European Journal of Case Reports in Internal Medicine

Lymphatic filariasis, an endemic disease.

2020-08-12T19:17:43+00:00

Filariasis is the most common cause of lymphedema in endemic countries. It is caused by parasites transmitted through mosquito bites. Elephantiasis is a late manifestation of lymphatic filariasis.

We present the case of a 25-year old male with elephantiasis. Because the patient was from an endemic area, a diagnosis of chronic filariasis was made from clinical history and examination.

Filariasis management includes use of antifilarial drugs in early stages, treatment and prevention of acute attacks (dermatolymphangioadenitis) through 'limb-hygiene' and antibiotics and where indicated, and physical measures to reduce the swelling.

COVID-19 Precipitating Euglycemic Diabetic Ketoacidosis with SGLT2 Inhibitor Use

2020-08-12T06:02:23+00:00

Objective

To describe a patient who developed euglycemic DKA in the setting of SGLT2 inhibitor precipitated by COVID-19 infection

Patients and Methods

A 52-year-old male with type II diabetes on empagliflozin and no history of DKA presents with symptoms of COVID-19 as well as lab findings consistent with euglycemic DKA. His hospital course was complicated by recurrent episodes of euglycemic DKA as well as hyperglycemic DKA.

Conclusion

SGLT2 inhibitors should be held as early as possible during COVID-19 infection due to risk of euglycemic DKA. These patients should also have more intense glucose monitoring.

Mondor’s disease: a rare diagnosis.

2020-08-11T17:30:09+00:00

Mondor’s disease is a rare and self-limited disease, often underdiagnosed. is characterized by superficial thrombophlebitis of the subcutaneous veins of the thoracoabdominal wall.

We present a case of a 38-year-old woman who presented with a tender and red mass in the thoracic wall. A diagnosis of Mondor’s disease was made based on the history and clinical findings.

It is often idiopathic, but it can be secondary to trauma and breast surgery or cancer. Treatment is based in relieving symptoms.

Invasive Pulmonary Aspergillosis in an Immunocompetent Patient.

2020-08-10T11:09:02+00:00

Invasive Pulmonary Aspergillosis (IPA) is an opportunistic infection that usually threatens immunocompromised patients. However, there are some reports of IPA in immunocompetent patients without classic risk factors. We present the case of an 82-year-old woman with a prior medical history of chronic obstructive pulmonary disease (COPD) and a recent short-term corticosteroids regimen for an acute exacerbation. She was admitted with dyspnoea, cough and pleuritic pain and was diagnosed with pneumonia. Clinical deterioration occurred and a diagnosis of IPA was made. She received treatment with voriconazole but died 14 days after admission. This case highlights the importance of considering IPA among the possible causes of infection in this population. Prompt institution of appropriate antifungal therapy is paramount for the management of this condition.

COVID Blindness: Delayed Diagnosis of Aseptic Meningitis in the Era of the COVID-19 Pandemic

2020-08-10T05:20:11+00:00

Diagnostic errors are a severe problem in healthcare. The COVID-19 pandemic can cause healthcare workers to make their usually accurate decisions incorrectly, and the diagnostic process can be highly susceptible to cognitive bias. We report a case of aseptic meningitis that required five visits to be correctly diagnosed. This case highlights the risk of anchoring bias and the importance of reflecting our diagnostic process during the COVID-19 pandemic.

Cutaneous angiosarcoma in an unusual location and without predisposing factors: a case report

2020-08-08T08:47:09+00:00

Cutaneous angiosarcoma is a rare, highly malignant tumor of vascular endothelial origin. Usually arise in skin and superficial soft tissue, most on head and neck. It presents as a variety of lesions, considered the great mimicker, leading to a delay in diagnosis and evidencing the importance of biopsy with immunohistochemistry confirmation. There are few reports of extremities involvement in patients with pre-existing chronic lymphedema, or exposure to radiation therapy. We report a case of an 82-year-old woman with lower limb extensive cutaneous involvement, distant metastatic disease, and poor therapy response. Its rare location without predisposing factors highlights the need to raise awareness about this disease.

Late worsening of COVID-19 pneumonia: successful treatment with ruxolitinib and steroid

2020-08-07T23:17:59+00:00

We describe the case of a patient hospitalized for the second time in a month due to delayed worsening of lung lesions in COVID-19 infection without bacterial superinfection. He was treated with hydroxycloroquine, iv steroid and ruxolitinib with rapid improvement of respiratory failure; one month after second discharge, mantaining low-dose oral prednisone, lung consolidations were significantly reduced at CT control.

Fondaparinux-associated Thrombocytopenia: A Case Report

2020-08-07T18:52:26+00:00

Heparin-induced thrombocytopenia (HIT) is an immune-mediated condition causing thrombocytopenia and paradoxical thrombosis after exposure to heparin or low-molecular-weight heparin. It has been rarely reported by fondaparinux, an artificial pentasaccharide similar to heparin. This article presents a case of HIT associated with fondaparinux use.

Cryptococcal necrotizing pneumonia with ARDS in a non-HIV patient

2020-08-05T14:41:04+00:00

We report the first description of an association between cryptococcal pneumonia and severe ARDS. A twenty years old woman treated in hematology for a T/NK lymphoma was admitted in intensive care unit for acute respiratory distress syndrome. After initial improvement, a CT scan performed after secondary deterioration revealed a necrotizing pneumonia. A bronchoaspirate was positive for Cryptococcus neoformans var neoformans. Despite specific treatment, hypoxemia worsened requiring vv ECMO. The patient died one month later with necrotizing Cryptococcus pneumonia complicated with refractory ARDS, without other etiology of pneumonia.

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Sinonasal chondrosarcoma, an unusual location

2020-08-05T00:54:14+00:00

Abstract

Introduction

Chondrosarcoma is a tumor with a cartilaginous matrix frequently encountered in long bones and the pelvis with rare sinonasal location.

Patient and Methods

We report the case of a 25-year-old patient who was referred to us for an extension workup for sinonasal chondrosarcoma confirmed by anatomopathological examination.

Results

Facial magnetic resonance imaging (MRI) completed by CT scan noted an osteolytic tumor process of the hard palate and walls maxillary left sinus locally advanced.

Conclusion

The sinonasal location of a chondrosarcoma is rare. Characterized by cross-sectional imaging, its confirmation is histological