Global Journal of Medical Case Reports - September 08, 2025
A man in his 60s with multiple vascular comorbidities presented with sudden, painless vision loss in one eye. Although he had a high risk for atherosclerotic events, initial evaluation for stroke was negative for acute ischemia, but found to have markedly elevated inflammatory markers. Accordingly, giant cell arteritis was investigated and Ophthalmologic findings and fulfillment of the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria supported the diagnosis of giant cell arteritis, despite a negative temporal artery biopsy. Management included high-dose glucocorticoids and delayed tocilizumab initiation due to the need for multiple vascular surgeries. Vision loss was irreversible, but systemic symptoms resolved and vascular interventions were successful. This case highlights the diagnostic and management complexities of biopsy-negative giant cell arteritis in patients with severe atherosclerotic vascular disease, emphasizing the importance of clinical judgment and established classification criteria when imaging and biopsy results are inconclusive.
Global Journal of Medical Case Reports - July 23, 2025
Lemierre’s syndrome (LS) is a rare clinical condition characterized by septic thrombophlebitis of the internal or external jugular vein, usually following an oropharyngeal infection. Here, we present a 20-year-old male patient who developed diarrhea, nausea, and vomiting after receiving clarithromycin for an upper respiratory tract infection. On admission, he had fever, hypotension, and elevation in acute phase reactants (WBC: 20,410/µL, CRP: 197 mg/L). Empirical treatment with ceftriaxone and metronidazole was initiated. Stool and throat cultures were negative. On the second day, abdominal tenderness developed; direct abdominal radiograph showed dilated bowel loops, but toxic megacolon was excluded during follow-up. Thoracic CT revealed septic emboli in the lungs. Due to persistent fever despite ceftriaxone and metronidazole therapy, treatment was escalated to meropenem on the fifth day. On the same day, blood cultures grew <i>Fusobacterium </i><i>necrophorum</i>, raising suspicion of LS. Doppler ultrasound detected a thrombus in the left external jugular vein. Anticoagulant therapy with low-molecular-weight heparin and clopidogrel was initiated. The fever resolved by the seventh day of full antibiotherapy After three weeks of intravenous therapy, follow-up imaging showed regression of the thrombus. The patient completed a four-week course of antibiotics and anticoagulants and was discharged with full recovery. This case highlights the diagnostic challenge of LS presenting with gastrointestinal symptoms and emphasizes the importance of early blood cultures and imaging. External jugular vein involvement due to F. <i>necrophorum</i> is rare and should be considered in patients presenting with septic emboli.
Global Journal of Medical Case Reports - July 11, 2025
Nodal marginal zone lymphomas are indolent and rare non-Hodgkin lymphomas, most often diagnosed at an advanced stage. Their clinical presentations are typically insidious, which can lead to delayed diagnosis. The concomitant secretion of IgM and IgG immunoglobulins with kappa light chains constitutes an exceptional feature in this type of lymphoma, as illustrated by our case. We report the case of a 62-year-old man with a history of treated syphilis and inferior vena cava thrombosis managed with rivaroxaban, who presented with a left inguinal mass evolving over three months, accompanied by fever, night sweats, and weight loss. Clinical examination revealed non-inflammatory left inguinal lymphadenopathy without other abnormalities. Laboratory tests showed non-regenerative anemia, leukopenia, and elevated LDH levels. Protein electrophoresis revealed a monoclonal peak in the gamma region, confirmed by serum immunofixation showing two monoclonal bands of IgG kappa and IgM kappa types. Biopsy of the inguinal lymph node revealed histological and immunohistochemical features consistent with a small B-cell marginal zone lymphoma, staged as IV based on the extension workup. A chemotherapy regimen consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was initiated, resulting in a partial response after four cycles. The coexpression of IgM and IgG kappa light chains in nodal marginal zone lymphomas, which are already rare, is an unusual finding. This particularity warrants multicenter studies to better assess its diagnostic, prognostic, and therapeutic implications.
Global Journal of Medical Case Reports - March 07, 2025
Marcus Gunn syndrome or unilateral trigemino-oculomotor syncinesis is a very rare autosomal dominant genetic disorder characterised by a combination of congenital ptosis and mandibulopalpebral syncinesis during certain mandibular movements. We report a series of two cases of children with Marcus Gunn syndrome. <b>Case 1:</b> A 5-year-old boy with no previous pathological findings presented with unilateral ptosis of the left upper eyelid at the age of 4 months. His visual acuity was 10/10 in right eye on the right and 5/10 in left eye. <b>Second case:</b> a 7-year-old girl, brought in by her parents for a ptosis of the left eye noted at birth. This is a 7-year-old girl brought in by her parents for ptosis of the left eye, diagnosed at birth. She had no particular pathological antecedents. Her visual acuity was 10/10 in right occlusion and 3/10 in left occlusion. Both children had undergone sectioning of the superior levator muscle with frontal suspension using prolene sutures, with good progression, followed by total optical correction and treatment of the amblyopia.
Global Journal of Medical Case Reports - March 07, 2025
Isavuconazole (ISCZ) is a novel antifungal agent that is expected to be effective against severe fungal diseases. A case of chronic pulmonary aspergillosis that was refractory to existing agents, such as micafungin, but was successfully treated by ISCZ, is presented.
Global Journal of Medical Case Reports - February 17, 2025
Rabies is a virus present in more than 150 nations and territories worldwide, but it can be prevented through vaccination. Each year, tens of thousands of people die from rabies, primarily in Asia and Africa, with children under the age of 15 representing 40% of these fatalities. Up to 99% of rabies transmissions to humans occur through dog bites, making dogs the leading cause of rabies-related deaths in humans. We present a fatal case of rabies after a 5-month exposure incident. The patient, a 55-year-old Nigerian missionary from Enugu state, Nigeria presented with restlessness, hydrophobia, occasional barking gestures, abdominal discomfort and agitation. His condition was said to have progressively worsened as patients was unable to eat and drink fluids for days. His wife reported that the patient had experienced a bite from a stray dog on his right arm 5 months before presentation, for which no antirabies prophylaxis was given. The patient died on the second day of admission to the hospital (within 7 days of symptom onset).
Global Journal of Medical Case Reports - December 25, 2024
<b>Background</b>: 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. <b>Case presentation: </b>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. <b>Conclusion: </b>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.
Global Journal of Medical Case Reports - November 15, 2024
<b>Background: </b>Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. <b>Aims and objectives: </b>This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. <b>Case report:</b> 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. <b>Results: </b>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. <b>Conclusions:</b> Electrical injury is a rare cause of normal MRI myelopathy and the potential for immediate, delayed, and long- term neurological disability.
Global Journal of Medical Case Reports - October 11, 2024
<b>Introduction:</b> 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. <b>Conclusion:</b> 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 management
Global Journal of Medical Case Reports - July 05, 2024
Scrub typhus is a common disease caused by <i>Orientia</i><i> </i><i>tsutsugamushi</i> in the tropical/ temperate zone. It usually shows the skin lesions, including eschar, but erythema multiforme is rare.
Global Journal of Medical Case Reports - February 25, 2024
We present a case of a critically ill patient with severe Legionella pneumonia complicated by morbid obesity (BMI ≥ 40 kg/m<SUP>2</SUP>) 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.
Global Journal of Medical Case Reports - January 02, 2024
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.
Global Journal of Medical Case Reports - December 17, 2023
This paper leverages gene and cell therapy research in diverse disorders ranging from monogenic to infectious diseases to cancer and emerging breakthroughs, where one can harness individual genes or a synthetic gene sequence designed based on a shared molecular pattern in infected cells to better fight various disorders [1]. A pivotal task is to predict the performances of candidate gene therapies to guide clinical translational research using methods such as retrospective bioinformatic analyses. Implementing them to a large-scale gene therapy database reveals that it is feasible to construct and apply well-performing interpretable, supervised learning models [2]. Preliminary evidence of machine learning approaches' statistical significance helps clinicians and biomedical researchers, market participants, and regulatory and economic experts derive relevant, practical applications, thereby enhancing the deployment of gene therapy and genomics to achieve positive, long-term growth for humanity while alleviating the ongoing worldwide economic burden precipitated by prolonged and recurring diseases. Deploying machine learning techniques to accelerate gene and cell therapy drug development and trials shall also mitigate the existing obstacle of limited patient access to emerging, transformative medical innovations such as gene therapy due to skyrocketing prices, which often herald gene therapy products as the world's most expensive medicines [3]. Moreover, in preventing patients from accessing effective, life-saving genetic medicines, there commonly exists a multidimensional access gap encompassing the availability, affordability, and quality or acceptability of these clinical treatments. The ensuing substantial gap has repeatedly been documented and mainly emanates from differential institutional and socio-political choices around resource allocation at international and domestic levels [4]. Particularly, it is also due to the stringent licensure and regulatory approval processes underpinned by insufficient evidence for novel safety and clinical efficacy profiles for genetic therapies in multiple micro-local diagnoses and subpopulations. We believe that a higher likelihood of gene therapy adoption shall result when the clinical evidence path contains adequate representation from the most diverse and relevant patient populations [5].
Global Journal of Medical Case Reports - November 01, 2023
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.
Global Journal of Medical Case Reports - October 12, 2023
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.
Global Journal of Medical Case Reports - October 09, 2023
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.
Global Journal of Medical Case Reports - August 31, 2023
<b>Background</b>: <i>Pseudomonas aeruginosa </i>(<i>P</i><i>.</i><i> aeruginosa</i>)<i> </i>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<i> P</i><i>.</i><i> aeruginosa</i>. <b>Case series</b>: Two cases of <i>P</i><i>.</i><i> aerugi</i><i>n</i><i>osa</i> 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 <i>P</i><i>.</i><i> aeruginosa </i>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. <i>P</i><i>.</i><i> aeruginosa</i> was isolated from his blood, and CTLZ/TAZ was started because the isolated <i>P</i><i>.</i><i> aeruginosa</i> showed resistance to PIPC/TAZ. Although he recovered on Day 28, and CTLZ/TAZ was switched to levofloxacin, his condition worsened again, and<i> P</i><i>.</i><i> aeruginosa </i>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<i> P</i><i>.</i><i> aeruginosa </i>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. <b>Conclusions:</b> These data and cases suggest that CTLZ/TAZ was effective for severe <i>P</i><i>.</i><i> aeruginosa</i> pneumonia although the isolated <i>P</i><i>.</i><i> aeruginosa</i> was resistant to PIPC/TAZ. However, the duration of CTLZ/TAZ administration may need to be considered for pneumonia cases with bacteremia due to <i>P</i><i>.</i><i> aeruginosa</i>.
Global Journal of Medical Case Reports - March 01, 2023
Acupuncture is an alternative medicine, actually it has had a greater acceptance in our continent being use for multiple therapeutic purposes. Although it is a minimally invasive procedure it is not exempt from complications, most common minor complications such as infections or local pain have been described, as well as less frequently but potentially fatal complications such as subarachnoid hemorrhage and tension pneumothorax. We report a case of pneumothorax secondary to acupuncture in a patient who was treated for carpal tunnel syndrome.
Global Journal of Medical Case Reports - February 21, 2023
The pharmaceutical industry is fundamental to global healthcare, providing essential medicines that improve health outcomes and quality of life. However, the demand and supply dynamics within this sector are highly complex, shaped by various factors including demographic changes, evolving disease burdens, technological advancements, regulatory challenges, and economic pressures. This manuscript explores the intricate relationship between pharmaceutical medicine demand and supply, focusing on key strategies that can help companies effectively navigate these challenges. The demand for pharmaceutical products is driven by several factors, such as population growth, the aging population, the rise of chronic diseases, and the emergence of new health threats. Additionally, healthcare accessibility, affordability, and policy changes significantly impact the consumption of medicines, while innovations in medical technologies and therapies create new treatment needs. On the supply side, pharmaceutical companies face challenges related to manufacturing capacity, raw material availability, distribution logistics, and compliance with ever-evolving global regulatory frameworks. To address these challenges, the manuscript discusses strategic approaches to managing both demand and supply in the pharmaceutical sector. Key strategies include advanced demand forecasting through data analytics, optimizing supply chains for efficiency and resilience, implementing just-in-time inventory models, and investing in flexible manufacturing systems. Furthermore, global collaboration and partnerships, as well as effective risk management practices, are highlighted as essential to ensuring the availability of medicines, particularly in times of crisis or global health emergencies. This manuscript also delves into the role of policy advocacy and regulatory harmonization in stabilizing the pharmaceutical market, ensuring that medicines are accessible to all populations. In conclusion, the pharmaceutical industry must continually adapt to meet the evolving challenges of demand and supply, embracing innovation and collaboration while maintaining a focus on patient access and global healthcare equity. Through strategic planning and adaptive solutions, the pharmaceutical sector can ensure the continuous availability of critical medicines worldwide, meeting both current and future health needs.
Global Journal of Medical Case Reports - December 26, 2022
The complexity of manufacturing photolithography has increased significantly. The increase in the level of integration has driven smaller feature-sized integrated circuits (ICs). The evolution in stepper technologies has been geometric. This has enabled the printing of printed ICs with a 45 nm feature size. Improvement in lithographic technology is moving towards 32 nm. This feature-size roadmap poses many challenges to semiconductor manufacturing technology. Advanced photomask synthesis, high-NA steppers, and computational lithography are some examples of the solution space. Optical proximity correction (OPC) and model-based optical proximity correction (MBOPC) are subsets of this solution space. OPC has matured significantly and is the de facto solution for manufacturing photomasks up to the 65 nm node. The OPC technique has been further refined as model-based OPC and has been applied to advanced printing technology of 45 nm. The OPC solution for 45 nm technology has limitations of mask rule check (MRC) and manufacturability restrictions. These restrictions are inevitable in OPC and MBOPC solutions because of the limits in lithographic technology. The technology evolution towards 32 nm has equally challenged the non-linear treatment of wafer-level problems in OPC solutions. PBOPC has limitations in reducing the wafer optical proximity error of the granny's issue, edge placement, mask rule check, etc. PBOPC also has limitations in reducing the mask error enhancement factor. With all these challenges, it is still a formidable solution methodology to address the wafer and mask level issues. Such a formidable solution architecture can result in a limited number of PBOPC solutions. This text looks at the performance of advanced PBOPC features on exposure tuning and the effects of higher-order wafer and aerial image effects. This text also discusses the performance of continuous process correction of masks, lenses, and scanners.