The American journal of case reports
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Case Reports
Retropharyngeal Hematoma as an Unusual Presentation of Myelodysplastic Syndrome: A Case Report.
BACKGROUND Retropharyngeal hematoma is a relatively rare diagnosis that requires a high clinical suspicion and stabilization of the airway to prevent rapid deterioration. We report a case of a spontaneous retropharyngeal hematoma in an elderly patient with myelodysplastic syndrome and associated thrombocytopenia. CASE REPORT A 90-year-old man with myelodysplastic syndrome was brought to the Emergency Department with complaints of difficulty swallowing and muffled voice for 24 hours. ⋯ CONCLUSIONS This case adds to the growing body of literature on spontaneous retropharyngeal hematomas. High clinical suspicion is warranted in patients who present with acute dysphagia, odynophagia, and dysphonia. Prompt imaging and airway management are vital in managing patients with this condition.
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Case Reports
A Case of Heyde Syndrome with Resolution of Gastrointestinal Bleeding Two Weeks After Aortic Valve Replacement.
BACKGROUND Heyde syndrome is the association between gastrointestinal (GI) bleeding from arteriovenous malformation (AVM) and aortic stenosis. The aim of this study was to review Heyde syndrome and to discuss the management of this condition. CASE REPORT A 56-year-old female with a history of severe aortic stenosis and recurrent GI bleeding secondary to small bowel AVM, presented for hospital admission with melena and maroon blood in her stool. ⋯ At the 6-month follow-up she showed stable hemoglobin at 14.3 gm/dL without further episodes of GI bleeding. CONCLUSIONS Physicians need to consider Heyde syndrome in patients with aortic stenosis and GI bleeding secondary to angiodysplasia. Physicians should also be attentive in patients with Heyde syndrome presenting with GI bleeding after undergoing aortic valve replacement, as GI bleeding might take time to resolve completely in these patients.
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BACKGROUND Bartonella infection is the causative organism of cat-scratch disease (CSD), which typically presents with self-limited localized lymphadenopathy. In HIV-infected patients, Bartonella infection can cause systemic illnesses with significant morbidity and mortality manifesting as bacillary angiomatosis (BA), hepatic peliosis, splenitis, bacteremic febrile illness, and other organ involvement. To the best of our knowledge, there have been no reports of HIV-infected patients presenting with generalized lymphadenopathy caused by Bartonella infection. ⋯ She responded well to a long course of azithromycin antibiotic therapy, with the resolution of lymphadenopathy. CONCLUSIONS Cat-scratch disease may present with prolonged generalized lymphadenopathy, an unusual presentation in HIV patients with advanced immunosuppression. Awareness of the possibility of CSD in a similar clinical scenario may prompt early recognition and management of this disease.