BMJ Case Reports

Journal Information
ISSN / EISSN : 1757-790X / 1757-790X
Published by: BMJ (10.1136)
Total articles ≅ 25,504
Current Coverage
SCOPUS
LOCKSS
MEDICUS
MEDLINE
PUBMED
PMC
ESCI
Archived in
SHERPA/ROMEO
Filter:

Latest articles in this journal

Emilie Anderssen-Nordahl, , Manel Perelló Carrascosa, Alicia Gómez Muñoz
Published: 25 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-244581

Abstract:
Sulfonamides have been related to drug-induced acute angle closure of the eye, but scarce reports exist concerning furosemide. We describe the second case of acute chamber narrowing (ACN) during furosemide exposure. A 65-year-old man with a renal transplant presented with ACN, after 3 months of furosemide intake. Finally, the patient required a bilateral iridotomy and right lens replacement. ACN has been associated with drugs containing sulfonamide derivatives, but an evaluation with pharmacovigilance scales for adverse drug reaction (ADR)-standardised causality assessment has not been provided. We use this case to illustrate how medicines and an ADR should be evaluated and reported. The spreading of pharmacovigilance information on what should be a rare and unexpected condition related to a drug could mean that other reports emerge about ADR with this drug and regulatory agencies perform consequently, as happened with topiramate.
Clara Cunha, Sara Donato, , Valeriano Leite
Published: 25 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-246742

Abstract:
Recurrence of Cushing’s syndrome due to functional metastasis from adrenocortical carcinoma (ACC) after adrenalectomy is extremely rare. We describe a case of a 56-year-old woman who presented with Cushing’s syndrome due to an ACC. Abdominal CT showed a heterogeneous left adrenal tumour of 8 cm as well as a right adrenal nodule with 3 cm. An 18F-fluorodeoxyglucose positron emission tomography-CT (18F-FDG/CT PET) revealed an increased uptake of both adrenal lesions (maximum standardised uptake values, 17.7 and 10.4 for left and right adrenal lesions, respectively). Patient underwent bilateral adrenalectomy with R0 resection. Pathological examination revealed a left ACC with a Weiss’ score of 7, Ki67 10%, stage II European Network for the Study of Adrenal Tumours and a right adrenal adenoma. After surgery, clinical improvement was noted. Two months later, she noticed recurrence of hypercortisolism and multiple liver and lung metastasis were demonstrable, without evidence of local recurrence on the 18F-FDG/CT PET and abdominal MRI.
, , Yash Paul Sharma, Neha Handa
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-243768

Abstract:
COVID 19, caused by SARS-CoV-2, is a highly infectious disease, mainly affects the respiratory system. In this article, we have presented a case of COVID-19, who presented solely with pericarditis without myocarditis, without any respiratory symptoms. The diagnosis was made based on clinical, electrocardiographic, radiological and biological findings. He was treated successfully with aspirin and colchicine. Our case highlights an atypical presentation of COVID-19, which should be kept in mind in the present pandemic and to diagnose and isolate early to limit the spread of infection.
Ashwini Sankhe, Pareekshith Rai
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-246888

Abstract:
A 23-year-old male presented with complaints of gradually increasing swelling of the left hemiscrotum. Preliminary ultrasound scan revealed a heterogeneous, predominantly solid lesion showing raised internal vascularity with few cystic areas in the paratesticular region, towards the midline with both testes seen separately from the lesion. To rule out presence of locoregional or distant metastases, a CT scan was done which revealed a well-defined, intrascotal, extratesticular, heterogeneous, moderately enhancing mass lesion with cystic areas in the scrotal sac with no significant lymphadenopathy or obvious distant metastasis. Subsequent MRI done for surgical planning revealed a heterogeneous signal intensity lesion with cystic areas and areas of haemorrhage with focal loss of fat planes with the left corpora cavernosa at the root of the penis. The patient underwent an inguinoscrotal exploration with excision of the left paratesticular mass. Final histopathology suggested an undifferentiated high grade pleomorphic sarcoma. Paratesticular tumours while rare are an important cause of scrotal swelling. Exact histological identification of tumour subtype is not possible based on imaging but preoperative multi-modality imaging has an important role in identifying tissue of origin, differentiating benign from malignant lesions, surgical planning and assessing the need for adjuvant CT/RT.
Joseph Roscamp, Sabapathy Balasubramanian,
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-243942

Abstract:
A newborn girl presenting with respiratory distress soon after birth was found to have a neck mass and required transfer to a paediatric intensive care unit with neonatal expertise. She subsequently underwent endoscopic airway assessment with microlaryngoscopy and bronchoscopy proceeding to open excision of the lesion in the right thyroid lobe on day thirteen of life, resulting in resolution of airway compromise and complete pathological clearance. The baby was discharged 10 days after surgery. Histology confirmed a thyroid teratoma. At 12 months, the child was thriving with no evidence of recurrence. This case illustrates a rare but serious diagnosis that, if not managed in a timely manner, can lead to significant morbidity and mortality.
, Mohan M Kumar
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-246039

Abstract:
Synovial chondromatosis is a rare, benign condition occurring due to metaplasia of synovium. A 65-year-old woman presented with pain in her right hip for 6 years. On examination, a swelling was palpable at the base of scarpa’s triangle and her right hip movements were restricted. Imaging modalities showed ossified nodules in the antero-inferior aspect of the hip joint, joint effusion and arthritic changes. We diagnosed the patient to have synovial chondromatosis with secondary arthritis of the hip joint. We performed a total hip arthroplasty with simultaneous synovectomy and extraction of the osteochondral loose bodies, 5 of which were about 2×2 cm in size. We found that excessive acetabular reaming was required due to craters, the osteochondral masses formed on the acetabular surface. Histopathological analysis confirmed the diagnosis. The patient had an excellent functional outcome and no recurrence 5 years following the surgery.
, Renato D'Onofrio, Mauro Branchini, Luigi Lovato
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-248468

Abstract:
The scrotal US scan showed a thickened and inhomogeneous, hypoechoic left epididymis (figure 1A) with normal vascularisation at Doppler imaging (figure 1B), findings consistent with ejaculatory duct obstruction. Both testicles were normal for size, echotexture and vascularisation; no significant hydrocele or varicocele was found; scrotal walls were normal. The additional use of a convex probe showed a left periprostatic cyst-like structure.
, Rambha Rai, , Anette Sundfor Jacobsen
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-246955

Abstract:
We present a rare case of Klinefelter syndrome who presented with perinatal ascites, unilateral renal agenesis and a prostatic utricle cyst. The patient was born at term via emergency Caesarean section with gross abdominal distension. Antenatally, amniocentesis revealed a fetal karyotype of Klinefelter syndrome (47, XXY), and the 34-week ultrasound scan showed a cyst measuring 17×21×27 mm located inferior–posterior to the bladder. There was no ascites noted then, but a small left pelvic kidney was present. Ultrasound kidney, ureter and bladder as well as CT scan of the thorax, abdomen and pelvis done at birth showed a solitary right kidney with large-volume ascites and no evidence of a cyst adjacent to the bladder. These findings suggest urinary ascites from an involuting left renal system or a ruptured prostatic utricle cyst. We report the first case of Klinefelter syndrome associated with a prostatic utricle cyst and unilateral renal agenesis, presenting with neonatal ascites.
Genesis Perez Del Nogal, Andres Mata, Prince Ernest, Ivania Salinas
Published: 21 January 2022
by BMJ
BMJ Case Reports, Volume 15; https://doi.org/10.1136/bcr-2021-247617

Abstract:
Disseminated histoplasmosis is usually associated with immunosuppressive conditions like AIDS. People with respiratory distress syndrome secondary to SARS-CoV-2 pneumonia are vulnerable to bacterial infections. Additionally, coinfection with fungal pathogens should be considered as a differential diagnosis even in immunocompetent patients who remain on mechanical ventilation secondary to COVID-19. The case presents a 61-year-old immunocompetent man, admitted to the medical ward due to COVID-19 pneumonia. Despite appropriate therapy, the patient required transfer to the intensive care unit for invasive mechanical ventilation. He remained critically ill with worsening respiratory failure. Two weeks later, coinfection by disseminated histoplasmosis was detected. After immediate treatment with amphotericin B and itraconazole, the patient tolerated weaning from mechanical ventilation until extubation. Awareness of this possible fungal coinfection in immunocompetent patients is essential to reduce delays in diagnosis and treatment, and prevent severe illness and death.
Back to Top Top