The American journal of case reports
-
Review Case Reports
Parapharyngeal Neuroglial Heterotopia: A Case Report and Literature Review.
BACKGROUND Pediatric neck masses have a wide differential diagnosis. Neuroglial heterotopia is a rare condition that was first described by Reid in 1852. The majority of neuroglial heterotopias are found in the nasal cavity (mistakenly termed as nasal glioma), but they can also occur in extra-nasal areas such as the scalp, orbit, palate, neck, and other areas. ⋯ CONCLUSIONS Neuroglial heterotopias is one of the differential diagnoses for masses causing airway obstruction in pediatric age groups. Preoperative diagnoses of parapharyngeal neuroglial heterotopias can be challenging, as they have no confirmed specific clinical or radiological features. This paper contributes to parapharyngeal neuroglial heterotopia research, which will ultimately enable clinicians to ascertain these tumors' characteristic features more promptly for earlier diagnoses.
-
Review Case Reports
Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature.
BACKGROUND One of the most common causes of central nervous system (CNS) opportunistic infections in immunocompromised patients is toxoplasmosis. It can cause focal or disseminated brain lesions leading to neurological deficit, coma, and death. Prompt management with optimal antibiotics is vital. ⋯ Decompressive hemicraniectomy for control of intracranial pressure and anti-infectious therapy were performed. CONCLUSIONS This should raise awareness that cerebral toxoplasmosis can occur in pediatric patients with HIV infection, and, more importantly, as the first manifestation of AIDS. Although the prognosis is often poor, early diagnosis and immediate treatment of this life-threatening opportunistic infection can improve outcomes.
-
Review Case Reports
Traumatic Diaphragmatic Rupture with Transthoracic Organ Herniation: A Case Report and Review of Literature.
BACKGROUND Diaphragmatic rupture is a rare pathology that reported in less than 0.5% of all trauma cases, with signs and symptoms that can easily be misdiagnosed. Clinicians must maintain a high index of suspicion to correctly diagnose and manage this pathology. We present a rare case of a large diaphragmatic rupture with transthoracic gastric and colon herniation that was successfully repaired, along with a literature review. ⋯ CONCLUSIONS This case highlights the importance of diaphragmatic rupture and its associated intra-abdominal injuries when treating trauma patients. With missed diaphragmatic injuries leading to a potential morbidity rate of 30% and mortality rate as high as 10%, the clinician must have a high index of suspicion to correctly diagnose and manage this pathology in a timely fashion. More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.
-
Review Case Reports
Pulmonary Hypertension and Polycythemia Secondary to Pulmonary Alveolar Microlithiasis Treated with Sequential Bilateral Lung Transplant: A Case Study and Literature Review.
BACKGROUND Pulmonary alveolar microlithiasis is an autosomal recessive disease in which a mutation in the SLC34A2 gene that codes for a sodium phosphate type IIb transporter protein (expressed in human epithelial tissues and functions in the clearance of phosphate ions) leads to the formation of extensive pulmonary intra-alveolar microliths. The subsequent characteristic clinical features of dyspnea and hypoxia are a manifestation of these microliths. There have been fewer than 1000 cases of pulmonary alveolar microlithiasis reported worldwide, and there have been 19 reported lung-transplanted patients. ⋯ After a successful extubatation with stable vitals and good recovery, he was discharged home in stable condition with planned follow-up. CONCLUSIONS We report a case of pulmonary alveolar microlithiasis successfully treated with a bilateral lung transplant. Although pulmonary alveolar microlithiasis is a rare entity, healthcare providers should consider it in the differential diagnoses of parenchymal lung diseases and differentiate it from tuberculosis and pulmonary fibrosis.
-
BACKGROUND Pulmonary edema is the accumulation of fluid in the lung secondary to increased hydrostatic pressure. Hypertensive cardiogenic pulmonary edema presents with a sudden onset of severe dyspnea, tachycardia, and tachypnea, and can occur when the systolic blood pressure exceeds 160 mmHg in association with acute decompensated congestive cardiac failure (CCF). A case is presented of hypertensive cardiogenic pulmonary edema treated with high-dose nitroglycerin and includes a review of the literature. ⋯ After 18 minutes of aggressive therapy, the patient's condition improved and he no longer required mechanical ventilation. CONCLUSIONS Hypertensive cardiogenic pulmonary edema is a challenging clinical condition that should be diagnosed and managed as early as possible, and distinguished from respiratory failure due to other causes. Although hypertensive cardiogenic pulmonary edema is usually managed acutely with high-dose diuretics, this case has highlighted the benefit of high-dose IV nitroglycerin, and review of the literature supports this treatment approach.