Journal of medical case reports
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Review Case Reports
Set screw fracture with cage dislocation after two-level transforaminal lumbar interbody fusion (TLIF): a case report.
Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a set screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported. ⋯ Hardware-related complications are rarely seen in patients with open transforaminal lumbar interbody fusion, but must be kept in mind and can potentially cause severe neurological deficits.
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Review Case Reports
A case of type B lactic acidosis as a complication of chronic myelomonocytic leukaemia: a case report and review of the literature.
Type B lactic acidosis represents a rare and often lethal complication of haematological malignancy. Here, we present a patient who developed a type B lactic acidosis presumably due to a concurrent chronic myelomonocytic leukaemia. Upon swift initiation of cytoreductive chemotherapy (doxorubicin), the lactic acidosis was rapidly brought under control. This case adds to the literature reporting other haematological malignancies that can cause a type B lactic acidosis and its successful treatment. ⋯ A high degree of clinical suspicion for haematological malignancy should be held when presented with a patient with lactic acidosis in clinical practice, even without evidence of poor oxygenation or another cause. Treatment with emergency chemotherapy, in lieu of a definitive diagnosis, was rapidly successful at lowering lactate levels within 8 hours. This may suggest a causal and perhaps direct relationship between lactic acid production and the presence of leukemic cells. Veno-venous haemofiltration had no apparent effect on reducing the lactic acidosis and therefore its benefit is questioned in this setting, especially at the cost of delaying chemotherapy. In the face of a life-threatening lactic acidosis, pragmatic clinical judgement alone may justify the rapid initiation of chemotherapy.
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Review Case Reports
Abnormal fingernail beds following carbon monoxide poisoning: a case report and review of the literature.
Carbon monoxide poisoning is a very common cause of death in accidental, suicidal, or homicidal cases throughout the world. Fingernail bed manifestation is reported in survivors of carbon monoxide poisoning. ⋯ Worldwide, carbon monoxide poisoning is a potentially lethal condition that is preventable with educational programs and installation of carbon monoxide detectors in the home setting. Exposure to carbon monoxide frequently goes unrecognized until it is too late and causes silent death. To the best of the authors' knowledge, this is the first report in the literature of fingernail bed manifestations in a survivor of carbon monoxide poisoning.
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Review Case Reports
Aeromonas sobria necrotizing fasciitis and sepsis in an immunocompromised patient: a case report and review of the literature.
Aeromonas veronii biovar sobria is a rare cause of bacteremia, with several studies indicating that this isolate may be of particular clinical significance since it is enterotoxin producing. A wide spectrum of infections has been associated with Aeromonas species in developing countries that include gastroenteritis, wound infections, septicemia and lung infections. This infection, caused by Aeromonas species, is usually more severe in immunocompromised than immunocompetent individuals. We here describe a case of soft tissue infection and severe sepsis due to Aeromonas sobria in an immunocompromised patient. ⋯ Our experience suggests that early recognition and aggressive medical and surgical therapy are determinants in the treatment of severe septicemia caused by an Aeromonas sobria in an immunocompromised patient.