Internal medicine
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Case Reports
Spondylodiscitis complicated by an epidural abscess and meningitis caused by Bacteroides fragilis.
Bacteroides fragilis is a rare causative agent of spondylodiscitis. The pathophysiology of B. fragilis in spondylodiscitis remains largely unclear because of its rare occurrence. ⋯ Moreover, the patient had a splenic abscess that was confirmed on magnetic resonance imaging. The patient completely recovered with antimicrobial therapy alone.
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Peripheral arterial disease (PAD) is a common clinical manifestation of the systemic atherosclerotic process, and the ankle-brachial index (ABI) is an ideal tool to diagnose PAD. Currently, there have been few long-term follow-up studies focused on the associations of the ABI with all-cause mortality and cardiovascular disease (CVD) mortality in Chinese MetS patients. The aim of this study was to evaluate the usefulness of ABI to predict the prognosis of CVD in hospitalized Chinese patients with metabolic syndrome (MetS). ⋯ An abnormal ABI value was not only a significant and independent risk factor for CVD, but also for the survival rate in Chinese MetS patients. Routine ABI evaluation could therefore be helpful for identifying high risk patients, especially MetS patients.
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Review Case Reports
Hypertrophic pachymeningitis and tracheobronchial stenosis in IgG4-related disease: case presentation and literature review.
Immunoglobulin G4 (IgG4)-related disease is a distinctive mass-forming disorder with frequent systemic involvement, most commonly in the pancreas, salivary glands and lacrimal glands. A few cases of dural involvement and one case of central airway stenosis have also been described. ⋯ We currently lack international standards for the diagnosis of extrapancreatic IgG4-related disease. Based on the findings of the present case and those reported previously, we discuss the distinctive features of IgG4-related pachymeningitis.
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Review Case Reports
A case of giant coronary artery aneurysm with fistulous connection to the pulmonary artery: a case report and review of the literature.
Giant coronary artery aneurysm is a rare condition with a reported prevalence of 0.02%. Herein, we report the case of a 79-year-old woman with a giant coronary aneurysm arising from a branch of the left anterior descending coronary artery that had a fistulous connection to the pulmonary artery. ⋯ Histology showed prominent mucinous degeneration and infiltration of inflammatory cells in the medial layer. After successful surgery, the patient was discharged uneventfully.
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A 28-year-old woman was referred to our hospital for treatment of tuberculous lymphadenitis, after presenting with fever, left cervical lymphadenopathy, and a positive interferon-gamma release assay (QuantiFERON®-TB Gold In-Tube; QFT) result. Surprisingly, biopsy specimens of the cervical lymph nodes showed necrotic lesions with prominent nuclear debris and a proliferation of histiocytes, consistent with Kikuchi-Fujimoto disease (KFD). ⋯ KFD may be misdiagnosed as tuberculous lymphadenitis, and antibiotics unnecessarily prescribed. Careful attention should therefore be paid when diagnosing cervical lymphadenopathy.