The American journal of case reports
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BACKGROUND Hiccup is a rare complication after a cervical epidural steroid injection used in the treatment of chronic pain. A few studies have reported on the physiological and pharmacological aspects of hiccups after epidural steroid injection and there have been some case reports published. ⋯ CONCLUSIONS Persistent hiccups after epidural injection is a serious complication. As the exact mechanism of hiccups is not yet known, regardless the level of epidural or the mixture of drugs used, and the incident of hiccups after epidural injection is not well-reported, we think that the etiology and the incident rate must be further evaluated.
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Review Case Reports
Splenic Rupture as the First Manifestation of Babesia Microti Infection: Report of a Case and Review of Literature.
BACKGROUND Babesiosis is an emerging, tick-borne zoonosis caused by intraerythrocytic protozoa of the genus Babesia. Babesia microti is the main pathogen causing human disease and is endemic in the northeastern and upper midwestern parts of the USA. Severity of infection ranges from mild, self-limited, febrile viral-like illness accompanied by nonspecific symptoms to life-threatening infection complicated by severe hemolytic anemia, disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and renal or/and hepatic failure. ⋯ CONCLUSIONS Despite its rare occurrence, SR due to B. microti infection is a dreaded complication that can rapidly progress to hemorrhagic shock and death. In contrast to other complications of babesiosis, SR is not correlated with parasite burden or immune status of the affected host. Babesiosis should be considered as part of the differential diagnosis in patients from endemic areas presenting with atraumatic splenic rupture.
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BACKGROUND Melioidosis is a rare tropical bacterial infection caused by the Gram-negative soil saprophyte, Burkholderia pseudomallei. Melioidosis can mimic a variety of diseases due to its varied presentation, and unless it is treated rapidly, it can be fatal. A rare case of melioidosis, with pericarditis and pericardial effusion, is described, which demonstrates the value of early diagnosis with echocardiography and pericardiocentesis. CASE REPORT A 38-year-old native (Iban) East Malaysian man presented with shortness of breath and tachycardia. ⋯ The diagnosis of constrictive pericarditis was confirmed by computed tomography (CT) and surgical exploration. Following pericardiectomy, his symptoms resolved, but patient follow-up was recommended for possible sequelae of constrictive pericarditis. CONCLUSIONS After the onset of melioidosis pericarditis, the authors recommend follow-up and surveillance for possible complication of constrictive pericarditis.
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Review Case Reports
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Secondary to Furosemide: Case Report and Review of Literature.
BACKGROUND DRESS is a rare, life threatening syndrome that occurs following exposure to certain medications, most commonly antibiotics and antiepileptics. While sulfonamide antibiotics are frequently implicated as causative agents for DRESS syndrome, furosemide, a nonantibiotic sulfonamide, has not been routinely reported as the causative agent despite its widespread use. CASE REPORT A 63 year old male who started furosemide for lower extremity edema 10 weeks prior presented with diarrhea, fever of 39.4°C, dry cough and maculopapular rash involving >50% of his body. ⋯ The RegiSCAR scoring system categorized this case as "definite" with a score of 8. CONCLUSIONS We report a case of severe DRESS syndrome secondary to furosemide, only the second case report in medical literature implicating furosemide. Given its widespread use, the potentially life-threatening nature of DRESS syndrome and the commonly delayed time course in establishing the diagnosis, it is important to remember that, albeit rare, furosemide can be a cause of DRESS syndrome.
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Review Case Reports
Acute Exertional Compartment Syndrome with Rhabdomyolysis: Case Report and Review of Literature.
BACKGROUND Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. CASE REPORT We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. He was diagnosed with compartment syndrome and rhabdomyolysis. ⋯ AECS requires prompt diagnosis and surgical intervention to prevent these consequences. Diagnosis of atraumatic cases can be difficult, which is why awareness is equally as important as history and physical examination. While diagnosis is primarily clinical, it can be supported with direct intra-compartmental pressure measurements and maintaining a high index of suspicion in acute presentations of exertional limb pain.