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A “tilt” toward cinefluoroscopy
Key Clinical Message Fluoroscopy permits rapid and straightforward assessment of mechanical valve function and allows a distinction between normal and malfunctional prostheses, acting as a complementary diagnostic step. Fluoroscopy permits rapid and straightforward assessment of mechanical valve function and allows a distinction between normal and malfunctional prostheses, acting as a complementary diagnostic step. (Source: Clinical Case Reports)
Source: Clinical Case Reports - December 11, 2017 Category: General Medicine Authors: Konstantinos Lampropoulos, Athanasios Bakalakos, George Bazoukis, Athanasios Saplaouras, Antigoni Sakellaropoulou, Aikaterini Anagnostou, Gary Tse, Michalis Tsamatsoulis, Christos Charitos Tags: Clinical Video Source Type: research

Suture ‐induced arthritis as a clinical mimicker of septic arthritis
Key Clinical Message Foreign body‐induced arthritis is a rare etiology of mono‐arthritis. It should be suspected in the case of postoperative arthritis, even if some decades have passed since surgery. Histopathology of the tissues is required for a definitive diagnosis, and debridement is essential for complete recovery. Foreign body‐induced arthritis is a rare etiology of mono‐arthritis. It should be suspected in the case of postoperative arthritis, even if some decades have passed since surgery. Histopathology of the tissues is required for a definitive diagnosis, and debridement is essential for complete recove...
Source: Clinical Case Reports - December 11, 2017 Category: General Medicine Authors: Nazuna Mizuno, Akira Mizuno Tags: Case Report Source Type: research

Toothpick ingestion and migration into the liver through the colonic hepatic flexure: case presentation, management, and literature review
Key Clinical Message The approach to toothpick ingestion and its complications should not be underestimated. The surgeon should be prepared for life‐threatening situations such as major vascular involvement, as well as highly specialized and technically challenging procedures, when the hepatic hilum is involved for instance. Referral to tertiary centers is sometimes mandatory. The approach to toothpick ingestion and its complications should not be underestimated. The surgeon should be prepared for life‐threatening situations such as major vascular involvement, as well as highly specialized and technically challenging ...
Source: Clinical Case Reports - December 11, 2017 Category: General Medicine Authors: Antoine El Asmar, Yasmine Papas, Imad Hajj, Mansour El Khoury Tags: Case Report Source Type: research

Trochanteric fracture following hip arthrodesis: case presentation
Key Clinical Message Even if the intertrochanteric fracture under an arthrodesis hip is rare and the optimal surgical treatment is controversial, we consider that treating this kind of fracture with a locked plate was a success. Even if the intertrochanteric fracture under an arthrodesis hip is rare and the optimal surgical treatment is controversial, we consider that treating this kind of fracture with a locked plate was a success. (Source: Clinical Case Reports)
Source: Clinical Case Reports - December 7, 2017 Category: General Medicine Authors: Bogdan Deleanu, Radu Prejbeanu, Dinu Vermesan, Horia Haragus, Lucian Honcea, Mihail ‐Lazar Mioc, Eleftherios Tsiridis, Vlad Predescu Tags: Case Report Source Type: research

A case of herpes simplex virus pneumonia detected by sputum cytodiagnosis
Key Clinical Message A sputum test is noninvasive and simple. It contributed to correct diagnosis of a patient with severe acute respiratory failure. We again point out the usefulness of sputum cytodiagnosis for differentiating severe pneumonia. A sputum test is noninvasive and simple. It contributed to correct diagnosis of a patient with severe acute respiratory failure. We again point out the usefulness of sputum cytodiagnosis for differentiating severe pneumonia. (Source: Clinical Case Reports)
Source: Clinical Case Reports - December 7, 2017 Category: General Medicine Authors: Mayumi Yoshimi, Yu Satou, Masaya Mori Tags: Case Report Source Type: research

Rare 48, XYYY syndrome: case report and review of the literature
Key Clinical Message 48, XYYY syndrome is a rare condition. A male with 32‐year‐old and three Y chromosomes is described. This syndrome is phenotypically similar to Klinefelter syndrome. In this patient, Semi‐Klinefelter characteristics such as tall stature, teeth dysmorphology, long length of fingers, partial deformity of the joints, likewise mental health problems were obvious. 48, XYYY syndrome is a rare condition. A male with 32‐year‐old and three Y chromosomes is described. This syndrome is phenotypically similar to Klinefelter syndrome. In this patient, Semi‐Klinefelter characteristics such as tall statu...
Source: Clinical Case Reports - December 7, 2017 Category: General Medicine Authors: Maryam Abedi, Arash Salmaninejad, Ebrahim Sakhinia Tags: Case Report Source Type: research

Graft ‐versus‐host disease, a rare complication after orthotopic liver transplantation
Key Clinical Message Acute graft‐versus‐host disease (GVHD) after orthotopic liver transplantation (OLT) is a rare but fatal complication that poses a major diagnostic and therapeutic challenge. Our case highlights the need for further studies to develop therapeutic modalities to improve outcomes in patients who develop GHVD following OLT. Acute graft‐versus‐host disease (GVHD) after orthotopic liver transplantation (OLT) is a rare but fatal complication that poses a major diagnostic and therapeutic challenge. Our case highlights the need for further studies to develop therapeutic modalities to improve outcomes in...
Source: Clinical Case Reports - December 7, 2017 Category: General Medicine Authors: Andrew Ofosu, Andrew Zabolotsky, Miguel Rufail, Joseph Spataro, Jesse Civan Tags: Clinical Image Source Type: research

Acute lymphoblastic leukemia secondary to myeloproliferative neoplasms or after lenalidomide exposure
Key Clinical Message Philadelphia‐negative (Ph−) myeloproliferative neoplasms (MPN) do rarely transform to acute lymphoblastic leukemia (ALL). While causality is difficult to establish, a few cases of ALL arising after exposure to lenalidomide for registered indications (multiple myeloma, myelodysplastic syndrome with 5q deletion) have been described in the literature. Philadelphia‐negative (Ph−) myeloproliferative neoplasms (MPN) do rarely transform to acute lymphoblastic leukemia (ALL). While causality is difficult to establish, a few cases of ALL arising after exposure to lenalidomide for registered ind...
Source: Clinical Case Reports - December 6, 2017 Category: General Medicine Authors: Ahmad Alhuraiji, Kiran Naqvi, Yang O. Huh, Coty Ho, Srdan Verstovsek, Prithviraj Bose Tags: Case Report Source Type: research

Issue Information
(Source: Clinical Case Reports)
Source: Clinical Case Reports - December 5, 2017 Category: General Medicine Tags: Issue Information Source Type: research

Leukemic phase and CSF involvement of diffuse large B ‐cell lymphoma with a complex karyotype including a TP53 deletion
Key Clinical Message Diffuse large B‐cell lymphoma in rare instances can present initially in a leukemic phase and mimic other lymphoid diseases. In such cases, advanced diagnostic testing including immunophenotyping, FISH analysis, and karyotyping can help determine the accurate diagnosis which is key in the management of the disease. Diffuse large B‐cell lymphoma in rare instances can present initially in a leukemic phase and mimic other lymphoid diseases. In such cases, advanced diagnostic testing including immunophenotyping, FISH analysis, and karyotyping can help determine the accurate diagnosis which is key in t...
Source: Clinical Case Reports - December 5, 2017 Category: General Medicine Authors: Jillian Sinkoff, Horatiu Olteanu, Jess F. Peterson, Nirav N. Shah Tags: Clinical Image Source Type: research

Association of isochromosome (7)(q10) in Shwachman –Diamond syndrome with the severity of cytopenia
We report two male siblings with SDS. They have the same compound heterozygous mutations. Only one of the siblings acquired cytogenetic abnormality of i(7q) 2 years after diagnosis, became transfusion‐dependent, and underwent allogeneic hematopoietic stem cell transplantation. These cases indicate that i(7q) is associated with significant cytopenia in SDS patients. We report two male siblings with SDS. They have the same compound heterozygous mutations. Only one of the siblings acquired cytogenetic abnormality of i(7q) 2 years after diagnosis, became transfusion‐dependent, and underwent allogeneic hematopoietic stem c...
Source: Clinical Case Reports - December 5, 2017 Category: General Medicine Authors: Yuko Shimosato, Reo Tanoshima, Shin ‐ichi Tsujimoto, Masanobu Takeuchi, Koji Sasaki, Ryosuke Kajiwara, Hiroaki Goto, Junichi Nagai, Masakatsu D. Yanagimachi, Shuichi Ito, Shumpei Yokota Tags: Case Report Source Type: research

Liposomal bupivacaine for the management of postsurgical donor site pain in patients with burn injuries: a case series from two institutions
Key Clinical Message Donor site pain associated with skin graft procedures is frequently intense and difficult to treat. Liposomal bupivacaine, a prolonged‐release local anesthetic indicated for single‐dose administration to produce postsurgical analgesia, may be a viable option in managing donor site pain. Donor site pain associated with skin graft procedures is frequently intense and difficult to treat. Liposomal bupivacaine, a prolonged‐release local anesthetic indicated for single‐dose administration to produce postsurgical analgesia, may be a viable option in managing donor site pain. (Source: Clinical Case Reports)
Source: Clinical Case Reports - December 5, 2017 Category: General Medicine Authors: Sharmila Dissanaike, Jayne McCauley, Carlo Alphonso Tags: Case Report Source Type: research

Hashimoto's encephalopathy – presenting with epilepsia partialis continua and a frontal lobe lesion
We report a case of Hashimoto's encephalopathy (HE), who presented with epilepsia partialis continua (EPC) and a frontal lobe lesion. The diagnosis of HE remained elusive until the serum thyroid antibodies became positive 7 months after the onset of EPC. The histopathology of this frontal lesion showed nonvasculitic inflammation. We report a case of Hashimoto's encephalopathy (HE), who presented with epilepsia partialis continua (EPC) and a frontal lobe lesion. The diagnosis of HE remained elusive until the serum thyroid antibodies became positive 7 months after the onset of EPC. The histopathology of this frontal lesion ...
Source: Clinical Case Reports - December 5, 2017 Category: General Medicine Authors: Lokesh A. Rukmangadachar, Sudeepta Dandapat, Esther N. Bit ‐Ivan, Yen‐Yi Peng Tags: Case Report Source Type: research

The first antenatal diagnosis of KBG syndrome: a microdeletion at chromosome 16q24.2q24.3 containing multiple genes including ANKRD11 associated with the disorder
Key Clinical Message The loss of ANKRD11 gene confirms the diagnosis of KBG syndrome but does not elucidate the pediatric phenotype providing a counseling challenge. With the expansion of prenatal diagnosis, and the potential to perform whole‐exome sequencing antenatally, we must describe the genetic abnormalities, antenatal ultrasound findings, and phenotype concurrently to facilitate counseling. The loss of ANKRD11 gene confirms the diagnosis of KBG syndrome but does not elucidate the pediatric phenotype providing a counseling challenge. With the expansion of prenatal diagnosis, and the potential to perform whole‐ex...
Source: Clinical Case Reports - December 1, 2017 Category: General Medicine Authors: Victoria Hodgetts Morton, Elizabeth Quinlan ‐Jones, Natasha Butts, Denise Williams, Sue Hamilton, Tamas Marton, Katie Morris Tags: Case Report Source Type: research

Basilar impression as complication of Grisel's syndrome
Key Clinical Message Grisel's syndrome presents a rare disease. Here, we present a peculiar case of Grisel's syndrome with an unfavorable course developing a basilar impression. This highlights the importance of close clinical and radiological follow‐up even in cases where the course seems uncomplicated. Grisel's syndrome presents a rare disease. Here, we present a peculiar case of Grisel's syndrome with an unfavorable course developing a basilar impression. This highlights the importance of close clinical and radiological follow‐up even in cases where the course seems uncomplicated. (Source: Clinical Case Reports)
Source: Clinical Case Reports - December 1, 2017 Category: General Medicine Authors: Lasse D ührsen, Tammam Abboud, Lennart Viezens, Sven Oliver Eicker, Marc Dreimann Tags: Case Report Source Type: research

Congenital methemoglobinemia type II in a 5 ‐year‐old boy
Key Clinical Message Congenital Methemoglobinemia is a rare neurologic condition which can mimic other diseases such as epilepsy syndromes and leukodystrophies. The responsible gene, CYB5R3, is not typically included on commonly order neurologic and epilepsy panels. We recommend that laboratories include this gene on these tests which often precede larger‐scale genetic studies. Congenital Methemoglobinemia is a rare neurologic condition which can mimic other diseases such as epilepsy syndromes and leukodystrophies. The responsible gene, CYB5R3, is not typically included on commonly order neurologic and epilepsy panels. ...
Source: Clinical Case Reports - December 1, 2017 Category: General Medicine Authors: Elizabeth A. Mannino, Thomas Pluim, Jacob Wessler, Megan T. Cho, Jane Juusola, Samantha A. Schrier Vergano Tags: Case Report Source Type: research

Longitudinal report of child with de novo 16p11.2 triplication
Key Clinical Message 16p11.2 deletions and duplications are commonly associated with autism spectrum disorder and linked to mirrored phenotypes of physical characteristics and higher penetrance for deletions. A male with a rare 16p11.2 triplication demonstrated a similar phenotypic presentation to deletion carriers with neurocognitive and adaptive skill deficits and above‐average physical growth. 16p11.2 deletions and duplications are commonly associated with autism spectrum disorder and linked to mirrored phenotypes of physical characteristics and higher penetrance for deletions. A male with a rare 16p11.2 triplication...
Source: Clinical Case Reports - December 1, 2017 Category: General Medicine Authors: Arianne S. Wallace, Caitlin M. Hudac, Kyle J. Steinman, Jessica L. Peterson, Trent D. DesChamps, Michael H. Duyzend, Xander Nuttle, Evan E. Eichler, Raphael A. Bernier Tags: Case Report Source Type: research

Nonhealing scrotal ulceration —an unusual manifestation of TB epididymo‐orchitis: case report and review of literature
Key Clinical Message The clinical presentation of genitourinary tuberculosis (TB) may be variable and a high index of suspicion is required for a timely diagnosis, especially in endemic areas. Recurrent scrotal ulcers associated with epididymo‐orchitis even without other constitutional symptoms should alert the clinician of a possible diagnosis of TB. The clinical presentation of genitourinary tuberculosis (TB) may be variable and a high index of suspicion is required for a timely diagnosis, especially in endemic areas. Recurrent scrotal ulcers associated with epididymo‐orchitis even without other constitutional sympt...
Source: Clinical Case Reports - December 1, 2017 Category: General Medicine Authors: Umesh Jayarajah, Pamathy Gnanaselvam, Sivasuriya Sivaganesh Tags: Case Report Source Type: research

Tetraploid –diploid mosaicism in a patient with pigmentary anomalies of hair and skin: a new dermatologic feature
We present an 11‐year‐old boy with tetraploid–diploid mosaicism and coexistent hair hypopigmentation with skin hypo‐ and hyperpigmentation. This case expands the current literature as we are not aware of previous documentation of this unique combination of pigmentary anomalies. Tetraploid–diploid mosaicism in humans is exceedingly rare. We present an 11‐year‐old boy with tetraploid–diploid mosaicism and coexistent hair hypopigmentation with skin hypo‐ and hyperpigmentation. This case expands the current literature as we are not aware of previous documentation of this unique combination of pig...
Source: Clinical Case Reports - November 29, 2017 Category: General Medicine Authors: John Paul Schacht, Elisha Farnworth, Jacob Hogue, Luis Rohena Tags: Case Report Source Type: research

PET/CT imaging in management of concomitant Hodgkin lymphoma and tuberculosis – a problem solver tool
Key Clinical Message Infectious lymph nodes mimicking lymphoma is challenging for accurate staging. Although 18F‐FDG is a nonspecific tracer accumulating not only in tumor cells but also in inflammatory tissues, the metabolic features and uptake kinetics give valuable information: 18F‐FDG PET/CT appears as a useful problem solver tool in ambiguous situation. Infectious lymph nodes mimicking lymphoma is challenging for accurate staging. Although 18F‐FDG is a nonspecific tracer accumulating not only in tumor cells but also in inflammatory tissues, the metabolic features and uptake kinetics give valuable information: 1...
Source: Clinical Case Reports - November 29, 2017 Category: General Medicine Authors: Nina Jehanno, Thibaut Cassou ‐Mounat, Anne Vincent‐Salomon, Marie Luporsi, Manel Bedoui, Frédérique Kuhnowski Tags: Clinical Image Source Type: research

Plunging ranula: surgical management of case series and the literature review
We present case series in children; with all cases having both oral and cervical components. It is important to note this type of presentation of plunging ranula and their appropriate management. Plunging ranulas are rare; report of this condition is particularly limited in our environment. We present case series in children; with all cases having both oral and cervical components. It is important to note this type of presentation of plunging ranula and their appropriate management. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 29, 2017 Category: General Medicine Authors: Akanbi Clement Olurotimi Olojede, Oladunni Mojirayo Ogundana, Christian Ibesi Emeka, Richard Ayodeji Adewole, Mubarak Mobolade Emmanuel, Olalekan Micah Gbotolorun, Adesina Olumuyiwa Ayodele, Sunday Babatunde Oluseye Tags: Case Report Source Type: research

EBV ‐associated hemophagocytic lymphohistiocytosis complicated by severe coagulation disorders and opportunistic infections: case report of a survivor
Key Clinical Message The possibility of hemophagocytic lymphohistiocytosis should always be kept in mind when examining/treating a patient with fever of unknown origin and sepsis‐like symptoms. Early diagnosis leading to prompt initiation of immunosuppressive therapy as well as aggressive supportive care, including correction of coagulation abnormalities and treatment of opportunistic infections, can decrease mortality. The possibility of hemophagocytic lymphohistiocytosis should always be kept in mind when examining/treating a patient with fever of unknown origin and sepsis‐like symptoms. Early diagnosis leading to p...
Source: Clinical Case Reports - November 29, 2017 Category: General Medicine Authors: Kirsten Saevels, Dominique Robert, Sylvie Van den Broeck, Ronald Malfait, Alain Gadisseur, Philippe Jorens, Anke Verlinden Tags: Case Report Source Type: research

Unexpected discovery of multiple myeloma following cardiomyopathy
We report the case of multiple myeloma of unexpected discovery in an old patient admitted to the emergency department of cardiomyopathy. This observation emphasizes the need for exploring any anemia before linking it to heart failure or kidney disease. Serum protein electrophoresis remains crucial especially in the elderly patients. We report the case of multiple myeloma of unexpected discovery in an old patient admitted to the emergency department of cardiomyopathy. This observation emphasizes the need for exploring any anemia before linking it to heart failure or kidney disease. Serum protein electrophoresis remains cru...
Source: Clinical Case Reports - November 28, 2017 Category: General Medicine Authors: Souhail Dahraoui, Jean Uwingabiye, Badia Belarj, Asmae Biaz, Achraf Rachid, Abdellah Dami, Sanae Bouhsain, Zohra Ouzzif, Samira Elmachatni Idrissi Tags: Case Report Source Type: research

Cutaneous diffuse large B ‐cell lymphoma
Key Clinical Message Cutaneous diffuse large B‐cell lymphoma accounts for ~6% of all cutaneous lymphomas. It is associated with poor prognosis, and solitary lesions are relatively rare. It often requires an aggressive approach with multi‐agent chemotherapy and radiotherapy. It is important to recognize these cases in order to offer rapid and appropriate management. Cutaneous diffuse large B‐cell lymphoma accounts for ~6% of all cutaneous lymphomas. It is associated with poor prognosis, and solitary lesions are relatively rare. It often requires an aggressive approach with multi‐agent chemotherapy and radiotherapy....
Source: Clinical Case Reports - November 28, 2017 Category: General Medicine Authors: Filipa Duarte Ribeiro, Henrique Coelho, David Tente, Margarida Badior Tags: Clinical Image Source Type: research

Acute fatty liver of pregnancy simulating liver tumor
Key Clinical Message Acute fatty liver of pregnancy (AFLP) is a rare liver disease unique to pregnancy that can lead to acute liver failure. Clinicians must have a high index of suspicion for AFLP because only early diagnosis and prompt delivery improve maternal and fetal prognosis. Acute fatty liver of pregnancy (AFLP) is a rare liver disease unique to pregnancy that can lead to acute liver failure. Clinicians must have a high index of suspicion for AFLP because only early diagnosis and prompt delivery improve maternal and fetal prognosis. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 28, 2017 Category: General Medicine Authors: Benjamin Anon, B éatrice Scotto, Yannick Bacq Tags: Clinical Image Source Type: research

Inflammatory myofibroblastic tumor of the esophagus presenting with hematemesis and melaena: a case report and review of literature
Key Clinical Message Esophageal inflammatory myofibroblastic tumors (IMT) are extremely rare, and the understanding on the clinical presentation is limited. IMT of esophagus should be considered as a differential diagnosis in the context of unexplained upper gastrointestinal bleeding and rapidly progressing dysphagia in young patients. Esophageal inflammatory myofibroblastic tumors (IMT) are extremely rare, and the understanding on the clinical presentation is limited. IMT of esophagus should be considered as a differential diagnosis in the context of unexplained upper gastrointestinal bleeding and rapidly progressing dys...
Source: Clinical Case Reports - November 28, 2017 Category: General Medicine Authors: Umesh Jayarajah, Rasika P. Bulathsinghala, Dassanayake M Sumana Handagala, Dharmabandhu Nandadeva Samarasekera Tags: Case Report Source Type: research

Visceral leishmaniasis in a patient with diabetes mellitus type 2 and discrete bicytopenia
Key Clinical Message An Austrian patient with diabetes mellitus type 2 developed visceral leishmaniasis after trips to Spain and Crete, presenting with slight bicytopenia, later developing severe pancytopenia. Travel history taking is important due to an extended incubation period. Coexistence of diabetes mellitus can impair T lymphocyte function and cause higher relapse rates. An Austrian patient with diabetes mellitus type 2 developed visceral leishmaniasis after trips to Spain and Crete, presenting with slight bicytopenia, later developing severe pancytopenia. Travel history taking is important due to an extended incub...
Source: Clinical Case Reports - November 28, 2017 Category: General Medicine Authors: Verena Schwetz, Christian Trummer, Claudia Friedl, Christine Beham ‐Schmid, Roman Kulnik, Albert Wölfler, Karl Horvath, Stefanie Wunsch, Jürgen Prattes, Ines Zollner‐Schwetz, Thomas R. Pieber, Julia K. Mader, Robert Krause Tags: Case Report Source Type: research

The clinical utility of serum free light chain and heavy/light chain assays in monitoring disease activity in patients with IgG myeloma after achieving a deep response
Key Clinical Message Heavy/light chain (HLC) assay will enable us to evaluate the changes in the concentrations of iHLC and uHLC separately and to better identify whether the change observed is clonal or reactive. It would therefore aid in decision making for earlier implementation or discontinuation of treatment for patients with intact immunoglobulin multiple myeloma (MM). Heavy/light chain (HLC) assay will enable us to evaluate the changes in the concentrations of iHLC and uHLC separately and to better identify whether the change observed is clonal or reactive. It would therefore aid in decision making for earlier impl...
Source: Clinical Case Reports - November 28, 2017 Category: General Medicine Authors: Kazuyuki Shimizu, Yoshikazu Kamiya, Junji Itoh, Jun Okada, Merrell Lim, Satoru Sugiyama Tags: Case Report Source Type: research

Metastatic HPV ‐related oropharyngeal carcinoma cured with chemoradiotherapy: importance of pretherapy biomolecular assessment
Key Clinical Message Pretherapy assessment has a crucial role in the management of advanced oropharyngeal carcinoma. The case report represents an example of how translational research may help to optimize the therapeutic options and to choose a well‐shaped therapy adapted to the tumor and the patient. Pretherapy assessment has a crucial role in the management of advanced oropharyngeal carcinoma. The case report represents an example of how translational research may help to optimize the therapeutic options and to choose a well‐shaped therapy adapted to the tumor and the patient. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 24, 2017 Category: General Medicine Authors: Francesco Perri, Francesco Longo, Giuseppina Della Vittoria Scarpati, Salvatore Pisconti, Vito Longo, Raffaele Addeo, Fabio Carducci, Carlo Buonerba, Franco Fulciniti, Raffaele Solla Tags: Case Report Source Type: research

Orbital plasmablastic lymphoma
Key Clinical Message Plasmablastic lymphoma is an unusual and aggressive form of diffuse large B‐cell lymphoma, which arises more commonly within the oronasal mucosa. It should be considered as a differential diagnosis for rapidly growing periorbital lesions, particularly in the context of HIV positivity. Plasmablastic lymphoma is an unusual and aggressive form of diffuse large B‐cell lymphoma, which arises more commonly within the oronasal mucosa. It should be considered as a differential diagnosis for rapidly growing periorbital lesions, particularly in the context of HIV positivity. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 24, 2017 Category: General Medicine Authors: Edward Bloch, Fiona Robinson Tags: Clinical Image Source Type: research

Diagnosis of benign notochordal cell tumor of the spine: is a biopsy necessary?
Key Clinical Message Benign notochordal cell tumor is a benign intraosseous lesion, demonstrates characteristic imaging features. The lesion demonstrates low‐signal intensity in T1‐weighted images, high‐signal intensity in T2‐weighted images, and no enhancement with contrast medium in MRI and slight osteosclerosis in CT. If typical imaging findings are identified, biopsy is not necessary. Benign notochordal cell tumor is a benign intraosseous lesion, demonstrates characteristic imaging features. The lesion demonstrates low‐signal intensity in T1‐weighted images, high‐signal intensity in T2‐weighted images,...
Source: Clinical Case Reports - November 24, 2017 Category: General Medicine Authors: Satoshi Tateda, Ko Hashimoto, Toshimi Aizawa, Haruo Kanno, Shin Hitachi, Eiji Itoi, Hiroshi Ozawa Tags: Case Report Source Type: research

Subcutaneous hematomas from prophylactic heparin use
Key Clinical Message Heparin is an anticoagulant, which is frequently used in hospitalized patients for prophylaxis of deep vein thrombosis (DVT). Subcutaneous administration of heparin may lead to complications such as bruising, hematoma, and pain at the injection site. Hematomas can develop without visible bruising, as in our case. Heparin is an anticoagulant, which is frequently used in hospitalized patients for prophylaxis of deep vein thrombosis (DVT). Subcutaneous administration of heparin may lead to complications such as bruising, hematoma, and pain at the injection site. Hematomas can develop without visible brui...
Source: Clinical Case Reports - November 24, 2017 Category: General Medicine Authors: Abhilash Koratala, Deepti Bhattacharya Tags: Clinical Image Source Type: research

Fulminant hemolysis in glucose ‐6‐phosphate dehydrogenase deficiency
Key Clinical Message Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is an X‐linked disorder affecting some 400 million people worldwide. Though clinically silent, it may result in hemolysis on oxidative stress induced by drugs or infections. Viral hepatitis A with coexisting G6PD deficiency can be devastating associated with severe hemolysis, anemia, renal failure, and hepatic encephalopathy. Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is an X‐linked disorder affecting some 400 million people worldwide. Though clinically silent, it may result in hemolysis on oxidative stress induced by drugs or in...
Source: Clinical Case Reports - November 24, 2017 Category: General Medicine Authors: Bushra Moiz, Sidra Asad Ali Tags: Clinical Image Source Type: research

Successful elimination of premature ventricular contractions by ablation of origin and preferential pathway
Key Clinical Message However, the common strategy for eliminating premature ventricular contractions (PVCs) is to explore the exit site and ablate, which may be difficult in some cases. The origin and the preferential pathway, an insulated pathway connected to the exit, may also become targets for eliminating PVCs. However, the common strategy for eliminating premature ventricular contractions (PVCs) is to explore the exit site and ablate, which may be difficult in some cases. The origin and the preferential pathway, an insulated pathway connected to the exit, may also become targets for eliminating PVCs. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 23, 2017 Category: General Medicine Authors: Kyoichiro Yazaki, Kenji Enta, Masahiro Watarai, Mitsuru Kahata, Asako Kumagai, Koji Inoue, Hiroshi Koganei, Masato Otsuka, Yasuhiro Ishii Tags: Case Report Source Type: research

Identification of a novel deletion within ALDH3A2 gene in an Iranian Family with Sj ögren–Larsson Syndrome
Key Clinical Message Sjögren–Larsson syndrome (SLS) is a rare type of congenital ichthyosis with neurological problems and intellectual disability. Homozygous mutations in ALDH3A2 gene are known to be responsible for this syndrome. Here, we report an Iranian family with congenital SLS bearing a novel two‐base‐pair deletion within ALDH3A2 genomic sequence. Our finding expands the mutation spectrum of ALDH3A2 that is applicable for further molecular studies and management of SLS. Sjögren–Larsson syndrome (SLS) is a rare type of congenital ichthyosis with neurological problems and intellectual disab...
Source: Clinical Case Reports - November 22, 2017 Category: General Medicine Authors: Maryam Taghdiri, Atie Kashef, Majid Fardaei, Mohammad Miryounesi Tags: Case Report Source Type: research

Functional plurihormonal adrenal oncocytoma: case report and literature review
We present a 27‐year‐old woman with an adrenal oncocytoma. This is a very rare entity. We provide a review of the clinical, biochemical and pathological features of cases reported in the literature. We present a 27‐year‐old woman with an adrenal oncocytoma. This is a very rare entity. We provide a review of the clinical, biochemical and pathological features of cases reported in the literature. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 22, 2017 Category: General Medicine Authors: Pablo Ren é Costanzo, Andrea Laura Paissan, Pablo Knoblovits Tags: Case Report Source Type: research

Liver injury secondary to chest tube placement: a case report of conservative management and review of literature
Key Clinical Message Chest tube placement is a routine procedure performed in different medical departments. Liver injury is a very rare complication that can occur but can be life‐threatening. Conservative management can be proposed in stable patient. Following guidelines and training physicians should decrease the incidence of such complications. Chest tube placement is a routine procedure performed in different medical departments. Liver injury is a very rare complication that can occur but can be life‐threatening. Conservative management can be proposed in stable patient. Following guidelines and training physicia...
Source: Clinical Case Reports - November 22, 2017 Category: General Medicine Authors: Badr Serji, Houda Mirali, Mohammed Chablou, Imane Kamaoui, Tijani El Harroudi Tags: Case Report Source Type: research

Co ‐occurrence of a novel PDGFRB variant and likely pathogenic variant in CASR in an individual with extensive intracranial calcifications and hypocalcaemia
Key Clinical Message This case report describes an individual with brain calcifications, cognitive decline, motor dysfunction, and hypocalcaemia. Exome sequencing revealed a previously reported variant in the CASR gene and a variant of uncertain significance in PDGFRB. The clinical phenotype is likely explained by the CASR variant, but we discuss how the PDGFRB variant could also participate in the phenotype. A novel case of brain calcifications with cognitive decline, motor dysfunction, and hypocalcaemia. Exome sequencing revealed a variant in the CASR gene and a variant in PDGFRB. The phenotype aligns closer to a CASR, ...
Source: Clinical Case Reports - November 20, 2017 Category: General Medicine Authors: Natasha N. DeMeo, Jeremy D. Burgess, Patrick R. Blackburn, Jennifer M. Gass, John Richter, Herjot K. Atwal, Jay A. Gerpen, Paldeep S. Atwal Tags: Case Report Source Type: research

Pancreatitis and myocarditis coexistence due to infection by Coxsackie B1 and B4 viruses
Key Clinical Message Myocarditis can be a rare late manifestation of acute pancreatitis caused by Coxsackie virus infection. Clinicians should be aware of potentially life‐threatening myocarditis because immediate recognition and management are the cornerstones in achieving a better outcome. Myocarditis can be a rare late manifestation of acute pancreatitis caused by Coxsackie virus infection. Clinicians should be aware of potentially life‐threatening myocarditis because immediate recognition and management are the cornerstones in achieving a better outcome. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 20, 2017 Category: General Medicine Authors: Konstantinos Lampropoulos, George Bazoukis, Athanasios Kolyviras, Gary Tse, Athanasios Saplaouras, Themistoklis Iliopoulos Tags: Case Report Source Type: research

Successful management of malignant carinal involvement by “side‐by‐side” method of self‐expandable metallic stents followed by chemotherapy
Key Clinical Message Bilateral self‐expandable metallic stents may be useful in the management of malignant carinal involvement and may improve the performance status of patients. This strategy may allow patients with poor performance status to receive additional chemotherapy. Bilateral self‐expandable metallic stents may be useful in the management of malignant carinal involvement and may improve the performance status of patients. This strategy may allow patients with poor performance status to receive additional chemotherapy. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 20, 2017 Category: General Medicine Authors: Takayuki Takeda, Hideki Itano, Mayumi Takeuchi, Masahiko Saitoh, Sorou Takeda Tags: Case Report Source Type: research

Neonatal diabetes mellitus: improved screening and early management of an underestimated disease
Key Clinical Message Neonatal diabetes mellitus is underdiagnosed in the neonatal period because of the metabolic adaptation capacities of the newborns. However, it is associated with increased risk of short‐ and long‐term morbidity; when transient it may recurs in adulthood. It is important to improve screening and early management with appropriate guidelines. Neonatal diabetes mellitus is underdiagnosed in the neonatal period because of the metabolic adaptation capacities of the newborns. However, it is associated with increased risk of short‐ and long‐term morbidity; when transient it may recurs in adulthood. I...
Source: Clinical Case Reports - November 20, 2017 Category: General Medicine Authors: Ma ëlle Wirth, Jean‐Marc Jellimann, Stéphanie Jellimann, Jean‐Michel Hascoët Tags: Case Report Source Type: research

Acute psychotic symptoms following a single dose of levofloxacin
The objective of our case report was to raise awareness of the neurotoxic potential of levofloxacin in naïve patients. In patients with severe infections and comorbidities, it would be difficult to discriminate the neurotoxic effects of levofloxacin from those of the medical condition itself. Thus, health professionals should be aware of the early onset CNS effects of levofloxacin in naïve patients. The objective of our case report was to raise awareness of the neurotoxic potential of levofloxacin in naïve patients. In patients with severe infections and comorbidities, it would be difficult to discriminate ...
Source: Clinical Case Reports - November 16, 2017 Category: General Medicine Authors: Larissa Takser, Roland Grad Tags: Case Report Source Type: research

Visceral leishmaniasis triggering an adult ‐onset Still's disease: a unique case
Key Clinical Message Adult‐onset Still's disease (AOSD) due to visceral leishmaniasis (VL) has not been previously reported. This case report analyzes a single episode of AOSD probably due to a visceral leishmaniasis successfully treated with pentamidine isethionate and prednisone. Adult‐onset Still's disease (AOSD) due to visceral leishmaniasis (VL) has not been previously reported. This case report analyzes a single episode of AOSD probably due to a visceral leishmaniasis successfully treated with pentamidine isethionate and prednisone. (Source: Clinical Case Reports)
Source: Clinical Case Reports - November 13, 2017 Category: General Medicine Authors: Silvia Spoto, Sebastiano Costantino, Emanuele Valeriani, Marta Fogolari, Eleonora Cella, Giordano Dicuonzo, Massimo Ciccozzi, Silvia Angeletti Tags: Case Report Source Type: research

Magnetic ‐guided catheter ablation of twin AV nodal reentrant tachycardia in a patient with left atrial isomerism, interrupted inferior vena cana, and Kawashima‐Fontan procedure
Key Clinical Message Twin AV nodal reentrant tachycardia most commonly occurs in patients with complex congenital heart disease who have two distinct AV nodes, His bundles, and non‐preexcited QRS morphologies. Catheter ablation of the weaker AV node may be hindered by anatomical complexities. In such cases, remote magnetic guidance offers a potentially effective solution. Twin AV nodal reentrant tachycardia most commonly occurs in patients with complex congenital heart disease who have two distinct AV nodes, His bundles, and non‐preexcited QRS morphologies. Catheter ablation of the weaker AV node may be hindered by an...
Source: Clinical Case Reports - November 13, 2017 Category: General Medicine Authors: Francis Bessi ère, François‐Pierre Mongeon, Judith Therrien, Paul Khairy Tags: Case Report Source Type: research

Hypoglycemia and severe lactic acidosis in a dog following metformin exposure
Key Clinical Message Hypoglycemia and lactic acidosis are rare complications with metformin use in humans. As metformin is not commonly used in veterinary medicine, severe adverse effects secondary to exposure are not known. Awareness of potentially life‐threatening complications with metformin exposure is an important addition to the veterinary literature. Hypoglycemia and lactic acidosis are rare complications with metformin use in humans. As metformin is not commonly used in veterinary medicine, severe adverse effects secondary to exposure are not known. Awareness of potentially life‐threatening complications with ...
Source: Clinical Case Reports - November 13, 2017 Category: General Medicine Authors: Nicole Barrella, Beth Eisenberg, Stephanie Nicole Simpson Tags: Case Report Source Type: research

Tumor lysis syndrome with massive hyperphosphatemia and hyperuricemia
Key Clinical Message Tumor lysis syndrome (TLS) occurs when tumor cells release their contents into the bloodstream, typically in response to chemotherapy, leading to the characteristic findings of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute kidney injury. Twinkle artifacts on renal ultrasound may indicate calcium phosphate deposits in such patients. Tumor lysis syndrome (TLS) occurs when tumor cells release their contents into the bloodstream, typically in response to chemotherapy, leading to the characteristic findings of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute...
Source: Clinical Case Reports - November 13, 2017 Category: General Medicine Authors: Abhilash Koratala Tags: Clinical Image Source Type: research

Prostate cancer infiltrating the bladder sphincter successfully treated with Electrochemotherapy: a case report
Key Clinical Message We demonstrate feasibility and safety of Electrochemotherapy for treatment of a prostate cancer (PCa) with infiltration of the urethral sphincter. The patient remained continent and potent, toxicity was low, and 6 months of follow‐up showed no cancer activity. We conclude that Electrochemotherapy should be further evaluated as treatment strategy for locally advanced PCa. We demonstrate feasibility and safety of Electrochemotherapy for treatment of a prostate cancer (PCa) with infiltration of the urethral sphincter. The patient remained continent and potent, toxicity was low, and 6 months of follow...
Source: Clinical Case Reports - November 13, 2017 Category: General Medicine Authors: Nina Klein, Enric Gunther, Stefan Zapf, Rachid El ‐Idrissi, Johannes Atta, Michael Stehling Tags: Case Report Source Type: research

Extra ‐pulmonary primary small‐cell neuroendocrine carcinoma arising from the duodenum: rare tumor, unusual location
Key Clinical Message Small‐cell neuroendocrine carcinoma is a high‐grade carcinoma rarely encountered in extra‐pulmonary sites. A 40‐year‐old lady presented with epigastric pain and was noted to have an ulcerated small‐cell neuroendocrine carcinoma in her duodenum with liver metastases. She underwent palliative chemotherapy but unfortunately passed away. Duodenal SCNC is an unusual malignancy with an aggressive phenotype. Small‐cell neuroendocrine carcinoma is a high‐grade carcinoma rarely encountered in extra‐pulmonary sites. A 40‐year‐old lady presented with epigastric pain and was noted to have an...
Source: Clinical Case Reports - November 13, 2017 Category: General Medicine Authors: Muhammad Awais Aamir, Shaheel Mohammad Sahebally, Hajnalka Gyorffy, Muyiwa Aremu Tags: Case Report Source Type: research

Change in bowel habit, abdominal pain, and a palpable abdominal mass in a 58 ‐year‐old female
Key Clinical Message Giant colonic diverticulum is a rare complication of diverticulosis, which may present in the acute or chronic setting. Colonic resection and en bloc resection of the diverticulum are the favored management, however, conservative treatment remains an option that could be considered in asymptomatic patients with minimal symptoms. Giant colonic diverticulum is a rare complication of diverticulosis, which may present in the acute or chronic setting. Colonic resection and en bloc resection of the diverticulum are the favored management, however, conservative treatment remains an option that could be consi...
Source: Clinical Case Reports - November 9, 2017 Category: General Medicine Authors: Julian Peacock, Zane Perkins Tags: Clinical Image Source Type: research

Issue Information
(Source: Clinical Case Reports)
Source: Clinical Case Reports - November 8, 2017 Category: General Medicine Tags: Issue Information Source Type: research