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Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department Case Rep. Acute Med. Pub Date : 2022-11-11 Tomoki Ito, Kasumi Satoh, Kotaro Sakaki, Masaru Sakusabe
Epigastric pain is a common complaint in the emergency department (ED). Clinicians require skills to differentiate the epigastric pain in the ED. Here, we report a case of acute esophageal necrosis (AEN) as a cause of epigastric pain in the ED. An 83-year-old woman with diabetes mellitus visited the ED because of worsening subacute epigastric pain, nausea, and anorexia. The patient’s vital signs and
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Giant Colonic Diverticulum of the Sigmoid with an Unusual Localization Case Rep. Acute Med. Pub Date : 2022-01-31
Diverticular disease is a common disorder of the colon. A rare complication of diverticulosis is a giant colonic diverticulum (GCD) defined as a diverticulum measuring #x3e;4 cm. It most often affects the sigmoid colon. We report a case of a 68-year-old male presenting at the emergency department with a giant diverticulum of the sigmoid with an unusual size and migration to the right hemi-abdomen.
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Giant Colonic Diverticulum of the Sigmoid with an Unusual Localization Case Rep. Acute Med. Pub Date : 2022-01-31
Diverticular disease is a common disorder of the colon. A rare complication of diverticulosis is a giant colonic diverticulum (GCD) defined as a diverticulum measuring #x3e;4 cm. It most often affects the sigmoid colon. We report a case of a 68-year-old male presenting at the emergency department with a giant diverticulum of the sigmoid with an unusual size and migration to the right hemi-abdomen.
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Giant Colonic Diverticulum of the Sigmoid with an Unusual Localization Case Rep. Acute Med. Pub Date : 2022-01-31 Misha R.M. Frenken,Lisanne M. Koenjer,Marieke G.J. Versteegen,Jeroen F. Vogelaar
Diverticular disease is a common disorder of the colon. A rare complication of diverticulosis is a giant colonic diverticulum (GCD) defined as a diverticulum measuring >4 cm. It most often affects the sigmoid colon. We report a case of a 68-year-old male presenting at the emergency department with a giant diverticulum of the sigmoid with an unusual size and migration to the right hemi-abdomen. Segmental
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Recurrent Generalized Seizures with Postictal Todd’s Paralysis Caused by Medication-Associated Severe Hypomagnesemia: A Case Report Case Rep. Acute Med. Pub Date : 2021-11-15 Abdalla Khalil, Jithesh Choyi, Khalil Hossenbux, Ahmed Taha
Hypomagnesemia is one of the electrolyte disturbances that can cause seizures. It is common in the hospitalized patients and can be induced by long-term usage of many medications. A 68-year-old male known to have hypertension and gastroesophageal reflux presented to the Emergency Department with an unprovoked first seizure at home followed by a temporary right-sided hemiparesis, dysphasia, and facial
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Bell’s Palsy Caused by SARS-CoV-2 Case Rep. Acute Med. Pub Date : 2021-11-15 Maythem Al-Kaisy, Mustafa Mahmood Eid
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to major healthcare and everyday life challenges. Every day, new disease associations and systemic manifestations are being explored and reported. Peripheral facial nerve paralysis or Bell’s palsy has been reported to be caused mainly by viral infections. This case represents a COVID-19-positive patient with Bell’s palsy making SARS-CoV-2
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Recurrent Generalized Seizures with Postictal Todd’s Paralysis Caused by Medication-Associated Severe Hypomagnesemia: A Case Report Case Rep. Acute Med. Pub Date : 2021-11-15
Hypomagnesemia is one of the electrolyte disturbances that can cause seizures. It is common in the hospitalized patients and can be induced by long-term usage of many medications. A 68-year-old male known to have hypertension and gastroesophageal reflux presented to the Emergency Department with an unprovoked first seizure at home followed by a temporary right-sided hemiparesis, dysphasia, and facial
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Bell’s Palsy Caused by SARS-CoV-2 Case Rep. Acute Med. Pub Date : 2021-11-15
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to major healthcare and everyday life challenges. Every day, new disease associations and systemic manifestations are being explored and reported. Peripheral facial nerve paralysis or Bell’s palsy has been reported to be caused mainly by viral infections. This case represents a COVID-19-positive patient with Bell’s palsy making SARS-CoV-2
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Traumatic Refractory Ventricular Fibrillation Successfully Treated with Intra-Arrest Esmolol Case Rep. Acute Med. Pub Date : 2021-10-05 Kevin Raymond, Emily Wheeler, Mark Shank
Here, we describe a case of refractory ventricular fibrillation (RVF) in an undifferentiated trauma patient that responded to intra-arrest esmolol. To our knowledge, this is the first case of RVF in an undifferentiated trauma patient that responded to intra-arrest esmolol. This case continues to support the growing evidence for use of esmolol as a treatment of refractory fibrillation and should be
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Traumatic Refractory Ventricular Fibrillation Successfully Treated with Intra-Arrest Esmolol Case Rep. Acute Med. Pub Date : 2021-10-05
Here, we describe a case of refractory ventricular fibrillation (RVF) in an undifferentiated trauma patient that responded to intra-arrest esmolol. To our knowledge, this is the first case of RVF in an undifferentiated trauma patient that responded to intra-arrest esmolol. This case continues to support the growing evidence for use of esmolol as a treatment of refractory fibrillation and should be
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Administration of Tranexamic Acid as Treatment for Angiotensin Converting Enzyme Inhibitor-Induced Angioedema: A Case Report Case Rep. Acute Med. Pub Date : 2021-07-19 Sohun Awsare, David Chirikian, Joseph Rogers
Background Angiotensin converting enzyme inhibitor-induced angioedema is a major cause of angioedema-related hospitalizations each year. Common swelling predilection sites include the face, periorbital skin, lips, pharynx, larynx, and tongue. Involvement of airway structures could lead to airway obstruction and ultimately death if not treated promptly. A 62-year-old man presented to a rural clinic
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Veno-Arterial Extracorporeal Membrane Oxygenation for Severe Heatstroke with Refractory Hemodynamic Failure Case Rep. Acute Med. Pub Date : 2021-07-19 Masahide Fujita, Keita Miyazaki, Momoko Horiguchi, Kouji Yamamoto, Shingo Ito, Hidetada Fukushima
A 68-year-old male was found unconscious in a hot bathtub on a cold winter’s day and was brought to our hospital. On arrival, the patient’s systolic blood pressure was 65 mm hg, heart rate was 134 beats per min, and rectal temperature was 40.5°C. A large volume infusion of acetated Ringer’s solution and vasopressors were administered as an immediate treatment for circulatory failure due to heatstroke
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Administration of Tranexamic Acid as Treatment for Angiotensin Converting Enzyme Inhibitor-Induced Angioedema: A Case Report Case Rep. Acute Med. Pub Date : 2021-07-19
Background Angiotensin converting enzyme inhibitor-induced angioedema is a major cause of angioedema-related hospitalizations each year. Common swelling predilection sites include the face, periorbital skin, lips, pharynx, larynx, and tongue. Involvement of airway structures could lead to airway obstruction and ultimately death if not treated promptly. A 62-year-old man presented to a rural clinic
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Veno-Arterial Extracorporeal Membrane Oxygenation for Severe Heatstroke with Refractory Hemodynamic Failure Case Rep. Acute Med. Pub Date : 2021-07-19
A 68-year-old male was found unconscious in a hot bathtub on a cold winter’s day and was brought to our hospital. On arrival, the patient’s systolic blood pressure was 65 mm hg, heart rate was 134 beats per min, and rectal temperature was 40.5°C. A large volume infusion of acetated Ringer’s solution and vasopressors were administered as an immediate treatment for circulatory failure due to heatstroke
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Case Report: De Quervain’s Thyroiditis as a Long-Term Sequelae Complication to SARS-CoV-2 Infection Case Rep. Acute Med. Pub Date : 2021-07-09 Mark Kong, Sarah La Porte
A 44-year-old man presented with an enlarged painful lower anterior neck lump with elevated serum concentrations of free thyroxine (T4) and tri-iodothyronine (T3), alongside the presence of antithyroid peroxidase antibodies. Prior to presentation, the patient was demonstrating recovery from a SARS-CoV-2 infection that required sedation, intubation, and invasive ventilation in the intensive care unit
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Case Report: De Quervain’s Thyroiditis as a Long-Term Sequelae Complication to SARS-CoV-2 Infection Case Rep. Acute Med. Pub Date : 2021-07-09
A 44-year-old man presented with an enlarged painful lower anterior neck lump with elevated serum concentrations of free thyroxine (T4) and tri-iodothyronine (T3), alongside the presence of antithyroid peroxidase antibodies. Prior to presentation, the patient was demonstrating recovery from a SARS-CoV-2 infection that required sedation, intubation, and invasive ventilation in the intensive care unit
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Fatal lymphocytic myocarditis masquerading as thoracic aortic dissection Case Rep. Acute Med. Pub Date : 2021-07-08 Eugene Sharma Henry
Acute myocarditis usually presents with a broad spectrum of symptoms and has variable clinical outcomes. A proportion of acute myocarditides may develop into fulminant myocarditis resulting in significant mortality if left untreated. This case report describes an unusual presentation of fatal lymphocytic myocarditis mimicking a thoracic aortic dissection in a previously healthy 45-year-old male. Fulminant
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Fatal lymphocytic myocarditis masquerading as thoracic aortic dissection Case Rep. Acute Med. Pub Date : 2021-07-08
Acute myocarditis usually presents with a broad spectrum of symptoms and has variable clinical outcomes. A proportion of acute myocarditides may develop into fulminant myocarditis resulting in significant mortality if left untreated. This case report describes an unusual presentation of fatal lymphocytic myocarditis mimicking a thoracic aortic dissection in a previously healthy 45-year-old male. Fulminant
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Could the Use of Antihistamines Have Triggered Reversible Cerebral Vasoconstriction Syndrome? A Case Report Case Rep. Acute Med. Pub Date : 2021-06-28 Sara Assadi, Latif Rahman, Mark Kong, Sukaina Asad
A 38-year-old woman presented to the emergency department with recurrent severe headaches. Although initial computer tomography (CT) brain imaging was unremarkable, a later CT venogram demonstrated a small subarachnoid haemorrhage. Magnetic resonance angiogram (MRA) brain imaging subsequently confirmed reversible cerebral vasoconstriction syndrome (RCVS). In the acute setting, RCVS rarely falls into
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Could the Use of Antihistamines Have Triggered Reversible Cerebral Vasoconstriction Syndrome? A Case Report Case Rep. Acute Med. Pub Date : 2021-06-28
A 38-year-old woman presented to the emergency department with recurrent severe headaches. Although initial computer tomography (CT) brain imaging was unremarkable, a later CT venogram demonstrated a small subarachnoid haemorrhage. Magnetic resonance angiogram (MRA) brain imaging subsequently confirmed reversible cerebral vasoconstriction syndrome (RCVS). In the acute setting, RCVS rarely falls into
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Post-Traumatic Meningitis: Case-Based Review of Literature from Internists’ Perspective Case Rep. Acute Med. Pub Date : 2021-06-02 Shubhabrata Das, Tanmoy Pal
Most cases of post-traumatic meningitis (PTM) occur following immediate head trauma or neurosurgical procedures. Hence, internists do not often come across these patients. However, closed-head trauma can be associated with community-acquired meningitis (CAM), and this history can often be missed especially if it is remote or trivial in nature. Therefore, meticulous clinical assessment is necessary
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COVID-19 Complicated by Concomitant Renal, Splenic, and Myocardial Infarction: Double Whammy Case Rep. Acute Med. Pub Date : 2021-05-28 Mehdi Ghaderian Jahromi, Marzieh Sheibani Abdolusefi, Mohsen Neshati Pir Borj
A 76-year-old man presented with shortness of breath, fever, and fatigue with confirmed COVID-19 by positive RT-PCR test for the SARS-COV-2. Abdominal and pelvis computed tomography with intravenous contrast was performed several days later given the patient’s severe abdominal pain which showed both renal and splenic infarcts despite the use of a proper thromboprophylaxis with subcutaneous heparin
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Cardiogenic Shock Related to Carbon Monoxide Poisoning Case Rep. Acute Med. Pub Date : 2021-03-25 Frédéric Bussienne, Marco Betello
Carbon monoxide (CO) poisoning is one of the leading causes of death by poisoning in occidental countries. We report the presentation and management of a patient who developed a severe cardiac dysfunction, leading to profound cardiogenic shock after CO poisoning despite an initial low CO blood level. Case Rep Acute Med 2021;4:32–35
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Limb Ischemia due to Extensive Arterial Thrombosis in the Absence of Venous Occlusion as an Unusual Complication of Critical Illness from COVID-19 Case Rep. Acute Med. Pub Date : 2021-03-19 Armin Nowroozpoor, Matthew A. Bank, Daniel Jafari
There is increasing evidence of a link between the coronavirus disease 2019 (COVID-19) and venous and arterial thrombotic events. Here, we report a 60-year-old male patient with severe COVID-19 who developed extensive arterial thromboses and limb ischemia despite being on therapeutic-dose anticoagulation. While the exact mechanism for such events is unknown, our report highlights the importance of
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Septic Shock due to Capnocytophaga: A Case Report Case Rep. Acute Med. Pub Date : 2021-03-18 Guillermo Jiménez-Álvarez, Sonia López-Cuenca, Belén Quesada-Bellver
The genus Capnocytophaga spp., recorded for the first time in 1979, comprises gram-negative bacilli, that colonize the oral mucosa of dogs and, to a lesser extent, cats, so that human transmission can be due to biting, scratching or close contact. Though it is not a common cause of infection in humans, it is a potentially serious one, which can occasionally go unnoticed causing sepsis, bacteremia,
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Rescue Pericardial Drainage and Return Connected to ECMO for Aortic Rupture into the Pericardial Sac with Acute Type A Aortic Dissection Case Rep. Acute Med. Pub Date : 2021-03-08 Shinichi Ijuin, Mariko Takeuchi, Chikashi Nakai, Akihiko Inoue, So Izumi, Nobuaki Igarashi, Shigenari Matsuyama, Satoshi Ishihara, Tomofumi Doi, Shinichi Nakayama, Takuro Tsukube
We present the first documented case of emergent pericardial drainage and return (PD-R) under extracorporeal membrane oxygenation (ECMO) for the management of aortic rupture into the pericardial sac caused by acute type A aortic dissection (AADA). An 83-year-old woman collapsed during an elective coronary intervention. ECMO was eventually required. Acute accumulation of pericardial effusion with aortic
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Spontaneous Pneumothorax as a Complication in Concomitant Diabetic Ketoacidosis and Pulmonary Tuberculosis: A Case Report Case Rep. Acute Med. Pub Date : 2021-02-25 Filbert Riady Adlar, Willy Anthony
Secondary spontaneous pneumothorax (SSP) can occur as a complication of several underlying diseases such as pulmonary tuberculosis (TB) or, rarely, diabetic ketoacidosis (DKA). As diabetes mellitus (DM) is significantly prevalent in tuberculosis patients, it is possible to have both TB and DKA concurrently. However, there has not been any documentation of SSP as a complication in concomitant DKA and
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Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide Case Rep. Acute Med. Pub Date : 2021-02-12 Panagiota Zikidou, Rozeta Meziridou, Sonia Alexiadou, Elpis Mantadakis
We present the case of a 14-year-old boy who developed an acute dystonic reaction 5 h following the overuse of a nasal metoclopramide spray that his mother gave him thinking it was a nasal decongestant. The patient had torticollis and intense motor restlessness, while he was fully conscious and hemodynamically stable. All laboratory investigations were normal. He was treated with a single dose of biperiden
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Acute Myocardial Infarction Complicated by Very Severe Hypertriglyceridemia Case Rep. Acute Med. Pub Date : 2020-11-17 Gregory Wu, Brianna Bockman, Jesse Perez
Hypertriglyceridemia (HTG) is the elevation of serum triglyceride levels above 150 mg/dL and is linked to complications such as pancreatitis and increased mortality risk. An uncommonly known co-presentation of HTG is acute ST-elevation myocardial infarction (STEMI), with the literature citing only one other case of acute STEMI complicated by very severe HTG. We report on a 36-year-old male with multiple
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Pneumatocele after Acute Respiratory Distress Syndrome in an Adult Patient: A Case Report Case Rep. Acute Med. Pub Date : 2020-10-30 Gouthami Chennu, Paulina Przydzial, Yee Tchao, Anthony Isedeh, Nikhil Madan
Pulmonary pneumatocele is a cystic, air-filled lesion in the lung parenchyma. It results from underlying inflammation or bronchial injury. It is seen in several lung pathologies including bacterial pneumonia, positive-pressure ventilation, chest trauma, chemical pneumonitis, and is most often seen in infants and children. On imaging, pneumatoceles appear as rounded, thin-walled, air-filled spaces in
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Lightning Injury with Multi-System Involvement Case Rep. Acute Med. Pub Date : 2020-08-26 Ashwini Ramesh Patankar, Smita Patil, Santwana Chandrakar
Lightning leads to trauma and disability such as burns, hearing loss, blindness, cardiac arrhythmia, cardiac arrest, stroke, kidney injury, and can also lead to death. Such cases are seldom reported, and hence their database is scanty. We present a case of a 40-year-old female with lightning injury with four such manifestations, which is not commonly encountered. We have elaborated on these complications
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Drug Reaction with Eosinophilia and Systemic Symptoms Secondary to Naproxen: A Case Report and Literature Review Case Rep. Acute Med. Pub Date : 2020-08-26 Sreethish Sasi, Heba Altarawneh, Mahir A. Petkar, Arun P. Nair
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe adverse drug reaction presenting with rash, fever, lymphadenopathy, and single or multiple organ involvement. It is most commonly associated with antiepileptics, NSAIDs, and sulfa drugs. We report a 40-year-old man who presented with a 1-week history of fever, sore throat, and a diffuse pruritic macular rash that started
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Gastric Antral Vascular Ectasia Associated with Asymptomatic Mixed Connective Tissue Disease Refractory to Endoscopic Treatment: A Rare Case Case Rep. Acute Med. Pub Date : 2020-08-25 Muhammed Jasim Abdul Jalal, K.M. Mohammed Iqbal, Roy J. Mukkada, Rashmi Ratnakaran, Shani Basheer
Gastric antral vascular ectasia (GAVE) constitutes 4% of all nonvariceal upper GI bleedings. It is characterized by the presence of erythematous or hemorrhagic ectatic vessels within the antrum that are distributed either in a striped or diffuse punctate pattern. We report a 64-year-old female without any co-morbidities, who presented with multiple episodes of blood in stools. Laboratory studies revealed
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Artery of Percheron Infarct: A Rare Presentation of Acute Ischemic Stroke in a High-Risk Antiphospholipid Syndrome Patient Case Rep. Acute Med. Pub Date : 2020-08-25 Sreethish Sasi, Ashraf Ahmed, Wajiha Yousuf, Surjith Vattoth
Artery of Percheron (AOP) is an abnormal variant of the arterial supply of the thalamus. AOP occlusion can lead to bilateral thalamic and rostral midbrain infarct presenting as memory loss, fluctuating levels of consciousness, and altered mental status. A 43-year-old woman with a history of antiphospholipid syndrome (APS), managed on dabigatran, presented with acute confusion and drowsiness. She had
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A Rare Misdirected Subclavian Venous Catheter to the Neck Case Rep. Acute Med. Pub Date : 2020-08-25 Miguel Nuno Lourenço Varela, Luís Flores, Rui Patraquim, Daniel Nunez, Cristina Granja
Placement of a central venous catheter (CVC) is not without complications, one of those being misplacement of the catheter tip. This event is dependent on the patient’s vascular anatomy, hence unexpected misplacements may occur. We describe a case where a right subclavian CVC was inserted uneventfully, but later found to have migrated into a vein coursing through the midline of the neck, for which
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Spontaneous Tuberculosis-Associated Tension Pneumothorax: A Case Report and Literature Review Case Rep. Acute Med. Pub Date : 2020-06-25 Aditya Doni Pradana
Secondary spontaneous pneumothorax (SSP) is one of the major complications of pulmonary tuberculosis (TB), and it can be a life-threatening condition if it progresses to tension pneumothorax. A correct initial assessment and prompt intervention will prevent a hemodynamic deterioration in tension pneumothorax. Needle decompression followed by large-bore chest tube insertion is usually required in the
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Hemoperitoneum following a Motor Vehicle Accident in a Patient with 20 Uterine Leiomyomas Case Rep. Acute Med. Pub Date : 2020-06-12 Gregory Wu, Olivier Urayeneza, Gudata Hinika
Uterine leiomyomas are neoplasms of the smooth muscle that can cause complications such as severe bleeding and infertility in women of reproductive age. While many individuals may be asymptomatic, others may present with anemia secondary to heavy bleeding, cyclical abdominal pain, pelvic pressure, and urinary or bowel symptoms. A rare complication of uterine leiomyomas is avulsion due to blunt abdominal
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Prilocaine-Induced Methemoglobinemia Case Rep. Acute Med. Pub Date : 2020-05-28 Alpay Medetalibeyoğlu, Elif Sitre Koç, Oyku Beyaz, Ahmed Edizer
Local anesthetics are used to anesthetize surface areas in several procedures. The history of anesthesia exposure has been established as an important factor for correct diagnosis. When they are used excessively, some systemic side effects such as methemoglobinemia, respiratory failure, cardiovascular arrhythmias, or neurological manifestations may occur. Methemoglobinemia which usually presents with
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A Rare Complication of Henoch-Schönlein Purpura: Acute Appendicitis Treated Conservatively – A Case Report and Literature Review Case Rep. Acute Med. Pub Date : 2020-04-29 Sarmad Farook Al Hamdani, Alaa Haitham Salman
Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis of childhood. It is a self-limiting disorder of unknown autoimmune origin. It affects multiple organ systems including the skin, joints, the gastrointestinal (GI) system, and the kidneys. GI symptoms include abdominal pain, nausea, vomiting, GI bleeding and intussusception. Acute appendicitis is an extremely rare complication of
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Caffeine Overdose Complicated by Acute Kidney Injury despite Mild Creatine Kinase Elevation Case Rep. Acute Med. Pub Date : 2020-04-07 Nao Koide, Nobuhiro Sato, Daisuke Kondo, Yasuo Hirose
Caffeine is a commonly used stimulant in our society. Prior case reports have described acute caffeine overdose resulting in rhabdomyolysis and acute kidney injury (AKI). We present the case of a 29-year-old man who presented to the emergency department after ingesting 20.1 g of caffeine in a suicide attempt and experienced AKI with only mildly elevated creatine kinase (CK). This case highlights the
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Child with Guillain-Barré Syndrome Responding to Plasmapheresis: A Case Report Case Rep. Acute Med. Pub Date : 2020-02-05 Sarmad Al Hamdani, Fatema Yusuf Aljanabi, Maryam Isa Abdulrasool, Alaa Haitham Salman
Intravenous immunoglobulin (IVIG) has long been regarded as the first-line treatment for Guillain-Barré syndrome (GBS), with plasmapheresis only being reserved for severe cases or used as an additional therapy of unproven efficacy. Here, we present the case of a 9-year-old girl with acute motor axonal neuropathy (AMAN), a rapidly progressive subtype of GBS that caused her to fall into respiratory failure
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Management of Copperhead Snake Envenomation Case Rep. Acute Med. Pub Date : 2020-01-10 Kevin Baumgartner, Michael Mullins
Case Rep Acute Med 2020;3:1–3
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Bilateral Basal Ganglia Lesions in Patients with Heroin Overdose: A Report of Two Cases Case Rep. Acute Med. Pub Date : 2019-12-12 Ali Hassan, Mahdi Al Jawad, Amna Alsaihati, Haitham Alaithan, Faisal Al Hawaj
The prevalence of opioid use has increased worldwide. Two-thirds of deaths caused by drug overdose are opioid-related. Individuals with opioid use may present with a variety of complications. The available history in unconscious patients is often insufficient, which may cause diagnostic difficulty and delayed management. We present two cases of 54-year-old and 25-year-old male patients who were brought
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Total Unilateral Lung Atelectasis in a Child with Asthma and Its Rapid Resolution with Medical Management without Any Invasive Intervention: A Case Report Case Rep. Acute Med. Pub Date : 2019-11-21 Sarmad Farook Yahya AlHamdani, Rashid Nadeem
Asthma is the most common chronic lung condition of childhood affecting approximately 6 million children in the United States. Right middle lobe syndrome or atelectasis is common in children with asthma though whole unilateral lung collapse is rare; only case series are reported. Bronchoscopy is usually required in addition to medical management of asthma and treatment of infection. We present a case
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Pentalogy of Fallot Firstly Diagnosed before Emergency Vertebral Surgery in an Adult Patient Case Rep. Acute Med. Pub Date : 2019-11-13 Xiaofeng Lu, Yinglu Zhao, Wenzhu Dang, Yuanjun Teng, Debin Liu
Pentalogy of Fallot (POF) is a variant of the more common Tetralogy of Fallot. We report the case of a 32-year-old man with asymptomatic POF, who was admitted to the department of acute medicine due to fracture of the lumbar vertebrae, and lumbar fusion was performed timely. No report of an adult with asymptomatic POF exists in the current literature. After 1.5 years, the patient returned to the hospital
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Central Airway Obstruction due to Mediastinal Malignant Lymphoma Requiring Venovenous-Extracorporeal Membrane Oxygenation Case Rep. Acute Med. Pub Date : 2019-07-25 Yoshihiro Ueda, Ichiro Hirayama, Ryohei Horie, Kent Doi, Naoto Morimura
Extracorporeal membrane oxygenation (ECMO) therapy might be controversial when patients with advanced malignant disease develop heart or lung failure refractory to conventional management. Especially as for the hematological malignancy patients, the induction of ECMO therapy must be considered carefully, since it is often associated with bleeding complications or infectious diseases. Here, we report
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Obstetric Management of Copperhead Snake Envenomation in Pregnancy: A Case Report Case Rep. Acute Med. Pub Date : 2019-07-23 Michelle J. Wang, Michelle Y. Lu, Elizabeth B. Ausbeck, Lorie M. Harper
Snakebites in pregnancy can result in significant maternal and fetal harm; however, the literature to guide management of this rare obstetric complication remains limited. We describe our approach to envenomation in pregnancy based on the currently available evidence. A 27-year-old G2P1 female presented at 27 weeks’ gestation after suffering a copperhead snakebite. She received antivenom and antenatal
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Silent Acute Renal Impairment after Low-dose Paraquat Ingestion Case Rep. Acute Med. Pub Date : 2019-07-16 Hiroshi Ito
Paraquat poisoning causes fatal multi-organ failure soon after ingestion. Here we report a case of paraquat poisoning presenting acute kidney injury without any preceding signs and symptoms other than nausea and vomiting. A 77-year-old man was admitted to our hospital because of paraquat ingestion and received fluid resuscitation until the negative conversion of urine paraquat on day 4. Serum creatinine
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Erroneously Analyzed F-Wave of Bradycardic Atrial Fibrillation as Ventricular Fibrillation for a Cardiac Arrest Patient Case Rep. Acute Med. Pub Date : 2019-06-19 Chikara Watanabe,Kento Nakajima,Kosuke Mori,Masayasu Gakumazawa,Naoki Nakayama,Makoto Kato,Fumihiro Ogawa,Kouhei Takahashi,Masayuki Iwashita,Takeru Abe,Ichiro Takeuchi
The prognosis of out-of-hospital cardiac arrest has improved in Japan due to the increasing availability of automated external defibrillators. However, priority should be placed on specificity to not perform unnecessary waveforms rather than sensitivity to perform defibrillation on necessary waveforms. This report describes a case in which the f-wave of bradycardic atrial fibrillation was erroneously
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Successful Conservative Treatment of Traumatic Intraperitoneal Bladder Rupture in a Child: A Case Report Case Rep. Acute Med. Pub Date : 2019-04-23 Naoki Yogo,Chiaki Toida,Takashi Muguruma,Masayasu Gakumazawa,Mafumi Shinohara,Makoto Kato,Ko Takahashi,Ichiro Takeuchi
The urinary bladder is protected by the pelvic bones and hence is a site less susceptible to external force injury than other organs. As children’s bones are not fully developed, the risk of bladder injury by external force is greater in children than adults. Pelvic fractures often cause the bladder to rupture, as do strong external forces when the bladder is filled. Bladder rupture is categorized
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A Near Brush with Death: A Case Report on Oral Foreign Body Impalement Case Rep. Acute Med. Pub Date : 2019-03-28 Rachel Christner,Marisa Homer,Oliver Atar,Brian Hynes
We describe a case of an 11-month-old baby presenting to the emergency room with a foreign body in the upper airway. After unsuccessfully attempting to remove the foreign body in the emergency department, the otolaryngologist was consulted. The patient was taken to the operating room, and a comb was successfully removed under conscious sedation. This case illustrates the need of a well-considered strategy
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Uncommon Association of Tuberculous Dactylitis and Cutaneous Polyarteritis Nodosa in a Hemodialysis Patient Case Rep. Acute Med. Pub Date : 2019-02-28 Picha Yincharoen,Nattachai Srisawat
Tuberculous dactylitis, defined as the infection of the metacarpals, metatarsals, or phalanges of the hands or feet, is an uncommon manifestation of extrapulmonary tuberculosis. It is mainly seen in pediatric populations, especially those less than 6 years old. Here, we present a case of tuberculous dactylitis in an elderly patient with end-stage renal disease on hemodialysis. Moreover, our patient
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Cardiac MRI-Proven Myocarditis Mimicking ST-Elevation Myocardial Infarction after a Cobra Bite Case Rep. Acute Med. Pub Date : 2019-01-11 Palapun Waitayangkoon,Suchai Suteparuk,Pairoj Chattranukulchai,Aekarach Ariyachaipanich
Cardiac complications following snake envenomation occur infrequently. Myocarditis, as a consequence of the toxic effect of the snake venom, is rare, and only a few cases have been reported. We present a case of an 84-year-old man who was envenomed by a cobra. In addition to respiratory failure due to neurotoxicity of the venom, cardiac abnormalities including elevated cardiac markers and abnormal
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Early Initiation of Hemodialysis for Progressive Lactic Acidosis in a Diabetic Patient Case Rep. Acute Med. Pub Date : 2018-11-19 Keisuke Nyunoya,Naoki Hayase,Kent Doi,Toshifumi Asada,Yoshihiro Ueda,Yoichi Kitsuta,Naoto Morimura
Metformin, a widely used medicine for diabetes mellitus, is well known to cause lactic acidosis, which may require intensive care, including hemodialysis, especially in severe cases because of the high mortality rate. Because metformin is effectively removed by renal replacement therapy, early initiation of hemodialysis is crucial for metformin overdose. We report a case of a 38-year-old male who was
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Peripartum Cardiomyopathy with Respiratory Failure and Cardiac Arrest Case Rep. Acute Med. Pub Date : 2018-10-11 Sakura Minami,Hayato Taniguchi,Takeru Abe,Tomoki Doi,Ichiro Takeuchi
We describe the case of a 33-year-old female who went into cardiac arrest outside the hospital 7 days postpartum. We diagnosed her with peripartum cardiomyopathy (PPCM). After the return of spontaneous circulation, she suffered from acute pulmonary edema and hypoxia. The patient received intensive care after gaining return of spontaneous circulation. We also present an effective use of venovenous extracorporeal
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Coincident Detection and Concomitant Repair of a Ventricular Septal Defect during Emergency Coronary Artery Bypass Grafting and Left Ventricular Aneurysm Resection Case Rep. Acute Med. Pub Date : 2018-10-08 Alexandru Mogaldea,Stefan Ruemke,Axel Haverich,Issam Ismail
This case report presents an accidental detection of a post-infarct ventricular septal defect (VSD) by a patient undergoing emergent coronary artery bypass grafting and left ventricular aneurysm resection. Both myocardial lesions were repaired simultaneously through the left ventricular aneurysm. The patient’s postoperative course was uneventful. This case shows the importance of intraoperative transesophageal
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Tracheal Perforation following Chemotherapy of Diffuse Large B-Cell Lymphoma Case Rep. Acute Med. Pub Date : 2018-08-03 Napplika Kongpolprom
Tracheal perforation is a rare and life-threatening complication following the treatment of lymphoma. There are only a few published cases of tracheal disruption from invasive lymphoma, and most of the patients did not survive. Tumor erosion and nodal necrosis from rapid tumor growth or chemotherapeutic response can cause tracheal disruption. We report here a case of tracheal perforation after chemotherapy