Asian Journal of Case Reports in Medicine and Health
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Tumor Recurrence of Breast Cancer Associated with Pulmonary Thromboembolism and Septic Shock: Case Report
No full textAims: Breast cancer is a malignant neoplasm caused by disordered clonal proliferation of breast cells, resulting from the influence of hormonal exposure or inherited susceptible genes.
Case Presentation: The present report is about a female patient with comorbidities, such as systemic arterial hypertension and depression, and with a previous history of breast cancer in 2008 and 2009 and underwent a mastectomy in 2015. She was admitted for investigation of tumor recurrence, and was diagnosed with a primary breast tumor, estrogen and progesterone receptor, which gave rise to a series of complications, culminating in septic shock and fatal outcome.
Discussion: According to the Global Cancer Observatory, breast cancer is the most common malignant neoplasm in the world.
Conclusion: The importance of cancer patients, especially those with breast tumors, is emphasized to maintain follow-up after undergoing surgical treatment for removal of the tumor and subsequent remission of the disease, since the early intervention of any complication is related to greater survival and better quality of life
Repair of Cerebrospinal Fluid Rhinorrhea in a Patient Presenting Empty Sella Syndrome: Case Report and Review of Literature
No full textIntroduction: The cause of Empty Sella syndrome is unknown, however it occurs when intracranial contents herniate through the sellar diaphragm, filling the sella turcica with cerebrospinal fluid (CSF) and giving the appearance of an absent pituitary gland on radiography.
Case Presentation: Author presents a rare case of a 67 years-old woman who was admitted into our department with a complaint of dripping clear fluid from the left side of her nose. Clinical examination and biological, radiological investigations found a CSF leakage through a minute bony defect in the floor of the sella associated with empty Stella syndrome. Treatment consisted of the reparation of the leak using a fascia lata graft, and the sphenoidal sinus was obliterated with fat.
Conclusion: When evaluating patients with non-traumatic CSF rhinorrhea, the otolaryngologist must consider empty sella syndrome as a diagnostic possibility
GBS, Breaking the Stereotypes of Clinicians’ Minds: A Case Study of Atypical Presentation of GBS, Caused by COVID-19 Vaccination?
No full textThe clinicopathologic spectrum of Guillain Barré Syndrome (GBS) has expanded to include both inflammatory injuries that lead to demyelination and axonal loss forms that cause the motor and sensory loss. However, GBS may also have atypical presentations, that intrigue the clinicians’ interest. COVID-19 vaccines and their adverse effects are an emerging topic in medicine. While GBS has been reported as a rare complication of COVID-19 infection as well as after the meningococcus, influenza, polio, and rabies vaccine; a definitive association with the COVID-19 vaccine is yet to be established
Fatal Intoxication with Metformin and Gliclazide – "Case Report"
No full textIntroduction: Biguanides (metformin) and sulfonylurea molecule (gliclazide) are oral antihyperglycemic drugs. Metformin can make lactate accumulation in patients with hepatic or renal failure or in patients with a suicide attempt. Gliclazide has very low toxicity, and it can develop acute renal failure in patients with massive ingestion in a suicide attempt.
The Patient's Primary Concerns and Critical Clinical Findings: A 53-year-old patient with a personal history of type 2 diabetes mellitus was treated with metformin 1000 mg twice daily and gliclazide 60 mg twice daily. On December 26th 2018, in the evening hours, he consumed 90 tablets of metformin 1000 mg (total dose 90 grams) and 95 tablets of gliclazide 60 mg (total dose 5.7 grams) for suicide. According to the report, he had been sick all night and suffered from muscle pain, diarrhoea, and vomiting.
The Primary Diagnoses, Interventions, and Outcomes: We concluded the diagnosis as a high anion gap metabolic acidosis. As a consequence of metformin intoxication, lactate level was furthermore elevated (24 mM).
Conclusion: Metformin and gliclazide are commonly using as effective drugs in patients with type 2 diabetes mellitus. Our case report described fatal intoxication with metformin and gliclazide. The aim is to remember the risk of daily used antidiabetic drugs – in high doses, in combinations, they can lead to pancreatitis, renal failure, or so long-known lactic acidosis
Delayed Bilateral Pulmonary Embolism Six Months after Mild SARS-CoV-2 Infection: A Case Report
No full textIntroduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been one of the most globally impactful diseases. It has been associated with significant morbidity and mortality, particularly due to acute respiratory distress syndrome (ARDS) in the acute stage. Venous Thromboembolism (VTE), particularly pulmonary embolism is well associated in the acute stages. Occurrence after initial recovery remains a rare encounter.
Case Presentation: A 49-year-old previously healthy gentleman was admitted following an acute onset severe shortness of breath. On examination he was tachypneic, tachycardic with clear lungs on auscultation. He had a S1Q3T3 pattern on his ECG with elevated d-dimer. Computed Tomography Pulmonary Angiogram revealed bilateral pulmonary embolism. There were no risk factors for VTE other than a mild SARS-CoV-2 infection 6 months back with persistent low grade systemic inflammation. Malignancy and thrombophilia screening was negative.
Conclusion: This case report highlights the possibility of the pro-coagulopathy state caused by SARS-Cov-2 virus infection to persist for a prolonged period even following a mild clinical infection. It raises the concern regarding the need for prolonged anticoagulation even after recovering from the initial infection
Blink of an Eye: A Case Report and Literature Review
No full textWe report here the case of a 36-year-old male emergency physician contracting the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) while performing endotracheal intubation on a coronavirus disease 2019 (COVID-19) positive patient with conjunctivitis as the sole symptom. On the day of exposure, a conjunctival swab was collected from both eyes which turned out to be negative. But, a nasopharyngeal swab sampled on the third day of exposure gave a positive result with cycle threshold (CT) value of 16. The physician was already vaccinated with two doses of ChAdox1 nCoV-19 vaccine, with a second dose taken 81 days prior to exposure. This case report demonstrates that conjunctivitis can be the sole manifestation of COVID-19 infection. It further reiterates the importance of Personal Protective Equipments (PPEs), goggles, and face shields at the time of intubation and more specifically to all vaccinated emergency physicians, intensive care specialists, and ophthalmologists to be more cautious if a patient is presented with a sole symptom of conjunctivitis
Fannyhessea Vaginae (Atopobium vaginae) Bacteraemia in Puerperal Fever: A Case Report and Review of Literature
No full textFannyhessea vaginae, formerly Atopobium vaginae, is a slow-growing anaerobic bacterium that frequently causes bacterial vaginosis and, rarely, bacteraemia and invasive infection. Published cases of bacteraemia are associated with childbirth or gynecological procedures that can lead to invasive infections such as endocarditis, peritonitis, and arthritis. In this study we present the case of a 25 year old woman with puerperal fever caused by this microorganism. The diagnosis was made from a blood culture and the identification of the species was carried out with MALDI-TOF. We also present a brief review of other published cases
De Grouchy Syndrome: An Unusual Presentation of Severe Short Stature in Type 1 Diabetic Children: A Case Study
No full textDiabetes mellitus type 1 (DM1) is associated with different clinical syndromes. Some are commonly encountered, like Turner's syndrome, while others are rarely found in clinical practice, namely, De Grouchy syndrome. This is a rare genetic disorder characterised by micro deletions in the short arm of the chromosome 18.
There are many contributing factors for a retarded growth in a diabetic child, for example, poor glycaemic control, associated thyroid disease, celiac disease, and an unusual one is de Grouchy syndrome. In the present article, we reported an isolated case of 18p deletion in a 6-year-old female who for the first time reported to the hospital for diabetes mellitus type 1. The patient was short statured with mental retardation and craniofacial, skeletal, dental, and endocrinal abnormalities. The aim of this case report is to increase the awareness about one of the genetic syndromes associated with diabetes mellitus. As the clinical features of de-grouchy syndrome is quite variable, it's presentation warrants prompt diagnosis for effective management, especially when associated with life threatened conditions, such as type 1 diabetes mellitus, special in need and severe growth retardation. Furthermore, genetic counseling for such patients and their families should be considered as a part of treatment itself
The Etiology and Diagnosis of Primary Myelofibrosis: Case Study
No full textPrimary myelofibrosis is a myeloproliferative neoplasm. It is the rarest among the group of myeloproliferative neoplasms and the incidence is 0.1-1 per 1,00,000 per year. This is characterised by the replacement of normal marrow by fibrous tissue. Patients may present with hepatosplenomegaly due to extramedullary erythropoiesis. A high index of suspicion is needed to diagnose the same. This study describes a case that was diagnosed to have myelofibrosis when he presented with splenomegaly as a main symptom
Autoimmune Hemolytic Anemia in a Patient with Chronic Myeloid Leukemia: Case Report
No full textAutoimmune hemolytic anemia is an unusual complication in chronic myeloid leukemia on Imatinib. In this case report, it had appeared in 76 year old male patient with major molecular response treated by Imatinib. During the etiological research, we had kept the drug or idiopathic causes. We had treated the patient as idiopathic autoimmune hemolytic anemia without Imatinib interruption and we had noted an improvement in anemia without losing the major molecular response