The American journal of case reports
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Case Reports
A Case of Infected Left Atrial Myxoma Presenting as ST-Elevation Myocardial Infarction (STEMI).
BACKGROUND Although left atrial myxoma is the most common benign primary cardiac tumor, infected atrial myxoma is rare. This report presents a case of infected left atrial myxoma with embolization to the left anterior descending (LAD) coronary artery, which was identified following an initial presentation with ST-elevation myocardial infarction (STEMI). CASE REPORT A 34-year-old man with a history of smoking tobacco and intravenous cocaine use presented to the emergency room with symptoms of a feeling of pressure on the chest and symptoms in the left arm. ⋯ Transesophageal echocardiogram (TEE) identified a large, mobile, pedunculated left atrial mass protruding into the mitral valve in diastole and mitral valve vegetations. Surgical excision and the histology confirmed a diagnosis of benign left atrial myxoma containing Gram-positive cocci. The patient required mitral valve replacement and a postoperative two-week course of gentamicin and a six-week course of ceftriaxone CONCLUSIONS A rare case is reported of infected left atrial myxoma presenting as STEMI secondary to coronary artery embolization, which was treated with PCI, antibiotics, and mitral valve replacement.
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BACKGROUND Herein, we describe a case of eosinophilic pneumonia that was likely to have been induced by vancomycin. CASE REPORT A 65-year-old man on maintenance hemodialysis presented with chest pain and dyspnea. He subsequently developed methicillin-resistant Staphylococcus aureus-positive acute pleural empyema in an evacuated right-sided pneumothorax. ⋯ All symptoms and the results of laboratory tests immediately improved after the discontinuation of vancomycin and initiation of prednisolone therapy. CONCLUSIONS We attribute this case of eosinophilic pneumonia to vancomycin, because all other candidate causes were ruled out, and only vancomycin fulfilled the criteria of both drug-induced eosinophilic pneumonia and drug-induced lung injury. If confirmed, this constitutes the first reported case of vancomycin-induced eosinophilic pneumonia.
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Case Reports
Flecainide Toxicity Resulting in Pacemaker Latency and Intermittent Failure to Capture.
BACKGROUND Flecainide is a class Ic antiarrhythmic agent used in the treatment of supraventricular and ventricular arrhythmias. It is associated with a potent adverse effect profile; however, the effects of flecainide toxicity in the setting of a pacemaker have not been well described. We describe a unique case of flecainide toxicity secondary to acute kidney injury in the setting of a dual-chamber pacemaker, resulting in ventricular capture latency and intermittent failure to capture. ⋯ The flecainide level drawn on arrival was 3.09 mcg/mL. CONCLUSIONS Flecainide increases the ventricular capture threshold for pacemakers. Toxicity in these patients may present with pacemaker ventricular capture latency or failure to capture.
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Case Reports
Grill Brush Bristle Case Series: Three Unique Presentations of Ingested Foreign Bodies.
BACKGROUND Much of the medical literature regarding injury from the ingestion of wire bristles from grill brushes has been published only in the last decade. Grill brushes are often used to clean grills, and small wire bristles may break off of the brush during the scrubbing process and subsequently become embedded into food and are accidently ingested. Fewer reports have been published on abdominal presentations with injuries past the gastroesophageal sphincter, yet perforation and subsequent need for operative management has been shown to be more prevalent in these types of cases. ⋯ Case 3 involved a 41-year-old male who presented to the ED after known ingestion of a grill brush bristle. He was found to have a small metallic foreign body protruding into the abdominal wall. CONCLUSIONS To avoid these injuries, there must be increased awareness among consumers, manufacturers, retailers, and medical professionals to promote prevention, timely diagnosis, and appropriate treatment.
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BACKGROUND Renal vein thrombosis is uncommon and can be associated with nephrotic syndrome. It is associated with high patient morbidity , and it may lead to thromboembolic event. CASE REPORT A 44-year-old woman presented with shortness of breath, chest pain and tightness, due to bilateral pulmonary embolism originating from right renal vein thrombosis. ⋯ No underlying diseases were found. She was treated with heparin infusion therapy and rivaroxaban with good clinical outcome. CONCLUSIONS A rare case is presented of isolated unilateral right renal vein thrombosis diagnosed following bilateral pulmonary embolism in a previously healthy 44-year-old woman, which was successfully treated with the DOAC, rivaroxaban.