Asian Journal of Case Reports in Medicine and Health
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Anesthesia Care for a Polytraumatized Eleven Years old Child with Thoraco-Abdominal Impalement Trauma
No full textThe present study explores anesthesia care for a polytraumatized eleven years old child with thoraco-abdominal impalement trauma. The anesthetist plays an important role in trauma management. We present the case of an 11-year-old boy who had thoraco-abdominal exploration for impalement injury. Children are at increased risk of peri-operative cardio-respiratory deterioration due to their unique physiological reserve. Post-operative care for polytrauma patient in the intensive care unit as for the index patient aimed at maintaining hemodynamic and metabolic stability via continued fluid resuscitation, and correction of metabolic derangements, mechanical ventilatory strategies and adequate monitoring. Judicious selection and use of anesthetic agents and post-surgical critical care play important roles in ensuring the desired successful outcome
Mycoplasma Pneumonia as a Rare Culprit in Acute Myocarditis
No full textMycoplasma pneumoniae (M. pneumoniae) is an atypical bacterium transmitted by respiratory droplets through close contact. It is a common cause of community-acquired pneumonia, with an overall mortality rate of approximately 30%. Besides respiratory symptoms, M. pneumoniae can cause extrapulmonary complications including myocarditis in 1%-5% of cases leading to arrythmias and heart failure. We are introducing the case of a 16-year-old boy who presented with acute chest pain, due to myocarditis related to Mycoplasma pneumoniae, an unsuspected cause of myocarditis. This case underscores the importance of considering atypical pathogens in myocarditis cases and emphasizes the need for comprehensive diagnostic approaches to guide timely and appropriate therapeutic interventions for rare presentations of cardiac involvement due to Mycoplasma pneumoniae
Anesthetic Management of Rare Diseases: Insights from Four Compelling Case Reports
No full textBackground: Rare diseases, with a prevalence of 4% globally, often manifest with diverse and challenging clinical presentations. Anesthetic management for these conditions demands a nuanced understanding of pathophysiology, potential complications, and interactions with anesthetic agents. This study aims to shed light on the anesthetic challenges posed by rare diseases through a detailed analysis of four cases. By exploring the complexities encountered in Hurler's disease, Rubinstein-Taybi syndrome, Churg-Strauss Syndrome, and Xeroderma Pigmentosum, we seek to contribute valuable insights into the adaptability required in anesthetic approaches for these unique patient populations.
Discussion: Through the exploration of four distinct cases, we have unraveled the intricacies surrounding anesthetic management in rare diseases. Each case highlighted the imperative need for adaptability, meticulous planning, and collaboration across medical disciplines to ensure favorable perioperative outcomes.
The success in managing Hurler's disease underscored the significance of tailored plans integrating enzyme replacement therapy and detailed preoperative assessments. Similarly, addressing difficult airway challenges in Rubinstein-Taybi syndrome showcased the adaptability essential in unique anatomical scenarios. Careful consideration of Churg-Strauss Syndrome's complexities emphasized the avoidance of specific agents and meticulous monitoring. The case of Xeroderma Pigmentosum highlighted the importance of adaptability, shifting from insufficient spinal anesthesia to general anesthesia promptly.
Conclusion: These observations stress the critical role of a patient-centric approach, multidisciplinary collaboration, and adaptability in navigating the diverse challenges presented by rare diseases. In conclusion, this study offers valuable insights into refining anesthetic strategies, ensuring personalized and safe care for patients with rare diseases
Pseudomonas Aeruginosa Meningitis: A Case Report
No full textAim: To present a case of Pseudomonas meningitis with an atypical presentation.
Case Presentation: A 48 year old male with history of RTA related brain injury and shunt placement, presented with complaints of diarrhoea. On further investigations he was found to have Gram negative meningitis on CSF studies. This case highlights patient’s course in hospital.
Conclusion: Patients with a prior history of neurosurgical intervention are at higher risk of meningitis due to Gram negative organisms like Pseudomonas aeruginosa and they may present with atypical symptoms
Images in Acute Ischemic Event of Bilateral Total Internal Carotid Artery: A Case Report and Review
No full textCerebrovascular disease represents one of the leading causes of morbidity worldwide and is the main cause of acquired disabilities. The degree of neurological damage varies according to the extent of the infarction and hemispheric dominance. The middle cerebral artery is the most commonly affected vessel in cerebrovascular pathology. Although rare, obstruction of both internal carotid arteries can occur and is rarely described. This article aims to guide the clinician in an organized manner to detect the severity of the disease and thereby guide the treatment. Without a doubt, it is important that medical centers, at least in regional centers, have both technological equipment and trained personnel to care for patients with these characteristics and thus achieve a favorable result.
Below is a case report of this phenomenon and the images obtained during your care at our hospital
A Case Report on Aneurysm of the Atypical Right Subclavian Artery: A Rare Embryological Aberration
No full textAtypical or an aberrant right subclavian artery, is the most prevalent vascular anomaly of the aortic arch but a rare embryological aberration. It is typically discovered by accident during imaging tests or autopsy and is usually asymptomatic. Dysphagia and dyspnea are the most common symptoms, which arise when the abnormal artery compresses the surrounding structures. It could be linked to further cardiac or vascular anomalies. We are presenting an 86-year-old woman who has an aneurysm connected to her atypical right subclavian artery. In order to prevent surgical complications, clinicians who undertake thoracic diagnostic and surgical procedures in thorax should pay special attention to the unusual or aberrant right subclavian artery
A Rare Case Report on Bernard Soulier Syndrome
No full textOur aim in this case report is to present the case of a fifteen‐year‐old boy diagnosed with Bounard soulier syndrome [BSS], to evaluate how the disease was managed, and to identify any shortcomings in its treatment. The patient previously diagnosed with BSS presented with epistaxis and vomiting episodes associated with blood. Immediate Complete blood picture was ordered and tranexemic acid was administered suspecting bleeding in the esophageal/gastric lining. The reports showed thrombocytopenia [27,000 109/L] with large sized platelets, after which Random donor platelets was administered along with antithrombolytics and vitamin supplements. Patients with BSS often experience variable frequency of bleeding manifestations due to fluctuating platelet levels and prompt management to rise platelet levels is considered important to for better patient outcome and quality of life. Females with BSS may be more prone to heavy bleeding in their menstrual period. Patient and parent [for pediatric patients] counselling help them understand this condition requiring life time interventions and monitoring. Helping them understand about possible risk of bleeding with other meds such as anticoagulants and advising to refrain from it may help. Constant supervising, reassuring and prompt medical intervention will contribute to positive patient outcomes
Generalized Bullous Pemphigoid and Glycaemic Control in the Geriatric age Group: A Case Report
No full textBullous pemphigoid (BP) is a rare autoimmunobullous disease which is seen more in the elderly. There are many factors that have been associated with BP including medications, vaccines, and different diseases including diabetes mellitus. Diabetes mellitus is known to enhance the production of autoantibodies by glycosylation of dermal proteins and increase skin fragility. This case report looks at the management of BP with consideration for glycaemic control; the accurate interpretation of the values in the older adult and emphasis on the need for multidisciplinary approach while also taking note of medication side effects
Metastatic Adenocarcinoma of the Rectum Revealed by Bilateral Occlusion of the Central Retinal Vein: A Case Report
No full textCentral retinal vein occlusion (CRVO) is caused by the formation of a thrombus in the central retinal vein, and constitutes an extreme diagnostic and therapeutic emergency due to its visual prognosis. The most frequent cause of CRVO is related to cardiovascular risk factors, although neoplasia is a very rare cause of CRVO. A few cases of CRVO secondary to cancer have been reported in the literature, the imputability of malignant pathology may be explained by the systemic procoagulant state observed during the latter.
We report the case of a patient who suddenly presented with CRVO and whose etiological work-up was in favor of metastatic rectal adenocarcinoma. This observation demonstrates the importance of systematically searching for a neoplastic source in any thrombosis that is atypical, even if it is distant from the thrombus
Exceptional Association of a Common Variable Immunodeficiency and Ankylosing Spondylitis: A Case Report
No full textWe report a new observation of an unusual association of CVID with ankylosing spondylitis (AS). Osteoarticular involvement associated with CVID occurs in approximately 5 to 40% of cases, most commonly in the form of septic arthritis, or non-septic arthritis, which is part of the joint manifestations of autoimmune and rheumatic diseases associated with CVID. A 53-year-old patient with a history of recurrent bronchopulmonary infections complicated by bronchial dilatation since the age of 38, pelvic-axial syndrome and peripheral inflammatory arthralgia affecting the large and medium-sized joints and enthesitis (talalgia), who has presented since the age of 40 with a digestive disorder consisting of chronic liquid diarrhoea with 6 stools a day, developing in the context of a deterioration in her general condition, without any mention of medication. Regarding biotherapy, in particular anti-TNF alpha, this is the first-line biotherapy for APS. It has been shown to be effective in patients with CVID with joint involvement in the course of granulomatous disease, which would be beneficial for our patient