ABSTRACT
Spontaneous renal artery dissection without aortic dissection in normotensive patients is rarely reported. Spontaneous renal artery dissection is also an uncommon cause of renal infarction that occurs, though rarely, in patients with hypercoagulable states such as protein C and S deficiency. We report here a case of spontaneous renal artery dissection and renal infarction associated with protein C and S deficiency.
Subject(s)
Humans , Infarction , Protein C , Protein C Deficiency , Protein S Deficiency , Renal ArteryABSTRACT
A 35-year-old man with known coccidioidal meningitis developed a severe headache and vomiting during routine treatment. Hydrocephalus was visible on brain imaging, and CSF study revealed pleocytosis, lowering of glucose, and increased intracranial pressure. Dexamethasone and mannitol was used for intracranial pressure control. Intrathecal amphotericin B administration and switching to itraconazole resulted in gradual improvement of symptoms. After 4 months of discontinuing amphotericin B intrathecal administration, the patient developed severe headaches with vomiting, diplopia and tandem gait. Coccidioidal meningitis aggravation was suspected based on brain MRI and CSF studies. Ventriculo-peritoneal shunt insertion was performed for intracranial pressure control and the combined therapy of intrathecal amphotericin B administration and fluconazole was maintained. This combined regimen kept the meningitis stable for 1 month.
Subject(s)
Adult , Humans , Amphotericin B , Brain , Coccidioidomycosis , Dexamethasone , Diplopia , Fluconazole , Gait , Glucose , Headache , Hydrocephalus , Intracranial Pressure , Itraconazole , Leukocytosis , Mannitol , Meningitis , Neuroimaging , Ventriculoperitoneal Shunt , VomitingABSTRACT
The genus Alternaria contains several species of melanized hypomycetes that cause opportunistic human infections. The most frequent clinical manifestations of alternariosis are cutaneous and subcutaneous infections, followed by oculomycosis, invasive and non-invasive rhinosinusitis, and onychomycosis. So far, only 17 cases of rhinosinusitis caused by Alternaria species have been reported since 1977. Although several domestic cases of cutaneous alternariosis have been reported, there is no report of Alternaria rhinosinusitis in Korea. The majority of Alternaria rhinosinusitis involves immunocompromised patients. We report the first case of alternariosis in a patient with neutropenia and myelodysplastic syndrome that was treated with endoscopic debridement and a conventional antifungal agent.
Subject(s)
Humans , Alternaria , Alternariosis , Debridement , Eye Infections, Fungal , Immunocompromised Host , Korea , Myelodysplastic Syndromes , Neutropenia , Onychomycosis , SinusitisABSTRACT
Cough syncope is characterized by the loss of consciousness occurring after vigorous coughings. There are approximately 90 reported cases of cough syncope within the medical literature. Most cases involving middle aged, overweight and chronic bronchitic male smokers. Although many studies have been published in the medical literature, the mechanism and pathophysiology for cough syncope has not been well established. Cough syncope is treated by correcting the underlying cause when identified, or by avoiding conditions that may cause the cough syncope. In addition, cough suppression modalities can also be used. We herein report 3 cases of cough syncope presenting in lung cancer patients.
Subject(s)
Humans , Male , Middle Aged , Cough , Lung , Lung Neoplasms , Overweight , Syncope , UnconsciousnessABSTRACT
Plasma cell myelomas generally manifest as bone or soft-tissue tumors with variable mass effects, pain, and infiltrative behavior. Extramedullary involvement occurs most commonly in the spleen, liver, lymph nodes, and kidneys, but intracranial involvement in plasma cell myeloma is a rare extramedullary manifestation. These authors recently encountered a case of intracranial involvement of plasma cell myeloma. A 69-year-old man was hospitalized for headache and mental changes. Brain CT showed subdural hemorrhage caused by plasma cell myeloma. Plasma cell myeloma with intracranial involvement has poor prognosis, and the patient in this case died from acute complications, such as subdural hemorrhage. Based on this case report, it is suggested that more effective treatment regimens of plasma cell myeloma with intracranial involvement be developed. Moreover, a screening method and decision on the appropriate time for intracranial involvement are needed for plasma cell myeloma patients.