The American journal of case reports
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BACKGROUND Kikuchi-Fujimoto (KFD) disease is a rare benign syndrome of necrotizing lymphadenopathy with distinctive histologic characteristics and was first reported in 1972. It is usually manifested by painful cervical lymphadenopathy and fever in young people, predominantly in females. KFD is a self-limiting disease and recurrence is rare. ⋯ She was treated with oral prednisone, with a favorable response. CONCLUSIONS In patients with recurrent lymphadenopathy, excisional biopsy can lead to definitive diagnosis and directed treatment. KFD is an uncommon and potential cause for recurrent lymphadenopathy.
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BACKGROUND This is of the first fatal case of coronavirus disease 2019 (COVID-19) pneumonia at a National Heart Center in Indonesia following planned elective triple-vessel coronary artery bypass graft (CABG) who was considered to be at low risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection when admitted for surgery. CASE REPORT A 48-year-old man was diagnosed with coronary artery disease (CAD) in 3 vessels (3VD) with an ejection fraction (EF) of 61% and chronic kidney disease (CKD) with routine hemodialysis. The patient was scheduled for a coronary artery bypass graft (CABG) surgery. ⋯ COVID-19 tracing was performed for all health care providers and relatives; all results were negative except for 1 family member. The patient was treated for 4 days in the isolation ICU but died due to complications of the infection. CONCLUSIONS This report shows the importance of testing patients for SARS-CoV-2 infection before hospital admission for elective surgery and during the hospital stay, and the importance of developing rapid and accurate testing methods that can be used in countries and centers with limited health resources.
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BACKGROUND Myasthenic crisis is a condition characterized by the sudden onset of myasthenic weakness involving the respiratory muscles and requires ventilatory support to prevent death. This is a case report of respiratory failure in a 43-year-old man as the first presentation of myasthenia gravis. CASE REPORT A 43-year-old man with underlying hypertension and a lacunar stroke with good muscle-power recovery presented with severe community-acquired pneumonia, complicated with respiratory failure requiring invasive ventilatory support. ⋯ However, his blood test was positive for serum anti-acetylcholine receptor antibodies and repetitive nerve stimulation tests showed the characteristic decremental response of compound muscle action potential amplitude, in keeping with the diagnosis of myasthenia gravis. He responded well to intravenous immunoglobulin and was discharged with anticholinesterase inhibitors and long-term immunosuppression therapy. CONCLUSIONS This report demonstrates that when patients are admitted to the hospital with acute respiratory failure without any underlying pulmonary disease and with weakness of the respiratory muscles, the diagnosis of myasthenia gravis presenting with a myasthenic crisis should be considered.
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BACKGROUND Pandemic coronavirus disease 2019 (COVID-19) originated in Wuhan, China, and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe respiratory symptoms are a hallmark of the disease, which may also include complications related to a hypercoagulable state and central nervous system involvement. These complications can occur during either the acute or the recovery phase. ⋯ After initial stabilization, noncontrast computerized tomography and magnetic resonance imaging confirmed an intracerebral hemorrhage with underlying cerebral venous thrombosis. The patient was successfully treated with enoxaparin anticoagulation therapy, and symptoms improved over the following 12 days. CONCLUSIONS Central nervous system venous thrombosis is an atypical presentation of the hypercoagulable state primarily seen in younger patients, and it can occur in a delayed fashion after recovery from mild forms of COVID-19.
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BACKGROUND Orf, also known as ecthyma contagiosum, is a zoonotic disease caused by a parapox virus, which is endemic in goats and sheep but rare in camels. Orf is usually transmitted to humans who are in contact with infected animals. The clinical manifestation of the disease and a personal history of contact with an infected animal are sufficient to diagnose orf virus infection. ⋯ We believe this is the first report of orf transmission from a camel to a human. CONCLUSIONS All physicians should consider this disease as a differential diagnosis in any patient who has a history of contact with camels. Although orf is a self-limiting condition, its early clinical recognition is critical to avoid complications, unwarranted psychological stress, and unnecessary surgical intervention.