Journal profile
Global Journal of Medical Case Reports(GJMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialties comprising a comprehensive resource for physicians in all fields and at all stages of training.
Latest Articles
Propranolol induced Raynaud phenomenon and facial edema in a patient with Hyperthyroidism: A case report
Abstract
Background: Propranolol is a non-cardio-selective beta-blocker, commonly used in patients with hyperthyroidism to treat the hyperadrenergic symptoms but also for its additional effect of blocking the peripheral conversion of inactive T4 to active T3. However, propranolol has many side effects, one of them being secondary Raynaud phenomenon. Case presentation: S.K.,
[...] Read more.
Background: Propranolol is a non-cardio-selective beta-blocker, commonly used in patients with hyperthyroidism to treat the hyperadrenergic symptoms but also for its additional effect of blocking the peripheral conversion of inactive T4 to active T3. However, propranolol has many side effects, one of them being secondary Raynaud phenomenon. Case presentation: S.K., 55 years old was hospitalized in the Endocrinology Department as an untreated hyperfunctioning goiter with typical clinical manifestations such as fatigue, anxiety, palpitations, heat intolerance, difficulties in swallowing and breathing. Unimazole 5 mg (2-2-2 tb) and Propranolol 40 mg (¼ -0- ¼ tb) were prescribed. Thirty minutes after taking Propranolol (the dose 40 mg), she had difficulties breathing, was agitated, sweating and had nausea. Her face was hyperemic and edematous and her extremities were getting blue and cold. Her vitals remained stable and her airways were opened, as evaluated from laryngoscopy and CT-scan of the neck. 8 hours later, her clinical manifestations got worse: her facial edema spread in her lips and submandibular region. On both cases, she clinically improved after prednisolone administration. 12 hours after taking propranolol, she showed no more signs of cyanosis or edema. Propranolol was replaced by Nebivolol, with no side effects. Conclusion: Secondary Raynaud phenomenon is a common side effect of beta-blockers and should be taken in consideration in very patient presenting with cold and cyanotic peripherals. In these cases, propranolol should be stopped and replaced. Further studies on beta-blockers side effects in patients with hyperthyroidism should be made.Full article
Figures
Case Report
Electrocution Cervical Myelopathy Presenting with Partial Brown Sequard Syndrome: A Case Report and Review of Literature
Abstract
Background: Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. Aims and objectives: This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. Case report: We report the case of
[...] Read more.
Background: Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. Aims and objectives: This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. Case report: We report the case of a 54-year-old housewife who presented with transient loss of consciousness and right sided hemiparesis following electrocution, while at home. Results: The patient met clinical critera for partial Brown- Sequard syndrome, which to our knowledge, has not been previously reported. She showed significant improvement over a month and is currently under monitoring. Conclusions: Electrical injury is a rare cause of normal MRI myelopathy and the potential for immediate, delayed, and long- term neurological disability.Full article
Figures
Case Report
Case Report: Unmasking Meigs’ Syndrome and the resolution of persistent Ascites after Oophorectomy in an 18-year-old Female at Cleveland Specialized Clinic Wampewo
Abstract
Introduction: Meigs’ Syndrome, characterized by a benign ovarian tumor that leads to ascites and occasionally pleural effusion, is a rare condition that often presents significant diagnostic challenges, particularly in young female patients. This case report highlights an 18-year-old-female with persistent gross ascites and pleural effusion unresponsive to diuretics, paracentesis, and
[...] Read more.
Introduction: Meigs’ Syndrome, characterized by a benign ovarian tumor that leads to ascites and occasionally pleural effusion, is a rare condition that often presents significant diagnostic challenges, particularly in young female patients. This case report highlights an 18-year-old-female with persistent gross ascites and pleural effusion unresponsive to diuretics, paracentesis, and thoracentesis. Despite extensive diagnostics evaluations including negative results from several tumor makers, histology and pathology reports, Liver and renal function tests, abdominal CT scans, ECHO, Ecg, Chest X-rays and HBV screening PCR test, the underlying causes of the ascites and pleural effusion remained elusive. The diagnosis was only made following an exploratory laparotomy, which revealed the presence of bilateral benign ovarian tumors. Subsequent bilateral Oophorectomy and Salpingectomy resulted in the complete resolution of the ascites. This case underscores not only the importance of considering ovarian pathology in young females with unexplained ascites but also highlights the critical role of exploratory laparotomy when non-invasive diagnostics fails to provide answers. Conclusion: This case emphasizes the need for a high index of suspicious for Meigs’ Syndrome in young females presenting with persistent ascites and pleural effusion, even when standard diagnostic tests yield negative results. It highlights the potential necessity of surgical intervention when other diagnostic approaches fail to identify the underlying causes. Clinicians should be aware of this condition and consider it in their differential diagnosis to ensure appropriate and effective managementFull article
Figures
Case Report
A severe scrub typhus case with erythema multiforme caused by Orientia tsutsugamushi
Abstract
Scrub typhus is a common disease caused by Orientia tsutsugamushi in the tropical/ temperate zone. It usually shows the skin lesions, including eschar, but erythema multiforme is rare.
[...] Read more.
Scrub typhus is a common disease caused by Orientia tsutsugamushi in the tropical/ temperate zone. It usually shows the skin lesions, including eschar, but erythema multiforme is rare.Full article
Figures
Commentary
A Case of Early Initiation of Veno-venous Extracorporeal Membrane Oxygen in Morbid Obesity with Severe Legionella Pneumonia
Abstract
We present a case of a critically ill patient with severe Legionella pneumonia complicated by morbid obesity (BMI ≥ 40 kg/m2) who was successfully treated with early initiation of veno-venous ECMO (V-V-ECMO) without any sequelae. The patient, a 48-year-old male, initially presented with symptoms of a sore throat, fever, significant
[...] Read more.
We present a case of a critically ill patient with severe Legionella pneumonia complicated by morbid obesity (BMI ≥ 40 kg/m2) who was successfully treated with early initiation of veno-venous ECMO (V-V-ECMO) without any sequelae. The patient, a 48-year-old male, initially presented with symptoms of a sore throat, fever, significant fatigue, and decreased appetite. Upon diagnosis of severe pneumonia complicated by morbid obesity, he was transferred to our hospital for further management. Upon admission, he was promptly intubated and placed on mechanical ventilation. Due to a positive urinary Legionella antigen test indicating a risk of deterioration, V-V ECMO was initiated immediately after intubation. During ECMO support, the patient received Levofloxacin Hydrate at 500 mg/day and Prednisolone Sodium Succinate at 100 mg/day. He was successfully weaned off ECMO after 12 days and transferred back to the referring hospital on day 20. While ECMO therapy for morbidly obese patients was traditionally considered relatively contraindicated, this case suggest that obesity alone is not a contraindication to initiating ECMO.Full article
Figures
Case Report
Inflammatory Bowel Disease associated with Intestinal Malrotation
Abstract
Intestinal malrotation is an embryological abnormality modifying the classic anatomy of the small and large bowels, particularly the topographical one. Inflammatory bowel disease (IBD) is characterised by anatomical lesions with preferential intestinal tropism. These two conditions are rarely associated. They represent a real diagnostic and therapeutic challenge due to the
[...] Read more.
Intestinal malrotation is an embryological abnormality modifying the classic anatomy of the small and large bowels, particularly the topographical one. Inflammatory bowel disease (IBD) is characterised by anatomical lesions with preferential intestinal tropism. These two conditions are rarely associated. They represent a real diagnostic and therapeutic challenge due to the overlap of non-specific symptoms and the complexity of the clinical management. We report the case of a young woman presenting with a flare-up of her IBD and a partial common mesentery syndrome. Clinicians should be aware of the potential pitfalls of the two entities to propose the adequate therapeutic strategy regarding the full understanding of the anatomy, notably when surgery is needed.Full article
Figures
Case Report
Off-Label Use of Esketamine
Abstract
Major depressive disorder (MDD) is a significant psychiatric condition, with many affected individuals not gaining remission from conventional treatments, leading to classification as treatment-resistant depression (TRD). This study aimed to investigate the potential of intravenous (IV) ketamine, particularly the S-enantiomer esketamine in nasal spray form, for treating patients with TRD
[...] Read more.
Major depressive disorder (MDD) is a significant psychiatric condition, with many affected individuals not gaining remission from conventional treatments, leading to classification as treatment-resistant depression (TRD). This study aimed to investigate the potential of intravenous (IV) ketamine, particularly the S-enantiomer esketamine in nasal spray form, for treating patients with TRD and associated comorbidities. We report three cases of patients with diverse psychiatric and medical backgrounds whom all reported significant symptomatic relief from depressive episodes and suicidal ideation (SI) following esketamine administration. Additionally, esketamine seemed to proffer benefits beyond the primary depressive symptoms, positively impacting other comorbid conditions, such as agitation, self-injurious behavior (SIB), and chronic pain. The goal of this paper is to highlight that while esketamine's primary utility is in addressing TRD, its therapeutic potential may extend to a variety of associated conditions. However, it is crucial to underscore the heterogeneity of MDD, emphasizing the necessity for individualized therapeutic approaches and further research into esketamine's broader applications.Full article
Case Series
A Report of Three Cases with Moderate Psoriasis Treated with New Topical Treatment
Abstract
Practice guidelines recommend fixed combinations of calcipotriol, a topical vitamin D analogue, and betamethasone dipropionate, a high potency corticosteroid, as first line topical treatment for mild to moderate plaque psoriasis of the body and scalp. A new foaming lotion for treatment of Psoriasis was developed and patented by the Spanish
[...] Read more.
Practice guidelines recommend fixed combinations of calcipotriol, a topical vitamin D analogue, and betamethasone dipropionate, a high potency corticosteroid, as first line topical treatment for mild to moderate plaque psoriasis of the body and scalp. A new foaming lotion for treatment of Psoriasis was developed and patented by the Spanish Ministry of Industry, Trade and Tourism (Invention patent reference number 202030824). The foaming lotion is composed of clobetasol, papaverine hydrochloride, spironolactone, milk-peptide-complex and propylene glycol. Three cases with moderate Psoriasis aged 34, 36 and 66 years old were treated with our new foaming lotion for 7-8 days. The three patients reported important improvement in the itching sensations and remission of the scaled lesions. Before and after application of the new foaming lotion, Psoriasis Area Severity Index (PASI) scores improved in the first patient from 24.3 to 1.8, in the second patient from 26.1 to 1.8, and in the third patient from 27 to 1.8. Our results show the short-term effectiveness of the new foaming lotion in treating moderate and extensive Psoriasis. Long follow-up is needed to evaluate the remission period of Psoriasis and possible side effects of the new topical treatment.Full article
Figures
Case Report
Anaphylaxis and Cardiogenic Pulmonary Edema due to Non ST Elevation Myocardial Infarction NSTEMI: A Case Report
Abstract
Anaphylaxis can be associated with hemodynamic shock, which requires the early initiation of adrenaline as part of its management. Cardiogenic pulmonary edema is a frequent entity in emergency services with increased mortality in patients with acute coronary syndrome. The case report presents the case of a 55-year-old male patient who
[...] Read more.
Anaphylaxis can be associated with hemodynamic shock, which requires the early initiation of adrenaline as part of its management. Cardiogenic pulmonary edema is a frequent entity in emergency services with increased mortality in patients with acute coronary syndrome. The case report presents the case of a 55-year-old male patient who entered the emergency department with a non-ST-segment elevation myocardial infarction (NSTEMI) associated to pulmonary edema and anaphylaxis. During his stay in the emergency room, he had an anaphylactic reaction to dipyrone (metamizole) used for pain control. The patient presented signs of acute pulmonary edema, a hypertensive urgency after the use of adrenaline for the management of anaphylaxis. There was doubt as to whether the dyspnea was of anaphylactic or cardiogenic origin, so an emergency ultrasound was performed, which suggested a bilateral pattern B. This allowed timely management of ventilatory failure with systemic nitrates, diuretics, and oxygen therapy, which controlled blood pressure and resolved ventilatory failure. Subsequently, he was transferred to an institution with a hemodynamic service for the management of NSTEMI. We highlight the utility of emergency ultrasonography for immediate decision-making and the low prevalence of anaphylactic reaction in a patient with NSTEMI leading to acute pulmonary edema.Full article
Figures
Case Report
Treatment by Ceftolozane/Tazobactam for Pseudomonas Aeruginosa Pneumonia Patients with or without Bacteremia
Abstract
Background: Pseudomonas aeruginosa (P. aeruginosa) is one of the most common pathogens in hospital-acquired pneumonia (HAP) including ventilator-associated pneumonia (VAP). Recently, ceftolozane/tazobactam (CTLZ/TAZ) has been used to treat pneumonia due to P. aeruginosa. Case series: Two cases of P. aeruginosa pneumonia treated by CTLZ/TAZ that had been initially treated by
[...] Read more.
Background: Pseudomonas aeruginosa (P. aeruginosa) is one of the most common pathogens in hospital-acquired pneumonia (HAP) including ventilator-associated pneumonia (VAP). Recently, ceftolozane/tazobactam (CTLZ/TAZ) has been used to treat pneumonia due to P. aeruginosa. Case series: Two cases of P. aeruginosa pneumonia treated by CTLZ/TAZ that had been initially treated by piperacillin/tazobactam (PIPC/TAZ) are presented. (Case 1): A 76-year-old man who underwent esophagectomy developed severe pneumonia caused by P. aeruginosa infection and received oxygen by high-flow nasal canula. PIPC/TAZ was started, and he improved 10 days later. PIPC/TAZ was switched to sulbactam/ampicillin, but on day 14, his respiratory condition worsened, and septic shock developed. P. aeruginosa was isolated from his blood, and CTLZ/TAZ was started because the isolated P. aeruginosa showed resistance to PIPC/TAZ. Although he recovered on Day 28, and CTLZ/TAZ was switched to levofloxacin, his condition worsened again, and P. aeruginosa resistant to CTLZ/TAZ was isolated from his blood on day 32. Finally, he died of septicemia and renal failure. (Case 2) A 51-year-old woman who underwent surgery for a brain tumor developed VAP due to P. aeruginosa and was treated by PIPC/TAZ. Her pneumonia improved, but pneumothorax developed, and she was therefore switched to CTLZ/TAZ on day 7. Her pneumonia improved smoothly without bacteremia 10 days later. Conclusions: These data and cases suggest that CTLZ/TAZ was effective for severe P. aeruginosa pneumonia although the isolated P. aeruginosa was resistant to PIPC/TAZ. However, the duration of CTLZ/TAZ administration may need to be considered for pneumonia cases with bacteremia due to P. aeruginosa.Full article
Figures
Case Series
Views of
Downloads of
Citations of
ISSN: 2770-8691
DOI prefix: 10.31586/gjmcr
Journal metrics
Publication year
2021-2025
Journal (home page) visits
40625
Article views
26666
Article downloads
13150
Downloads/article
547.92
APC
99.00