We present the case of an adult patient with acute dyspnoea and stridor following thyroidectomy. After excluding other causes of postoperative stridor, we concluded the patient was suffering from laryngospasm due to hypocalcaemia secondary to postoperative hypoparathyroidism. It is important to consider hypocalcaemia as a differential diagnosis in stridor.
The biological father of an 11-year-old girl infects his daughter, who returns to her biological mother's family before the father's diagnosis. The daughter endures a 1-day, mild illness. However, despite close physical contact prior to and during the girl's illness, her mother, stepfather and 1-year-old half-brother were not infected.
This case showed that anticancer drug administration induces unhealthy subcutaneous tissue (thrombus or edema) without subjective symptoms, abnormal sign by palpation or inspection, which have an extravasation risk. Especially, short-term interval therapy such as a weekly chemotherapy have high risk for anticancer drug infusion to the risky site.
Neoplastic meningitis remains a diagnostic challenge due to its varied clinical manifestations. We discuss a presentation with dizziness with an initial diagnosis of Benign Paroxysmal Positional Vertigo. We highlight the hallmark findings and reflect on how clinicians may miss evolving features in recurrent attenders due to ‘anchoring’ to previous diagnoses.
Binswanger's disease is a type of vascular leukoencephalopathy that can lead to cognitive impairment and neurological deficits and is sometimes difficult to diagnose. We present a case of Binswanger's disease with an interesting differential diagnosis based on clinical aspects, laboratory findings and imaging studies.
A 73-year-old woman with occult hepatitis B virus (HBV) infection was diagnosed with hepatocellular carcinoma (HCC). Serum HBV core-related antigen (HBcrAg) was elevated and HBV covalently closed circular DNA (cccDNA) was presented in the liver tissue. This report shows HBcrAg might be a predictive factor for development of HCC.
A young man presented with sudden onset chest and neck pain, dyspnoea and dysphonia, following vigorous coughing. Examination identified surgical emphysema and subsequent CT scan revealed a spontaneous pneumomediastinum. The patient remained well despite the remarkable radiological findings. He was managed conservatively but his travel plans were interrupted.
Cracked tooth syndrome is a common well documented condition that many occur due to morphologic, physical and iatrogenic factors. Epidemiologic data revealed that splits or fractures are the third most common cause of tooth loss. Simvastatin allowed a good management for a case suffered from cracked tooth.
We experienced refeeding syndrome (RFS) with an eating disorder and distal renal tubular acidosis (dRTA). A low body mass is high-risk factors for RFS development. Therefore, frequently measurement of serum phosphorus levels at the initiation of nutrition and rapid administration of phosphate preparations are required to prevent RFS-related organ failure.
Bilateral concomitant inguinal and femoral hernias are very rare. Preoperative examinations may not be able to detect coexisting inguinal hernias. However, laparoscopic surgery can identify these subclinical hernias and repair them appropriately. We report about the use of laparoscopic surgery to repair coexisting bilateral inguinal and femoral hernias.
A 14-year-old girl presented with the rapid growth of bilateral breasts within a year, causing her chest discomfort, and pressure sores in the inframammary fold. Bilateral reduction mammoplasty with free nipple-areola graft was performed. Nine kilograms of breast tissue, accounting for 15% of her total body weight, were excised.
Systemic mastocytosis (SM) can be extremely heterogeneous and its treatment should be highly individualized. We reported a description of clinical management of an aggressive SM characterized at diagnosis by multiple organ involvement. The patient underwent to different lines of treatment, from standard chemotherapy to the novel tyrosine kinase inhibitor midostaurin.
We present a 30-year-old male with end-stage renal disease (ESRD) secondary to anti-glomerular basement membrane (anti-GBM) disease who presented to the emergency room with hypertensive emergency and seizures. He was treated with antihypertensives and lorazepam. His seizure etiology was attributed to hypertensive emergency due to ESRD from anti-GBM disease.
Kikuchi-Fujimoto Disease (KFD) is a self-limiting condition that typically presents with lymphadenopathy and fever. It’s autoimmune in nature, and possibly associated with systemic lupus erythematosus (SLE). The case report highlights an unusual case of KFD associated with autoimmune hemolytic anemia and provided a review for other atypical presentations.
Jejunoileal atresia is a common cause of neonatal intestinal obstruction with high mortality and morbidity in a low resource setting where surgical care is lacking. Herein, a 4-day-old presented with features of acute abdomen and septicaemia, managed with ileostomy diversion and recovered uneventfully.
Retrieval of central venous catheters fragments often puts us in front of different situations. Having more techniques available for strategic planning of the procedure is imporatnt. The authors propose the simultaneous use of two different approaches for the recovery of a CVC fragment from the pulmonary artery.
Two different types of ophthalmic optical coherence tomography (OCT) imaging were used to evaluate ocular health in a guinea pig suspected of having heterotopic bone formation (HBF). Captured images facilitated diagnosis of HBF. This case report provides reference OCT images of HBF in the guinea pig.