1 cm with a lack lustre appearance and unremarkable serosa. Microscopically the muscularis propria show multiple islands of typical endometrial glands surrounded by a cellular endometrial stroma.
Conclusion: In conclusion, endometriosis of the appendix can imitate acute appendicitis and it should always be considered in the differential diagnosis of women complaining of nonspecific lower abdominal pain
Effects of Functional Proprioceptive Neuromuscular Facilitation with Mental Practice to Improve Activities of Daily Living in Syringomyelia Patient - A Case Report
No full textBackground: Syringomyelia is a rare disorder in which a syrinx is formed in the spinal cord and it expands over the time, damaging the entire spinal cord. It shows low prevalence and is difficult to diagnose. Syringomyelia is a physically disabling condition and its symptoms are profoundly similar to that of spinal cord injury (SCI). Since it is a rare disorder, there is lack of literature about the effects of various physiotherapy techniques in syringomyelia patients.
Objective: The aim is to determine the effects of functional Proprioceptive Neuromuscular Facilitation (PNF) with Mental Practice to improve activities of daily living in syringomyelia patient. Case report: We report the case of a 25 year old female presenting with history of fever and chills for a month followed by convulsions and loss of sensations and muscle power 1/5 in both lower limbs below the trunk. The condition was managed by functional PNF techniques along with mental practice. Conclusion: PNF with Mental Practice is effective to improve activities of daily living in syringomyelia patient
Herpes Zoster Infection in Young Adult in the Nabdam District of Ghana: A Case Report
No full textThe varicella zoster virus belongs to the family of alpha herpes viridae which is responsible for both primary and recurring infections. Herpes zoster is a condition caused by the reactivation of the varicella zoster virus. The reactivation follows a suppressed immune system or aging. Herpes zoster mostly affects the aged population; however, it can also occur at any age. Herpes zoster is capable of affecting any sensory ganglia and its cutaneous nerve. The infections mostly affect the dermatomes of T3 to L2, however, about 13% of the patients manifest infections relating any of the three branches of the trigeminal nerve. Prodromal symptoms may include malaise, neuropathic pain, headache and interrupted sleep. Herpes zoster causes pruritic, confined, blisters which usually occur unilaterally in the distribution of either one or more adjacent sensory nerves that comes along with neuropathic pain in the affected dermatome. This case of Herpes zoster is reported on a 32-years-old man who was managed based on the symptoms he presented