Internal medicine
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Case Reports
An Autopsy Case of Disseminated Varicella Zoster Virus Infection During the Treatment of Nephrotic Syndrome.
A 68-year-old woman developed systemic blisters while receiving treatment for nephrotic syndrome. As she also developed marked liver dysfunction and disseminated intravascular coagulation, she was admitted to our hospital. ⋯ A post-mortem examination showed micro-abscesses and necrosis caused by varicella zoster infection in multiple organs, including the liver, kidneys, and gastrointestinal tract. Because VZV infection can become severe in immunocompromised patients, careful consideration is needed for the prevention and treatment of the viral infection.
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Case Reports
A Patient with a Unilateral Insular Lesion Showing Bilaterally Reduced Perception of Noxious Stimulation.
No study has reported a unilateral localized cerebral lesion of the posterior insula bilaterally reducing noxious stimuli perception. A 57-year-old man with an infarct involving the right posterior insula presented with reduced somatosensory response in the upper and lower left extremities. ⋯ Other somatic sensations, including non-noxious temperatures, remained intact in the right upper and lower extremities. These findings in our patient with a unilateral insular lesion indicated a bilaterally reduced perception of noxious stimulation.
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We herein report a case of mitochondrial disease with heart and intestinal tract involvement resulting in hemodynamic collapse. A 66-year-old woman was transferred to our hospital because of cardiogenic shock. ⋯ Insertion of a colorectal tube immediately decreased the intra-abdominal pressure, improving the hemodynamics. Finally, we diagnosed her with mitochondrial disease, concluding that the resulting combination of acute heart failure and abdominal compartment syndrome had aggravated the hemodynamics.
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Case Reports
Durvalumab-associated Late-onset Myocarditis Successfully Treated with Corticosteroid Therapy.
We herein report a 66-year-old man with locally advanced non-small-cell lung cancer (NSCLC) who developed durvalumab-associated myocarditis. The patient underwent durvalumab administration every two weeks following concurrent chemoradiotherapy, without any adverse events or apparent disease progression. He presented with fatigue and dyspnea on exertion seven months after the first administration. ⋯ The definitive diagnosis was confirmed by a myocardial biopsy. Myocarditis was alleviated by cessation of durvalumab and corticosteroid therapy. This is a noteworthy case to describe late-onset myocarditis following the administration of durvalumab for NSCLC.