Journal of medical case reports
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Tetralogy of Fallot is one of the most common forms of cyanotic congenital heart disease and in the absence of surgical correction it has an elevated early mortality, with most patients dying in childhood.The authors reported this case because of the unusual course of an uncorrected tetralogy of Fallot. There are only a few reports of patients with an uncorrected tetralogy of Fallot who reach an advanced age and to the best of our knowledge this is the first case report of a possible endocarditis in a patient with an uncorrected tetralogy of Fallot who is older than 70 years. ⋯ The longevity of this patient is probably due to the association between a large ventricular septal defect, a balanced subpulmonary stenosis and to the presence of systemic hypertension. After empiric antibiotic therapy, the patient was discharged and no surgical intervention was performed due to her previous benign evolution.
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Little information is available on the pathogenesis of heatstroke without strenuous exercise in younger patients. Here, we report the case of a 31-year-old man who developed heatstroke secondary to hyponatremia. His condition was initially misdiagnosed as classic heatstroke. We hope the detailed description of our patient's case will provide valuable information for medical professionals faced with similar cases in the future. ⋯ Clinicians should consider the presence of underlying diseases, especially consciousness disturbance, when younger individuals develop heatstroke in the absence of strenuous exercise.
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⋯ Although endocrine disorders, including hyperthyroidism, are listed among the etiological factors contributing to secondary delusional parasitosis, as far as we are aware this is the first case demonstrating a temporal pattern of thyroid hyperfunction and delusions through a protracted period of follow-up. It may be that the treatment of delusional parasitosis depends on clarifying the etiology and that atypical antipsychotics may help in the management of primary delusional parasitosis. Further studies on the relationship between thyroid hormones and dopaminergic neurotransmission may be warranted.
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⋯ This case demonstrates that fulminant and fatal reversible posterior leukoencephalopathy syndrome may occur spontaneously, that is, in the absence of any of the known predisposing systemic conditions.
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Intravascular large B-cell lymphoma is a rare aggressive disseminated disease characterized by the presence of lymphoma cells in small vessels without lymphadenopathy. Rituximab, a novel monoclonal antibody against the CD20 B-cell antigen, has been reported to be effective in treating intravascular large B-cell lymphoma. However, adverse events have been reported in association with rituximab infusion. ⋯ Our data indicate that the incidence of adverse reactions to rituximab can be markedly decreased if the tumor load is first reduced with an initial course of chemotherapy excluding rituximab. Future prospective studies of the timing of rituximab administration are warranted.